So, I’ve gone keto.
What’s keto? Ketogenic eating is a low-carb, high fat way of eating. It switches your body from being fueled by glycogen (sugar) to being fueled by ketones (fats). Nutritional ketosis means you’re generating some ketones, but not as extreme as the medically supervised rapid weight loss programs (starvation level ketones) nor ketoacidosis (that’s sky-high ketones, and very dangerous). The idea of nutritional ketosis is to heal your body, heal your hormones, and prevent disease – which is precisely why I’m doing it.
First, to address the specific ketone levels we’re talking about:
0< 0.2 not in ketosis 0.2 - 0.5 slight/mild ketosis OK 0.5 - 3.0 nutritional ketosis Optimal! 2.5 - 3.5 post-exercise ketosis OK 3.0 - 6.0 starvation ketosis Too high - eat more 15 - 25 ketoacidosis Dangerous
You don’t have to test your ketones to eat this way (I do, but I love data!). I’ve included the chart to make it clear what this is about.
Further, you don’t actually have to eat ketogenically to be “fat fueled”; once you’re fat adapted (ie running on ketones), you can up your carbs slightly and teeter on the edge of nutritional ketosis. You’ll have many of the benefits of keto, and maintain long term health; getting a periodic “dose” of carbohydrates, either through cyclical keto or through carb ups is particularly important for women of reproductive age.
Ok, we’ve got that out of the way.
The Lead Up
Over the last few years, it felt like I was losing my health. I was getting sick more often. I had no energy, to the point where I didn’t have the energy to socialize. Memory issues. Cuts took weeks and weeks to heal, then scarred. I felt horrible every summer, blood sugar spiking and crashing. I was ravenous if I didn’t eat, and at times I needed to carry snacks to prevent horrible “crashes”. Starting seven or eight years ago, and lasting a couple of years, I lost more than half my hair. My body hurt. Joints started hurting, and then deteriorated – knee, shoulder, wrist. More facial acne than I had as a teen. Acne on my shoulders, even cystic acne on my chest. My period got longer, and ridiculously heavy, but cycles were shorter. Thickening of my ankles. Blood vessels just above my ankles looked different, and the skin was painful when touched. GERD (acid reflux), leading to a prescription antacid. Cold hands and feet, and low body temperature. I could be diagnosed as depressed, and felt it closing in, but it didn’t feel like a normal depression. My doctor told me that I “just wasn’t aging well”.
And, to be blunt: I’m overweight. Since university, I’ve gained and lost weight several times. A few years ago, I took a more sustainable approach: lose a size a year. Recently, the weight changes have been somewhat inexplicable – not losing when I tried to lose weight, and dropping when there was apparent no reason. But with my health crashing, losing the remaining three sizes became a preference; the priority had to be getting healthy.
I was not going to accept living so sick. I knew something was wrong – and I didn’t want this to be my future. In desperation, I asked my chiropractor for advice, and he suggested a naturopath. My GP had mentioned that, too. I looked up what they were; I wasn’t sure if they were “quacks” or legit, I didn’t know. Naturopaths are licensed health care professionals in Ontario, who focus on whole body (a holistic approach) and on preventing disease, whereas conventional medicine focuses on treating disease. So, finally, someone who was concerned about my not-yet-disease symptoms!
First, she identified that I had very high levels of chronic inflammation, and put me on a modified paleo diet. I was already gluten free, and usually avoided dairy. She said to also avoid legumes and nightshades, and start taking zinc. It was hard to say goodbye to tomatoes and eggplants, but it got me through the knee surgery – I healed a little slowly, but within the normal time frame. I healed fully, and got my lower limbs “back”.
