Top 3 Keto Mistakes to Avoid 
Monday, January 28, 2019
LifeTime WeightLoss in Paul Kriegler, keto diet, ketogenic

The ketogenic diet has recently made a resurgence — in a big way. The influx of keto-labeled items at the store and keto-this talk in the media may make it seem as if it’s a new concept, but this way of eating has actually been used for various therapeutic reasons for nearly a century. 

The ketogenic diet calls for a very low amount of carbohydrates, a moderate amount of protein, and very high amounts of fat. When macronutrients are broken down this way, it can help to reduce insulin levels. And, when there’s the absence or a scarcity of insulin, the body is then able to use body fat or dietary fat to generate what’s called ketones. This process can result in the body burning fat, as opposed to carbohydrates, for energy, and supply that energy to your brain, heart, and other organs. 

This change in how your body is fueled can benefit a number of medical and metabolic conditions, as well as lead to weight loss — and that’s why we’ve seen keto’s resurgence in popularity. But just because positive results have been achieved by some doesn’t mean everyone should follow a ketogenic diet, despite what the health influencers you follow might suggest. It’s much more complicated than that. 

To truly follow a ketogenic diet, you have to be in nutritional ketosis, which is the term for change in process I just outlined. (This should not be confused with the similar-sounding, life-threatening condition ketoacidosis.) To achieve nutritional ketosis, you need to strictly follow guidelines around the amount of carbohydrates, protein, and fat in your diet. 

The exact degree to which you limit carbohydrates varies from person to person depending on factors like individual carbohydrate tolerance, current metabolic health, activity level, and overall lifestyle. But to give you an idea of what your meals might look like, it might be eating 5 percent carbohydrates, 10 percent protein, and 80 to 85 percent fat. 

If this way of eating is applied incorrectly or executed poorly, it can have some devastating effects on several metabolic systems that your health depends on, including thyroid health, sex-hormone balance, carbohydrate intolerance, adrenal resistance, cholesterol metabolism, and more.  

As you can imagine, this somewhat extreme dietary approach isn’t always easy to start or maintain, and shouldn’t be jumped into lightly. The only way to know for certain if the ketogenic diet is a viable option for you is to first do blood testing to gain a detailed understanding of your physiological and metabolic health, which is why I always recommend first consulting with your doctor and evaluating your blood chemistry, as well as weighing the pros and cons of this and other nutritional strategies. 

That being said, there are still many people who experiment with the diet, and in doing so make errors that can have negative health implications or prevent them from achieving nutritional ketosis. These are the three most frequent missteps I see. 

1. You’re eating too much protein and not enough fat.

A properly designed ketogenic diet is nothigh in protein — it’s high in fat. Eating too much protein, however, can very easily halt ketone production, take you out of nutritional ketosis, and contribute to what some refer to as the “low carb flu,” with symptoms like general fatigue or fluctuating energy levels, poor mental acuity, and loss of strength or endurance. 

Protein intake levels most conducive to nutritional ketosis appear to be between 1.5 and 1.75 grams per kilogram of your ideal body weight per day1, which is higher than the recommended dietary allowance, but not as high as many fitness enthusiasts who don’t follow a ketogenic diet commonly consume. 

For example, I’m 5 feet 9 inches tall and my ideal body weightis around 160 pounds, or 72.7 kilograms. So, my protein needs on a ketogenic plan would be between 110 and 127 grams per day, compared to the estimated 155 grams per day I would aim for on a non-ketogenic plan (according to the guidelines of the International Society of Sports Nutrition3). It may seem like a small difference, but that variance is actually huge when you look at how the body responds to the nutrients consumed, not just the calories or macros. 

Eating protein stimulates an insulin response, as well as provides amino acids that the body can convert to glucose in the liver. Both of these things can either diminish, disrupt, or halt ketone production. The anti-ketogenic impact of eating too much protein can be made worse if your fat intake isn’t high enough, either; instead of burning fat and ketones, you’ll burn the carbs your body makes from the protein. 

Well-formulated ketogenic diets need at least 80 percent of calories supplied by dietary fat, most of which should come from high-quality saturated and monounsaturated fats. Good quality saturated fats include coconut oil, grass-fed butter, full-fat dairy products, or lard, while monounsaturated fats could include olives and olive oil, avocados and avocado oil, macadamia nuts, and animal fats from grass-fed and pasture-raised animals.  

