The Challenges of Going Keto

As one begins to embark on the Ketogenic diet many challenges arise; ranging from social to medical to the fear-inducing Keto-flu to fighting carbohydrate or sweet cravings to the “what on Earth am I going to eat?!” question.

Friends and family may be shocked when you decide to eat a high fat diet after believing that fat is the enemy campaign for the last 40 years, options at the coffee shop are slim to none, and people look at you like you are in a cult as you describe your fat-burning breakthrough.

While all these challenges may seem funny, they feel very real to those of us that have “Gone Keto.”

Let’s go through and see how we can get through some of these challenges.

Medically research has shown the Keto diet has shown great promise in slowing and in some cases stopping the progression of many chronic diseases such as Type 2 Diabetes, Alzheimer’s, arthritic conditions, high cholesterol/low HDL cholesterol, cardiovascular disease, and obesity. Unfortunately, we cannot say the same for a high carbohydrate diet.

The Keto-Flu is a short period during which the body is adapting over to using ketones for fuel instead of carbohydrates. One way to reduce the symptoms of the Keto-Flu is to begin the Keto diet slowly with a slow carb diet by gradually getting rid of carbs over a few weeks.

Increasing salt intake will also help as it is critical to keep a healthy electrolyte balance; pink Himalayan sea salt has a nice blend of minerals and works well for this. Increasing water intake to about 2-3 liters per day is very important as well because as we decrease the number of carbs we eat the body will flush out excess water.

Social life can get a little tricky on Keto. Most people socialize around food and will not support a person who isn’t eating the typical American fare. This is when Keto support groups and Keto meet-ups can be helpful. There are many options for support groups that only meet online and there are some groups that meet in person on a regular basis.

Sharing recipes and pushing through a plateau is always easier with friends that have been through the same struggles. Carrying your own oil packets can also be helpful when eating out as you can add a healthy fat to most meals and still get it to be Keto-friendly.

And the question… What am I going to eat?!

As one transitions from high carb to slow carb to keto increasing fat is easy because it is done in steps. Cutting out grains, sugar, and potatoes the first week is a great way to reduce carbs. Adding coconut oil or grass-fed butter to coffee is a nice way to increase fat intake. Pouring olive oil on everything you eat will increase the fat intake. Eating one avocado per day will add over 20g of fat while only adding about 10g of carbs. Taking the next steps of eliminating underground vegetables, keeping protein to about 20% of your caloric intake and fueling up on fats can come later when you have gotten comfortable with the slow carb lifestyle.

Fighting the carb and sweets craving can be a challenge if there are no healthy options around. A great thing to have on hand at all times is dark chocolate (either 70% cacao or stevia sweetened); a square or two can usually cut through any sweet craving. Also, dropping one in your coffee along with a spoon of coconut oil is like eating a Mounds bar. Another option to have stored in your freezer or fridge is sweet or savory Keto-bombs/fat-bombs. These are like truffles made with healthy fat and a small amount of flavoring (you choose) that can be popped in your mouth whenever you feel a craving come on.

As with any new diet or exercise program, it is always recommended to consult your medical doctor especially if you are on any medications.

Listen to your body and go slowly.

– Erin Kirkpatrick

Is the Ketogenic diet effective for men?

A lot of people are interested in the ketogenic diet as a way to increase weight loss and improve their health. At a recent talk I gave about the benefits of the keto diet, I noticed something interesting: the majority of the audience were women.

It is amazing how few men are aware of, and reaping the benefits of the ketogenic diet. Why men are less interested in dieting as a whole has always been an area of curiosity for me.

From my observation, there are some significant gender-specific differences when it comes to nutrition. Women tend to have a higher awareness and better knowledge of nutrition than men. They also seek nutrition counseling more frequently than men do.

Studies have shown that women eat more fruits, vegetables, cereals, milk, dairy products and whole grain products, whereas the consumption of red meat, particularly pork, sausages, eggs, alcohol, and high sucrose foods is higher in men.

Men’s approach towards nutrition is uncomplicated and pleasure-orientated whereas women have an ambivalent attitude to food. Women are typically less satisfied with their weight.

For this reason, restricted eating, dieting, and eating disorders are much more common in women. Men tend to control their weight with exercising and implement diets often for health reasons more than appearance.

The prevalence of obesity is similar between men and women. However, men are more frequently overweight.

For this reason, adopting a ketogenic diet can be an excellent way for men to get their weight under control. And because of the simplicity and pleasurable foods that can be eaten on the keto diet (bacon, anyone?), it is easier for men to stick to than other diets.

