Constipation and Keto: Does it go away?

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One common side effect of a ketogenic diet is constipation. Constipation can be caused by many things namely: dehydration, lack of fiber, improper gut bacteria, etc.

Good news, constipation is temporary and there are many remedies you can do to reverse and prevent it, whilst still remaining on the keto diet. Below we have listed a few.

  1. Hydrate: Drink enough water & add salt to your water

As our bodies switch to replacing carbohydrates as a main fuel source to ketones, one loses electrolytes and fluids naturally. Loss of fluids can cause stool to dry out and lead to constipation.

Make sure you drink enough fluids each day and consider adding 1-2 tablespoons of salt twice a day to a glass of water to ensure you are getting enough electrolytes, as well.

  1. Eat enough fiber: Consume more low-carb & high fiber fruits and vegetables

Cutting out carbohydrates often means cutting out our main sources of fiber (i.e. grains). Fiber helps for healthy stool growth and evacuation (too much fiber can have the opposite effect).

Make sure you are getting enough fiber in your diet by adding low-carbohydrate fruits like avocados, tomatoes, cucumbers, and olives. Also eat plenty of low-carb, high-fiber leafy greens like kale, spinach, and lettuce.

  1. Consume MCT oil: Switch out your coconut oil for MCT oil

MCT (medium-chain triglycerides) oil has a natural laxative effect. Switch out your coconut oil for MCT oil to help with constipation.

Be careful to gradually incorporate MCT oil into your diet, because too much of MCT too quickly may cause stomach cramps, etc.

  1. Drink apple cider vinegar & herbal teas: Apple cider vinegar before each meal & tea after

Both apple cider vinegar and certain herbal teas have been known to aid in digestion.

Consider adding 1-2 teaspoons of apple cider vinegar to a glass of water before each meal. Drink herbal teas that have things like ginger, licorice, or dandelion after meals or as a replacement for coffee.

  1. Add proper probiotics & prebiotics to diet: Make sure your gut bacteria are healthy

Making a transition from carbs to lot of fats for fuel can have an effect on the many natural bacteria of your gut. The bacteria of your gut aid in digestion, which in turn aid in stool formation and evacuation.

To ensure you keep the proper ratios and health of these bacteria make sure that you are getting enough probiotics and prebiotics in your diet by incorporating things like whole-fat and low-carb yogurts and probiotic coconut yogurt like Coconut Cult yogurt.

  1. Consider supplementation: Milk of Magnesia & fiber supplements can be used

If the above changes to your diet do not work or are not feasible, try over-the-counter supplementation with things like Milk of Magnesia and/or fiber supplements.

All in all, as your body adapts to a ketogenic lifestyle and you implement a few of the above remedies, you should be able to enjoy a ketogenic lifestyle free of constipation. If constipation continues despite these remedies, see a doctor.

- Dr Jerrry Hizon

Vegetarian Options for the Ketogenic Diet

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Are you a vegetarian and want to start the ketogenic diet?

Good news, a vegetarian keto diet is both reasonable and possible. Here are a few things to consider when doing so.

Since vegetarians naturally eat more vegetables and grains as a replacement of meats and animal flesh, they must be careful to not to go beyond the typical 35 grams limit of carbohydrates per day on a keto diet.

To assist you here is a guide to carbohydrate options as a keto-vegetarian:

What to Avoid:

  • Grains (pasta, bread, tortillas, rice, cereals, etc.)
  • Legumes (beans, etc.)
  • Sugars (honey, soda, table sugar, syrups, etc.)
  • Fruits (especially juices; eat more whole fruits and limit the number of whole fruits)
  • High-starch root vegetables (potatoes)

What to Eat:

  • Swiss chard
  • Kale
  • Spinach
  • Broccoli
  • Cauliflower
  • Asparagus
  • Cucumber
  • Summer or winter squash
  • Mushrooms
  • Eggplant
  • Garlic
  • Onion
  • Tomato
  • Green beans
  • Bell peppers
  • Cabbage
  • Zucchini

It is also important for vegetarians on keto to ensure that they are getting enough proteins and fats in their diet. An easy way is to incorporate the following oils, fats, and proteins in their daily diets.

