Frequently Asked Questions (FAQ)


(Richard Morris) #1

#2KetoDudes Ketogenic Lifestyle FAQ

Before you ask a question about the ketogenic diet, or any aspect of the keto lifestyle, please check this list of Frequently Asked Questions for an answer. This FAQ is public. It was created by Carl Franklin and Richard Morris, two middle aged men who reversed their type-2 diabetes with diet alone, and created a podcast (www.2ketodudes.com) to share their experiences.

what is a podcast and how can I listen to it?
Read This

you can also download a more comprehensive 23-page PDF document by Carl and Richard, The Ketogenic Diet in a Nutshell. Please share it!

if you’re looking for just a few key studies to print out and bring to your doctor, here they are.


Screw all this science. I’ve been keto for weeks and haven’t lost a pound!!

We see this mainly in women who go from years of low fat dieting to ketogenic. It takes time for hormones to adjust. At least, that’s the current theory. If you’re female and fall into this category, stop what you’re doing right now and listen to the “FEMAIL” episode of 2 Keto Dudes, in which Carl and Richard took a back seat to Brenda Zorn and Kim Howerton. They explain the ketogenic diet from a woman’s perspective. Turns out females react differently to keto than males. Here’s the link. Go listen. http://2ketodudes.com/show.aspx?episode=32

[details=What is a Ketogenic Diet]A ketogenic Diet is any diet that produces ketones. The specific diet that the Keto Dudes follow is
Carbohydrate: < 20g (Trace amounts)
Protein: 1-1.5g/Kg of Lean Body Mass
Fat: To Satiety[/details]

What is Lean Body Mass?

The weight you would be if you had 0% body fat. Think about what you weighed when you were fit. If you were never fit, guess. :slight_smile:

I hear you talk about “macros.” What’s a macro?

The term Macros is shorthand for Macronutrients. These are sources of energy (or Calories): Protein, Fat, and Carbohydrates. See our definition of a Ketogenic diet for the “Macro” formula we have used ourselves. You may see other ketogenic resources refer to a macronutrient ratio of 20% PROTEIN, 5% CARB, and 75% FAT. This is a description of the fuel that the body is using. The 75% fat component will be a combination of fat on your plate and fat that you draw down from your body. Eat more plate fat and you will lose less body fat and vice versa. That may sound good on paper, but when you start a ketogenic diet, you’ll need to eat more fat to satisfy your hunger.

Can you help me calculate my macros?

Even better, we can point you to a web resource: Keto Calculator

What are Fundamentals and Variables?

Fundamental foods are those that have never been shown to significantly raise blood sugar and/or insulin. Fresh meats, pure fats, and eggs fall into this category. Variable foods are those that affect everyone differently, but still technically have very few carbs. These include dairy products, nuts, nut flours, sweeteners, additives; as well as low-carb foods made from them.

Can I eat or drink x and stay in ketosis?

We are not dogmatic about what to eat, drink, or otherwise ingest. Rather, we encourage you to test these items on yourself to see if a) your blood sugar increases, or b) your insulin increases. This basic philosophy of “test thyself” permeates everything we do. Do not seek the answer from an expert, or anyone else in the group. Ask us about our experiences. Don’t ask us what you should or should not eat.

[details=How can I test to see if my blood sugar increases in response to ingesting x?]You’ll need a blood glucometer to test the glucose in your blood, and you are going to chart a Glucose curve in response to that food.
Start at least 2 hours after your last food (4 if you are type 2 diabetic), and at least 2 hours after you have woken up.
Take a Time 0 measurement - this is your baseline.
Eat the food in question, and set your alarm to 30 mins.
Take a Time 30 measurement - this is your glucose spike from that food
Take a Time 60 measurement - this should show your glucose coming back to baseline
If not at baseline take another test every hour until you are close to your baseline[/details]

[details=How can I test to see if my insulin increases in response to ingesting x?]This is something you can do to test to see if you brain is going to play tricks on you and secrete some insulin when you eat an artificial sweetener. It doesn’t happen to everyone one and the only way to find out is to test.

