A ketogenic diet is a very low carbohydrate, moderate protein and high fat based nutrition plan. A ketogenic diet trains the individual’s metabolism to run off of fatty acids or ketone bodies. This is called fat adapted, when the body has adapted to run off of fatty acids/ketones at rest. Critical Ketogenic Diet Tips!
This nutrition plan has been shown to improve insulin sensitivity and reduce inflammation. This leads to reduced risk of chronic disease as well as improved muscle development and fat metabolism (1, 2).
I personally recommend a cyclic ketogenic diet for most of my clients where you go low-carb for 3 days and then have a slightly higher carbohydrate day, followed by 3 lower carb days. This cycles the body in and out of a state of ketosis and is beneficial for hormone balance while keeping inflammatory levels very low.
The biggest challenge with this nutrition plan is to get into and maintain the state of fat adaption. Here are several advanced tips to get into and maintain ketosis.
1. Stay Hydrated:
This is considered a no-brainer, but is not easy to follow. We often get so busy in our day-day lives that we forget to hydrate effectively. I recommend super hydrating your system by drinking 32 oz of water within the first hour of waking and another 32-48 oz of water before noon.
I have most of my clients eat light in the morning doing smoothies or keto coffee or tea. So hydration around these dishes should be well tolerated by the digestive system.
2. Practice Intermittent Fasting:
This is one of the best ways to get into and maintain ketosis because you are reducing calories and not consuming protein or carbs. It is a good idea to go low-carb for at least a few days before starting this in order to avoid a hypoglycemic episode.
I recommend breaking your day into a building phase and a cleansing phase.
Building Phase: Time between your first meal and your last meal
Cleansing Phase: Time between your last meal and your first meal
I personally coach people to begin with 12-16 hour cleansing phases and 8-12 hour building phases. Over time, as your body adapts you may be able to move into a 4-6 hour building window with 18-20 hour cleansing phases each day. If you are able to do this effectively than it is easier to maintain ketosis.
During the fast, I recommend hydrating and consuming herbal teas and organiccoffee with MCT oil, coconut oil and/or grass-fed butter. The good small and medium chain fats in these help to boost up ketone production and stabilize blood sugar more effectively than water fasting alone.
Most people feel very good while they are fasting like this. For women, particularly those who struggle with hypothyroid, adrenal fatigue and hormonal imbalances, I will often recommend adding some collagen protein (about 5-10 grams) in with their coffee/tea. The protein will help with blood sugar regulation and satiety levels and improves overall hormone function.
3. Consume Enough Good Salts:
We are told in our society that it is important to reduce our sodium intake. Many individuals in our society struggle with a high sodium/potassium ratio. This is due to the fact that when we are on a higher carbohydrate diet, we naturally have higher insulin levels. Insulin effects our kidneys in such a way to retain sodium which can lead to a higher sodium/potassium ratio (3, 4).
When we are on a low carbohydrate, ketogenic diet, we have lower insulin levels and therefore our kidneys excrete more sodium which can lead to a lower sodium/potassium ratio and a greater need for sodium in the diet.
On a low-carb diet you should look to get an additional 3-5 grams of sodium from natural foods and through the use of a pink salt like Himalayan sea salt. 1 tsp of pink salt is equivalent to 2 grams of sodium. Here are the ways I recommend adding in additional sodium:
- Drinking organic broth throughout the day.
- Being generous with the amount of pink salt you use on your food
- Adding ¼ tsp of pink salt to 8-16oz of water throughout the day
- Adding sea vegetable like kelp, nori and dulse to dishes
- Consuming celery and cucumber which are low carb and have natural sodium
- Having sprouted and salted pumpkin seeds or salted macadamia nuts as a snack
4. Get Regular Exercise:
Regular, high intensity exercise helps to activate the glucose transport molecule called GLUT-4 receptor in the liver and muscle tissue. The GLUT-4 receptor acts to pull sugar out of the blood stream and store it as liver and muscle glycogen. Regular exercise doubles the levels of this important protein in the muscle and liver (5).
This is a very important adaptation for maintaining ketosis because it will allow the individual to handle a little bit more carbohydrates in the diet because the body wants to store them in the muscle and liver tissue.
Large compound exercises that use multiple muscle groups have the greatest impact on GLUT-4 receptor activity (6). This includes squats, deadlifts, push-ups, standing overhead presses and pull-ups or pull-downs or bent over rows.
Incorporating a regular exercise program that includes these resistance training exercises along with running sprints and low-intensity exercise such as walking helps to balance blood sugar and improve the ability to get into and maintain ketosis.
Just be sure not to overdo it. Small amounts of high intensity training go a long way. If you overtrain your body, you will secrete higher amounts of stress hormones that will drive up blood sugar and pull you out of ketosis (7).
