I’ve been living a secret life. I’ve been following a ketogenic diet for the last month. Why is this a secret? I’m a nutritionist and we are trained to believe that we need to eat a balanced diet of proteins, “healthy” fats (but not too much), and “healthy” carbohydrates. That whole grains are part of a healthy diet and we need them in order to get all our vitamins and other essential nutrients. And that a high fat diet is only a fad that will soon be proven to be harmful to us. And I’ve been trained that mindful eating, intuitive eating, and the Health at Every Size model are all you need in order to achieve a healthy weight and maintain a healthy body. I’ve told just a handful of people about my experiment because I fear judgment from well-meaning, but ill-informed people. But after successfully competing one month of keto, and having amazing results, I’m ready to come out of the closet. Hey everyone, I’m running on ketones (ketone bodies) and loving it! ,Month 12
Why did I start this experiment?
I was very sick. I was in a car accident on March 4, 2014, that was pretty devastating to me physically, emotionally, and financially. As I write this, it has been nearly 16 months since that accident and I still have not fully healed. Initially my legs were the worst of my injuries and I spent a couple of months in bed from the pain. As my legs began to heal, I started experiencing neuro-endocrine symptoms. The symptoms became so bad in January of 2015, I was again bedridden for nearly 3 months due to exhaustion and extreme lightheadedness and had to shut down my private practice. I went to doctor after doctor after doctor that didn’t have any real solutions for me. Due to frustration, and having all that time on my hands, I began searching research literature to see if I could figure out what was causing all my symptoms. I finally landed on Post Traumatic Hypopituitarism (PTHP). (here is an excellent article if you’d like to know more.)
My symptoms of PTHP: hypoglycemia*, low cortisol, mental fogginess, cognitive problems, memory problems, constant lightheadedness, extreme fatigue, amenorrhea, insomnia, and clumsiness with my hands, among many others. Additionally, I had chronic pain and hypersensitivity in my legs. And then I developed gastroparesis (my stomach was not digesting food and it would just keep getting fuller and fuller all day), GERD, and diarrhea. I was also prone to week-long migraines with no known cause.
(*The hypoglycemia was caused by adrenal fatigue likely from PTHP. When adrenals are fatigued, they struggle to make cortisol, which is necessary to help mobilize energy in between meals. Without enough cortisol, my blood sugar was highly unstable and even the simplest of tasks, like going to the grocery store, would make me shake, tremble, feel confused and forget where I parked my car because my body was unable to mobilize glucose from storage to maintain my blood sugar level.)
Being stuck at home (mostly in bed) for so long, my metabolism was also in terrible shape. I had gained 25 pounds in a little over a year; my inflammatory markers, LDL-cholesterol, HDL-cholesterol, and triglycerides were not great. My waist measurement exceeded the 35 inch mark and my blood pressure was making doctors consider putting me on meds. I had Metabolic Syndrome. Part of this I can blame on the accident, part I can blame on genes, but I have to admit looking back now, I hadn’t been taking the best care of my metabolism over the last 7-8 years. I had been embracing the modalities that I had learned in grad school and taught to my clients. But they weren’t working. The intuitive food choices I was making were more and more full of refined carbohydrates, that I very mindful ate (and enjoyed!). (What I know now is that once this level of glucose intolerance is achieved, it actually perpetuates appetite, cravings, and overeating, so much so that willpower and mindfulness can’t overcome it.) These poor food choices plus inactivity, when you have the genetic code for metabolic syndrome, leads to a ticking time bomb. And my bomb was ticking.
In addition to all this, my family history was staring me in the face. One of my grandparents had died with dementia a few years ago. My other grandparents had just been placed in assisted living due to dementia. And I have family members with type 2 diabetes and high blood pressure. If I didn’t do something drastic, I was headed down the same road. (July 2015 update: my second grandmother died due to complications from dementia, as well.)
After I thoroughly researched ketogenic diets, I knew it could help reverse my Metabolic Syndrome, but I wondered if it could help heal my brain and PTHP, providing me with better, more stable energy since my adrenal fatigue was contributing to the frequent energy dips and hypoglycemia and likely my mental fogginess. Could it be the answer to all my health problems?
So how did I land on a ketogenic diet?