What you can do is do a glucose curve and see if you are still at baseline at T30 (the sweetener doesn’t produce glucose in your blood), and then your glucose goes below your baseline at T60 then you probably secreted some insulin in response to the sweetener and you will probably have to restrict use of that sweetener.[/details]

I’ve heard that Ketones are bad. Why would I want them in my body?

Some people, especially medical professionals, have only heard about ketosis in the context of a condition that Type 1 diabetics have a risk of, called ketoacidosis. This is when the body produces way too many ketones, and the blood turns acidic, which can be deadly. As long as you have a working pancreas, you are not in danger of developing ketoacidosis. Nutritional ketosis is a benign state.

[details=What can I eat on this diet?]Meat, fatty fish, eggs, bacon, coconut oil, butter, lard, tallow, olive oil, heavy cream, cheese, cream cheese, green leafy vegetables, coconut, non-starchy vegetables (brussels sprouts, cabbage, peppers, celery, cucumber, broccoli, cauliflower, spinach, and the like), onions in moderation (onions are higher in sugar), pork rinds, Shiratake noodles, coconut flour, almond flour. Did we mention bacon? In moderation: nuts, berries (raspberries, blackberries, strawberries). Please test these foods on yourself before eating them regularly[/details].

What can’t I eat?

Sugar in all forms (anything ending in “ose”), honey, most fruits, bread, pasta, cereals, breadings, rice, starch, potatoes and other starchy vegetables.

What level of ketones is ideal?

How can I tell if I’m in ketosis?

Before you go out and buy ketostix, short litmus-like strips that you pee on to measure ketones, let’s talk about ketones. Ketones are a byproduct of your liver breaking down fats for fuel. The short answer is: If you are eating 20g or less of carbs per day you are in nutritional ketosis. Some people like to buy the pee strips. That’s fine. They will tell you if you’ve begun to produce ketones. Once you know that, however, they are useless. First of all, they measure only one of three types of ketone body - acetoacetate. There are three different ketone bodies: acetone, acetoacetate, and beta-hydroxybutyrate (BHB). Secondly, they only show what is being excreted, not what is being used. Once your body gets good at using acetoacetate, your pee strips will not show color even though you’re still in ketosis. The best way to measure your available ketone level is to use either a blood meter or a breath meter. For a more complete discussion of measuring ketones see http://ketodietapp.com/Blog/post/2013/11/30/Ketosis-Measuring-Ketones

[details=What does satiation mean?]When you are in ketosis you are using primarily FAT for energy. If you are trying to lose weight then you want a lot of that to come from your body fat - but can you just eat almost NO fat and lose weight fast? Not really. Humans are only able to draw down about 31 Calories per day per pound of body fat - so there is a limit. You need to eat fat when you are hungry or your metabolic rate will be slowed to compensate.

When you first start adapting to fueling your body on fat you may not be as efficient at mobilizing energy stored in body fat to the mitochondria of tissue that needs to use energy. So in the early days you are probably going to still eat 3 meals a day and most of that will be fatty meats, eggs, butter, and the like. If you are hungry, really hungry, then your body is telling you that it is running out of energy. Satiation is the point where you are no longer hungry.[/details]

[details=How do I eat just fat when eating to satiety?]If you have no available protein of carbohydrate grams left for the day you will have to find food that has calories only from fat. You could eat a small amount of coconut oil or butter - like a teaspoon full - and wait 15 minutes until your body has digested the additional energy and reassess if you are still hungry. We like to cook a bunch of bacon, put it in the fridge, and when hungry, spread some cream cheese on a slice of bacon and use it like a cracker.

