What is Keto and how do I get started with it? 

For anyone totally new to the Ketogenic arena, here is a short definition: A Ketogenic diet is a high-fat, adequate protein, low-carbohydrate diet that forces the body to burn fat rather than carbohydrates.

The benefits and history of Keto

Eating this way makes the liver convert fat into fatty acids and ketone bodies. An elevated level of ketone bodies in the blood is a state known as ketosis. This is not the same as ketoacidosis, and as long as your body produces even a minute bit of insulin this will never happen to you (it is a dangerous state in a Type I diabetic but can be avoided). The Ketogenic diet was first used to treat difficult-to-control epilepsy in children, and the nutritional Ketogenic diet most people use is not as severe as the medical Ketogenic diet, which has a ratio of 4:1 fat to combined protein and extremely low carbohydrate. When you say, “I’m eating KETO,” it generally means the nutritional Ketogenic diet. You become a fat burner instead of a sugar burner!  

Why we limit carbohydrates in the Keto lifestyle

The very first thing you do in order to be Keto (and get into ketosis) is to limit your carbohydrates. Carbohydrates is a class of macronutrient (macro means LARGE – micronutrients are needed in smaller amounts like minerals and vitamins). Carbohydrate-rich foods are anything that contain any form of sugar (fruits to candy!) or starch (potatoes, bread, pasta, for instance) which turns into sugar (glucose) in your system. These sugars (whether straight sugar or sugar that has been converted in your body from another food) trigger an insulin response. Insulin is responsible for fat storage. Over the years by eating high-carbohydrate food, you can develop insulin resistance (meaning your blood sugar cannot get into your cells to be used for energy – that is why your blood glucose readings will be high when you have Type 2 diabetes). Your body actually makes the glucose it needs from other food you eat so that you do not need to ingest it to have it available where and when needed.  

Very few people eat zero carbohydrates and I wouldn’t expect you to eat that way. You can choose several levels of carbohydrates and the option to count them as Total Carbs or Net Carbs but if you want to do "full-on Keto," you might want to start at 20 total carbohydrates and see how you feel and whether it is best for you to go up or down from there, or whether you would feel best and do best counting Net carbs. My Keto system combines Net and Total and I have had many clients who are successful with that. If you have worked your way through the steps of my Granny Keto Transitions Program™ and have sat for a while on the Low Carb step, you might go into Keto with a better idea of what your body can handle in terms of amount of carbohydrates in order to stay in ketosis and/or lose weight.

Ketosis is your fat-burning state in full Keto

Ketosis, not to be confused with ketoacidosis, will be your metabolic state where your body’s energy supply comes from fat, which produces ketone bodies that are produced when you metabolize fat, converting fatty acids into ketones. There are three types of ketones: acetone, acetoacetate and Beta-Hydroxybutryate (BHB), each of which is measured differently, respectively in the breath, urine and blood. When you are in Full Keto, you will have measurable ketones and you can be sure that you are fat burner!

What carbohydrates can you eat that will best suit your Keto lifestyle so that you can be in a state of ketosis? To be in a healthy state you will want to eat acceptable sources of carbohydrates (specifically those not coming from sugar, grains or legumes) because these sources of carbohydrates tend to lead to inflammation everywhere: from your gut to your arteries to your joints. Once you are full Keto, the carbohydrates you ingest should be coming from (above-ground) vegetables, dairy and some foods where they are naturally occurring (for instance, a 3 ounce serving of scallops contains 2 total carbs!).  

Eat moderate amounts of protein

The next macronutrient is protein, and the Keto policy is to moderate your protein intake. There are calculators for this (based on height, age, lean body mass, etc.) but the rule of thumb is 50–65 grams of protein (not by weight but the actual grams of protein in the food) for a woman and 75 grams for a man. Some people can add more if they are young, athletic and not metabolically damaged. This, like finding the sweet spot on carbs, is individual but within a reasonable range. Your sources of protein would be from animal proteins, but as with the carbohydrates being found in scallops, if you are very closely tracking protein (with the use of an internet tracker), don’t be surprised that protein will show up in some vegetables! One cup of chopped kale, for instance, has 2 grams of protein! Miniscule amounts like these normally do not make or break your success, but just be mindful!

Why do we moderate protein on Keto? Protein is an essential macronutrient. Proteins are the building blocks of cells and muscles and it is essential for brain function and other functions such as healing cuts and wounds. However, the body "recycles" much of its protein and you do not need to consume large quantities to have a health body. In fact, by a process called gluconeogenesis, the liver can turn too much unneeded protein into glucose, thus spiking insulin. In addition, protein contains a lot of phosphorus that is a stimulant and you will find you might not sleep well after a heavy protein dinner.  

