Ketogenic Diet 101

Here’s all you have to do to ‘try’ keto: just stop eating carbohydrates!

This page isn’t intended as a FAQ, it’s just my tested, first hand experience and advice. I’m evolving this 101 as I learn. If you want your questions answered, go to r/keto

I’m a month into keto lifestyle at time of writing.

• GOLDEN RULE: keep NET carbs (ie not including fiber) below ~20g a day
  • this is required to engender and maintain proper ketosis
  • You have to be vigilant and informed about hidden/added carbs in foods and get your 20g from healthful sources (fresh vegetables)!
  • Go over your carb limit and you’ll secrete insulin and drop out of ketosis (so yes, ‘just one time’ does hurt!)
• Get enough protein - around 90g per day - this is needed to repair body tissues and prevent your body depleting muscle (using muscle protein to generate the small bit of glucose actually needed)
• Fill up calories with healthful fats (monos like olive oil, saturated like butter/ghee/coconut/dairy - avoid polys like canola or ‘vegetable’ oil, or trans fats)
  • This is your caloric intake for energy. If you want to lose weight, you still need to maintain a calorie deficit relative to energy expenditure
• (CICO - calories in, calories out) still matters but humans are complex machines and do not follow the Laws of Thermodynamics with quite the dogged simplicity of a rock!

Keep this up for at least 2 full weeks and the following will happen:

• Your body will burn off the ~200g of stored glucose in liver and muscles and start using fats for energy in the first 24-48 hours
• That glucose (glucagon) store also requires lots of spare water, which your body will consequently release, quickly: be prepared to piss like a racehorse over the next couple days and lose 5-10lbs of pure water from body weight! (My BP was a little lower after this too!)
• You will start producing ketones (measurable in breath, urine and blood)
  • ketostrips are an indicator that you’re excreting ketones, but not accurate as a reliable guide to ketosis
• You will probably get some kind of ‘keto flu’ which is a feeling of fatigue, headache, heat/coldness, and general malaise, mostly caused by 2 things:
  1. Low blood glucose, since your body is used to high carbs and is still secreting lots of insulin, which will cause glucose to be removed from blood.
     • The resulting low blood sugar (‘crash’) will cause the ‘panic’ release of adrenalin (intended to restore emergency glucose to the blood) and you will experience the resulting trembly/sweaty/cold flushes that adrenalin causes.
     • If it is extreme, take a little bit of sugar to cope, but ideally, just tough it out!
     • It will settle down over a few days as you stop secreting so much insulin
  2. More likely, all the water now draining out of your system will be flushing out electrolytes.
     • Drink LOTS of water throughout the day and replace electrolytes: specifically, sodium, potassium, magnesium. (The Reddit keto FAQ has some details).
     • I drink a cup of hot broth 1-2 daily - just made from a small stock cube (or half of one) - a new habit I happen to love.
     • Sodium is easy to replenish/maintain, potassium is harder, magnesium harder still! I’m relying on good food sources such as mushrooms, spinach, avocado and nuts for these.
     • Supplements are available. (NB too much magnesium will give you diarrhea!)
• SUMMARY: if you feel like shit, your electrolytes are probably low. Drink broth!
• After the initial water loss, your weight will steady, then after a few days, you will a) piss like a racehorse again, and b) lose a few pounds quickly. What happens here is, as your body accesses fats from fat cells for energy, it replaces the fat with water (this is some kind of homeostatic effect). After a few days it reaps the cells (or the water in them, not sure) quickly, and that’s when you lose the weight. This is known as the keto ‘whoosh’! It’s a cyclic process thereafter
• If you’re doing any kind of muscular training (weights etc) you’ll need additional protein, and also, your muscles retain water to repair themselves, and release later. This might cause apparent (temporary) weight gain but resolves with another ‘whoosh’ scenario!
• Sleep disturbances:
  • You’ll probably need to pee more at night (I never did, before)
  • I tend to wake early (~4am) for no apparent reason, which is annoying. Haven’t solved this yet.
• Full keto adaptation supposedly takes 4-6 weeks or longer. I feel great!

