Miriam Hatoum
What is Keto? Your questions answered about: Ketosis, Ketones, Carbs, Protein and Fat
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What is Keto? Your questions answered about: Ketosis, Ketones, Carbs, Protein and Fat

blog faq Jan 09, 2022

What is Keto?

Your questions answered about Ketosis, Ketones, Carbs, Protein and Fat.

If you are exploring keto and low carb I thought it would be best to give you the bones to explore the question: "What is keto?".

For anyone totally new to the Ketogenic arena, here is a short definition: A Ketogenic (Keto) diet is a high-fat, adequate protein, low-carbohydrate diet that forces the body to burn fat rather than carbohydrates.

There - you have it. It is eating in a way that makes your body burn fat for fuel instead of sugar.

To help you navigate this blog, here are some essential points:

What is Ketosis?

Ketones

Carbohydrates

Protein

Fat

The Keto Flu & Electrolytes

What is Ketosis?

Medical Keto(sis) vs. Nutritional Keto(sis)

  • Eating this way makes the liver convert fat into fatty acids and ketone bodies.
    • An elevated level of ketone bodies in the blood is a state known as ketosis.
    • This is not the same as ketoacidosis, and as long as your body produces even a minute bit of insulin this will never happen to you (it is a dangerous state in a Type I diabetic but can be avoided).
  • The Ketogenic diet was first used to treat difficult-to-control epilepsy in children.
    • This has a ratio of 4:1 fat to protein.
  • The nutritional Ketogenic diet most people use is not as severe as the medical Ketogenic diet.
  • When you say, “I’m eating KETO,” it generally means the nutritional Ketogenic diet.
  • You become a fat burner instead of a sugar burner!  

Ketosis is your fat-burning state 

Ketosis, not to be confused with ketoacidosis, will be your metabolic state:

  • where your body’s energy supply comes from fat;
  • where ketone bodies are produced when you metabolize fat;
  • fatty acids  are converted into ketones.

There are three types of ketones:

  • acetone
  • acetoacetate
  • Beta-Hydroxybutryate (BHB)

Measuring Ketones

  • Breath (using a Breathalyzer) measures acetone
  • Urine (using urine strips) measures acetoacetate
  • Blood (using a blood monitor) measures BHB

When you are in ketosis, you will have measurable ketones and you can be sure that you are fat burner!

Controversy with urine strips

  • When you first start, it is great feedback to see that you are producing ketones.
  • The problem lies in the fact that as you are in ketosis for longer periods of time and your body gets used to producing and using ketones, there aren’t as many left over to “spill” into your urine.
  • Many people go berserk, when all of a sudden, their sticks go back to beige and they no longer pee pink or purple.
  • They think they are doing something wrong and start to cut their macronutrients back to practically nothing – or – they give up just when things are actually at their best.
  • Another flaw with these sticks is that you might “pee purple” (the highest level) but it might be that you are dehydrated.
    • When you drink water to correct this, the next day your color might drop back down to a light pink.
    • Then you worry you are losing your ketosis edge (not true!).
  • For the $10 or so that a bottle of “pee-sticks” cost, it is a great way to find encouragement at the beginning of your journey.
  • That being said, there are very successful people who have never measured their ketone levels by any manner 

Carbohydrates

Why we limit carbohydrates in the Keto lifestyle

The very first thing you do in order to be eating Keto (and get into ketosis) is to limit your carbohydrates.

  • Carbohydrates is a class of macronutrient (macro means LARGE). (Micronutrients, vitamins and minerals, are needed in smaller amounts.)
  • Carbohydrate-rich foods are anything that contain any form of sugar (fruits to candy!) or starch (potatoes, bread, pasta, for instance) which turn into sugar (glucose) in your system.
  • These sugars (whether straight sugar or sugar that has been converted in your body from another food) trigger an insulin response.
  • Insulin is responsible for fat storage.
  • Over the years by eating high-carbohydrate food, you can develop insulin resistance.
  • Insulin resistance (IR) means that your blood sugar cannot get into your cells to be used for energy and remains floating in your blood. That is why your blood glucose readings will be high when you have Type 2 diabetes.
  • Your body actually makes the glucose it needs from other food (proteins) you eat so that you do not need to worry about having it available where and when needed.  

Very few people eat zero carbohydrates and I wouldn’t expect you to eat that way.

  • You can choose several levels of carbohydrates and you have the option to count them as total or net carbs:
    • Total is the full amount of carbohydrates in the food
    • Net  is the amount of carbohydrates in the food after you have subtracted the fibers in the food.
      • When using packaged or prepared foods, people usually also subtract the sugar alcohols in the foods as well.

If you want to do "full-on Keto," you might want to start at 20 total carbohydrates and see how you feel and whether it is best for you to go up or down from there, or whether you would feel best, and do best, counting Net carbs.

