Should You Be On a Ketogenic Diet?

Keto diets are all the rage these days and I've had so many people ask me what I think of keto, if should they be doing it, and if it will it help them lose fat, heal from chronic illness, achieve better brain health, etc.  So I'm finally sitting down to give you the skinny on this high fat protocol in hopes of shedding some light on the subject to help you decide if it's right for you.  Keep in mind, this article is not intended to guide you through following a ketogenic diet.  I simply want to present you with some facts and considerations to help you decide if it’s worth pursuing depending on your goals.

First of all let me say that there is no single perfect diet that EVERYONE should be on, regardless of what “the experts” might say.  The closest thing to that would be a whole or non-processed food diet where you eat real food that comes from the earth, not from a lab or factory.  But you probably knew that already.  

If you're not yet familiar with the ketogenic diet, it is a very high fat, low-moderate protein, extremely low-carbohydrate diet.  It has been used as an effective therapeutic diet for epilepsy since the 1920's, and more recently for cancer, Lyme disease and neurodegenerative diseases like Alzheimer's and ALS.  When the body is deprived of glucose (which we get from carbohydrates), it is forced to burn fat for fuel instead which is why it can be effective for fat loss, mitochondrial function and brain/neurological health.

The most well-known diet that people associate with keto is the Atkins Diet, but this differs from a true ketogenic diet in that it includes high amounts of protein.  A proper, healthy ketogenic diet will not be high in protein since the body can convert protein into glucose more easily than it can convert fat, so even if you're eating really low-carb, too much protein can prevent you from getting into ketosis.  With that out of the way, let's dive into what you need to know before doing keto.

Do Your Research First

There is SO much misunderstanding and misinformation out there about keto and there are certain people who should absolutely not follow it, so it's important to understand what it's all about before you try it.

While many people may benefit from a ketogenic diet for several weeks or even a few months, I don't believe that people should be on a ketogenic diet long-term unless they first do genetic testing to understand how a high fat diet might affect them in light of their genetic predispositions.  This applies both for those wanting fat loss and those considering keto as a therapeutic diet, and stay with me here because I'm gonna get all science-y for a minute...

For example, in people who have one or two alleles (+/+ or +/-) of the the APOE4 gene, high saturated fat intake is associated with greater risk for Alzheimer's.  Since the ketogenic diet has actually been shown to be beneficial for Alzheimer's and Parkinson's patients, it would be important for APOE4 individuals to limit saturated fats and eat mostly  unsaturated fats.  And while the keto diet has become the hot ticket for fat loss, there are some people with a gene variant who are more likely to actually gain weight if they eat a high fat diet.  There are yet other genetic variants that put people at greater risk of obesity and diabetes if they consume a high fat diet, so bottom line, if you're following or considering the ketogenic lifestyle, you may want to do some genetic testing.

I also recommend regularly checking in with your doctor and monitoring your thyroid and hormone levels since some people (usually women) will experience suboptimal thyroid levels and hormonal changes. If you have thyroid or adrenal issues,  a keto diet may not be the best idea for you.

Carbs Matter

Let's start with what it takes to actually get into ketosis and how to measure it.

Depending on your goals for doing a keto diet, your daily intake of net carbs (total grams of carbohydrate - grams of fiber = net carbs) will vary between about 20-60 grams.  Men can often go higher and still achieve ketosis, especially if they are active, but everyone is different and it takes some people longer to get into ketosis than others which is why it's important to measure your ketones regularly.  Total daily net carbs should be lower If you are using keto as a therapeutic diet, versus for fat loss, but again this varies according to the individual.

I was at recent event when a woman who was "trying the ketogenic diet" refused to taste a special cocktail because it had a few grams of sugar, when meanwhile she was snacking away on cheese crackers.  I think some people believe that just because something isn't sweet means that it doesn't contain sugar.  The fact is that foods made from grains and starchy vegetables like potatoes are easily converted into glucose (yep, that's sugar) once we eat them, so it doesn't matter if you're avoiding actual sugar if you're still eating too many carbs.