It can be noted that eggs and high-fat dairy are a GREAT source of both fats and protein for a vegetarian. To be eco and animal-friendly with these items, you can consider sourcing from local farms. Make sure to research brands at your local supermarkets that pasture-raise their animals (not just marketing terms of �cage-free�).

Fats and Oils options as a keto-vegetarian:

  • Avocado (whole and in oil form)
  • Olive oil
  • Coconut oil
  • MCT oil
  • Olives
  • Coconut cream
  • Full-fat cheeses
  • Grass-fed butter

Protein options as a keto-vegetarian:

  • Eggs
  • Full-fat dairy
  • Tempeh (fermented and organic tofu)
  • Tofu
  • Seitan (grain-based so higher in gluten)
  • Miso
  • Nuts and seeds (best= macadamia nuts, walnuts, coconut, almonds, pecans, brazil nuts, pine nuts, chia seed, flax seeds, etc.)

In addition to the above, here is a list of possible substitutes that vegetarians (and vegans) may want to consider using when going keto. Be careful to check the carbohydrate content of these substitutes, as they often have added sugars or more carbs than their �meat� replacements.

Vegetarian alternatives or substitutes on a keto diet:

  • Replace heavy cream with coconut cream
  • Replace yogurt and sour cream with nut-based yogurt
  • Replace butter with coconut oil or vegan butter
  • Replace animal cheeses with nut-based or vegan cheeses
  • Replace table sugar and honey with stevia or erythritol

All in all, there are many options when going keto as a vegetarian. Make sure to stick to the proper macro ratios of a ketogenic diet. You can do this by using a keto macro calculator to help you keep track of and obtain the proper macro ratios.

- Courtney Assuma

How to measure your Keto Diet success

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When you start the Keto diet how do you know when you have achieved nutritional ketosis? How do you know if the diet is successful? Have you actually reached ketosis?

There are three different types of ketones we can measure in the body to see if we are in ketosis: acetone, acetoacetate, and Beta-Hydroxybutyrate (BHB).

Measuring Acetone

Acetone is the least invasive ketone to measure, as it is found in the breath. Since acetone is not the ketone used for energy by the body this is not a direct measure of ketosis. The presence and level of acetone positively correlates with BHB and can be used as a less precise measure of ketosis. When measuring ketones with breath, the Ketonix will light up with a color corresponding to the amount of ketones present. Usually yellow to red is the goal.

Measuring acetone can be done by using a Ketonix breathalyzer. The device can be used multiple times without anything more to purchase. While a little pricey, about $189-$239, the one-time investment is the only investment.

Measuring Acetoacetate

Found in the urine during the first few weeks of the Keto diet, measuring acetoacetate is relatively easy to do. This method is probably the least effective because it is dependent on the user�s ability to correctly identify which color the stick actually is and the overflow of ketones not the actual level of ketones in the body is what is measured here. When measuring ketones from a urine stick match the color of the stick to the color on the label, usually the darker purple, the higher the levels of ketones.

Acetoacetate can be measured using ketone urine strips like Ketostix, which are inexpensive around $10 for 50-120 strips. Measuring ketones through the urine is only feasible for 2-4 weeks at the beginning of the Keto diet, after that the body is Keto-adapted this is no longer an effective way to measure ketones.

Measuring Beta-Hydroxybutyrate (BHB)

Found in the blood, BHB is the most precise measurement of ketosis and is measured the same way as glucose. This method is the most invasive as pricking the finger is needed to obtain the blood to be tested. When measuring the BHB, the ideal range for weight loss is about 1.5-3 mmol/L and for a therapeutic diet (think cancer support) it is from 3-6 mmol/L.

A blood meter and strips are needed to perform this measurement, and these can be pricey, the strips alone run from $5-10 and the meters are around $40-60.

Are There Other Ways to Measure?

Yes, once you have been on the Keto diet awhile, there are signs you can look for that will indicate you are in ketosis. These include:

  • Reduced hunger, you can go longer than 2 hours without eating
  • Mental clarity will be increased
  • Stable energy throughout the day, no afternoon crashes
  • Reduced cravings

While these are not a way to measure your ketone level, once you have established your Keto diet and tested your levels, you can begin to know how your body feels when in ketosis and when you have slipped back into using glucose. If you cannot tell a difference, then testing with one of these methods will be necessary.

As always, before beginning a new diet or lifestyle change, please consult your doctor, especially if you are on medication.

