This part 3 in a series on ketogenic diets. Check out part 1 and part 2.

As promised here are the results from my first 2 weeks of a ketogenic diet.

Fasting Ketones: 1.3 millimolar! Weight Lost: 6 lbs

On average I eat between 1900 and 2200 calories. Since I’m a 5’ 8” tall female and my “maintenance” is theoretically 2,300 I think that’s okay. I don’t try to eat a certain number of calories and am instead focusing on energy levels, hunger and making sure I don’t overdo it on carbs or protein.

It varies from day to day but overall here is the macronutrient breakdown:

Carbs: 20-40 g Protein: 70-100 g Fat: 140-190 g Ketogenic Ratio: 1.8 – 2.2

I eat 3 meals a day with 2 snacks. I decided to take pictures and boy, that’s a PITA so enjoy the only pics you’ll ever see. :) I don’t have a nice camera, good lighting, cooking skills, etc so … they taste better than they look!

Breakfast
Deviled Eggs and Bacon

Carbs: 3, Protein: 23, Fat: 28, KR: 1.64, Calories: 371

Morning Snack
Coconut Oil Chocolates

Carbs: 7, Protein: 2, Fat: 32, KR: 2.55, Calories: 287

Lunch
Avocado Salad with Balsamic Dressing

Carbs: 7, Protein: 2, Fat: 32, KR: 2.55, Calories: 287

Lunch
Buttered Pot Roast

Carbs: 18, Protein: 32, Fat: 60, KR: 1.61, Calories: 719

Dinner
BBQ Pork and Broccoli

Carbs: 12, Protein: 24, Fat: 38, KR: 1.51, Calories: 483

Evening Snack
Faux Chocolate Mousse

Carbs: 8, Protein: 4, Fat: 45, KR: 3.03, Calories: 431

Thoughts

So far I am very happy with the changes in my diet. I love, love, LOVE eating as much fat as my desire dictates. I miss my giant steaks but have found that as I stuck to the lower protein, my overall hunger went down and my post-meal satisfaction went up.

While I think it is preferable to get my fat from my 3 meals, the regular desserts are a fun compromise. I’m eating much more than I have on previous diets and am starting to build a better relationship with my food. I know that sounds corny but when you get to the point where you hate yourself every time you eat, want to eat, see food on the TV, etc … it’s a huge relief to lose some of the guilt.

I have been stalled at the same weight for a year, so losing 6 lbs is significant for me. According to my body fat monitor, I’ve lost .5% body fat, so hopefully it wasn’t all water and muscle. I find that if I have a bad day, I can easily gain 2 lbs which is pretty normal for a low-carb diet as you gain water quickly when low-carb. Still frustrating though! I guess I could weigh myself less often but I like the immediate feedback. I have my fingers crossed that I continue to lose fat at a regular pace.

Stay tuned, I’ll be following up with more information on ketogenic ratios, calorie deficits and progress reports!

This part 2 in a series on ketogenic diets. Check out part 1.

I’m on day 4 of monitoring my ketogenic diet with a ketone meter. Things are looking well so far and I promise to report my results after 1 week. In the meantime, if you would like to try The Ketone Challenge yourself here is some information on how to get started.

I would love to hear about your progress and thoughts! Please leave a comment or if you use twitter, use the tag #KetoneChallenge.

Ketone Meters

At the moment there are only 2 ketone meters: Precision Xtra and Nova Max Plus. As usual the price of the strips should probably dictate which one you buy. If you are willing to wait, sometimes you can request a free meter directly from the manufacturer (nova max plus).

Ketone Strips

There’s no getting around it, they are much more expensive than blood glucose strips. Here are some average prices and places to find them:

• Amazon: $5-$6 per strip for Precision Xtra, $3-4 per strip for Nova Max Plus
• Ebay: $4-$6 per strip. Usually only cheaper when sold in bulk
• Online Canadian Pharmacies: $2-$4 per strip. Make sure to select an accredited pharmacy! Most should not require a prescription since it is “over the counter”.

The Basics

Here is my understanding of how to go about this based on my reading of two books by Drs. Steve Phinney and Jeff Volek: The Art and Science of Low Carbohydrate Living and Performance.