One last thing because this comes up a lot:  When you measure protein (or carbohydrates or fat) the reference to how many grams you are eating is the amount of protein in the food, not the weight of the food. For example, 3 ounces of ground chuck cooked weighs 85 grams and contains 22 grams of protein. You count the 22 grams toward your protein total.

Eat enough fat to be comfortably satiated

The last macronutrient is fat. The rule here is to eat to satiety. There are various ratios (the medical one where the Ketogenic diet is used to treat and control epilepsy) can be as much as a 4:1 ratio of fat to protein. However, a more comfortable ratio is, at the very least, 1:1, but most people settle in at 2:1. Even at the 1:1, some people starting Keto find it difficult to eat so much fat especially those of us baby boomers who grew up in the fat-free era — or even younger people have been fed the myth of fat-free. FAT – AND ESPECIALLY SATURATED FAT – DOES NOT CAUSE HEART DISEASE. It is the sugar/carbohydrates in your diet that cause hardening of the arteries. HONESTLY. If you need convincing please start by reading Cholesterol Clarity by Jimmy Moore and Dr. Eric Westman. Bring the book to your doctor if you have to!

The easiest way to start to increase your fat intake is to go for fattier cuts of meat. Forget the boneless skinless chicken breasts or turkey deli meat (and these are highly insulinogenic — spiking your insulin which makes you fat!!!). Move to roast beef, corned beef and pastrami, chicken thighs with skin or even duck! Forget the lean ground beef. Start to get 85% (or more) beef (it will be cheaper too) and don’t drain the fat! Enjoy rib eye steak and a nice marbled chuck roast instead of lean sirloin and London broil. Eat more fatty fish like salmon and mackerel — don’t feel you have to eat cod or other white fish because they are leaner.

Move to full fat dairy. Yes, I said FULL FAT:  sour cream to top your steak, butter to top your vegetables, heavy cream in your coffee, REAL cheese!  And bacon. No need to weigh or measure or count out the pieces. If you enjoy it, just eat it. And NO – you do not have to eat bacon or any pork products on Keto. But you can if you want. Avocados and other fats and oils are perfect ways to add to your fat intake.

The Keto flu and electrolytes

The next thing that you will have to work with in Keto is electrolyte balance. Sometimes you will experience the "Keto Flu" the first week or so of starting Keto. The symptoms might be:

  • Fatigue
  • Headache
  • Irritability
  • Difficulty focusing (“brain fog”)
  • Lack of motivation
  • Dizziness
  • Sugar cravings
  • Nausea

You can usually spare yourself this experience if you have adequate amounts of three electrolytes: sodium, magnesium and potassium.

I always look at a carbohydrate as a sponge. On the standard American diet — or almost any cultural way of eating — you consume upwards of 300 carbohydrates or more per day. When you start Keto you will be starting with 20 carbohydrates. Imagine those 300 sponges wringing out all the water they hold. You will be releasing a lot of fluid when you start Keto and, because you will not be eating any more sponges, your kidneys will not be overloaded with fluid (but will actually find just the right sweet-spot of where they need to be for perfect functioning). Remember: salt follows the water. When you are eating Keto you must replenish your salt (and water!). It is recommended that you have 4g–5g a day of salt. Ladies and gentlemen:  That is 2 teaspoons straight salt if you are not salting your food. When you go to Keto sites you will read a lot about leg cramps at night and people who jump out of bed and drink pickle juice or guzzle salt straight out of the shaker. I have done this myself when I haven’t been careful during the day! (A word about salt: purchase pink, sea or gray salt. Table salt sometimes is mixed with anti-caking and bleaching agents.)

Magnesium and potassium can also be flushed from your system. Magnesium can come from foods: dark chocolate (which you can have on Keto but limited and ones not high in sugar), avocado, nuts and seeds, fatty fish and leafy greens. However, most people are deficient in magnesium even if they eat these foods and so a supplement is usually recommended (there are different types of magnesium. I take this one). You should be consuming up to 4000mg of potassium a day — but try to get what you need from foods — the same list as the magnesium. If you have an avocado and a nice helping of Swiss chard or spinach with one of your meals, you will easily approach what you need. Add tomatoes and Brussels sprouts, and you are good to go. (And by the way, sugar cravings can be caused by the need for potassium, so make sure you keep up with that mineral!) 

Summary

There is so much more to learn about Keto, but remember the following:

  • Keep carbs low
  • Moderate your intake of protein
  • Eat high fat to satiety
  • Address your electrolytes: sodium, magnesium and potassium