But my hair started falling out in clumps, and then came some significant work stress, and I lost all energy – I couldn’t socialize, cook, or do my share of the housework. Over the summer, my naturopath tweaked things, trying to heal my thyroid. That hair loss stopped and the hair regrew. Oddly, I began craving salt and fats, two things I normally avoided (instinctively). I needed potato chips, when normally, I’m utterly indifferent to them. The naturopath told me to take a little MCT oil, and I found a tablespoon or two helped. But my energy levels were deteriorating, other than a brief respite for part of a week while away on vacation. Autumn was even worse. I even got sick (mono?) and slept for over a week!
So she told me to try Leanne Vogel’s approach to low carb/high fat eating. I was resistant: combine a lifelong genuine dislike of the taste of fat with the [mistaken] belief that fat was bad, and you have a recipe for procrastination. But I got sick of feeling lousy, I had another surgery coming up, she ordered me to do it, and I trusted her – so I gave in, bought the Keto Beginnings e-book, and read it.
Wow! The Improvements!
I started on January 31, 24 days before I was scheduled to have wrist surgery. I wanted to get maximum healing as soon as possible, so I followed the meal plan. (I even made the bacon; I usually don’t want pig in the house). The first week’s meal prep was really hard, because I had no energy. For months, my husband had been doing all the cooking. It took me hours some evenings to prep the food since I had no energy or focus. The changes were subtle at first, then sped up. Week 2’s meal prep was easier, and by Week 3, I had no problem preparing and freezing extra meals, for my first days post-surgery. I was quite literally bouncing, I had so much energy! I felt like myself again – but better, because I could appreciate what I now had.
This post was written at four months into eating keto, and 14 weeks post-surgery. I had been trying to eat intuitively, without a formal meal plan, for three weeks.
So, here were the benefits that I personally experienced, at that time:
- More energy. When my macros were working for me, I almost “bounce”! I had the desire do things again and the ability to follow through. See friends, cook, clean, organize, exercise with enthusiasm — I did back-to-back workouts and 30 minute brisk walks, and then had energy to spare all evening.
- Morning body temperatures rose (a sign of thyroid healing). They were still lower than average, though.
- Felt warmer – and my hands were warmer, too.
- Breathing was better – it seemed like a clearer, more open airflow passage. (Inflammation in the airways??)
- My ankles were slimmer. No edema. And the skin pain healed.
- Facial skin looked much better. Less acne, particularly before my period
- Age spot on my cheek faded a little
- Shin skin wasn’t itchy any more
- Toenails weren’t splitting in half, catching and warping; they looked normal again. And may be growing faster.
- First, what I thought was ‘normal’ hair loss slowed. And then (by 7 weeks) I noticed regrowth — actually getting back some of the hair I lost 6 years ago! I was told by a dermatologist that it was permanent lost, “female pattern baldness”. Apparently, it was due to hormones out of whack! Stress/cortisol/thyroid related imbalances.
- Even with cramps and heavy bleeding, I still had energy when have my period. No longer needing to curl into a ball for a few days. And they were getting shorter.
- PMS: fewer mood changes before it. Hormones were more stable. Periods catch me unawares – often, even my husband doesn’t notice any differences
- Longer time between periods – moving towards “normal” cycle, from the shorter-than-historically-typical after going off the pill
- Weight loss – down 5-10 lbs, and more than half a size. (Inches come off before pounds)
- No more blood sugar spikes and crashes! That alone was worth it. Blood sugars were now 3.8-4.8 most days (keto numbers are lower than sugar fueled numbers)
- Memory improved a little (it worsened after an untreated concussion years ago)
- Less acid reflux/GERD: I was taking the Tecta every second night, and am hoping I’ll be able to move to every third.
- Any signs of depression have disappeared – I’m happy, and positive again.
- Healing from the wrist surgery faster than normal. Surgeon and physiotherapist are thrilled
- Graduated from post-surgery physio
- Less general joint pain
- Graduated from rehab lower body exercises to real leg workouts, and can now do rehab exercises for the upper body. I’m getting stronger, and notice more muscles.
- Had no trouble quitting sugar, unlike any time in the past. Taste-buds were reset to need less “sweet”.