Just google the term ‘keto diet results,’ and you will see how beneficial it can be for both men and women.

In my experience, men enjoy a more simple, streamlined approach to eating. So, for men looking to start a keto diet, here are a simple few tips to follow:

Think Fat

Because men enjoy protein-rich foods, it is often easy to consume too many proteins. It is better to seek fatty cuts of meat or foods with lots of butter and fat. There are many healthy ways to get your fats increased in your diet. The key is always to ask ‘how can I get more fat in this meal?’


Stay above ground

Generally speaking, the best vegetables to help you on the keto diet are those that grow above ground. Leafy greens (kale, spinach, chard) are the best, in fact, anything in the salad variety works well to keep your carbs low. Vegetables that grow below ground (potatoes, carrots, beets) are higher in carbs and reduce the ability for your body to stay in ketosis.

Say no to beer

Perhaps one of the easiest ways to lose weight (and improve your health) is to reduce the amount of alcohol in your diet. When it comes to the keto diet, the best way to lower your carbs is to stop drinking beer. Beer contains both carbs and sugar, which both are going to mess with your ketone levels. If you really need to consume alcohol, then the best are liquors such as gin, vodka, tequila, etc. A glass or two of red wine can also be a great alternative to beer.

These are just some basic tips to help me on the path to better health on the keto diet. As I said before, it is rare to see men interested in their diet, but the keto approach I believe is about as simple (and enjoyable as you can get).

Hopefully, as more research shows the success of the keto diet for men, there will be a larger uptake of adoption.

Dr. Jerry Hizon

Snacking and keto: is it allowed?


The simple answer is, yes.

Snacking on the ketogenic diet is most definitely allowed. However, since the ketogenic diet is so high in fats, most find that they don’t need snacks to remain satiated until next meal. For those who are accustomed to snacking or hold busy schedules and may need snacks to get them through to their next meals, though, there are options one can indulge in and still remain in ketosis.

Here are a few important things to take into consideration in order to snack the right way on keto:

  1. Stick to macros: Make sure snacks are high in fat, low in carbs, and moderate in protein.
  2. Never go without keto-options: The last things you need is to be unprepared when hunger strikes in between meals. satisfying their hunger with the only easy and available options like bagels or bananas, kicking one out of ketosis.
  3. Don’t overdue the prepackaged snacks: Yes, there are some healthier and keto-friendly packaged food options, but most packaged food contains preservatives and other added ingredients not as healthy for our bodies. Keep consumption of these products to a minimum.
  4. Take time to prep: Buying and prepping the right keto-friendly options can help one remain in ketosis by eating healthy snacks and avoid overconsumption of prepackaged snacks mentioned above.
  5. When in doubt, test: If you are not sure whether or not a snack option is keto-friendly, test your ketone levels (they won’t lie).
  6. Not all low-carb snacks are created equal: Many low-carb snack options, like Atkins products, contain large amounts of protein and added ingredients to make up for lack of carbohydrates. Avoid
  7. Stick with a few basic rules-of-thumb: Stick to items with 5 or less ingredients. Stick to the outside circle of the grocery stores. Eat whole-food based snacks as much as possible. Avoid foods with large health food claims, most are false or have unnecessary added ingredients.

With these general guidelines in mind, we have included some great keto snacks below with some tips on how to keep each keto-friendly. It is important to have a few of these snacks on hand at all times to kick cravings and keep your body properly fueled but in ketosis throughout each day.

Store-bought Keto-Friendly Snacks:

  • Pork rinds
  • Seeds
  • Nuts or nut butters
  • Dark chocolate
  • Sardines
  • Pepperoni or salami
  • Cheese
  • Cacao nibs
  • Olives
  • Jerky
  • Seaweed
  • Hummus
  • Cherry tomatoes
  • Veggie sticks
  • Avocados
  • Coconut chips

Homemade Keto-Friendly Snacks:

  • Fat bombs
  • Bulletproof coffee
  • Bacon
  • Kale chips
  • Celery and cream cheese
  • Hard-boiled eggs
  • Guacamole
  • Lettuce wraps
  • Berries and cream

Common snack foods to avoid on keto:

These options should be avoided as most contain large amounts of refined carbs and sugars)

  • Bananas or grapes
  • Cashews and peanuts
  • Juices and vitamin water
  • Café Lattes
  • Potato chips
  • Donuts
  • Chocolate bars

In summary, if you feel the need to eat a snack on keto, just be prepared to have the right types of foods available. As always, preparation is key to you success. The more you think ahead, the more success you will have with you snacking on a keto diet.

