Excited to start your keto diet journey, but you’re not sure exactly how? This FAQ section will get you started off on the right foot.
What Is Keto?
Keto is short for ketogenic, and refers to the ketogenic diet. The ketogenic diet is an extremely low carbohydrate (carb), moderate protein, and high healthy fat diet. This combination of macronutrients, aka “macros”, encourages ketosis. Ketosis a fat-burning state. Sometimes, keto is also referred to as Low Carb, High Fat (LCHF).
Your food intake would break down like this:
- 5%-10% from carbohydrates
- 15%-25% from protein
- 65%-80% from healthy fats
The ketogenic diet is about 100 years old, with a long history of safety. It was originally a form of treatment for epileptic seizures in children. Doctors are still not sure, however, why ketosis leads to a reduction in seizures. One theory is that ketones produced may be neuroprotective.
The keto diet has gained a large and loyal following for weight loss. The keto diet is also used to manage and reverse several chronic illnesses. Some of these are Metabolic Syndrome, Polycystic Ovarian Syndrome (PCOS), Non-Alcoholic Fatty Liver Disease (NAFLD), and type 2 diabetes.
Type 1 diabetics and insulin-dependent type 2 diabetics may find their need for insulin reduced on a ketogenic diet. This is because keto helps maintain stable healthy, stable blood glucose levels without the dangerous spikes or drops in blood glucose common with high carbohydrate foods. It is important to test your blood glucose regularly if you are a diabetic.
What Are the Benefits of A Ketogenic Diet?
When the body burns glucose for fuel, it has no need to burn fat. By eating a ketogenic diet, the body burns off that excess glucose. The body then turns to fat storage for fuel.
Healthy ketone production (ketosis) is the goal of eating a ketogenic diet. Ketones are a stable form of energy that will last for hours, as opposed to the energetic peaks and valleys common with higher carbohydrate diets.
Here are some of the benefits keto dieters report:
- Cravings for high carbohydrate food diminishes
- Hunger in general diminishes
- Greater reduction in visceral fat, aka “belly fat”
- Reduction in triglycerides (fat that travels through the blood)
- Improved sensitivity to insulin
- Encourages healthy blood glucose level
- Increased energy and less fatigue
- Helps to manage PCOS symptoms
- Encourages a better HDL/LDL ratio
- Helps resolve candida
- May help clear up acne and other skin conditions
- Decrease in “brain fog”
- Can help induce autophagy
What are Ketones?
Ketone bodies, or ketones, are a source of fuel for the body. Ketones are molecules produced in the liver after the body’s stores of glucose have been used up. This happens with fasting, prolonged exercise, or eating a carb-restricted diet. Ketones are also produced in unhealthy situations, such as liver damage or uncontrolled diabetes.
What is Ketosis?
Ketosis is state in which the body burns fat for energy instead of glucose, a type of sugar. Ketosis is a normal, controlled response to a carbohydrate-restricted diet.
When the body has used up it’s excess stores of glucose, it still needs energy. The liver shifts from metabolizing sugar to metabolizing fatty acids. These fatty acids are then further metabolized into acetyl-CoA, and then into ketone bodies. The presence of ketone bodies between 0.5-3.0 mmol/L indicates ketosis.
With the sugar out of the way, your body can turn to its fat stores as a fuel source. In other words, ketosis makes you a fat-burning machine!
What is Ketoacidosis?
Ketoacidosis is an uncontrolled production of ketone bodies that results in a drastic change in the body’s ph levels. Ketoacidosis represents a life-threatening emergency.
Ketoacidosis is caused by uncontrolled high blood glucose, as is found in type 1 diabetes, late stage type 2 diabetes, and liver damage. It is also generally accompanied by elevated blood glucose levels over 250 mg/dl. High levels of ketones are produced in ketoacidosis, sometimes higher than 10 mmol/L.
That’s much higher than ketosis levels. This high production of ketones is also why sudden, significant weight loss is a sign of uncontrolled diabetes.
Ketosis vs Ketoacidosis
Ketoacidosis is not the same thing as ketosis. The mechanisms behind each are entirely different. Ketosis cannot magically become ketoacidosis.
Ketosis is a controlled state of ketone production brought about by healthy actions like reducing excess sugar, exercising, and fasting. Ketoacidosis is an uncontrolled state of ketone production brought on by illness, such as diabetes or liver disease.