Measuring Ketone Levels

I’m not going to sugar coat it; accurately measuring ketones is a giant pain in the ass and it’s expensive. Ketones are detected in the blood, breath and urine and testing methods vary greatly in cost and accuracy.  

Most people rely on urine strips which are the least expensive option but are notoriously inaccurate since ketones will appear in lower and lower levels in the urine the longer someone is in ketosis.  Urine strips often work well for the first 1-2 weeks, but after that they become less reliable and results can differ depending on how hydrated you are at the time of testing.  Testing ketones via blood is the most accurate, but it’s also painful and expensive.  Other methods test acetone in breath and include the Ketonix and LevlNow devices.  I had the chance to test the Levl for a couple months when I was following a keto protocol and I was impressed with it, but it requires a significant investment both initially and monthly.  

At this point in time, the Ketonix device may be the happy medium when it comes to price and accuracy, but I’m hopeful that the Levl will become less expensive in the near future.  They’re a great bunch of people and the accuracy of the device is the next best thing to blood testing, so if you don’t mind the price tag, this is a good way to go.

The beauty of measuring your ketones regularly is that you will learn how your food, exercise, and schedule affect your body’s ability to get into and stay in ketosis.  If you don’t measure you can end up being more or less strict than you need to be and you may not reap the benefits of the protocol.

Not all Fats are Created Equal

Probably the biggest and most detrimental mistake people make when on a keto diet is not being careful about the types of fat they’re eating.  If you’re eating a high fat diet you want to make sure that the fats you’re ingesting are high quality, anti-inflammatory fats, versus inflammatory, processed, or hydrogenated ones, as these will exacerbate the problems that a keto diet is supposed to reverse.

Good fat sources to eat include avocado, olives, coconut, nuts, seeds, cold water fish, and fats & dairy products (if you tolerate dairy) from organic, pasture-raised, and grass-fed animals.  Fats to avoid as much as possible include processed/refined industrial “vegetable oils” like canola, soybean, sunflower, safflower, corn and peanuts oils, and fats from non-organic and factory-raised animals.

It’s also important to use the right cooking temperature for each type of oil to prevent oxidation for overheating which can turn an otherwise healthy oil into a trans-fat.

Don’t Skimp on Veggies

Another common mistake keto dieters make is not eating enough vegetables.  Getting plenty of the vitamins, minerals and antioxidants found in veggies is crucial for good health, and as long as you’re eating non-starchy vegetables that are low in starches/sugars, you can eat quite a lot of them without going overboard on net carbs.  Some of the best bets are dark leafy greens, broccoli rabe, cauliflower, cabbage, asparagus, bell peppers, mushrooms, zucchini, celery, and cucumbers.

Is Keto Right For You?

A ketogenic diet can be healing and life-changing for some and a disaster for others, so it’s important to listen to your gut instincts, talk to a trusted health practitioner, and do some research before diving in.  I’ve coached many clients to successfully navigate a keto protocol so if it’s something you’re considering, let’s talk more about it.  I am more than happy to answer any questions you may have to help you decide if it’s right for you.

As I've said in previous blog posts, I'm not one for bandwagons. In fact, if "everyone is doing it" I'm extra skeptical.  The first question that runs through my head is, does this have any merit or is it just the latest fad? Usually it's a combination of the two and the important thing to ask yourself when you’re intrigued by the newest, hottest thing is “Does this resonate with me as something that might be truly helpful or is it just a shiny new object?” Because at the end of the day, it’s all about figuring out the right approach for your body and your lifestyle, not what’s right for the current Hollywood “it girl”. 

Continually jumping on trend bandwagons will keep you in a cycle of dieting and prevent you from creating a sustainable and healthy lifestyle that enables you to get results AND enjoy life.  If you are looking for support and guidance in finding the right approach for you, I can help! Click here to schedule a free Coffee Talk session and let’s chat about what you want to achieve.