If you are new to Keto Sister, then welcome. In my series titled Keto Basics, I have explained so far how ketogenic (keto) diets came into being and why the body prefers to be fueled by ketones (fat) rather than fueled by glucose (carbs). This next post will cover the basics for eating keto.
A study that was published in Endocrinology and Metabolism (2011) fed rats various macronutrient ratios of a high fat, low carb ketogenic diet to compare the effects of diet on ketosis. In simple terms, they fed rats three different high fat diets that differed by the amount of fats, protein and carbohydrates calories. Those rats who received 75% of calories from fats and 10% from protein were in deeper ketosis than those fed either 65% fat/20% protein or 55% fat/30% protein. As I discussed in the last post, the body fuels its activities with either glucose or ketones. In the absence of one, it must use the other. Thus, all three groups were fed a high fat diet, which means that they used ketones in place of glucose to some extent.
This begs the question: is being in “deep ketosis” the primary goal of eating a ketogenic diet? The answer is that it depends on your ultimate goals.
When I started my ketogenic journey on June 1, 2015, I did everything in my power to maintain high levels of blood ketones. Using a glucometer, one can test blood ketone levels. I thought that the higher amount of ketones I found when I tested (up to about 4.0 mmol/L), the “better” my ketosis was. I wanted to help my body heal from its history of postpartum hormonal imbalance (which I will write about in a future post). But like almost everyone who finds low carb living, I also wanted to drop the extra body fat I was still carrying from my pregnancies. Keto calculators told me that I needed to limit my calories to 1,400 per day to hit my goal pre-pregnancy weight of 140 lbs. I started eating 80% fat, 15% protein and 5% carbs because I wanted to get into “deep” ketosis. This is what those ratios looked like:
My initial Ketogenic protocol: 1,400 calories
80% from fat—1,120 calories (125 grams fat)
15% from protein—210 calories (53 grams protein)
5% from carbs—70 calories (18 grams total carbs is how I started)
What did my meals look like? This was a typical day’s eating.
- Breakfast: 2 large eggs cooked in a tablespoon of butter, 2 slices bacon and 4 cups fresh spinach cooked in bacon grease.
464 calories, 40 grams fat, 21 grams protein, 5 grams carbs.
- Lunch: 2.5 oz salmon and 1 cup chopped broccoli cooked in 2 ½ tablespoons butter.
404 calories, 34 grams fat, 20 grams protein, 6 grams carbs.
- Dinner: 3 oz burger patty made with 80% lean beef and salad made with ¼ avocado, 4 romaine lettuce leaves, 3 cherry tomatoes, and 2 tablespoons of olive oil and 1 tablespoon apple cider vinegar poured over my salad.
519 calories, 49 grams fat, 16 grams protein, 6 grams carbs.
Day’s Total: 1,387 calories:
- 123 grams fat (~80% of calories)
- 57 grams protein (~15% of calories)
- 17 grams carbs (~5% total calories)
I measured my blood ketones to ensure that I was in nutritional ketosis as defined by Drs. Volek and Phinney (2012). My ketones at the beginning were always between 2.0-3.0 mmol/L and I was losing weight. At the time, I did not track my body fat so I never knew whether what I lost was body fat or muscle. What I did track was ketones and blood glucose. I also took notes about my hunger and activity levels and how I felt.
How to know when eating keto is not working for you
The problems I developed following this strategy appeared slowly. The first was that my weight loss stalled after a few weeks. To combat this, I began exercising and increased the energy expenditure in an attempt to force my body to burn body fat. (This was the absolute WRONG thing to do, but there is alot of bad advice out there and at the time I believed that cutting what I ate while increasing my caloric burn would force fat burning. Of course, it did not.) Instead, it raised my cortisol levels and I could see a ring of belly fat growing on my frame. Besides my weight decreasing from 160 lbs to 150 lbs and then stalling, I also had difficulty sleeping, my hair started falling out, I was cold, my energy fluctuated day to day. And I was hungry ALL THE TIME. Ever meet a hungry woman? If so, then you know that means I was pissy too.
Feeling hungry, cranky, tired and generally terrible was not the salvation eating keto had promised me. What was going wrong?
A number of things. Rather than eating nutrient dense foods, rather than eating to meet my hunger and other hormonal needs, I was eating so that I produced ketone levels to demonstrate that I was in nutritional ketosis. In essence, I used eating keto like I would a typical diet. I was not eating enough food for my body, I was exercising on top of it and creating stress (which affected my cortisol levels), and I was making myself sicker instead of being able to take advantage of the healing that keto can offer.
Getting your keto diet on track
Since that time, I have tried and tested multiple variations of this and other protocols. I have tested ketones and blood glucose, but my health is about more than ketones and glucose levels. I know that I am on track when a) I truly feel satisfied by my diet, b) I am sleeping well, c) my moods and energy levels are stable, d) I can mobilize body fat with ease, and e) my hormone function is optimal. I have journaled to keep track of my progress since becoming keto and have also utilized my strategies with my low carb clients. And in this time, I have learned several important lessons that make a ketogenic protocol work much better for me and for my clients.