Ketosis is safe. Ketoacidosis is not. Eating a ketogenic diet will not lead to ketoacidosis.
How Do I Know if I’m in Ketosis?
In general, you will notice two things:
- You won’t feel hungry between meals and smaller portions will fill you up easily.
- You will likely see either weight dropping on the scale or notice a smaller measurements with a tape measure.
However, the only way to really know if you are in ketosis is to test for ketones. Ketones can be measured in the breath, urine and in the blood.
The most accurate measurement is a blood test. The presence of ketones between 0.5 and 3.0 mmol/L (millimoles per liter) indicates ketosis, with readings above 3.0 mmol/L indicating ketoacidosis. You can do this test at home with a meter.
Some blood glucose meters also measure ketone levels. The one I use is Keto-Mojo. It’s accurate, affordable, and measures both glucose and ketones. There are all sorts of keto-oriented devices, apps, trackers, and whatnot. If you do invest money in anything else other than keto-friendly foods, I strongly suggest getting the Keto-Mojo combination blood glucose and ketone meter.
Ketones in the urine are measured using ketone testing strips. Ketones can also be detected and measured with a breath meter. These methods avoid having to prick your finger. But, they are not as accurate as a blood test, and they only detect ketones. They can’t tell you your blood glucose levels. Even if you are not diabetic, it’s extremely helpful knowing how specific foods impact your blood sugar.
Does Keto Change How Your Body Odor?
Everyone experiences body odor. It’s a normal function of sweat and bacteria on our bodies. Sweat is how our body detoxifiesSomething I have noticed is that my body odor is less when I eat keto with lots of fresh, low carb vegetables.
Ketoacidosis can cause the breath to smell fruity. In worse cases, it may even smell like acetone (nail polish remover). Some people have said that their breath can smell like this while in normal ketosis. I have not had that experience myself.
Keto vs. Low Carb: What’s the Difference?
Keto is a low carb diet. But, not all low carb diets are keto. The difference is the amount of carbohydrates you can eat.
Low carb diets tend to restrict carb intake to between 50g to 150g daily. A keto diet restricts carbs to just 5% to 10% of the days total food intake. This ends up being 11g to 50g daily based on a 2000 calorie diet. Most keto eaters stay below 30g of carbs daily in order to stay in ketosis.
What you need specifically is going to depend on a number of factors. How active are you? How much weight do you have to lose? How much insulin resistance do you have? Do you have other hormonal imbalances, such as in PCOS, adrenal fatigue, or a hypothyroid? All this, plus genetic disposition, can influence what diet is most effective for you.
Use these numbers as guidelines, and give it a week. See if you lose weight. Try it for another week. Did you lose weight? If not, try eliminating a few more carbs. You will need to find what works for your own body and it’s own unique needs in the moment. Those needs will change throughout your healing process. Be willing to respond to those needs. Maybe you need to adjust your serving sizes. If you count total carbs, maybe only net carbs, or vice versa. Listen and pay attention to your body’s signals.
Total Carbs vs Net Carbs: Which Do I Count?
Total carbs are the total carbohydrates grams in a serving of food. Just count your total grams of carbs until you reach your limit for the day. Easy peasy.
Total Carbs Example: A medium avocado has about 13 grams of carbs. If you eat one, you count it as 13 grams of carbs.
Net carbs are total carbohydrate grams minus any grams of fiber or sugar alcohols. These have no impact on blood sugar, so they don’t count toward “net carbs”.
Net Carbs Example: A medium avocado has 13 total grams of carbs. It has 10 grams of fiber. The net carbs for an avocado is 3 grams.
Some keto eaters find they must count total carbs, while others find they reach ketosis and succeed at weight loss by counting net carbs. I lost my first 100 pounds by counting net carbs only. Perhaps it might have been faster if I had counted total carbs. I don’t know. I did, however, have more variety in my meals as a result of only counting net carbs.
What Can I Eat on Keto?
“But, without bread, rice, and potatoes, what can you eat on keto?” If I had a dime for every time I heard this, I would be a wealthy woman.
Yes, keto is carb-restrictive. But, there are lots of delicious keto-friendly foods out there. You can eat anything that fits the low carb, moderate protein, high healthy fat model, that keeps you in ketosis.