Dr Jerry Hizon

A guide to Exercise and the Keto Diet

Before we talk about exercise and the ketogenic diet, it is important that we address two common misconceptions regarding diet, exercise, and weight loss.

Misconception # 1:  Less calories in than calories out causes weight loss. Therefore, more exercise and less calories eaten equals even more weight loss.

Reality: Less calories and more exercise equals hunger, fatigue, stress, and ineffective weight loss.

No matter which way you look at it, your diet is the weight loss ‘game-changer’. What you eat is more important to weight loss than exercise.

Therefore, focusing on what you eat versus how much you eat is a much more successful and safe approach to weight loss.

This is where the ketogenic diet is such a useful tool to those wanting to lose weight.

Misconception # 2: You need carbohydrates to exercise  at optimal levels. Thus, low-carb diets decrease exercise performance.

Reality: Carbs are stored in the form of glycogen and are only used as a fuel source in quick bursts of high intensity exercise and can only sustain an individual for a few minutes of these types of exercises.

Fats are the main source of fuel for all aerobic exercise (i.e. long jogs or cycles) and are used as fuel once glycogen stores are depleted in anaerobic exercise (i.e. sprints or heavy lifting).

Once you understand the importance of diet over exercise, andexplained why you don’t necessarily need carbs for optimal exercise performance, you may be asking: should I even exercise on the ketogenic diet?

Although diet is arguably the most important variable to weight loss, exercise is also a key component to optimal health benefits.

Here are a few of the many benefits of incorporating regular exercise into your ketogenic lifestyle:

  • Improve bone mineral density (bone-loading)
  • Improve immunity
  • Increase cognition
  • Regulate mood
  • Reduce the effects of aging
  • Increase insulin sensitivity in diabetics
  • Prevent injury
  • Improve overall locomotion and flexibility
  • Burn 2-3x more fat doing endurance or ultra-endurance exercise (20-30+ minutes)
  • Prevent fatigue during long periods of aerobic exercise
  • Maintain blood glucose during exercise in obese individuals
  • Increased exercise performance overall

    What Should I Expect with Exercising on Keto Diet?

As your body is becoming keto-adapted (switching from using carbohydrates as a main fuel source to fats) in the first 2-3 weeks of starting the ketogenic diet, your exercise performance may be negatively affected. You may feel tired, fatigue, or even dizzy during exercise, especially anaerobic exercise (like heavy lifting or sprints) and you most likely won’t be able to perform at the same level as you did before.

It is important to note that these effects are short-term and performance will only suffer until you are keto-adapted. This is natural and due to your body’s natural transition from carbs to fats for fuel resulting in keto flu symptoms.

You will be able to presume regular aerobic exercise safely and efficiently after your body makes its’ transition to using fats as its’ main source of fuel, so have patience and trust your bodies normal process. How should you go about your exercise routine?

Exercising in the first few weeks on a keto diet

Before adaptation: Before being keto-adapted, in the first 2-3 weeks of adopting the ketogenic diet, you should stick to low-intensity, aerobic exercise for a majority of the time so as to prevent sugar cravings and muscle catabolism during exercise (i.e. yoga, Pilates, or long walks/ jogs).

You should also increase electrolyte and fluid intake (i.e. drink a large glass of water with a pinch of salt before working out). You should avoid doing high-intensity, anaerobic exercises until you’re are keto-adapted because it can be counterproductive to adaptation and you will have decreased performance during this time period. We keep saying anaerobic exercise versus aerobic exercise and you may be unfamiliar with these terms. As a general rule of thumb: if you can breathe easily through your nose without panting during the exercise, it is an aerobic exercise. These include things like 20-30 minute + jogs and cycles. If you cannot breathe easily through your nose during an exercise, these exercises are considered anaerobic. Examples of anaerobic exercises include: heavy weight lifting, sprints, and explosive sports like soccer, lacrosse, hockey, etc. However, exercise in general will help you get into ketosis faster, so that is not a deterrent from embarking on exercise during this time frame. Instead, you should focus more on endurance and mobility.

Bottom line: Before keto-adaptation you will experience an initial drop in performance. During this time period you should increase electrolytes (sodium) and fluids and stick to low intensity, aerobic exercise.

After keto-adaptation: After you are adapted to using ketones and fat for fuel, your energy levels will improve along with your training. Your aerobic exercise performance will increase, you will burn more fat and feel less fatigued during these exercises. Studies have suggested that a keto diet will increase endurance or ultra-endurance athlete performance, lead to greater fat loss in these individuals, and maintain their muscle mass.

