Want to get a better understanding of the basics of the ketogenic diet? Read Part 1 of this series, Ketogenic Diet, What's It All About?
I get a lot of my nutrition clients asking me about the ketogenic diet and if it’s the right tool for their dietary needs. Unfortunately, this questions is not so easy to answer, as I feel there are several aspects about the diet that need to be properly considered before you jump on the latest fad.
The ketogenic diet has many benefits but also some challenging aspects that you should be aware of if you are considering implementing this diet. Let’s explore some key aspects about the diet and discuss some of the pros and cons of going Keto.
Key Aspects of the Diet
1. You’ll need to track your macronutrients, at least in the beginning, to establish if you have gotten into ketosis. Let’s review some of the basics of keto dieting, you need to eat around 100 grams or more of fat per day and around 20-25 grams or less of carbohydrates (this can be net carbohydrates). Many people hear this and are initially excited, “I can eat all the dairy and bacon I want! That will be easy.”
You are eating a large amount of fat on the diet, much more than you would probably eat normally or are used too. The type of fat you eat is very important to the success of the diet, as poor quality fats are actually carcinogenic to the body. We’re talking good fats like olive and coconut oil, grass fed butter, avocados, nuts and seeds, not foods like French fries and donuts.
In order to establish a baseline, you’ll need to find a way to track the foods you eat and the amounts daily. This can be done via a macronutrient tracker like My Fitness Pal or Carb Manager, or via a specially devised meal plan for keto eaters, where the nutrients have already been calculated by a nutritionist or health professional. Some of my favorite keto meal plan sources are Ruled.me and perfectketo.com.
Can you do the ketogenic diet and not track your macros? No, at least not in the beginning. You need to get to that special ratio of 100+ grams of fat to 20-25 grams or less carbs to get into ketosis and start burning fat for fuel. If you truly cannot manage tracking your macros, then your alternative is to strictly follow a quality meal plan.
Once you are fat adapted, or have officially made it into ketosis, than you may not need to be so strict with tracking your macros. You may also be able to play around with your fat to carb ratio and enjoy a bit more carbohydrates, or even a cheat day, here and there and still have the ability to stay into ketosis and burn fat for fuel.
2. You’ll need to test daily to determine if you have successfully made it into ketosis. Ketosis is the state when your body has now successfully switched from burning glucose for fuel to burning fat, becoming officially fat adapted. In this state, the body produces ketones, a measurement of the body’s ability to adapt to burning fat in the absence of food or adequate carbohydrate.
Measuring ketones is done via daily testing of either blood, breath or urine. If you’re going to test blood (the best way) you’ll need to purchase a special device called a ketone meter. To test properly, you will use your ketone meter to prick your finger for blood and that blood is used to measure ketone bodies. You can also test your urine or breath utilizing specialized meters or strips, but in the keto world, these are not considered to be very accurate and you can get questionable results. Want to learn more about testing your ketone levels and the best testing options? Here is a great article by Dr. Anthony Gustin on the topic.
Can I do the ketogenic diet without testing my blood, breathe or urine? Not really. The only way to determine if you are producing ketones, and thus in official ketosis, is to test blood (the best way), breath or urine. Once you get the hang of eating keto and have been in ketosis for some time, you may not need to track ketones, daily, if at all. Staying on regular keto meal plan that maintains the right fat to carb ratios can make it possible to enjoy the benefits of ketosis and allow you to move forward with diet without ongoing daily ketone tracking.
3. You need to eat a minimal amount of carbs, at least in the beginning and this part can hard for some. Carbohydrates are a large category of foods that include all fruits, veggies, grains and legumes. These foods vary widely in their overall level of carb content. In general, grains, legumes and fruits contain a fair amount of carbs, while veggies contain significantly less. In order to maintain the initial 20 or so grams per day of carbohydrate means, that most will want focus on eating primarily above ground veggies only, in order to stay within the carb requirements for ketosis.
This means that in order to get into ketosis you must stop eating grains, legumes, most fruits (but not all) and many below ground veggies such as potatoes and beets, at least in the beginning. For example, there are 25 grams of carb in apple and 25 grams in 2 pieces of whole wheat bread. Because it is essential to maintain enough fiber, vitamins and minerals in the diet for optimal health and because above ground veggies are naturally low in carbs ( 1 cup of kale is only 6 grams of carbs), ketogenic dieters need to focus their energies on eating lots of fat, moderate amount of proteins and mostly above ground veggies for their food sources.
4. Getting into ketosis can be associated with some side effects, be prepared before jumping into the diet. Shifting from glucose to fat for fuel is not easy on the body. As people enter into ketosis they may experience symptoms as headaches, chills, feeling of malaise, called the keto flu. These symptoms can easily be corrected or avoided with the right supplements including electrolytes, herbs to reduce uric acid build up, and increased sodium intake to balance the changes in metabolism.
This diet is also lower in fiber and the limited number of veggies may affect your microbiome causing changes in digestion. Monitoring digestion carefully will help to prevent significant changes in bowel habits. If you have already have digestion problems to begin with or a specific health issue, consult a practitioner skilled in ketogenic diets to see if it’s the right fit for you. Bottom line, this is not a diet you just jump into. You need to understand what you’re getting into and have the right tools and training and support to make it work.
What Does it Take to go Keto?
In order to be successful on the ketogenic diet you must be committed to tracking your food (at least until you have successfully made it into ketosis), you need to be ok with not eating grains, legumes, most fruits and some veggies, and you have to stick with all of this with some level of consistency.
If you are the type who can follow a rigid diet, stick to a plan, and don’t feel deprived on a simplified diet, than the ketogenic diet may work for you. If you have a hard time staying on a plan, can’t give up sugar, gains or alcohol or are the type that wants to try and sneak a few "no foods" in here and there (no one’s looking, right?), the diet most likely will not work for you or it may take a long time to actually get into ketosis.
The ketogenic diet, although rich with benefits, is not a quick fix fad diet. It takes some serious planning and fair amount of rule following. I have many clients who are very successful on the diet and many clients who are not. Those who are not, are often not well prepared or educated on how to do it properly, not ready to commit to dietary change or do not have the right lifestyle to implement the tracking successfully. Being able to clearly identify your personality type will help you have a better chance of success.
For those who have a higher level of commitment around food, or those with serious health issues who are committed to change, the ketogenic diet can have some serious benefits. I do think that it can be a beneficial tool for those wanting to lose weight, burn fat, lower inflammation and improve cognitive function. My best advice is work with a professional who knows the ins and outs of ketogenic dieting and more importantly, can determine if it’s a good fit for you and your lifestyle. I would avoid the “do it yourself” or “on the fly” ketogenic method, and beware that there are some health issues that it may not be well suited for. If not done properly, the ketogenic diet can cause serious nutritional deficiencies and possibly unwanted and uncomfortable side effects.
Want to learn more about the Ketogenic diet and see if it is the right fit for you, your lifestyle and your dietary needs? I teach clients how to eat on a ketogenic diet and help them to determine if it’s a diet suited to their health needs. I also work with a variety of specialized diets including FODMAP, Paleo, GAPS, Specific Carbohydrate, autoimmune paleo and more. Schedule a private consultation with me to learn more about specialized diets and how to implement them successfully into your nutrition regime.