If you have protein grams available you could eat some salami or some kind of meat. If you have excess carbs available for the day you could eat fatty nuts like Macadamia nuts. Be careful, though. A small handful once or twice a day is advisable. Still, you should test your reaction to all variable foods.[/details]

[details=Do I need to take nutritional supplements?]When in ketosis, your kidneys are removing more Sodium from your bloodstream. Therefore, you need to take in a modicum of salt every day, the equivalent of 2 cups of salty broth. You may need to supplement other minerals. You should talk to your doctor about your levels of Magnesium, Potassium, and Calcium. You can get that from supplements, or you can drink bone broth (stock made from simmering bones - chicken soup, for example). There is a great recipe for brown chicken stock on Richard Morris’ blog: http://easylocarb.com/recipe/brown-chicken-stock/

You may also need to supplement vitamin B12 especially if you are also taking metformin, and during seasons when you are not getting a lot of sun; vitamin D. Talk to your doctor about these.[/details]

[details=What is Fat Adaption, and how is it different from Nutritional Ketosis?]
Nutritional ketosis happens overnight. Just about every day when you wake your body is in a mild state of nutritional ketosis. Babies are born in ketosis. After about 3 days on a ketogenic diet, your body will most likely be deeper into nutritional ketosis. That’s great! However, there is still work for your body to do. Your liver is getting good at oxidizing body fat in nutritional ketosis, but the cells in your body (including your brain) that once thrived on glucose now need to get more efficient at using the ketones generated by your liver as their primary fuel source. Slowly, your body gets more efficient over time. This process is called fat adaptation. It’s not a switch. It’s a spectrum. It starts with ketosis and ends with being completely fat adapted. The process can take 6 to 8 weeks to complete.[/details]

How will I know if I’m fat adapted?

We just told you! Generally, if you have gone 6 weeks without eating carbs, and your hunger has gone away, to the point where you are forgetting to eat, you are most likely completely fat adapted. There is no litmus test for it, other than these subjective observations.

Why does my breath smell bad?

When you first get into ketosis, you’ll notice your breath is bad. This comes from the blood vessels close to the surface of the inside of your mouth spontaneously outgassing acetone (one of the three ketone bodies). It tends to go away after a while.

[details=What can I expect after I start a ketogenic diet?]Within the first week you may experience what we call “carb withdrawal.” You may lose energy, get headaches, cramps, and the like. It is not recommended that you exercise during this period. In fact, if you are obese, you might want to put hard exercise on hold, especially running or jogging, as you can actually hurt yourself. Withdrawal symptoms typically last a few days to a week, and are to be expected. Just like an extra in a play, it’s just a stage you’re going through. .

After you get through withdrawal symptoms, you will most likely continue to lose quite a bit of weight. And then, the dreaded stall. Atkins called this PISS (Post-Induction Stall Syndrome). Some people actually gain weight in the first few months. That is entirely possible. However, if you feel better, there’s no reason not to continue. In fact, you will most likely see Non-Scale Victories (NSVs) such as inches lost around your middle, increased muscle mass, and loss of other maladies.

Once you get to your first plateau, and you are not hungry - generally, the next phase is to attempt a dinner-to-dinner fast, or an Intermittent Fast (IF). That’s right. Stop eating. Drink only water, black coffee, or black tea. You may get hungry at about hour 18. If that happens and you can’t stand it, have a bit of bone broth (½ cup, perhaps) or just some hot salty water. One strategy is to fast lunch to lunch. If you do that, you will most likely be asleep during the 18th hour hunger pang, and you won’t even notice it! After one day of fasting, you might feel so good (your energy level will go through the roof) that you might continue for another day, and perhaps a third. 3 days is the optimum length for an extended fast (EF). After that, your metabolism will most likely slow down. There is so much science around fasting, and the thought leader here is Dr. Jason Fung. His book, The Obesity Code, is a must-read. https://intensivedietarymanagement.com/the-obesity-code-available-for-pre-order/ You can read his excellent Fasting FAQ for a quick intro.

The biggest benefit of fasting is lower basal (fasted) insulin levels and increased insulin sensitivity. These effects tend to last. That means, every time you fast, you increase your body’s ability to deal with dietary glucose. Lower insulin means more fat burning power.

After you’ve made it through your first fast, whether one day, two days, or three, you have so many options. You can now figure out what eating pattern works best for you. Some eat one meal a day - lunch or dinner. Some still eat when hungry and stop when full - whatever time of day that happens to be. You have options, and that’s a good thing![/details]

Isn’t eating fat bad for you? Am I going to get heart disease?