Successfully entering ketosis requires a fundamental shift in food choices toward higher fat options. You cannot go keto by restricting carbs and continuing to eat boneless, skinless chicken breasts, 90-percent lean meat, or low-fat dairy. 

2. You’re not eating enough produce.

As the ketogenic diet has become more popular outside of its established therapeutic uses, many people may view it as a free pass to start adding butter or MCT oil into their coffee, eat as much bacon as they please, or banish all sources of carbohydrates — including non-starchy vegetables and modest amounts of fruit.

This is problematic for a few reasons. First, when you restrict carbohydrates, your fiber intake usually plummets. But fiber is important for preventing constipation, as well as maintaining good bacterial balance in your digestive tract4

Second: Without adequate produce intake, it becomes very difficult to consume adequate vitamins, minerals, and antioxidants, which are crucial for cellular function and protection against oxidative stress (which is a byproduct of normal metabolism, especially if you exercise).  

Whether you’re following a ketogenic diet or not, it’s beneficial to try to eat ample amounts of colorful produce, especially leafy greens and other non-starchy vegetables, as well as deeply colored fruits like berries. This helps to ensure you’re getting plenty of fiber and other nutrients vital to your overall health.  

If you are following the ketogenic protocol, you’ll have to tinker with the amounts and sources of produce that fit into your personal carbohydrate “budget” in order to maintain a regular bowel pattern and get adequate nourishment, while also keeping your ketone levels within the desired range.  

3. You’re under-consuming sodium. 

Let’s pretend that you’ve fully transitioned to eating the desired amounts and kinds of carbohydrates, protein, and fats, and you’ve successfully restricted your carbohydrates to a level where you should be feeling energized, focused, and satiated as you “magically” get leaner by the day. Except, you don’t feel awesome. Instead, you feel sluggish, moody, and your workouts stink. What gives? 

When the quick, efficient source of energy you were once dependent on (carbs) are restricted, there’s a period of time in which energy levels can be much lower, at least until your body ramps up fat metabolism. And there are impacts of this shift.  

As you deplete your internal carbohydrate stores, a sizable shift in your cellular hydration can happen. For each gram of carbohydrate you store in your muscles and liver on a normal diet, you also store three to four grams of water. When you deplete those carbs through low-carb diets, like keto, you lose that stored water, as well as a considerable amount of sodium through your urine, sweat, and breath, as insulin is needed to stimulate the kidneys to retain sodium and fluid5.  

The combination of a drop in insulin, depletion of stored carbohydrates, and loss of accompanying water can result in a six- to 10-pound weight loss in just a handful of days. However, if you don’t adjust your electrolyte intake adequately, your cells may remain in this dehydrated state, leaving you feeling sluggish. 

Recent evidence suggests that a healthy sodium intake level on a normal diet is around 5 grams per day6, and if you sweat regularly, it may be slightly higher. On a very low carb, ketogenic diet, you may need even more sodium to help maintain adequate hydration and energy production — I’ve seen recommendations north of two teaspoons of added salt per day. This is why you’ll often hear about people eating pickles, olives, salty cheeses, or drinking broth on this diet.  

What it takes to get — and stay — in nutritional ketosis is a large departure from what we’ve historically been told constitutes “healthy” eating, and it can make a lot of people nervous, especially when it comes to liberalizing their fat and sodium intake. And, even if you follow the guidelines perfectly, the diet still might not be right for you — bio-individuality and your current health status play a role. 

That’s why it’s so important to only embark on a ketogenic diet if you’ve consulted with your doctor, captured detailed baseline lab data, and understand that doing the diet successfully isn’t as easy as many enthusiasts would lead you to believe. 

The best, intended use for the diet really is for therapeutic reasons. And, if you do choose to embark on it, it will require daily monitoring of your blood ketone levels, and strictly following dietary guidelines to ensure you stay in nutritional ketosis — including not making any of the three missteps explained here. 

In health,

Paul Kriegler, Registered Dietitian and Life Time Nutrition Program Development Manager

This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.   








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