• If you are already trying a low-carb or ketogenic diet (and think you may be in ketosis), you may want to try keeping your diet the same until you get your strips so that you get a baseline. Maybe you already have good ketone levels.
• Start your ketogenic diet. You should read up about it yourself being starting but here are the highlights:
  • Restrict carbohydrates to < 50g a day. You most likely will need to be lower, use your meter to guide you.
  • Get adequate protein for your size and activity (0.7 - 1.5g per lb lean body mass) but keep it on the low-end if you are having trouble getting high enough ketones. Too much can prevent ketosis. Here is some info on protein requirements, my protein calculator and Blood Sugar 101’s Diet Calculator.
  • All your remaining energy is coming from healthy fats. Prefer saturated and monounsaturated fats like animal fats (meat, eggs, dairy), coconut oil, olive oil, avocados, etc.
  • Stay hydrated!
  • You may need to supplement with sodium (2 cubes of bouillon), magnesium (400mg mag citrate), potassium or zinc. See the chapter on Mineral Management from The Art and Science of Low Carbohydrate Performance for details.
• A healthy goal for ketones is 0.5 - 3 millimolar. A note for diabetics: If you go higher than that, please be careful and check your blood sugar too. If you already have your blood sugar under control, DKA should not be a concern but if you have ketones AND high blood sugar, get thee to a doctor.
• Since strips are expensive, figure out a testing plan. I decided to test fasting ketones since ketones are lowest in the morning (fasted) and rise through the day. My plan is to test 1x a day until I’ve hit my goal of > 1.0. Once I’m in ketosis for a week, I will test less often, maybe 1x a week to make sure I’m staying there.
• It may take up to 2 weeks to get your ketones into the desired range. How long really depends on many factors such as: previous diet, glycogen stores, blood sugar control, medications and identifying your personal carb/protein/fat ratios.

Yesterday I received a few emails letting me know about the latest study on “low-carb” diets. The inept conclusion of the media being that “low-carb” diets cause heart disease! Oh noes! Thankfully, once again, researchers managed to waste a ton of money gathering crap data to make unfounded conclusions and then convinced the media to report on it like Godzilla had just attacked Tokyo.

Here is a great article explaining what really went on in the study and why the conclusions are a load of BS.

What Reading That Low-Carb Gives You Heart Disease Paper Actually Told Me.

For the attention span impaired, here are the highlights:

• They asked people to remember what they ate SIX MONTHS ago and assumed that’s what they ate for the next FIFTEEN YEARS! I can’t even remember what I ate yesterday and I can guarantee that I don’t eat the same thing for 15 years straight.
• The lowest carb group was 150g / day. That isn’t even low-carb, let alone Atkins.
• They didn’t differentiate between food quality, e.g. trans fats which we know causes heart disease. So if someone was in the “low-carb” group and ate motor oil every day, oops.
• The actual change in calculated risk was an extra 4 women per TEN THOUSAND. So even with all this bad data, it didn’t significantly increase heart attacks.

So yeah… it’s the same bad study and reporting that we see every day about “low-carb” diets. I haven’t even been following low-carb all that long and I think it’s the 5th ZOMG YOU ARE KILLING YOURSELF headline I’ve run into. I can’t understand how anyone is still paid to churn out this crap when low-carb has been around since 1970. You would think that they would either stop repeating the same flawed design or just give up.

UPDATE:

Denise Minger just posted a very detailed look at this study, its design and why they are all doomed to failure.

This part 1 in a series on ketogenic diets. Check out part 2, part 3 and part 4.

After reading Jimmy’s Moore’s post on his amazing success going from a low-carb to a ketogenic diet, I was inspired to try it again. I have tried ketogenic before but it takes some planning to do correctly and I found it easier to just do low-carb. Though I haven’t been plateaued as long as Jimmy, it’s been a year and desperation has definitely sunk in.

Jimmy found that even on a strict low-carb diet, his blood ketone levels were low, definitely not high enough to fuel his body adequately on a low-carb diet. By following the recommendations of Drs. Phinney and Volek from The Art and Science of Low-Carbohydrate Living (and the follow up on Performance), in 30 days he raised his ketone levels from 0.3 to 2 and lost 20 lbs. After being stalled for 6 years, that’s quite an accomplishment!