The short answer is no. Since around World War 2 the western world has been under the spell of one man, Ancel Keys, who perpetuated half-truths and outright falsehoods about the dangers of eating fat, especially saturated fat. This one man is responsible for the fat phobia that has permeated society since WW2. So much science has since disproved his claims, and yet the phobia persists. To get the whole story, read the book that The Economist magazine labeled “Science Book of the Year” in 2014: The Big Fat Surprise by Nina Teicholz. You can also listen to Carl Franklin and Richard Morris interview her on the 2 Keto Dudes podcast.

What happens if I fall off the horse?

Get right back on it as soon as possible? OK, that’s a bit glib. Let us tell you what works for us. Let’s say you have a bad day and eat some carbs. You’ll probably feel the carb cravings come back. You’ll recognize that hunger pang that would have you believe you’re starving to death. First thing in the morning, we eat fat. Maybe you whizz up some coconut oil in your coffee. Maybe you fry up some eggs in butter with some cheese and a side of bacon. Eat some fat, STAT! That’s your weapon against hunger. Remember: Eat when hungry. Stop when full. Don’t shy away from fat. It will satisfy your hunger. After a few days your hunger will have vanished completely (again), and you’ll be back in control. Don’t even worry about the scale. You most likely just put on a little water weight.

[details=What is water weight, anyway?]When we eat glucose (bread, starches, sugars, etc.) about a day’s worth of energy is placed in short-term storage (like your fridge) as glycogen. Glycogen carries a lot of water. It is believed that one gram of glycogen attaches to 4 grams of water. Glycogen provides the glucose to your body for fuel (when not in ketosis). Since there’s only about 2000 calories available, once it gets low (from exercising and not eating) you’ll “bonk” - run out of energy - and you’ll have to eat some glucose to replenish the fuel supply.

When you go into ketosis, now your fuel source is your body fat, of which there are thousands and thousands of available calories. There is no bonking. Athletes in ketosis can perform for much longer in ketosis than burning glucose. Think of your fat stores as a walk-in freezer (as opposed to the fridge - short-term small-capacity storage).[/details]

Are there any resources for Deaf members?

A volunteer group among our listeners have started (slowly) transcribing our old episodes into readable and you can find them and other resources in the Files section of the Facebook group.

[details=How can I support your podcast?]If you are the donating kind, you can do so via PayPal. Of course, every little bit helps. Monthly subscriptions sustain us the most. Just go to our website (http://2ketodudes.com) and click the Donate button next to our happy faces!

Thank you for your support![/details]


Mayo is making me nervous 😂
How to interpret blood glucose for newbies
Helping Out A Newbie
Essential research to show my doctor?
There is no keto rulebook
Net or total carbs - let's have a heated debate!
New on Keto and Struggling
First post!
Yikes! Truvia Spike!
No Weight Loss
Quick start into ketosis?
PLEASE USE THE F'IN SEARCH FUNCTION (yes I'm shouting :weary: )
Total Newbie
Please help me understand. Testing artificial sweetener
Blood sugar spike?
Just Started Keto, Tips?
Xylitol
Intermittent Fasting Frequently Asked Questions (FAQ)
Learning as I go
January 2018 IF/EF chat - all welcome
New to all this
#3

The 2009 Am Heart J study linked on blog.2keto.com is a bit frustrating.

The author’s study conclusion says: “These findings may provide further support for recent guideline revisions with even lower LDL goals and for developing effective treatments to raise HDL.”

Richard’s study conclusion says: “138K people admitted to US hospitals with a heart attack. Cholesterol was measured. Average was 105!! Non-correlation = non-causation = high LDL is NOT a marker for heart disease.”

I understand the “standard” LDL range to be between 60 - 129 mg/dL. The author’s conclusion seems to suggest that the standard range should be lowered, but don’t call the link between LDL and CAD into question. This seems odd.

