Q:  Ok, so let’s do this thing.  What do I need?

A:  There are a few things that will help you succeed.  First, a kitchen scale.  Weigh everything you put in your mouth until you feel you’ve learned how you should be eating.  Second, an account on MyFitnessPal.com.  You can change your macro nutrient ratios and total calorie intake to match the numbers you got on the Keto calculator.  Last you’ll need to get rid of your carbs.  (Donate to a food pantry or throw a huge party.  Don’t waste food!)  Buy ingredients listed here.

Q:  I can’t find some of these ingredients in my local markets.  Where can I get them?

A:  I live in a rural area and I have a hard time finding things locally that are helpful to have around.  The Amazon Prime 30-Day Free Trial has been a godsend.  Amazon typically has some of the harder to find ingredients used often in a ketogenic diet.  With Amazon Prime you pay a yearly fee and anything marked with the prime logo under shipping ships in two days free.  I need Mortons Lite Salt?  Xanthan gum?  Order it with one click and its here in two days.  I’ve saved hundreds of dollars in shipping and I can have anything I need in two days.  I highly recommend it.

Q:  I’ve heard a medical word or two in my life and I know that ketoacidosis is bad.

A:  Ketosis and ketoacidosis are two different things centering around the innocent ketone!  Dietary ketosis is a controlled, insulin regulated process which results in a mild release of fatty acids and ketone body production in response to low carbohydrate intake, and higher fat consumption.  Ketoacidosis is a condition in which abnormal quantities of ketones are produced in an unregulated biochemical situation. In order to reach a state of ketoacidosis, the body has to be in a state of not producing enough insulin to regulate the flow of fatty acids and the creation of ketone bodies.  In summary, ketosis is a controlled release of ketones into the bloodstream regulated by your production of insulin.  Ketoacidosis primarily affects Type 1 diabetics because they don’t have any insulin to regulate the release of ketones into the bloodstream and therefore it is uncontrolled.  *note:  If you’re diabetic, have any other medical problems or are just being cautious and are considering Ketogenic eating please consult with your physician first.  

Q:  It can’t be healthy to eat all that fat.  I’ll have a heart attack!

A:  It can’t be healthy to eat all those carbs!  Let’s look at how carbohydrates affect your insulin levels.  Following a carbohydrate rich meal your blood sugar increases so the body secretes extra insulin.  Carbohydrates that aren’t used are stored by insulin.  You can see that blood glucose levels peak and then fall off and insulin does the same, however insulin levels peak later than blood glucose. Once blood glucose levels reach normal again, you can see that it takes insulin a little bit longer to reach normal again. It is this lag time in normalization of insulin levels which gives us those sugar cravings after carbohydrate rich meals. This is because blood sugar levels are normal but we still have insulin present in the blood and that insulin needs something to do – without sugar to store it gets bored! So it has the effect of asking the body for more sugar. That’s why we get hungry even though we just ate a few hours ago.

Q:  You didn’t answer the question.  Fat.  Heart attack.  Go!

A:  Ketogenic eating IMPROVES the risk factors that lead to heart disease. More and more research is pointing to a high carb diet as one of the main factors in what causes heart disease. Here’s why.  Eating lots of carbohydrates on a daily basis:

• increases blood glucose levels and in turn, increases circulating insulin levels, contributing to insulin resistance. High blood glucose is inflammatory and damages body tissues through glycation of the protein structures (think of what pouring maple syrup on a keyboard would do to its performance).
• increases your risk of coronary heart disease and mortality through the ravages of high blood sugar.
• increases triglyceride levels. High levels of triglycerides are strongly associated with heart attack risk.
• increases the prevalence of small, dense, glycated LDL cholesterol in the blood (That’s the dangerous kind).
• decreases the levels of healthy HDL cholesterol. Low levels of HDL are associated with a higher risk of atherosclerosis.
• increases the risk of the development of Metabolic Syndrome, which is characterized by the presence of elevated fasting glucose, low HDL cholesterol, high LDL cholesterol, high triglycerides and high fasting insulin. (See the vicious circle there?)
• increases the levels of lipoprotein(a), a cholesterol derivative of LDL highly associated with heart attack risk.
• increases insulin resistance and the risk of diabetes, both of which are highly correlated with heart disease risk increase.

Recently the Dietary Guidelines Advisory Committee, a nutrition advisory panel that helps shape the country’s official dietary guidelines, dropped a longstanding recommendation that Americans restrict their intake of dietary cholesterol from foods like eggs and shrimp — a belated acknowledgment of decades of research showing that dietary cholesterol has little or no effect on the blood cholesterol levels of most people.  Instead the panel singled out added sugars as one of its major concerns. Previous dietary guidelines have included warnings about eating too much added sugar, but for the first time the panel recommended that Americans limit it to no more than 10 percent of daily calories — roughly 12 teaspoons a day for many adults — because of its link to obesity and chronic disease.

Q:  How can I tell if I’m in ketosis or not?  I don’t feel any different!

A:  If you’ve religiously kept your carbohydrates between 20-35 grams every day you should enter into a ketotic state within 2 days.  If you’re the type of person who absolutely needs evidence to back that up you can use two different methods to test your ketone levels.  The first one is ketostix.  Ketostix are little strips that you can buy in the diabetic section of your local pharmacy.  You urinate on the end of the stick and wait a set amount of time detailed in the instructions then compare the color change to the packaging.  Ketostix are good to use initially just to confirm you’re in ketosis but shouldn’t be relied on once you’re keto adpated.  Often times your body is able to utilize all the ketones generated in an adapted state and they’re no longer passed in the urine.  The second method is a glucose meter that can also measure ketones in the blood.  While this method is more invasive (and mildly uncomfortable to give your skin a poke) it can give you accurate blood ketone levels.  I don’t recommend this.

Q:  Can I drink beer/alcohol?  I love my beer and I don’t want to give that up!

A:  Short answer yes…  and no.  Let me explain.  While beer is a tasty nectar of the gods it will do nothing less than knock you out of ketosis.  Many beers, especially craft beers, are very high in carbohydrates.  They’re basically liquid bread.  With that being said there are many lower carb lite beers that you may be able to insert into your macros.  My wife can have two or three Miller Lite beers and be fine.  I have one and I balloon up with water weight and I have severe gastrointestinal distress.  Of course your mileage may vary.  I prefer to stick to the old standards.  Scotch, vodka and white rum are good choices mixed with a diet soda of your choice.  Avoid liquors that have sugar in them.  Keep in mind that manufacturers aren’t required to put the nutritional information for alcohol on labels.  Ethanol (that’s the alcohol that get’s you drunk) contains 7 calories per gram.  That’s a considerable amount of calories in a single night out on the town drinking.  Alcohol calories will be processed by the body first and will slow down ketosis.  Here is a comprehensive list of alcoholic beverages and their carb contents from getdrunknotfat.com.