Here is a Sample Exercise Program to Help:
|Monday:||Upper Body resistance training for 15-20 mins|
|Tuesday:||Lower Body resistance training for 15-20 mins|
|Wednesday:||30 minute walk around the block|
|Thursday:||Upper Body resistance training for 15-20 mins|
|Friday:||Lower Body resistance training for 15-20 mins|
|Sat/Sun:||Recreational activities and walking|
*If you are a high level athlete or CrossFitter, consult with your trainer or coach who is familiar with your goal to achieve a state of ketosis and modify the training based on that.
*If you are battling a chronic disease or have stage III and beyond of adrenal fatigue than I would recommend not doing any intense exercise and instead focus on stretching and breathing exercises such as yoga and tai chi and low impact movement such as light walking or elliptical exercises.
5. Improve Your Bowel Motility:
Constipation is one of the biggest challenges people have on a ketogenic diet. If you are constipated, you will not be able to remain into ketosis as it drives up stress hormones and blood sugar. Constipation is often due to one of the following:
- Pre-existing struggles with constipation due to small intestinal bacterial overgrowth (SIBO) or Candida overgrowth.
- Not consuming enough fibrous vegetables & fermented foods, drinks and tonics
- Inadequate electrolyte consumption (sodium, potassium, calcium andmagnesium in particular)
- Chronic stress which shuts down the gastrocolic contractions
To remedy this, I recommend correcting bacterial or yeast overgrowth issues, consuming fermented foods if tolerable such as kimchi, sauerkraut, coconut water kefir, etc. I also recommend doing extra magnesium supplementation and consuming a lot of clean water and adding in pink salts for extra sodium. Doing a fresh green drink everyday will also help with increasing potassium, magnesium and calcium levels.
6. Don’t Eat Too Much Protein:
Many people doing a ketogenic diet consume too much protein. If you consume excessive protein than your body will turn the amino acids into glucose through a biochemical process called gluconeogenesis (8).
If you notice yourself coming out of ketosis than see how you are responding to the amount of protein in your meals. Some people need higher protein levels while others can do just fine on lower protein levels.
The key variables include your level of exercise intensity and type of exercise (resistance vs aerobic) and your desire to gain muscle or lose weight. Someone who does intense resistance training in order to gain muscle will need moreprotein than someone who is the same size and is doing aerobic or resistance training to lose weight. Another person who weighs the same but is only walking for exercise, will need even less than the other two.
You want to aim for about 1 gram per kg of body weight. So, I weigh 160 lbs which comes out too (160/2.2 lb/per kg) 73 grams of protein. When I do heavy strength training (4 days a week), I will go up to 100-120 grams but I typically am around 80 grams a day on my off days.
Take your weight and divide by 2.2 to figure out the grams of protein per kg of body weight. Aim to get this on your lighter workout days. If you are doing more strength training or trying to gain muscle, bump it up to 1.5 grams per kg.
It is ideal to get your protein in 2-3 different servings daily with a minimum of 15 grams and a maximum of 50 grams per meal. The lower level is for a light weight individual while the upper limit is for a very large, strength training male.
Most of us should aim for 20-35 grams per meal. Here is an example of how this would work:
Individual A: 150 lbs – needs 68 grams of protein daily. Does not exercise other than walking. This person should eat either 2 meals of 30-35 grams or 3 meals a day with roughly 20-25 grams of protein per meal.
Individual B: 150 lbs and enjoys doing resistance and aerobic training 3-4x a week but does not want to gain weight. This person should look to get 68 grams on non-training days and 75-80 grams on training days. So 25-30 grams of protein per meal.
Individual C: 150lbs and does high intensity resistance training 4-5x per week and wants to gain muscle mass. They should consume around 80 grams of protein on off days and 100 grams of protein on training days. This would mean 30-40 grams of protein per meal.
7. Choose Carbs Wisely:
We all know that a ketogenic diet is a low-carb plan but I recommend consuming nutrient rich carbohydrate sources such as non-starchy veggies and small amounts of low-glycemic fruits like lemon, lime, ½ granny smith apple in green shake and/or a small handful of berries in a protein shake.
When you cycle out of ketosis once or twice a week, you increase your carbs on that particular day by adding in nutrient dense sources such as more berries in a shake or a sweet potato with tons of grass-fed butter and cinnamon.
On low carb days, avoid the sweet potato and keep berries down to a small handful at most. A half of granny smith apple or 1 carrot or 1 beet would be the maximum you would want to put in a green shake on a lower carb day.
3 Low carb days with no more than 1 serving of fruit (other than lemon/limes) and no starchy veggies and keeping net carbs (not counting fiber) to 40 grams or so.
1 higher carb day with 2-3 servings of anti-oxidant rich low-glycemic fruit and 1-2 servings of starchy veggies (pumpkin, yam, sweet potato, carrot or beet) and allowing yourself to go up to 100 grams of net carbs.
8. Use MCT Oil Whenever Possible:
Using a high quality medium chain triglyceride (MCT) oil is perhaps the most important thing one can do to get into ketosis and maintain it. That is because the use of a high MCT oil based diet allows one to consume more protein/carbs and maintain ketosis.