Since all other markers seem to consistently improve on Keto, having overwhelming evidence that there is no link between LDL and CAD would be the holy grail for the Ketogenic diet. Its going to take a lot to change the current food pyramid.


(Richard Morris) #4

Essentially that the average LDL-c of people who were admitted with a heart attack (not just a marker of disease but the disease itself) was right in the middle of the safe range.

There are two ways to look at that.

If your primary goal is to reduce death from cardiovascular disease disease, you have to conclude that you need to find a better marker of disease.

If however you own intellectual property rights on a pharmaceutical that is particularly effective at lowering cholesterol, then maybe the “safe” level needs to be lowered.

… Follow the money.


#5

I guess pharma $ trumps beef, dairy and poultry $.


(Rich Hopkins) #6

I was explaining this to my wife, and she asked me to repeat it (I could see the gears turning). I replied, “Your body can only consume itself so fast, so you still need to eat fat.” She busted out laughing.


(Christopher Avery) #7

Hi there. I’m new here and reading through the FAQ. I think I may have found an edit. Under the question “Do I need to take nutritional supplements?” is a new paragraph:

Should this be one of the FAQs?


(Richard Morris) #8

Oh thanks - I’ll fix that up


(Val Bundy) #9

ok so does this mean for example if I am 250lbs then my body will burn 7750 calories?


#10
  1. if your body is 250lb of pure fat

  2. if you are expending 7750 calories of activity

Yes.


(Richard Morris) #11

if @Val_Bundy is 250lbs and let’s say 40% body fat then we are talking about 100lbs of body fat. I chose 40% to make the numbers come out easy to calculate … but really it could be any amount.

Let’s say for the sake of easy calculations you have 100lbs of body fat. So the maximum amount of energy that can be drawn from 100 lbs of body fat is 3150 kCal/day. You would have to need to use that amount of energy for all of that to be withdrawn from body fat.

Let’s say your normal metabolic rate is 2000 kCal a day (again choosing easy numbers to calculate). And that you fasted (so no energy coming in) and got onto a treadmill and did 1500 kCal of running maybe 3 hours worth - ugh. Now you have gone 500 kCal over your available energy and now you will do two things … your metabolic rate for the rest of the day will drop a little, and you will burn a little protein to make up the difference.

This is all assuming no hormonal interference. Insulin will further limit your access to energy. The more insulin you have in circulation the less of your maximum amount of energy you can get from body fat.

You pretty much have to have fasted insulin below 4 mIU/l to have your body fat release energy at it’s maximum rate.


(Val Bundy) #12

Oh! thanks…that makes sense!


(Phil Gilbert) #13

Been keto for just a few days and as with everything else in my life, I go full speed. Been less than 12g carbs each day. I’m feeling wonderful, focused, and energetic. Haven’t felt hungry in two days. My only concern has been my mouth/tongue. Somewhat painful and tingly. Is that the “metal taste” I read about?


Keto tongue?
(VLC.MD) #14

Try this thread


(C Del) #15

According to Thomas Dayspring and Peter Attia, neither LDL-C nor particle size matters but rather only total particle number. Could it be that these patients with supposedly normal or lower LDL-C actually had a discordant high particle number?


(C Del) #16

So, I drank decaf coffee with 60ml heavy cream and 2 squirts of liquid splenda. Baseline blood glucose:72 30min:73 60min:65. Is this significant or am I ok with sucralose.


(C Del) #17

Sorry, one more time point 90min: 60
I had just finished a 5 mile walk when I started this test so am not sure how valid this is


#18

I think you may have to test again without the walk as that is a variable that you can’t really know if it had any bearing. If you have the same result of the lowering BG when rhe walk is not a factor then it would seem that you have indeed responded to the sweetener by having an insulin surge which then lowered your BG.


#19

Oh, also could have been the cream though. I had the same thing happen after eating bacon and eggs. BG took a big downward turn at T30 and T60. I guess since I didn’t put any glucose in but the protein made my pancreas put out insulin. Best way to test would be to put some sweetener into a small amount of water and drink that only. Then there are no variables.