The benefits of keto diet  for athletes

Becoming keto-adapted using a ketogenic diet can also specifically help aging athletes who struggle with impaired recovery, increased body weight, and have difficulty maintaining desired body composition. In addition to these aerobic performance effects, anaerobic exercise performance should proceed almost back to normal levels, if not normal.

It is expected that you will be able to perform at 90% of maximum equally as good anaerobically. Your muscle glycogen stores that fuel these types of exercises will be replenished despite lack of carbs and with the increased ability to use fats for fuel, you won’t tap into glycogen stores as often.

An everyday, moderately active individual will experience less fatigue during exercise and greater performance on a normal ketogenic diet. Those that do more intense, anaerobic exercise often may want to consider adapting the ketogenic diet to optimize anaerobic performance.

Here are two ways to do so:

Targeted ketogenic diet (TKD): Eat 25-50 grams or less of fast-acting carbs (i.e. whole fruit) within 30 minutes of workout and/or 30 minutes after workout. This will ensure that your body has the proper amount of glycogen to perform during training and recover after. This will not take you out of ketosis, as your body will use up this glycogen during training and after for recovery.

Cyclical Ketogenic Diet (CKD): Eat strict keto for 5-6 days to get the benefits of ketosis, then eat a higher carb diet 1-2 day a week to replenish glycogen levels and help improve high intensity performance. This can be especially helpful for athletes who train throughout the week and can up their bard intake to perform well in games/ matches on weekends.

The standard ketogenic diet can lead to increased fat loss for the normal individuals and increase exercise performance of ultra-endurance, endurance, and aging athletes.

It is possible to receive all the health benefits of the keto diet and be able to participate in regular exercise or preform at a high level as an athlete.

After being keto-adapted, aerobic exercise performance may increase, as your body can use fats for fuel more efficiently and you experience less fatigue.

– Dr Jerry Hizon, MD

 

Your guide to beating the Keto Flu

When some people begin their journey towards a ketogenic diet, they experience something called the ‘keto flu’. This typically is experienced within the first 7-14 days on the keto diet.

Switching your body from metabolizing glucose to metabolizing fats can be a shock to your system. This is especially true within the few first days of adopting the keto diet. This transitional period and resulting side effects, termed the “keto flu,” because some of the symptoms feel the same as catching a cold or flu. typically begin within 24-48 hours of starting the keto diet plan and last about 3-7 days.

What causes the Keto Flu?

These flu-like symptoms occur due to your body’s natural process of protecting itself during what it recognizes as carbohydrate starvation. As carbohydrate and blood sugar levels decrease, insulin decreases and insulin sensitivity increases.

As blood sugar levels go down, our body signals to our kidneys to release electrolytes (sodium, magnesium, and potassium), carrying with them water. This often causes dehydration.

As our bodies go into carbohydrate starvation mode, they also upregulate cortisol (stress hormone) levels in an attempt to increase energy levels.

What are the symptoms of the Keto Flu?

If you think you are experiencing the keto flu here are a few common symptoms:

  • Headaches
  • Fatigue
  • Mental fogginess
  • Muscle cramps
  • Lower strength and stamina
  • Digestive issues
  • Constipation
  • Insomnia
  • Sugar cravings

How to Beat the Keto Flu

It’s important to know that the keto flu symptoms are a sign that your body is in the process of making the proper metabolic adaptations.

All of these are normal when switching to the keto diet and as your body becomes adapted to using fats and ketones as a main source of fuel, they will subside.

But in the meantime, while you are suffering from the keto flu, here are a few strategies to combat the symptoms.

Drink lots of water

You should increase your fluid intake to replace the water lost in the first few weeks of keto. This means consuming about 10-12 glasses per day. As a rule, drink a glass of water for every hour you are awak during the day.

Replenish electrolytes: sodium, magnesium, potassium

Make sure to increase your sodium levels for the first 14 days. How much? Divide your body weight in pounds by two and that is roughly how many ounces of sodium you will need per day (around 5,000- 7,000 mg/day). Add sodium to your diet by adding more unrefined salts (Himalayan pink salt or sea salt are the best) to water or foods, drinking salted lemon water, or drinking bone broth. You should also get roughly 1,000-3,500 mg of potassium per day.

Potassium is found in foods such as fish, meat, leafy greens, and winter squash. Magnesium is another electrolyte you should increase intake of, taking about 300-500 mg per day. You can find magnesium in foods like spinach, chicken, beef, fish. All of the above electrolytes can be taken in supplemental form if you cannot get proper amounts from your daily diet.

