A Tale of Two Keto Dieters Part 2
As far as I’m concerned, the rule of thumb for any diet a person tackles is to take it with a grain of salt. This is because every person and every body is so different that it’s far more important to listen to what your body is saying than it is to strictly follow any regimented diet plan. That said, I personally believe the best possible diet plan for all humans, except for a few rare incidences, is a version of the ketogenic diet. The keto diet is gaining popularity and recognition, but even the experts who encourage this diet for its incredible health benefits also recommend following it with a bit of moderation. This is because the high-fat, carb-restricting aspect of it can lead followers to miss out on their needed fruits and vegetables, which obviously are very important in achieving optimal health. These experts also say the human body is not meant to be in ketosis all day, every day but instead should regularly transition in and out of it.
My sister Jo and I realized at about the same time that by following the keto diet, we were slacking on our vegetable intake. For me, a few servings of vegetables each day fell by the wayside when I began intermittent fasting, which is an important part of a successful keto diet. The fasting led me to only eat two main meals per day instead of three. This caused me to go from eating 5 servings of fruit and vegetables to only about 3. Jo told me she had the same issue.
“When trying to significantly reduce my carb intake, it was easy to eliminate vegetables altogether,” she said. “Also, now that I’m in ketosis, I find I am not as hungry as I used to be, and the fat I consume is very filling and satisfying. As a result, I tended to eat only very small meals, which, even though vegetables were included in that meal, resulted in barely more than 1 serving of vegetables.”
The U.S. Department of Agriculture and its MyPlate.gov recommends adults eat roughly 2½ cups of vegetables and 1½-2 cups of fruit per day. I think this is probably a good goal for people who are eating three full meals or more per day. It could, however, be a bit excessive if, being fat adjusted on a keto diet, you’re used to only eating two very small meals per day along with a small snack or two. In this case, I think ratio is more important than serving size – make sure the majority of your meal is vegetables slathered in fat and don’t worry about number of servings.
“The New Primal Blueprint” author Mark Sisson says early humans likely were frequently in ketosis but not permanently, and no known human populations live entirely in the state. Recent studies on keto dieting and ketosis are very promising but only show a short-term perspective. Studies on long-term sustained ketosis, however, remain “something of an experiment, with potential negative repercussions for gut health and hormone function if occasional carb refeeds don’t occur,” he writes. Women in particular have reported these issues after switching to a keto diet, he says, because their bodies are hardwired to store enough fat to ensure healthy reproduction.
“Some primal [keto] enthusiasts, particularly females who transition to primal after decades of high-carb eating and yo-yo dieting, report experiencing fatigue, sleep disturbances (either insomnia or excessive sleeping), thyroid disturbances (particularly lower-than-normal body temperature), gut health disturbances (because many carbohydrate foods contain healthful resistant starches), and difficulty losing excess body fat,” Sisson writes.
Jo and I have both experienced some of these issues, much to our frustration. She has struggled to jump-start weight loss, while my issues have been hormonal. I discovered a little over a year ago I was maintaining a lower-than-normal body temperature (97.4-97.7 range). Blood tests then confirmed a sluggish thyroid, and I was promptly medicated for hypothyroidism. I’m not entirely convinced, however, my thyroid issues stem from the keto diet since my diet transition occurred gradually and began a few years before experiencing any issues. Jo and I also have been working to improve gut health. I don’t necessarily think the keto diet caused my recent digestive issues, either. Rather, I think it brought to the surface and made me aware of underlying issues I’d always had. I will go into much greater detail on both my thyroid issues and gut health in future posts.
Sisson, as stated above, recommends people who experience these issues have occasional “carb refeeds” by allowing more healthy carbs than usual in a day – every once in a while have an extra serving or two of fruit, add a sweet potato to your dinner or have a small bowl or cup of hot buckwheat cereal as a snack. (Buckwheat, by the way, is a great grain-free substitute for oatmeal. Despite its name, buckwheat is not wheat and is not even a proper grain. It’s the ground seed of a type of rhubarb plant. Just make sure what you buy has no other gain/gluten added ingredients. I like Bob’s Red Mill buckwheat cereal.) Sisson stresses that carb refeeds are not en excuse to eat grain and sugar.
Carb intake for full ketogenisis is 0-50 grams in a day, Sisson says, while 50-100 grams of carbs per day equals what he calls the weight-loss sweet spot. Carb refeed days can be up to 150 grams per day. The 0-50 grams of carbs nowhere near covers the amount of vegetables and fruit that should be eaten in a day, but 50-100 grams should cover it as long as fruit is limited to 1 serving and is only in the form of low-glycemic fruit (berries, tomatoes) and 3-4 servings of non-starchy vegetables. For most fruits and vegetables, 1 serving equals 1 cup. A serving of leafy greens is 2 cups.
Dale Bredesen, M.D., author of “The end of Alzheimer’s,” Takes Sisson’s diet advice one small step further, creating what may just be the ideal diet for the human body. In his book, he lays out his ReCODE protocol for preventing and reversing cognitive decline and Alzheimer’s disease. Part of ReCODE is his Ketoflex12/3 diet. The plan blends the ketogenic diet and the intermittent fasting regime of eating no later than three hours before bedtime and waiting at least 12 hours and even up to16 hours before having breakfast the next day with the plant-based flexitarian diet. He says to follow the ketogenic plan of high fat and no sugar/grain, but to make sure the majority of the fat comes from seeds, nuts, avocados and eggs while keeping meat as a “condiment.” (Read my post on meat to find out just how much fun I’m having following Bredesen’s advice on that!) He stresses the importance of eating plenty of vegetables while also recommending purchasing a ketone meter and test strips, as Jo did, to make sure you’re regularly dipping into and out of ketosis.
Now being fat adapted and regularly achieving ketosis, Jo for the new year has set her sights on doubling her vegetable intake while trimming back protein to better follow Ketoflex12/3. I’ve increased my vegetables to a small extent but feel I’m getting plenty with about 4 servings per day (including my fruit serving). Instead I felt I wasn’t eating enough fat and have made the effort to add coconut oil, olive oil, avocado oil or butter to pretty much everything (making everything taste infinitely better!). I think I’ve found my so-called diet sweet spot by following Ketoflex12/3.
I’m not perfect. I still have (and will continue to have) splurge days, and I’m likely still eating too much meat, although I now don’t eat more than a serving or two each day. This plan, however, is working really well for me. I will continue to tweak and adjust as I see fit and as any issues arise, but I am very happy with it. I have no doubt that I am in ketosis when I wake up in the morning and remain there likely most of the day. I previously had thought I was likely leaving ketosis after drinking my breakfast smoothie between noon and 1 p.m. and eating my afternoon vegetable-based snack a few hours later. But testing my blood using Jo’s meter shortly after eating my afternoon snack one day showed I was still in the ideal mild ketosis, which surprised me. I’ve never tested after dinner but I can pretty much guarantee I’m kicked out of ketosis at this time each day since it’s my biggest meal and most carb dense with at least 2 servings of vegetables and a serving of fruit. Then as I sleep during the night, I return to ketosis and start all over again the next day. To me, that sounds (and feels) just about perfect.