- A friend said I looked different, I “glowed” and a colleague commented that I was looking good
- Am more in touch with how I feel, and what I need to be healthy.
Lesson learned: Conventional medicine is great if you have disease, but when something is sub-clinical, or just starting, or it’s an interaction of several things – that’s where a naturopath pays off.
Update from 1 year of keto:
- The energy improvements didn’t completely last – while I’m now more functional at work, and I have enough energy to engage in hobbies in the evenings (e.g. sew), it became clear that something was still not ‘right’. While I feel warmer, my hands are getting cold sometimes, again, and morning temperatures fell and remained low. Skin got super itchy, and was bruising. Supplements and other thyroid supports weren’t resolving the symptoms, so I went on natural dessicated thyroid (NDT). The natural healing helped me realize that there was an underlying issue.
- Asthma is healed – other than when allergic, I breathe well. I had no idea why a doctor had told me my asthma wasn’t well controlled until it finally was.
- Hormone balancing continued – particularly noticeable with the continued improvements with respect to periods. I get acne around my period once again, but not as bad as before. I may have turned the clock back a bit on perimenopause.
- Food insensitivities cropped up at around six months: a moderate histamine intolerance, and a sensitivity to all things coconut. That may be resolving, after abstaining for six months.
- Blood sugar levels remain stable, even when exposed to carbs and sugars such as over the holidays. No longer insulin resistant – not even physiologically, that can happen from being too low-carb.
- Hair continues to improve – I can wear clips again. I’ve gone through the worst of the bad-hair phase of regrowth, but there’s some changes in texture (it went super curly after the hair loss, and new growth may be more my natural wave) so styling and care still needs tweaking.
- I’m completely off the prescription anti-acid (Tecta), and the prescription asthma/skin allergy medication (Singulair).
- This has supported recovery from disordered eating (bulimia).
- The general healing plus the wrist healing means my shoulder has improved enough that I am no longer a candidate for surgery.
- I can now have real workouts! Upper body is still light – the shoulder can’t tolerate a “real” weights – but I’m able to get muscle tone back and feel stronger again.
- I’ve shrunk 1.5 sizes, including a couple of inches during the winter. I’m now half a size away from the original goal I set. I will continue with this way of eating, and see if I can get down to my personal ideal, “didn’t think possible ever again”, size. Interestingly, I’m still the same weight as when I started a year ago.
- I’m much more in touch with my body, how I feel, and what it needs.
How can food make such a difference?!
I’m enjoying reading about the science, but the bottom line is that the North American way of eating is known to increase the risk of obesity, diabetes, cancer, heart disease, and more. It’s heavy on carbohydrates (particularly grains and sugar), low on fibre, and low on fats. Even worse, we’ve added snacks or more “mini meals” to our day, so that we’re constantly eating – our insulin levels never get to drop. The heavy carbs and constant eating lead to insulin resistance, and eventually, to Type 2 diabetes. Which increases the risk of heart disease and dementia.
We know that poor food choices can lead to disease, so it makes sense that good food choices support health.
I’m skeptical of all the claims that paleo or keto is how people used to eat, or that it’s inherently better/natural for humans. Humans didn’t have easy access to grocery stores with all the variety of protein, vegetables, fruits, and nuts or seeds they could want. But it does make sense that humans, historically, have run off their own fat stores rather than having to feed every few hours. Old recipes were pretty high fat. And we know what some cultures traditionally ate. We also know that we’ve gotten totally off track with manufactured/commercial foods and their marketing, slipped into bad habits of daily treats, and been impacted by some bad nutrition science.
The plan I’m doing is whole food – no pre-made, or processed food. It’s all home-made, from quality ingredients. I’ve always felt better when I ate home-made dinners, rather than frozen dinners (even “good” ones). It just makes sense that feeding your body nutrient-dense, quality fare is better for you than filling up on additives, low-nutrient and over-processed starches, and sugar.