Foods to look for are meats, eggs, healthy fats and oils, berries, leafy greens, cruciferous vegetables, and all non-starchy vegetables, plus herbs and spices. You can also have limited amounts of dairy and nuts. These foods can have higher amounts of carbs, and they sneak up on you.
Other limited foods are vegetables with a few more carbs, like onions, garlic, carrots, ginger, tomatoes, and legumes. For example beans in general have too many carbohydrates. However, a small serving of green beans or peas spread out through an entire recipe will probably still stay under your carb limits for the day.
If you tolerate dairy, stick to lower-carb cheeses, cream, cream cheese, and homemade keto ice cream. If you tolerate nuts, look for higher fat, lower carb nuts, like macadamias, brazil nuts, walnuts, and almonds. With nuts, always measure them out. They can rack up those carb grams fast!
Some of my favorites keto choices include:
- Fish- especially cold water and fatty fish, like salmon
- Beef- grass fed is best, if available
- Pork- (bacon has zero carbs, just watch out for the salt content)
- Rabbit (add a lot of cooking fat, as rabbit meat is very lean)
- Avocado oil
- Olive oil
- MCT oil
- Coconut oil
- Coconut cream
- Real butter- grass fed is best (Both Kerry Gold and Finlandia are grass fed brands)
- Ghee (clarified butter)
- Beet greens
- Bak choi
- Summer squash
- Munk fruit- based sweeteners
- Stevia-based sweeteners
- Alcohol sugars (like erythritol and xylitol*, if tolerated)
*Keep xylitol away from dogs. It is poisonous to dogs.
This is really a lot of varied foods to pick from with plenty of low carb fruits and vegetables. So, the next time someone says, “Keto is so restrictive,” you can bust that myth.
What Can’t I Eat on Keto?
Even with so many keto-friendly foods, there are restrictions. If you’re only eating 30 grams of carbs daily, certain foods are going to be off limits. For example, a cup of cooked, brown rice has about 50 grams of carbohydrates. That’s more than is allowed for the entire day.
You could technically opt for wild rice, which is a seed, not a grain. It would have around 35 grams of carbs in one cup of cooked wild rice. So, a half cup would be around 17.5 grams of carbs, leaving you around 12.5 for the rest of the day. That might look like an omelette & bacon in the morning, and a bowl of Easy Keto Chicken Curry, and maybe a half of a cup of blueberries and heavy cream whipped with vanilla Lakanto drops for dessert.
Keto is a low carb diet, not a “no carb” diet. We do eat carbs. We just eat a whole lot less of them.
Ketoers also source our carbs differently. Most people in the US get their carbohydrates from grains and starchy vegetables, like oats, wheat, rice, potatoes, and corn. We get ours from non-starchy vegetables.
- No sugars
- No grains
- No starchy vegetables
- No soy
- No legumes
- No soda (stevia-sweetened sodas, like Zevia are ok if limited)
- No higher-carb dairy (no milk, yogurt, etc)100000
- No higher-carb fruits
Again, there are some gray area foods that you might be able to sneak into your meals without a problem. For example, you may be able to eat a small serving of green beans depending upon what else you eat that day.
Peanuts are legumes. Peanut butter can be a sneaky source of carbs. I found a bulk-sized, organic, natural peanut butter at BJ’s Wholesale that has only 1 net carb per serving. Some natural, unsweetened peanut butters can have up to 4 and 5 grams. Save those carbs wherever you can. Those extra carbs could be spent enjoying some sliced bell peppers dipped into full fat sour cream. Yum!
Just keep in mind to limit any sweet items, including naturally sweet foods, like maple syrup and most fruits. This is true even for keto-friendly sweeteners, like stevia, monk fruit, and sugar alcohols. The taste of sweet alone is enough to trigger the body to call for more insulin in anticipation of more sugary foods on the way.
What are Macros?
Macros is short for macronutrients. There are 3 macronutrients: Protein, fat, and carbohydrates.
How Do I Calculate My Macros?
Remember all those questions about “When am I ever going to need to do math in real life?” This is that moment.
Keep in mind, your macros should break down roughly like this:
- 5%-10% from carbohydrates
- 15%-25% from protein
- 65%-80% from healthy fats
You need to do a bit of research to determine how many calories you personally need to maintain weight. Then decide upon a calorie deficit of between 10% and 30% of those calories. Subtract that deficit from your total daily intake. With that number, do the math with your chosen percentages to get the grams of carbs, proteins and fats.