I don’t remember the exact trajectory, but I began looking for research on herbs, supplements, and diets that supported healing a traumatic brain injury. I started on a regimen of anti-inflammatory herbs, which helped, but it wasn’t enough. I remembered hearing/learning that ketogenic diets were quite effective in the treatment of epilepsy, so I wondering if it could help heal the brain and started looking down that path. Somewhere along the way, I was reading an article on Chris Kresser’s website (I’ve been a big fan for several years) and one of the comments mentioned Dr. Peter Attia and his website Eating Academy. I began reading his site and the more I read, the more fascinated I became. It really started to pique my interest about what a ketogenic diet could do for me and my health. As I read more, I realized that I recognized Dr. Attia from this Ted Talk. Finally I watched Dr. Jeff Volek’s research in this video and this video, and then bought his book, The Art and Science of Low Carbohydrate Living: An expert’s guide to making the life-saving benefits of carbohydrate restriction sustainable and enjoyable. I felt very strongly that this diet was not only safe, but very healing and healthful for me, as well as a large percentage of the population.
What is a ketogenic diet?
A ketogenic diet, or keto diet, is a very-low carb, high fat diet (LCHF), with adequate protein. Basically, I limit my carbohydrates to no more than 20 grams per day, eat adequate protein (0.8 grams per kilogram of my body weight) and eat the rest in fat. Limiting carbs (in the presence of adequate protein) forces your body to begin using fat as its primary fuel source, which unlike glucose, is abundant in they body. With a steady supply of energy from fat, your body no longer is dependent on the carbs from each meal you eat and you get a constant, steady energy for both body and mind. Once you experience it, there really is nothing like it. You’ll wonder why you’ve been doing it the other way your whole life.
Isn’t a ketogenic diet dangerous? Isn’t ketosis harmful to our bodies?
Short answer: no.
I’ve discovered that only people that don’t understand the biochemistry and haven’t read the research think that a ketogenic diet is harmful. You can find articles about how unhealthy it is, but it’s all based on false and/or misunderstood information. Why would we put little kids with epilepsy on this diet if it was harmful or dangerous?
Don’t we need carbs for energy?
I was surprised to learn after re-reading my biochemistry lessons from grad school that we do not need (to eat) carbs for energy. And Dr. Peter Attia answers this perfectly on his website:
“This is actually the wrong question. If the question is, “Do we need to eat carbohydrates for energy?” the answer is, no. The conventional wisdom is that we need a minimum of 120 to 130 grams of carbohydrates (glucose) per day to fuel our brains, and we need copious glycogen (the storage form of carbohydrates) for endurance activities. This is just a misconception of what is not controversial science. Our body can fuel both our brains and hours and hours of endurance activities from protein and the breakdown products of fats.” (See the links in the question above for all the biochemistry and sciencey stuff.)
What does a typical day of food look like? What do you eat?
Breakfast: Decaf coffee (with cream and/or coconut oil), 2-3 egg omelet with spinach, topped with salsa and cheese
Lunch: Salmon filet, a few almonds, and side of broccoli with butter
Dinner: Hamburger patty (no bun) topped with sliced tomato, avocado, and cheese and a wedge salad with blue cheese dressing.
This is a typical day, but there is a lot of variability. I don’t typically snack because I’m not hungry between meals. Each of these meals keeps me full and satisfied for 4-6 hours.
I eat real, natural whole foods. The proteins I eat are beef, pork, chicken, fish, seafood, eggs, lamb, bacon, etc. For fats, I eat butter, coconut oil, olive oil, olives, avocado, cheese, lard and bacon fat. For my carbs, I mostly eat leafy greens (lettuce, kale, spinach), tomatoes, zucchini, broccoli, cauliflower, etc. Salt, herbs and spices are used freely, too. For the most part, I avoid sugar, grains, starchy vegetables and fruits, and any oil besides coconut or olive (no hydrogenated anything, too.). After my health stabilizes and I reach some goals, I plan to add back in some carbohydrates to a level that my body tolerates and my health is still stable.
Is keto safe for everyone?
Of course, you’ll want to check with your doctor. Dr. Volek’s research shows that almost every body type can thrive on a well-formulated keto diet, but only about 30% of the population can thrive on a low-fat diet (but even that type still does great on a keto diet). There are numerous health conditions that can be helped by carbohydrate restriction (PCOS, GERD, chronic pain, hypercholesterolemia, hypertension, type 2 diabetes, pre-diabetes, Metabolic Syndrome, just to name a few), but a few that may need to use caution, like those with gallstones or gallbladder disease. Some people with IBS find that keto eliminates their symptoms, while others find they do better with a bit more carbs.