By dropping the sugar and grains, and focusing on low-carbohydrate vegetables, fatty meats and fish, and fats, you heal inflammation in the gut. We now know that the gut is key to your immune system and also effects mental health. Food allergies and intolerances, skin rashes/ inflammation/other issues, IBS, autoimmune issues, mood imbalances and depression, thyroid, chronic inflammation – all can be caused or exacerbated by issues with the gut! So, healing can only help. The symptoms of leaky gut and candida overgrowth are closely related, and inflammation and depression as well; eating a low carbohydrate, sugar-free, grain-free diet removes the irritants and supports healing.
A low-carb/high fat (LCHF) eating style has been identified to help with:
- Healing the thyroid. Low energy, not “like you”; depression and anxiety, even bi-polar; feeling cold/cold extremities/low body temperature; acid reflux; craving sweets; hair loss, dry hair; acne; dry skin; can’t lose weight even if dieting/exercising; brain fog; can’t concentrate, forgetful; get sick often; and more. The thyroid controls all hormone systems, so if the thyroid is imbalanced enough it throws the adrenals (cortisol) and sex hormones off as well. (For a full list of typical, patient reported symptoms: https://stopthethyroidmadness.com/symptoms/).
- Moods – PMS, “meltdowns”, ability to handle stressors, other (see thyroid section)
- Blood sugar – regulates out the spikes and drops. Particularly good for diabetics and pre-diabetics, but will help anyone who’s insulin resistant (ie most people).
- Leaky gut – an estimated 70-80% of people have this, and awareness is raising. Most of your immune system is from the gut. The cells in your gut are supposed to be tightly spaced, controlling what gets through to your bloodstream; stress and poor diet loosens the junctions and lets undigested food, toxins, and pathogens through — so your immune system reacts. (https://draxe.com/7-signs-symptoms-you-have-leaky-gut/ among others)
- Food sensitivities – I suspect this is linked to healing the leaky gut. Although, at the beginning, you may discover sensitivities you didn’t know you had, and may need a specialized diet (low histamines, no FODMAPs, or even AIP).
- Infertility -getting your period back, getting pregnant.
- A specialized version of LCHF eating is used to control epileptic seizures; this version requires strict medical supervision, particularly to start.
- And more. There’s some indications it can be protective against cancer and dementia.
Bottom line: eating better quality food to heal hormones and the gut pays off. Just as poor food choices can cause harm, good foods can be medicine.
So what are you eating?
- Fatty cuts of meat or fish, about the size of the palm of your hand, cooked in fats
- e.g. Chicken thighs, lamb, marbled cuts of beef, sausages, bacon and pork shoulder roasts (if you eat pork), salmon, sardines, herring, whole eggs. It’s important that they’re good quality meats (hormone and antibiotic free, ideally grass-fed), since toxins linger in the fat.
- Vegetables, about two to three fistfuls per meal, with added fats (sauce, dressing)
- e.g. Zucchini, broccoli, cauliflower, brussels sprouts, celery, okra, green beans, fennel, leafy greens (e.g. spinach, kale, collards, lettuce), radishes (includes daikon and jicama), mushrooms, summer squash.
- While I can’t eat them, many also enjoy vegetables in the nightshade family (eggplant, tomatoes, bell peppers).
- Healthy fats, like flax oil, olive oil, coconut oil, cacao butter, avocados, olives, ghee, and also rendered fats from meats (tallow, shmatlz, duck fat, drippings). Drizzle it on, use mayo or hollandaise sauce or coconut milk based dips, or eat fat bombs.
- For carb ups you enjoy higher-carb vegetables, and fruits.
- E.g. Winter squashes (e.g. acorn, butternut, spaghetti, pumpkin), white rice, berries, pineapple, apples, bananas, root vegetables (e.g. parsnips, carrots, beets), sweet potatoes, potatoes (if you can do nightshades).