- Erin Kirkpatrick

What are the Benefits of the Keto Diet?

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When considering a ketogenic diet, many people wonder if the change is worth it? Obviously any diet is usually started because of the health and weight loss benefits. However, there are many benefits to low-carb, high-fat ketogenic diets.

Below I have listed a few of the benefits that sway many people to choose a keto diet.

Increased weight loss

Eating a high-fat diet, low-carb diet facilitates weight loss by diminishing hunger, reducing overeating or eating too many “empty” calories. Feeling satiated longer also helps facilitate fasting, which can further assist in weight loss.

In addition, a high-fat, low-carb diet can decrease total body fat as it decreases insulin levels, leading to less fat storage, and it causes the body to “burn” its’ fat stores for fuel decreasing fat stores overall.
Reduced risk of Type II diabetes

When we eat carbohydrates, they are broken down into simple sugars. They are then released into the bloodstream, leading to increased blood sugar levels. As blood sugar levels increase, insulin is released. Insulin is a hormone that tells our bodies to store as much energy in the form of glycogen and fats as possible.

By eating a low-carb keto diet, one can normalize blood sugar levels, control the release of insulin, and reverse the effects of insulin resistance (characteristic of type II diabetes). In this manner, keto can be used to treat or possibly reverse type II diabetes, sometimes even replacing or supplementing medication.

Improvement of neurological disease

A high-fat, low-carb keto diet has a neuroprotective effect by correcting abnormalities in cellular energy usage common in most neurological disorders.

In this way, a keto diet can improve memory function, minimizing diseases like Alzheimer’s and Parkinson’s.

It has also been shown to help epilepsy by reducing seizures and lead to mood stabilization when dealing with diseases like autism and even schizophrenia.

Reduced risk of heart disease

A low-carb, high-fat diet can reduce the risk of heart disease by reducing triglycerides, increasing “good cholesterol” and decreasing “bad cholesterol,” lowering blood pressure, and reducing abdominal fat.
Increased triglycerides levels in blood and increased fat in the abdominal cavity lead to increased risk for heart disease. A keto diet decreases the amount of triglyceride in blood and lowers the amount of fat in the abdominal cavity, reducing the risk of heart disease.

Furthermore, a low-carb, high-fat diet leads to increased HDL (“good cholesterol”) and a decrease in LDL (“bad cholesterol”). LDL, the “bad” cholesterol, carries cholesterol from the liver to the rest of the body. Whereas, HDL, the “good cholesterol,” is a lipoprotein that carries cholesterol away from the body and to the liver where it can be reused or excreted.

In addition to the above, a low-carb, high fat keto diet is also known to decrease blood pressure, reducing the stress on the heart and the risk for heart disease.

Cancer treatment and prevention

Cancer cells, unlike normal cells, can only metabolize glucose for energy. Thus, switching to a high-fat and low-carb diet can essentially “starve” cancer cells of glucose, whilst still feeding normal cells which can metabolize fats as energy.

Consistent energy levels

A low-carb, high fat keto diet can help to stabilize energy levels throughout the day as one can avoid the “bonking” or crashes from carbohydrate intake (rapid blood sugar increase and decrease).
The high fats can keep one satiated and full of energy longer, reducing any cravings or caffeine needs/ crashes as well.

Increased performance for endurance athletes (endurance performance)
A low-carb, high fat keto diet has been implicated with increased output and increased performance for a longer duration for endurance athletes.

Increased longevity

A keto diet can decrease the risk of cardiovascular disease and myocardial infarction and protect against strokes, in turn decreasing associated mortality.

Anti-aging

As mentioned above, a low-carb keto diet can lower insulin. Lowering insulin reduces oxidative stress on the body. Reduced oxidative stress increases lifespan and slows degradation, having an “anti-aging” effect.

Decreased pain and lower inflammation

A low-carb keto diet also decreases inflammation. Decreased inflammation, leads to decreased pain.

These are some of the benefits that you can expect from the keto diet, if you stay committed to it. Of course, there can be challenges, but the results are worth it.

If you are interested in getting started with a keto diet, we can help you stay on track, with our Nudge Coaching program, and guidance from Dr Jerry Hizon. Contact us to see how much better you can feel!

- Courtney Assumma