My successful Keto system, that I call "Hybrid Counting" combines Net and Total :

  • Count the net carbs for natural foods that will have fiber 
  • Count the total carbs for food with no fiber
  • The sum of these two together is your goal (usually 20, total)
  • Do not count leafy greens at all
  • Here is a blog on how to count carbohydrates.The net carb myth

Please do not get caught up in the net carb myth. A food can have 2 net carbs (sometimes called impact carbs) but be loaded with, for instance:

  • sugar alcohol
  • various types of fiber
  • starches

For example, the label on PowerBar®’s double chocolate flavor "ProteinPlus Carb Select" bar says it has "2 grams of impact carbohydrates." The Nutritional Facts label on the product says it has 30 grams of total carbohydrates. 

Unless you are talking about fresh vegetables, net carbs are usually a manufacturer's way of making you think they are inconsequential when, in fact, many of the subtracted carbohydrates do impact blood sugar and insulin in many people.

If you decide to go the net-carb route, be very aware of stalls in weight loss, how your body feels and whether your blood glucose is affected (if you test regularly).

What carbohydrates can you eat that will best suit your Keto lifestyle so that you can be in a state of ketosis?

  • To be in a healthy state you will want to eat acceptable sources of carbohydrates, specifically those not coming from sugar, grains or legumes.
  • These sources of carbohydrates (sugar, grains, legumes) tend to lead to inflammation everywhere: from your gut to your arteries to your joints.
  • Once you eating Keto, the carbohydrates you ingest should be coming from:
    • above-ground vegetables
    • dairy
    • some foods where they are naturally occurring (for instance, a 3 ounce serving of scallops contains 2 total carbs!)  

 List of Carbohydrates

To see the SHORT LIST and the LONG LIST of acceptable Keto carbohydrates, be sure to visit the blog, Is Keto Hard.

Protein

Eat moderate amounts of protein

The next macronutrient is protein.

  • The Keto "policy" is to moderate your protein intake.
  • There are calculators for this (based on height, age, lean body mass, etc.)
  • My rule of thumb is 75-100 grams of protein (not by weight but the actual grams of protein in the food) for a woman and 100-125 grams for a man.
  • The older you are, the closer you can be at the higher range because as we age we process protein less efficiently.
  • Some people can add more if they are young, athletic and not metabolically damaged.
  • This, like finding the sweet spot on carbs, is individual but within a reasonable range.

Sources of Protein

Your sources of protein would be from animal proteins, but as with the carbohydrates being found in scallops, if you are very closely tracking protein (with the use of an internet tracker), don’t be surprised that protein will show up in some vegetables! One cup of chopped kale, for instance, has 2 grams of protein! Minuscule amounts like these normally do not make or break your success, but just be mindful!

To see the SHORT LIST and the LONG LIST of Keto proteins, be sure to visit the blog, Keto Made Simple.

Why do we moderate protein on Keto?

Protein is an essential macronutrient.

  • Proteins are the building blocks of cells and muscles and it is essential for brain function and other functions such as healing cuts and wounds.
  • However, the body "recycles" much of its protein and you do not need to consume large quantities to have a health body.
  • In fact, by a process called gluconeogenesis, the liver can turn too much unneeded protein into glucose, thus spiking insulin.
  • In addition, protein contains a lot of phosphorus that is a stimulant and you will find you might not sleep well after a heavy protein dinner.  

HOWEVER, GLUCONEOGENESIS APPEARS TO BE DEMAND DRIVEN, NOT SUPPLY DRIVEN, SO THE INORDINATE AMOUNT OF FEAR THAT POPS UP WITH PROTEIN INTAKE IS NOT NECESSARY!

This is the blog covering further information on protein.

Measuring protein

  • When you measure protein (or carbohydrates or fat) the reference to how many grams you are eating is the amount of protein in the food, not the weight of the food.
  • For example, 3 ounces of ground chuck cooked weighs 85 grams and contains 22 grams of protein. The 22 grams is counted toward your protein total.

Fat

Eat enough fat to be comfortably satiated

You can't answer the question "What is Keto?" without addressing the the last macronutrient, fat.

  • The rule here is to eat to satiety.
  • There are various ratios (the medical one where the Ketogenic diet is used to treat and control epilepsy) can be as much as a 4:1 ratio of fat to protein.
  • A more comfortable ratio is, at the very least, 1:1, but most people settle in at 2:1.
  • Even at the 1:1, some people starting Keto find it difficult to eat so much fat especially those of us baby boomers who grew up in the fat-free era — or even younger people have been fed the myth of fat-free.
  • FAT – AND ESPECIALLY SATURATED FAT – DOES NOT CAUSE HEART DISEASE. It is the sugar/carbohydrates in your diet that cause hardening of the arteries.
  • HONESTLY. If you need convincing please start by reading Cholesterol Clarity by Jimmy Moore and Dr. Eric Westman. Bring the book to your doctor if you have to!
  • Please visit and use your hunger scale to learn your satiety cues if you are afraid of going overboard.