Many people eat nuts or dairy, but there’s less emphasis on that for Leanne Vogel’s approach since sensitivities are so common. Personally, I’ve never tolerated dairy very well, so I eat a little ghee or butter as a rare treat, but otherwise I’m dairy-free. I can eat nuts and seeds, but choose to eat very few as they can be inflammatory and it’s so easy to over-indulge. Calories don’t count on keto as much, but they do still matter when you’d like a little weight loss (as a secondary benefit)!
Nothing is “off limits” or forbidden. The focus is on healing, and what feels good in your body. What happens is that your body learns to prefer LCHF and “clean” eating, so typical Western foods just don’t feel that good. But after a while of eating this way, you actually need periodic “doses” of higher carbs. So if you’re craving a starchy vegetable, or some fruit, go for it. Your body needs it. In fact, if you want some birthday cake, or are out for a special dinner, you can choose to indulge; it may not be as nutritious, but there’s no harm if it’s once in a while. This is supposed to be a way of eating, for the long run.
Many find they’re eating more food than they did when eating a standard diet– and often, it’s actually more calories. Even if you want to lose weight! When I started, before the surgery, I lost inches without even trying; I then stalled while healing from the surgery and work stress, but then the shrinking continued. A ketogenic diet speeds up your metabolism, so I eat significantly more yet still lose body fat. It can also help you gain muscle.
This isn’t complicated or difficult to do: most the dishes we make are quick and easy! We use spices and oils to add flavour. It’s delicious. We love good food; there’s no compromising on taste. And we’re also lazy, wanting to do other things with our time most weeks. But, when we want something different, Leanne’s books and website, plus online recipes, provide us with alternatives (chicken pot pie, kebabs, meat balls, desserts, “breads”, etc). We’ve served some of her recipes to non-keto friends and family, to rave reviews.
How low carb is low carb?
To start, I was down at roughly 20 grams a day, just to get “fat adapted” (where your body is used to getting its energy from fats). Leanne Vogel recommends that, once adapted, you up your daily carbs. (She gives a few different approaches – profiles – for how and when to do this, but the bottom line is that you eat more healthy carbs). Healthy carbs are starchy vegetables (e.g. squash, potatoes, yams, beets, cassava) and/or fruits (e.g. strawberries, blueberries, pineapple, apples, bananas). It’s quite common to eat 50, 75, even 100 grams of carbs a day, depending upon your activity levels and the kind of healing you need.
In fact, you don’t even need to be in ketosis to be fat fueled! Certainly, if you are, you get the maximum health benefits/speediest healing. (I spent my first three months in ketosis). But under 100-150 grams/day of carbohydrates counts as low carb.
Note that grains aren’t on the list. Wheat’s inflammatory and problematic, even for people without an “official” sensitivity, and the other grains and pseudo grains just have lower nutrient values or other issues, so it’s best to base our meal plans a higher quality foundation. But, this remains an option for carb-ups or treats.
But what’s nice about this approach to LCHF is that nothing is off-limits. It accepts that lapses happen, cravings happen, and life events happen. You make choices, and learn to balance them. You learn to to think about a craving or a lapse – was it a sign of something your body needed, or was it emotional eating? If it’s a real craving, then you learn to recognize it and choose something that’s good for you. If it’s emotional, you start to figure out strategies to handle that. Always, we learn to be more aware of how food and drink feels in our body, to fuel it with the healthiest fare we can. And to know that something that’s considered healthy may not actually agree with us! So it’s not always about realizing that sugary foods don’t feel good and thus we find that can live without them – it may also be realizing we have sensitivities that we have to respect, to get and stay healthy.
Leanne Vogel’s approach is about healing your body and getting healthy, with the goal that it’s a sustainable way of eating, for life. In her interviews and books, she says that once your body has healed enough, and feels safe to do so, your body will move to its optimal weight. Do not restrict, as your metabolism will slow. Being fat-fueled speeds up the metabolism, so your body will get you healthy in time. If you want it a bit faster, eat cyclically at a slight deficit. But you’ll need to heal first, and the weight loss process is slow and steady.