Or, you could just use any of the many free macros calculators that are available for free online. I use the Carb Manager app. It calculates and tracks my macros, meals, and allows me to do meal planning, add my own recipes and recipes that I find online, and add them to my meal plan. It’s really a fabulous app. Plus, it allows you to track net carbs, which not all food tracking apps do.
Carb Manager also syncs with my FitBit. Now, the FitBit app also has a food tracker, and you can play around with your macros goals. But, it doesn’t track net carbs, unfortunately.
You can also use this free app from Keto-Mojo to calculate your macros.
Can I Eat Dairy on Keto?
Yes, you can. However, women who have PCOS might find that they are sensitive to dairy. Dairy can exacerbate PCOS symptoms and stall weight loss for women with PCOS.
The reason for this is hormones. Some of this is recombinant bovine growth hormone (rBST). This is a synthetic hormone given to cows to increase milk production. There is also naturally-occurring growth hormone in milk. Beyond that, milk from pregnant cows has significantly higher amounts of hormones, including estrogen, than from non-pregnant cows. For as risky as synthetic growth hormomes and synthetic estrogen-mimicking chemicals (from BPA and pesticides), natural estrogens can pose more of a risk. The naturally occuring estrogen from pregnant cows is 100,000 times more potent than the synthetic.
In the US, dairy cows give milk about 10 months out of the year. Cows also take about 9-10 months to give birth to a calf. US cows are regularly artificially inseminated. This means, cows are almost always pregnant when being milked. Therefore, most of our cow milk is loaded with pregnancy hormones.
Milk from a cow late in pregnancy can have more than 30 times the level of estrogen as milk from a non-pregnant cow. A cow not part of our industrialized food system might only give milk for 5-6 months a year and has no where near the levels of pregnancy hormones that commercially available milk has.
If you have PCOS, you may be better off avoiding dairy. The last thing PCOS women need are extra hormones to throw us even further off balance.
I have been able to lose weight with strictly reduced dairy. I stick to full-fat & low-carb cheese, real butter, small amounts of full-fat sour cream, and heavy whipping cream. I use them in limited amounts when it really adds something to a recipe.
Can I Eat Nuts on Keto?
Sure, but be careful. A serving of nuts is smaller than you think. That being said, you’ll be able to make keto-friendly versions of some of your favorite non-keto foods by adding nuts. For example, almond flour can be used to make “fat head” dough, plus delicious muffins and quick breads. I also use almond flour along with psyllium husks to make delicious keto dinner rolls.
A serving of almonds is 1 ounce. That’s about 23 almonds and 2 net carbs. One ounce of cashews, on the other hand, has about 9 net carbs. That’s a big difference when you’re looking for a quick snack.
Coconut is a great choice. Coconuts are versatile and provide so many keto-friendly products. Coconut flakes, shredded coconut, coconut milk, coconut cream, coconut flour, coconut aminos, and I’m probably forgetting a few. The fat in coconut is medium-chain triglycerides, a form of saturated fat that is easily used for fuel by the body. MCTs help us get into ketosis and stay there, happily burning away fat for fuel.
Obviously, if you are allergic to nuts, do not include them in your diet, no matter what benefits they may have for other people. Nut allergies are no joke. Always take them seriously. You can, however, substitute Sunbutter (made from sunflower seeds) for peanut butter in many recipes.
What Is Keto Flu?
When switching to a keto diet, one of the first things that happens is the body releases a ton of excess fluid. You can easily drop a lot of water weight during the first week of keto eating. That means two things:
- You will pee a lot.
- You can run low on electrolytes from peeing a lot.
When this happens, you can experience muscle cramps, headaches, fatigue, nausea, constipation, diarrhea, dizziness, and even bad breath. This is nicknamed “keto flu”.
Keto flu usually only lasts a couple of days, if at all. It’s not a given that you will experience the keto flu. To prevent or relieve symptoms of keto flu, you can sip on bone broth with sea salt. This is quick and easy to make if you have an Instant Pot. Alternatively, you can buy keto-friendly bone broth, like Kettle & Fire. Add sea salt to taste to help the keto flu.
Another option is to take supplemental electrolytes. I keep this electrolyte powder on hand in my first aid supplies for dehydration. It makes a carb-free orange soda when mixed with selzer water.