How to increase your fat intake

  • The easiest way to start to increase your fat intake is to go for fattier cuts of meat.
  • Forget the boneless skinless chicken breasts or turkey deli meat (and these are highly insulinogenic — spiking your insulin which makes you fat!!!).
  • Move to roast beef, corned beef and pastrami, chicken thighs with skin or even duck!
  • Forget the lean ground beef.
  • Start to get 85% (or more) beef (it will be cheaper too) and don’t drain the fat!
  • Enjoy rib eye steak and a nice marbled chuck roast instead of lean sirloin and London broil.
  • Eat more fatty fish like salmon and mackerel — don’t feel you have to eat cod or other white fish because they are leaner.
  • Move to full fat dairy. Yes, I said FULL FAT:  
    • sour cream to top your steak
    • butter to top your vegetables
    • heavy cream in your coffee
    • REAL cheese  
  • Other sources of fat:
    • Bacon. No need to weigh or measure or count out the pieces. If you enjoy it, just eat it.
    • (And NO – you do not have to eat bacon or any pork products on Keto. But you can if you want.
    • Avocados
    • Real (but low-carb) dressings: Blue Cheese and Ranch are favorites.
    • Any other fats and oils are perfect ways to add to your fat intake.
    • Seeds and nuts - but be aware of the carbohydrates in them

Here are two blogs on what you should know about fats and what kinds of fats there are.

The Keto flu and electrolytes

The next thing that you will have to work with especially when you start Keto is electrolyte balance. Sometimes you will experience the "Keto Flu" the first week or so of starting Keto. The symptoms might be:

  • Fatigue

  • Headache

  • Irritability

  • Difficulty focusing (“brain fog”)

  • Lack of motivation

  • Dizziness

  • Sugar cravings

  • Nausea

You can usually spare yourself this experience if you have adequate amounts of three electrolytes: sodium, magnesium and potassium.

I always look at a carbohydrate as a sponge. On the standard American diet — or almost any cultural way of eating — you consume upwards of 300 carbohydrates or more per day. When you start Keto you will be starting with 20 carbohydrates. Imagine those 300 sponges wringing out all the water they hold. You will be releasing a lot of fluid when you start Keto and, because you will not be eating any more sponges, your kidneys will not be overloaded with fluid (but will actually find just the right sweet-spot of where they need to be for perfect functioning).

Salt

Remember: salt follows the water.

  • When you are eating Keto you must replenish your salt (and water!). 
  • It is recommended that you have 4g–5g a day of salt.
  • Ladies and gentlemen:  That is 2 teaspoons straight salt if you are not salting your food.
  • When you go to Keto sites you will read a lot about leg cramps at night and people who jump out of bed and drink pickle juice or guzzle salt straight out of the shaker.
  • I have done this myself when I haven’t been careful during the day!
  • Purchase pink, sea or gray salt. Table salt sometimes is mixed with anti-caking and bleaching agents.

Magnesium and Potassium

Magnesium and potassium can also be flushed from your system.

  • Magnesium can come from foods:
    • dark chocolate (which you can have on Keto but limited, and ones not high in sugar)
    • avocado
    • nuts 
    • seeds
    • fatty fish 
    • leafy greens

However, most people are deficient in magnesium even if they eat these foods and so a supplement is usually recommended. There are different types of magnesium. I personally take buffered chelated magnesium bisglycinate.

  • Potassium
    • You should be consuming up to 4000mg of potassium a day
    • Try to get what you need from foods: the same list as the magnesium.
    • If you have an avocado and a nice helping of Swiss chard or spinach with one of your meals, you will easily approach what you need.
    • Add tomatoes and Brussels sprouts, and you are good to go.

And by the way, sugar cravings can be caused by the need for potassium, so make sure you keep up with that mineral! 

Stop Dieting

What is Keto? There is so much more to learn about Keto, but remember the following:

  • Keep carbs low

  • Moderate your intake of protein

  • Eat high fat to satiety

  • Address your electrolytes: sodium, magnesium and potassium

Learn more about this with my book and course:

Book Breaking Free From Diet Prison: Common Sense Keto and Low Carb 

Course Breaking Free From Diet Prison: The Roadmap to Low Carb and Keto Success

 If you have not already picked up this FREE bonus guide, I highly recommend that you have it in your arsenal. It is all about the five steps you need to reach a keto or low carb eating style PLUS the four most important lists you will need on your journey.

Five Steps Out of Diet Prison

 

Inflammation and Grains

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