It all started when I went to a continuing education event to teach providers how to implement the ketogenic diet with patients. Of course, I knew about this diet in the treatment of epilepsy but I had not implemented it with any of my patients. I like to try ways of eating or ‘diets’ on myself before asking patients to follow them. This allows me to provide better support for patients following the diet. Historically, I have been a big fan of moderation with diets. I don’t like adding a lot of restrictions to patients diets; I worry it can cause added stress. Who needs more stress? No one. So naturally, I expected that I would not like the ketogenic diet. But, (spoiler alert!) I was wrong. If you don’t want the whole story just skip down to ‘Nitty Gritty’ section.
Disclaimer: this is my personal story and not a recommendation to follow the ketogenic diet. There is no one size fits all diet and this diet is not for everyone. If you chose to follow the ketogenic diet, you need to consult with your healthcare provider first and have lab testing done to monitor your health.
You need a little historical context to understand why I ended up really enjoying the ketogenic diet. First of all, I’m a workaholic. Notice I don’t say recovering workaholic because that just isn’t true. I love what I do and I thrive on work. So, I tend to work between 50-60 hours per week. The trouble is I tend to prioritize work over exercise, which isn’t great for weight management (duh!). Starting Wellness Minneapolis put an added layer of stress on my body and I found myself carrying more body fat than is healthy for my body. My glucose started to trend upward and I struggled daily with back pain, stiffness and general joint aches. As I said before, I’ve followed many ‘diets’ in the past, too many to list. I felt better when I cleaned up my diet and exercised, but I could never get it to stick. I would work a long week and a little voice in my head would tell me I deserved (insert ‘healthy’ junk food here - my favorite is Pirates Booty).
This was my life for years until I started the ketogenic diet in April of 2018. What sold me at the CE event was the cognitive benefits people report while following this diet. The idea of being able to work smarter instead of harder is always appealing to me. So I read up on the ketogenic diet and made a plan for myself.
The ketogenic diet does feel like a fad right now and it has absolutely been gaining in popularity. But, it isn’t new. On a ketogenic diet, the majority of your nutritional fuel comes from fat instead of carbohydrates. Shifting your nutritional intake in such a drastic way causes your body to switch from burning carbohydrates for fuel to burning fat for fuel. The body produces ketones during the process hence the name ‘ketogenic’ diet. Being in ketosis and burning fat for fuel accelerates burning stores of body fat, causing weight loss.
Starting on Keto
Likely because I am used to following a lower carb diet, keto wasn’t a big shift for me and I didn’t suffer too much that first week getting into ketosis. Often during the first week people experience what has been dubbed the ‘low carb flu’ causing fatigue, body aches, headaches and general malaise. But, I did struggle with physical endurance for several weeks. It took my body that long to catch up and really use ketones for fuel. Before ketosis, I could easily walk a brisk 4 miles. For the first few weeks on keto, I struggled to walk just a few miles; it would completely exhaust me.
Once I broke through, though, I felt incredible. I did experience better memory and sharper overall cognition. I also felt a significant reduction in body pain and inflammation. My labs corroborated what I was feeling; My glucose, insulin and A1c dropped while total cholesterol stayed constant. And, unexpectedly, I lost weight easily. I have always struggled being ‘overweight’ and diets that helped people lose weight never worked for me. I didn’t expect miracles with a keto diet and I surely didn’t expect to lose 30lbs and drop 3 sizes.
A little voice has always been with me; it asks when my next meal was, plots how to sneak treats in to my day and sabotages my healthy eating habits. I realized a couple weeks into keto, that it was finally silent! Suddenly, I was eating to live instead of living to eat, which might sound a little sad but it was so freeing. To have that mental chatter go away opened up so much space in my brain and my day. I was enjoying my food but I wasn’t obsessing over it. What surprised me the most was how satisfied I felt eating a ketogenic diet. I modified it from what you typically see online and did a mostly plant based ketogenic diet with lots of vegetables, plant based fats and tofu. I still ate meat, but I wanted to focus on really nutrient dense food sources. I also didn’t find it challenging to eat at restaurants or with friends and family.
Here is what I am not sure about yet: What does maintenance look like? If you read books like The Art and Science of Low Carb Living the answer is: keep eating a ketogenic diet! Many proponents argue this is the way to eat for the rest of your life. I personally took a break from the ketogenic diet starting in September 2018 because a lot of Fall travel made it harder to eat this way and I wanted to see what would happen. I continued intermittent fasting (a topic for another blog) and went back to eating a healthy non-low-carb diet rich in vegetables.
After about 2 months off the ketogenic diet, while I was able to keep my weight consistent, my pain and stiffness started to return. Now, it’s the end of December, I have indulged in a few too many high sugar treats, and my pain is back in full swing.
I am starting the ketogenic diet again for the first two months of 2019 to knock my inflammation back down. After that, I want to try carb cycling. I do worry about long term consequences of very low carb diets for specific populations and want to see if carb cycling could be a compromise between the two. I am also seeking out more continuing education and resources on the ketogenic diet. I will post an update to my blog halfway through the year about what maintenance looks like for me and if I can find a balanced way to keep my pain level low, energy high and cognitive function optimized.
In summary, I personally found the ketogenic diet to be helpful for my body. I experienced less body pain, better mental clarity and I lost body fat that I had been hanging on to for years. And it was easier to follow than I anticipated. I took 4 months off, it took about 2 months for my pain to come back and now I am getting back to a ketogenic way of eating. After a few more months eating ketogenic, I will try to figure out what maintenance looks like. I do worry about long term consequences of very low carb diets for specific populations and plan to take more continuing education classes in this area of nutrition.
Some of my secrets for success:
Food tracking: Using a food tracking app called cronometer to track not just my macros (protein, fat, net carbs) but also my nutritional status. This app showed me how low on calcium my diet was in the beginning and I was able to correct that.
Customizing macros: I found that I do better with a little higher protein and lower fat than traditional ketogenic diet.
Planning ahead: I used cronometer to plan my meals for the week to ensure I was hitting my nutritional targets. Hitting all of these targets can be difficult if you leave it up to decisions each meal. Making food ahead of time and having it ready to go all week takes the pressure off.
Electrolytes: Using electrolytes is critical on a ketogenic diet as you lose water more easily. I opted for a sugar free, not artificially sweetened electrolyte blend made by Jigsaw.
Adding intermittent fasting: I varied my fasts from 12-16 hours per day, eating an earlier dinner rather than a later breakfast. I have continued intermittent fasting even when I take breaks from the ketogenic diet.
Keeping costs down: I buy healthy fats like nuts, seeds, and some oils in bulk to keep the costs lower. I also try to buy meats from local farmers in bulk or buy in to meat shares. I use the clean 15 and dirty dozen guide to know which produce you need to buy organic and which ones you can buy conventional.
I could (and will!) write entire blog posts on recipes, what do when eating out and traveling and other tips for success so stay tuned!