Moderately exercise, practice yoga or meditate

Exercise can help balance out the increase in cortisol levels during the keto flu. Moderate exercise is suggested so as not to put more stress on your body than the metabolic shift it is already dealing with. If moderate exercise is too much, especially with the possibility of other symptoms, consider practicing yoga or other forms of meditation to reduce cortisol levels during the first transitional weeks of adopting the keto diet.

Eat more fats and calories

Yes, that’s right: more fats! Increasing fats can help surpass the keto flu growing pains and increase energy levels. A great way to add fats during these transition periods is with MCT oil because it goes straight to the liver after digestion. Other ways include things like adding coconut oil to your morning coffee, eating grass-fed jerky, or even eggs. You can also increase ketones with exogenous ketone supplementation at smaller doses, spread throughout the day, for the first 3-5 days of keto.

Reduce your carb intake slowly

Instead of dropping straight to the goal mark for daily carbohydrate intake (i.e. below 20g per day), it may be helpful to slowly decrease carbohydrate intake and in a sense prevent the shock  of the keto flu.

For example, if you generally eat 140 g of carbohydrate per day, it may be useful to cut back by increments of 20 g a day (or every other day) for the first week (or two) of starting keto (day 1= 140 g, day 2= 120 g… day 6= 40 g, day 7= 20 g). You can read our full guide to your first seven days on keto here.

Remember that it’s short-lived

Maybe most important is to remember that all these symptoms will pass, and you will feel much better soon. Don’t let these temporary keto flu symptoms scare you away from continuing your keto journey and acheiving a healthier lifestyle!

– Dr. Jerry Hizon, MD

Your first seven days on the keto diet

So you’re considering a keto diet?

The low carb, high fat ketogenic diet is known to help with weight loss, certain metabolic disorders (i.e. Diabetes), increase energy levels, reduce hunger, and is simple to follow. Because of all these reasons, it seems that starting such a diet with all these benefits seems like a no-brainer.

However, for most people, the transition from carbohydrates to fats as a main source of fuel is not as easy as it sounds. This is especially true for the first week of adopting the ketogenic diet.

In this article, we explore some tips for your first seven days on the ketogenic diet.

Set a goal. Create a plan.

The first thing to decide is why are you starting the ketogenic diet?

Define a goal for yourself (i.e. weight loss, better health,). Having a clear picture in your mind of why you’re starting the ketogenic journey and a way to track your progress towards your ultimate goal will help keep you invested, especially within the first week of physical and mental transitional challenges.

Next, determine how you will measure progress towards your goal. In the beginning, rather than a weight loss goal, it can be better to set a goal to stay on the keto diet for 7 days. This might seem simple, but it will help you get through the first few days, which can be challenging.

Research and join a community.

Like anything else in life, know what you are getting yourself into before starting. Look around, read blogs, testimonials, recipes, and research. Hear what doctors have to say about the diet and people, like yourself, have experienced within this first 7 days of their keto journey.

Find a community such as ours on Facebook or a physician to provide you with support, feedback, and information throughout your transition to keto. You can also consider the use of support apps such as The Nudge App, in which your physician can help monitor and guide you through the adoption of a ketogenic lifestyle safely and effectively.

For the first week, it may be useful to also research a 7-day keto meal plan, since counting your calories and keeping macromolecules within range may be harder at the beginning of switching to keto.

Meal plan and prep your pantry.

A day or two before you start full keto, create a food diary of foods that you currently eat and make note of which items are keto-friendly and which are not.

Stock up on the foods you eat daily that are keto-friendly, and find replacements for those that you currently indulge in that are not keto-friendly.

Rid your pantry (if possible) of bread, pasta, grains, starchy vegetables, and sugary foods or drinks to avoid temptation throughout the first week struggles.

Fill your fridges and pantries with lots of healthy fat options, lots of water, and foods rich in sodium, magnesium, and potassium.

Mentally prepare.

Switching your body from metabolizing glucose to metabolizing fats as our primary source of fuel can be a “shock” to our systems, especially within the first days of the switchover.

It is important to realize that there will be side-effects, often called the ‘keto-flu’ when making this original transition. If you experience headaches, fatigue, mental fogginess, muscle cramps, reduce stamina, know that these are very normal to experience within the first 7-14 days on the ketogenic diet.

All that’s left is to get started!

The truth about keto is that it will be hard to begin with, but it will be worth it after several weeks!

Each day, keep focused on your goal. Make sure to track your progress toward your goal. Reach out to your established keto-community or physician throughout the process.

Have patience, and know that very often, the first week is the hardest!

Dr. Jerry Hizon