Is it hard to do it or stick with it?
It does take some time for our bodies to adapt to primarily using ketone bodies (keto-adaptation). I read about this and was well-informed going in, so I knew what to expect, for the most part. It typically takes 1-3 days to get the body into ketosis, and about 3-4 or more weeks (for some up to 12 weeks) to become keto-adapted. Signs of keto-adaptation are clear head, steady energy, improved energy, reduced appetite, and general sense of well-being. While the body is adapting, it is common to feel a bit fatigued, but since I was already feeling that way, I figured it couldn’t be any worse. I self-committed to trying it for at least 3 months and if it wasn’t working for me by then, then I would give it up. (Spoiler alert: I didn’t have to wait 3 months to see if it would work.)
I gave myself a “Week 0” the week prior to my start date to eat what ever I wanted, but the opposite happened. I was so very ready to start feeling better, I actually reduced my sugar and carb intake to 100 grams per day. It ended up being a great natural transition week of reduced carb eating.
I expected the first 3 days of full-on keto to be the hardest, giving up sugar and most carbs, but it wasn’t really until Day 5 that I had the worst sugar and carb cravings. I didn’t know if I was going to make it and it felt like the hardest thing I’d ever done in my life at that point! But I knew that if I gave in then, I’d be setting myself back that many more days and I’d just have to go through it all over again. I wanted desperately for my brain to heal and for the debilitating symptoms to go away. I knew if I could get through the withdrawals, the other side would be so worth it. And it was. By about Day 10, things started getting much easier.
I developed some strategies to make things easier in the beginning:
- Avoid looking at recipes and Pinterest
- Keep meal prep really simple. Follow my hunger, eating when hungry. Make meals that take only a few minutes to prepare.
- Stock fridge and freezer with easy to make, keto-friendly foods that I love (butter, bacon, avocado, beef, salmon, pork, fresh veggies, etc.)
- Toss out any sugary/carby foods that might derail me
- Avoid going to the grocery store (My kitchen was already stocked, so I didn’t need to go. I used to go out of habit, often, just buy more unnecessary carbs.)
I’ve never been able to follow any kind of diet plan in the past due to extreme feelings of deprivation and constant hunger. And as far as the middle path–mindful eating, intuitive eating, all that stuff I used to teach to all my clients–well, that is what lead me to all the metabolic health problems and a 50 pound weight gain over 10 years! However with keto, it has been so easy for me to stick to it, partly because of the threat of having to start over with keto adaptation, but mostly because of the lack of constant hunger and how good I feel. And once I removed the carb and sugar addiction, I can now actually intuitively and mindfully eat healthful foods.
Results the First Two Weeks
At about 2.5 weeks in I was feeling fantastic. Improvements at that point:
- Pain and swelling in my legs is nearly gone
- Cognition is nearly as good as pre-motor vehicle accident
- Gastroparesis gone
- Heartburn gone
- C-RP (inflammation marker) dropped 62%
- Hypoglycemia symptoms gone; energy stable all day
- No more migraines
- Menses returned
- And appetite normalized
Results the First Month
- Blood pressure normal
- 5 inches gone off my waist
- 18.5 pounds gone
- Even more improved mental cognition; no more hand clumsiness
- Appetite greatly reduced, no hunger between meals. Normal.
- No headaches or migraines
- Dramatically improved energy that is stable all day
- Lightheadedness improving (I still seem to have adrenal fatigue symptoms, but improving)
- Even more reduction in pain, swelling, and sensitivity in legs
- Sleeping better and my clock is getting reset. Whereas I used to stay up late (until 2, 3, or 4 am), now I’m tired by 11 pm or midnight and getting up by 9 am with no alarm clock.
- Steady energy all day. No hypoglycemia dips, no crashes, no problems! In fact, I was able to go to an event and hadn’t eaten lunch, and I didn’t get hypoglycemic, no headache, not ravenous, nor irritable, nor food obsessed; I could have gone all night without food. It was extremely liberating.
- And for the first time in my life, I’m WANTING to walk for exercise everyday; and when I go for a walk, I feel like I have enough energy that I could walk forever.
- Additionally, I’m saving lots of money on food. This is the cheapest way I’ve ever eaten.
Bottom line is, I feel fantastic. My health has dramatically improved. Doing a keto diet experiment on myself might have been the greatest thing I’ve ever done for myself.
Stay tuned, for more updates.