Do I Have to Exercise to Lose Weight on Keto?
You don’t have to. You can lose weight just by eating keto. However, exercise will help you lose weight, get fit, and look better faster.
Exercise has so many benefits of its own. Exercise can lower stress, improve sleep, and relieve depression. Lack of exercise is a major contributing factor of most chronic illnesses. While exercise isn’t mandatory to lose weight while eating keto, there is zero reason not to work out.
Do I Have to Take Supplements on Keto?
If by eating keto you mean only eating bacon and steak, you probably should consider a multivitamin.
If by eating keto you are eating intelligently, with a variety of low carb fresh vegetables, berries, and herbs, then no. You should not have to take supplements to succeed on the keto diet.
That being said, I personally take a number of nutritional supplements and herbal remedies to address my specific health issues. These include PCOS, hair loss associated with PCOS, insulin resistance from type 2 diabetes, NAFLD, underactive thyroid, and adrenal fatigue. I will cover those in separate blog posts.
I’m Vegan/Vegetarian. Can I Still Do Keto?
Yes, you can be vegetarian, and even vegan, and still eat keto. Keto isn’t about specific foods. It’s about changing over from burning carbohydrates for energy to burning fat for energy through ketosis. To get and stay in ketosis, you need to watch your macros. Eat extremely low carb, moderate protein, and high healthy fats.
Meeting the healthy fat requirement shouldn’t be hard. Coconut oil is a favorite cooking oil of many vegetarians and vegans. Coconut milk makes a high healthy fat dairy substitute. Unsweetened almond or cashew milk are also vegetarian/vegan non-dairy options.
Meeting the protein requirements without exceeding carbohydrate limits will be more challenging. Vegetarians will have an easier time than vegans. Vegetarians can still have eggs and dairy to help them reach their protein goals. The inclusion of cheese and eggs means that “fat head” dough is an option for rolls and pizza crusts, and opens up a lot of vegetarian-friendly keto meal options.
Vegans will have a few more challenges. Vegans get all of their protein from plant sources, and tend to be too high to stay in ketosis. Vegans will need to incorporate more nuts, as well as some other items that wouldn’t typically be included, like seitan (made from wheat) or various soy products, like tofu. Tofu is fairly low in carbohydrates, but the phytoestrogens can stall weightloss for some people.
Other vegan-friendly options include keto baked goods, like muffins and quick breads. These are made with coconut and almond flours. Vegetarians can use eggs, and vegan versions can be made with flax seeds as an egg substitute. Some low-carb peanut butter slathered on a keto chocolate chip banana bread (recipe coming soon) makes a filling, vegetarian or vegan breakfast.
Personally, I would consider going pescatarian for keto. This opens up so many more meal options, and it makes getting into ketosis so much easier. But, if that isn’t an option for you, you can still make your vegetarian or vegan diet work. It will just take a bit more meal planning. I will post more vegetarian and vegan-friendly recipes as time goes on. But, if you need some inspiration in the meantime, the Carb Manager app’s paid version* has ready made vegetarian and vegan keto meal plans.
*I do not receive any compensation from Carb Manager. I recommend it because I use it personally and consider it one of my more valuable tools in my keto tool box.
I’m In Ketosis, But I’m Not Losing Weight. What’s Wrong?
Plateaus are frustrating, and they happen to everyone. There could be any number of things happening. Here’s what to do when the scale just won’t budge.
- Check your measurements. Your shape may be changing, even if the numbers on the scale aren’t.
- If you haven’t, invest in a ketone meter. It is the most accurate way to tell if you are truly in ketosis.
- Consider investing in a scale that also measures your fat, water, and lean mass, like the Aria 2 from FitBit. If you put on 2 pounds of water weight, that’s very different than 2 pounds of fat, and needs a different solution.
- Have you been slacking off on meal planning? Just winging those measurements in the kitchen? You may be taking in too many carbs, too much protein, too much sodium, or too many overall calories without even realizing it.
- Are you getting enough sleep? Lack of sleep can kill your weight loss efforts. Beauty sleep is a real thing.
- Are you more stressed than you normally are? Stress can sabotage your weight loss by flooding you with hormones like cortisol, known for its role in packing on the belly fat.
These are just a few things to look into. If you’re still having trouble breaking through a plateau, or have any more keto diet questions, drop me a line at ketocatblog dot com.