A diet that consists of long chain fatty acids, depends upon 80-90% of calories coming from fat. Adding in lots of MCT oil brings this down to 60-70% fats (9). This is because MCTs are immediately metabolized into ketone bodies and used for energy quickly in the body (10).
Many people, including I for many years, believe that coconut oil is the same as MCT oil. This is not true. Although MCT oil is made from coconut oil, it contains 100% pure medium chain triglycerides (capric and caprylic acids), while coconut oil contains about 35% long chain trigylceride (LCT) and 50% lauric acid which is classically considered a MCT but acts more like an LCT. That means that coconut oil is only 15% MCT and only 1/6th as ketogenic as pure MCT oil.
You can cook with MCT oil, add it to protein shakes, green drinks, coffee/tea, etc. throughout the day to keep your ketone levels up. I recommend using Bulletproof Upgraded XCT oil as I have found it to be by far the best MCT oil on the market.
9. Keep Stress Down:
Chronic stress will shut down your ability to be and stay in ketosis. If you are going through a tough period of your life, than maintaining ketosis may not be the proper goal. This doesn’t mean you should begin carb loading, but instead reset your goal to simply stay on a lower carb, anti-inflammatory diet.
Stress raises up stress hormones who function to elevate blood sugar so you can fight or flight from the chronic stressor. This is fine when it is for very short periods of time, but when it is prolonged, it drives up your blood sugar and lower ketones.
Devise some strategies that will help you lower your stress load and be able to create more peace and relaxation in your life. Read this article on Thriving under Stress for some advanced strategies.
10. Improve Your Sleep:
If you are sleeping poorly, you will elevate stress hormones and cause blood sugar dysregulatory problems. Be sure to set yourself up to go to sleep at a good time (before 11pm) and sleep in a completely dark room. I recommend sleeping 7-9 hours each night depending upon your stress levels (more stress means you need more sleep) and the amount you feel as though you need to feel good and mentally alert throughout the day.
Keep your room cool (60-65 degrees is usually ideal) with an overhead fan providing circulating air. I also recommend using a sleep mask to block out more melatonin disrupting light. If you are extremely sound sensitive or in a louder area than using ear plugs can be extremely helpful!
Healthy lifestyle strategies play a very important role in helping you get into and maintain ketosis. Using some sense with your lifestyle habits and activities can mean all the world of difference between a state of fat adaption where you have sustainable energy and mental clarity or a state of sugar burning where you are feeling sluggish, having brain fog and carbohydrate cravings.
By understanding how your body tolerates stress and following the strategies above you will give yourself a significant advantage in life. You will be able to understand what unique factors keep you in ketosis and what factors knock you out of it. This will help you prepare yourself for optimal career performance, a lean physique and great energy for relationships and recreational activities.
Sources For This Article Include:
- Krilanovich NJ. Benefits of ketogenic diets. Am J Clin Nutr. 2007 Jan;85(1):238-9; author reply 239-40. PMID: 17209202
- Manninen AH. Metabolic Effects of the Very-Low-Carbohydrate Diets: Misunderstood “Villains” of Human Metabolism. Journal of the International Society of Sports Nutrition. 2004;1(2):7-11.
- Friedberg CE, van Buren M, Bijlsma JA, Koomans HA. Insulin increases sodium reabsorption in diluting segment in humans: evidence for indirect mediation through hypokalemia. Kidney Int. 1991 Aug;40(2):251-6. PMID:1942773
- DeFronzo RA, Cooke CR, Andres R, Faloona GR, Davis PJ. The effect of insulin on renal handling of sodium, potassium, calcium, and phosphate in man. J Clin Invest. 1975 Apr;55(4):845-55. PMID: 1120786
- Ren JM, Semenkovich CF, Gulve EA, Gao J, Holloszy JO. Exercise induces rapid increases in GLUT4 expression, glucose transport capacity, and insulin-stimulated glycogen storage in muscle. J Biol Chem. 1994 May 20;269(20):14396-401. PMID: 8182045
- Richter EA, Hargreaves M. Exercise, GLUT4, and skeletal muscle glucose uptake. Physiol Rev. 2013 Jul;93(3):993-1017. PMID: 23899560
- Brooks K, Carter J. Overtraining, Exercise, and Adrenal Insufficiency. Journal of novel physiotherapies. 2013;3(125):11717.
- Manninen AH. Very-low-carbohydrate diets and preservation of muscle mass. Nutrition & Metabolism. 2006;3:9.
- Liu YM, Wang HS. Medium-chain triglyceride ketogenic diet, an effective treatment for drug-resistant epilepsy and a comparison with other ketogenic diets. Biomed J. 2013 Jan-Feb;36(1):9-15. PMID: 23515148
- Page KA, Williamson A, Yu N, et al. Medium-Chain Fatty Acids Improve Cognitive Function in Intensively Treated Type 1 Diabetic Patients and Support In Vitro Synaptic Transmission During Acute Hypoglycemia. Diabetes. 2009;58(5):1237-1244.
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