Too good to be true?
I am feeling much better, but I have found that “intuitive eating” is tough – I’m overcoming two decades of restrictions, an eating disordered past, and “shoulds”, and “shouldn’ts”. It’s hard to learn to listen to your body.
When following the Keto Beginnings meal plan, I felt awesome almost every day; now there are better and worse days — but even the worst day is still better than I was before I started. And I’m getting more “better” days than “worse”, now. That’s the thing: Leanne Vogel’s approach is about figuring what works for your body, so there isn’t a standard template. Some people work best on oodles of protein, others on less; or need a ton of fats, or can’t do a lot; or need very low carb or do better with more carbs; or find they have sensitivities they didn’t know they had.
Trial and error takes time, and can be frustrating! But I’m still working on it because I’m feeling much better, and every few weeks notice a new benefit. So, while I haven’t seen much actual weight loss, I am definitely getting slimmer and healthier. And I think it’s good to learn this.
I’m learning to listen to my body. I’ve learned how even sub-conscious restricting thoughts can lead to eating too much, particularly of the “wrong” thing. I’ve learned how to recognize actual hunger. I have freedom from being focused on food, and the next meal – I can easily go 6-9 hours between brunch and dinner! I’ve learned how super-sensitive my body is to stress. I’m taking the next step in healing my relationship with food. I’m learning my food sensitivities (hopefully temporary!). I’ve realized that I’m not getting enough carbs, even though I thought I was carbing up “a lot”, so I’m trying to up them further. I learned that recovering from surgery takes time, and it’s normal to not feel as good as I did before surgery. I learned that you can go in cycles of feeling good, and then realize you’re not feeling so great – sometimes, it’s a step back (if that, it’s stress related, in my case), and sometimes it’s that I’ve healed enough that I can now recognize that something’s going on and needs additional support.
I’m not doing this alone. By buying Leanne Vogel’s books (or by being hooked on her podcasts), I was able to join a private Facebook support group with thousands of incredibly kind, supportive, and knowledgeable keto-ers. I would not have made it past the first weeks if it weren’t for their advice and encouragement. It’s through their guidance, and my own work, that I’ve realized these things.
And just for the record, this isn’t a sponsored post – my naturopath recommended this particular approach to LCHF eating, and it’s working for me. It’s my only experience with that way of eating, but it’s been so positive, I’d recommend that people consider it. I’m a moderator of one of the private support groups, but I wrote this post before that honour – and it’s unpaid.
- Leanne Vogel’s Healthful Pursuit website, which has links to her podcasts and e-books
- Leanne Vogel’s new print book (The Keto Diet). That’s available at book stores (online and local) and at some Costcos.
- The Keto Sister site.
- Dr Axe (link above) has useful information.
- The first is a simpler site (https://www.dietdoctor.com/low-carb), and then
- He has this wonderful science one
- the video lectures: https://intensivedietarymanagement.com/category/lectures/the-aetiology-of-obesity-lecture-series/, and
- my favourite, the blog posts – it’s long but I’m a Public Health geek – https://intensivedietarymanagement.com/how-do-we-gain-weight-calories-part-1/).
- He’s Canadian, and a specialist in managing obesity (here’s a Toronto Star article: https://www.thestar.com/life/health_wellness/2016/01/25/scarborough-doctors-book-says-insulin-makes-you-fat-fasting-makes-you-thin.html).
Of course, there’s a lot more, but these are my favourite so far for advice. There are also some really good recipe sites – I started with Healthful Pursuit’s recipes since they’re dairy-free and gluten free, but I regularly go beyond that.
PS I definitely recommend seeing a naturopath, and if you’re in Ottawa, do consider Colleen McQuarrie of the Ottawa Integrative Health Centre. She’s been a huge help to me, and I’ve passed her name on to friends. But naturopaths are local caregivers, and the Healthful Pursuit books and site are available anywhere in the world.