So what was the trick? Normally, when someone one a low-carb diet wants to see if they are “in ketosis” they use urine test strips (ketostix). Unfortunately, those only test for one type of ketone and depending on how well your body is keto-adapted, it’s terribly inaccurate. Phinney and Volek recommend using a blood ketone meter instead. It tests for beta-hydroxybutyrate, the more common ketone found in keto-adapted individuals and measures the real amount, not excess that your body flushed away. By testing your blood ketones, you can really tell not only if you are in ketotis but if you are well adapted, i.e. making enough ketones to fuel your brain and the rest of your body runs on fat. If you are on the borderline, then your liver will create glucose from protein which if you are trying to lower glucose metabolism, isn’t terribly helpful. In addition it seems that in that borderline state you aren’t getting enough glucose to use it as your primary fuel and yet you aren’t able to run off of fat well either and consequently you probably feel awful with low-energy, fatigue, cravings and mood swings. Sounds like me for the past 6 months! :(

Well, $120 later and I’m the proud owner of a ketone meter (Precision Xtra) and 20 ketone strips. Holy cow the strips are expensive! On Amazon they were about $6 each… I figured if it helps me lose weight, it will be money well spent. fingers crossed

I just tested this morning (fasted) and I was strangely ecstatic to see that my ketone level was only 0.4! Not because I don’t want to be in ketosis but by being low there’s hope that my weight loss stall is due to not following a “well formulated low-carbohydrate diet”. I love that phrase from Phinney and Volek. :)

I’ll keep testing once a day and am striving to lower my protein and raise my fat intake. My new goals are: 30g carbs, 80g protein and 140g fat. That comes to about 1,700 calories, which is a mild deficit for me. If I’m hungry (which hopefully once I’m adapted I won’t be!) I’ll stick to fat (mmm heavy cream!).

So I’m going to need to be a bit more creative on limiting protein and getting in enough fat… If you have any ideas (other than chugging heavy cream or coconut oil), please let me know in the comments.

Wish me luck, I’ll report back in a week.

EVERYONE tells me that exercise will help lower my blood sugar. BG is a little high? Go for a walk. Want to “afford” the carbs in an apple? Lift some weights. Every piece of literature from “established” sources such as my doctor, the diabetes magazine and mainstream media tells me that I should feel better after exercising and it will give me greater control of my blood sugar. It’s all a load of BS.

You know what happens to my blood sugar when I work out? It goes up about 50-100 points (maybe from 84 – 175, god help me if I start out higher), hangs out there for maybe 2 hours then nose dives to around 45-60 for 5 hours later. Here’s a typical workout day for me:

1. Eat a solid breakfast with quality fats and protein. Sometimes a little bit of carbs, like 10 raspberries.
2. Drink a cup of broth to keep my sodium up. If I skip this, I often will pass out after the workout or get wicked headaches.
3. Workout. This could be 20 minutes of low-rep high weight lifting, an hour of tennis, 45 minutes of running, etc. My blood sugar spikes immediately, with a red face like a drunk and cold, clammy limbs.
4. Come home as fast as I can before faintness sets in.
5. Feel like something is terribly wrong for about 2-6 hours, can’t think well, having trouble with coordination so I lie down.
6. Zone out until I feel like I can walk and talk again.
7. Get up and drink more water, maybe take some Advil for the inevitable fuzzy head and wonder why I waste an entire day recovering from less than an hour of “healthy” exercise…

I’ve been like this since I was a (thin) kid, though it’s only gotten worse over the years as the diabetes has progressed. I have tried varying my pre and post macronutrient ratios (more protein, carbs, etc), supplementing with magnesium, potassium and sodium, doing cardio, doing HIT, doing super-slow… So maybe I’m just a lazy fat-ass or maybe there’s more to it than “exercise helps control blood sugar” and I should feel free to kick the next person in the junk who helpfully tells me to workout regularly.

I used to go through this 5-6 times a week for about 8 years when I was an athlete. Now I “only” do this to myself 2x a week. Why? It’s sure as shit not because I get a high from exercise, feel better about myself as a person or believe that my blood sugar control is better the rest of the time. I do it because I’m a stubborn mule who at one point used to like being fit and active. Plus I tell myself that I’m preserving lean body mass. I’ll report back when I’m an old lady and let you know how worked out for me.

sigh Not sure why I’m sharing this other than hopefully some other poor diabetic will read this and not get so hard on herself when she has similar results. Okay that’s it for me, back to counting ceiling tiles!