Here are six basic strategies for eating keto:
- Stop eating to the meter. Unless therapeutic ketosis is your goal to improve a health condition such as epilepsy or cancer, undereating the foods that help you feel satisfied (such as protein and fibrous carbs) or overeating fats can be detrimental to your goals. I discovered that I needed more fatty protein to feel satisfied, but I worried that changing my ratios would take me out of nutritional ketosis. Still, I increased my protein consumption considerably and also found that eating twice a day during a 4-6 hour window rather than spread throughout the day works best for me. The result? I hit my goal weight while improving my sleep, my hormone levels, regulating my body temperature, stopping hair loss and satisfying my hunger for hours at a time.
- Being in “deeper” ketosis does not guarantee body fat loss. There are multiple ways to increase measurable ketones in the body. You can:
- eat a very low carb diet
- undereat protein
- undereat total calories
- drink too little water and be dehydrated, or
- combine two or more of the above.
This is yet another reason not to eat to the meter. Since higher ketone readings or “deeper” ketosis can be induced for a number of reasons, having more ketones does not necessarily mean you are burning more body fat or closer to reaching your personal goals. Ketosis can be the easiest way to achieve and maintain fat loss due to its effects on reducing hunger, reducing insulin levels and countless other benefits. But it works best when it is incorporated into a protocol to optimize your health overall.
- Your ideal calories and ratios should differ from others based upon your gender, height, lean mass, activity, health status, and your goals. What works for another person may not work for you, which is why an individual approach is more important than following pre-determined ratios and macro calculators to a “T”. And you can be in nutritional ketosis and reap all of the benefits of ketosis—including mobilizing body fat—without suffering through someone else’s idea of the “ideal keto diet.” If you decide to use a macro calculator to determine how much food to eat, then make sure to use it as a STARTING POINT ONLY. You may need more or less than a calculator says, and the only way to find out is to test and see how it feels in your body.
- You may need to eat more carbs. Wait, did you read that right? Yes, you did. You don’t have to eat 15 or 20 grams of carbs to be in ketosis. If you feel better or stop hair loss, have regular menstrual cycles, sleep better, etc. eating 40 grams of carbs per day rather than 20, then please eat more. I can maintain measurable blood ketones eating up to 60 grams carbs, though most days my carbs are under 20 grams. But stubbornly following a protocol to maintain ketosis is not smart strategy and will end up making this way of eating unsustainable for you long term. Flexibility is key.
- Ketosis should feel good—if it does not, you can adjust your protocol until it feels best you you. If your primary goal is to develop your ideal body, be healthy and feel amazing, then more important than high ketones is to find the best ratios that you can sustain and enjoy. Keto Sister can help you figure this out—click here to learn more.
- Sometimes the best way to break a stall is to stop everything and eat MORE. No, that was not a typo. A ketogenic diet is successful at fat mobilization because it mimics starvation without a human having to actually starve. However, actual starvation is dangerous (and will stop you from burning fat). Dieting strategies that suggest dropping calories do work temporarily, but eating keto can only be a long term and sustainable way of eating if you eat enough to sustain your lifestyle. By increasing calories sporadically, you can increase your metabolism and signal your body that calories are in abundance. This sometimes alerts the body that burning calories is safe to do, which is the opposite to the signal given by cutting calories to break through a stall.
What does my diet look like today? I eat between 80-110 grams protein, between 100-170 grams fat and between 0-30 grams carbs, or 1,500-2,100 calories. It varies quite a bit day to day because I eat intuitively, which means I eat less when I am not hungry and I eat more when I am. Am I still in nutritional ketosis eating this way? Absolutely, and I confirm this by testing blood ketone levels on occasion (though over time, I have learned to tell by how I feel). I also easily maintain my goal weight of 140 lbs, which is not too shabby for a woman who is 5’10”!
Rather than having ketone levels above 2.0 mmol/L, they are usually between 05.-1.0 mmol/L. In my case, sacrificing higher ketones levels to feel better was an optimal trade.
I celebrate the many benefits of being in ketosis, but it is important to know that you can still benefit by eating more than 1,000 calories, 10 grams of carbs or 40 grams of protein per day. And ketosis feels great in my body. If you are struggling with finding the best way to adapt a low carb protocol, then maybe adjusting your protocol is the missing component to help you feel your best. It could be just that simple!
Bielohuby M., Menhofer D., Kirchner H., Stoehr B.J.M., Müller T.D., Stock P., Hempel M., Stemmer K., Pfluger P.T., Kienzle E., Christ B., Tschöp M.H., Bidlingmaier M. (2011) Induction of ketosis in rats fed low-carbohydrate, high-fat diets depends on the relative abundance of dietary fat and protein. Am J Physiol Endocrinol Metab. 300(1): E65–E76. Published online 2010 Oct 13. doi: 10.1152/ajpendo.00478.2010
Volek, J. and Phinney, S. (2012) The Art and Science of Low Carbohydrate Performance. Beyond Obesity LLC.