Some coping strategies I’ve developed (mostly around meals):

• KCKO (Keep Calm, Keto On!) Ultimately the key is to create for yourself an eating plan which allows you to meet your macros with the least friction and the most enjoyment
• Use a macro calculator (like the one in the Reddit Keto FAQ) to calculate personal macros (for carbs, protein, fats), and recalculate every 10-15lbs weight loss
  • In practice eating more fats means eating more mostly protein foods with fats incorporated (meat, fish, eggs, dairy, avocados, nuts) rather than over-consuming pure fats
  • Give yourself permission to totally reset your expectations around food and meals. The established ‘low fat, low animal, high carb, 3 meals per day’ model is very ingrained!
  • Learn to expect and eat less. Protein and fats are dense foods, and you need less volume to feel and stay satisfied
• Intermittent Fasting (IF): I eat lunch at 12, dinner before 8 and fast the rest of the time (black coffee and water in the morning, try to avoid snacking between meals to keep insulin really low). It’s really not a penance! There are online support groups
  • Some good keto-friendly snacks: nuts, jerky, raw celery/carrots/peppers and low-carb dips
• Gym/morning exercise in fasted state helps ‘kickstart’ keto metabolism and also build muscle, which is a virtuous cycle
• Hack sleep too. This is the 3rd pillar of health after exercise and keto (maybe the first pillar actually). I’m going to bed earlier (10pm) and aiming for 8 hours, though I rarely achieve it
• Meal Prep! I find it hard to create interesting meals without carbs, and especially ‘portable’ ones (eg for lunch) because I’m used to using the carb foods to ‘absorb’ and bulk out the rest of the macros. On the other hand it’s an opportunity to learn and invent!
• Salads! I eat like a gallon volume (ok, hyperbole!) of leafy salads most days, as dinner. I chop a metric buttload of salad stuff one day, store it dry in the fridge, and eat it over the week. Add lean meats or fish for protein. Salad veg (lettuce, spinach, celery cucumber, tomatoes, bell peppers, radish etc) are all low carb, provide fiber and are loaded with good electrolytes, vitamins and minerals)
• Don’t go crazy with fiber. Your digestion will probably slow down since you’re eating less, but adding more fiber can be counter-productive. I find the regular salads are enough to keep me regular!
• Cheat meals or cheat days aren’t worth it. They are in direct opposition to your long-term goals - but don’t beat yourself up over it.
  • I think it’s better to spontaneously allow yourself give in to temptation occasionally than plan to do so in advance!
  • (I strangely don’t find myself tempted to cheat much, because I know those foods are verboten, and also because I make palatable alternatives available to myself)
• Social situations are tough. Group events tend to feature ‘rewards’ of pizza, donuts and other junk! The material benefits of keto outweigh the temptations for me
• Avoid eating out as much as possible until you’ve adjusted your habits and developed some strategies. Look ahead at online menus and plan
• Alcohol tolerance will be impaired (I think due to the lower body fluid volume)
  • Also your body will metabolize alcohol in preference to fats so you aren’t in ketosis while drunk!
  • Figure out some low-carb drinks ahead of time so you’re not tempted to conform or and an order a beer out of lack of options
    • My current choice is soda water + fresh-squeezed lime juice
• Travel is tough. Plan ahead. Look at menus and meal choices available to figure out how to stay in keto. Intermittent Fasting helps - you don’t need to always eat
• Don’t Talk About Keto Club: People will vary in support, some will be judgemental. Avoid explanations and evangelism (don’t go ‘vegan’).
  • I find that just telling people I’m cutting down carbs and processed junk helps a lot
  • Vegetarianism is an ethical eating plan, not a nutritional one. It’s possible but very difficult to do keto as a vegetarian/vegan. Decide which is more important to you at this time.

Some other things are making sense now:

• why in the past I always stayed or returned to being overweight no matter what approaches I tried
• why I haven’t had much energy for years but now, on keto, I feel like I’m on a Duracell battery!
• why, on a low-animal-produce diet I really struggled to put on muscle, but I’m doing so now
• why, after eating a high-glycemic food, I’d feel really thirsty and dehydrated an hour later
  • it’s not the salt or sugar per se, it’s the insulin spike telling your body to store the excess quickly, and your body grabs a bunch of water in order to store it and you get dehydrated even without losing any bodily fluid volume