How would you respond?

(karen) #1

I’m on the fence about how to respond to this email from my MIL.

“Well, Lisa got the results of her blood work back. Her A1C very high, and blood glucose 171. She is not at all careful about her diet and I am always amazed at what she allows herself to eat given her diabetes. Anyway, she is saying that she is “ready” to make big change in diet, and as always I will help her, but you 2 are the experts. Can you give me the skinny on it, and a list of absolute nono foods and foods that are ok and good? I need to get her started right away. She has 3 months to get things better or she will end up at a specialist and on insulin.”

Anyone want to take this on with a concise explanation of what to do - or a really really simple website that lays things out step by step? I’m not sure why I’m struggling, but my brain just doesn’t seem able to come up with a simple explanation of how keto works and how to get started, I just keep thinking things like “it’s complicated” and “I don’t think you can do this, you want an answer that doesn’t involve sacrifice or discipline for good health, and I don’t have one.” I’d like to be a bit more helpful!

(Running from stupidity) #2

Keto is this easy (Keto for beloved noobs)

This is for Phase One - the starter phase. it’s still not complicated later, but this is the really easy to explain version which will help you no end.

  • Eat under 20g of carbs a day

  • Eat plenty of good food - fat and protein - while adhering to 20g/carbs/day. Don’t worry too much about macros and calories EXCEPT carbs. Keep them below 20g/day. (Getting up near your protein amount is a good thing, but in the short-term it’s not going to be an issue, so don’t panic about it.) Your job is to get fat-adapted, so give your body the fuel you want it to use. Also, your appetite will vary - it’ll disappear, then it’ll come roaring back. Happens to most people, don’t sweat it.

  • ELECTROLYTES/SALT - KEEP THEM UP

  • This site has a search function (magnifying glass at the top of the page) and a newbies section - use them both, you’ll get a better variety of answers to your questions far more quickly that way. SERIOUSLY, THIS IS VERY USEFUL.[1]

That’s as difficult as it needs to be for a couple of months.

My good friend Terence (being friends with a Kiwi feels kinda dirty, but there you have it, keto makes for strange bedfellows) tells me this thing I have described above is called “dirty keto.” So yeah, do dirty keto, kids! :slight_smile:

Lots of Love, THE JUICE

Expanded version is HERE

[1]If you can’t find a useful answer after searching and reading for a while, we can help you a lot more if you tell us relevant data about yourself such as your reasons for doing keto, your weight/height/age/gender, a sample menu plan & any relevant health conditions.

(karen) #3

Ok thanks, but it’s not for me, it’s for someone else and that is my whole point here. I’ve been doing this for a year, I’ve been 100% successful except for almost going bald. I could, frankly, write a book on the subject including the biochemistry at this point. But they don’t know what fat adapted means. They don’t know what macronutrients are. They don’t know what electrolytes are. I’m not sure they’d know a carbohydrate if it bit them on the ass. They don’t want to use a calculator or look up carb values. They want someone to do all of it FOR them. My MIL is smart and she does want to help Lisa, but she’s been through this before with Lisa, I think she’s looking to me because I succeeded at this. So I guess what I’m looking for is a website or a book to recommend that literally lays out every action they should do, every bite they should eat and when they should eat it, because I’m not going to do that - and then have to explain every “order” they don’t like or want to tweak.

#4

I would add that first and foremost tell her that all of this isn’t her fault by choices she’s made. Doctor’s usually say what your email had, which puts blame on the patient.:

Without her realizing, the foods that she has been eating have actually been subconsciously controlling her decisions. There are two vicious cycles she’s caught in.

  1. eating carbs->raises insulin-> insulin blocks the hunger signal (leptin) from the stomach to the brain-> resulting in more eating-> resulting in even more insulin-> (cycle continues), and…
  2. fasting insulin levels steadily rise over time while eating lots of carbs. Once fasting insulin passes a level of 14, fat cells are chemically blocked from releasing any fat. If you’re far past 14 then you will solely rely on the glucose you eat for energy. Hence this is where the paradox of the obese person that has tons of fat, but are consistently hungry. Tons of energy is stored in fat and since they can’t access it, they’re hungry and eat all the time. The bloodstream usually only holds 2 tsp of glucose before it starts going into fat stores.

Next, divulge that this can be remedied very easily! Just cut back the carbs as @juice has laid out. Cutting back carbs-> lowers insulin -> with a few days, fasting insulin should drop below 14, unlocking fat reserves-> keep insulin low in order to burn body fat.

(Running from stupidity) #5

I read that, and thought you could point them at it, because it surely is the simple version.

But if they’re that determined to make ZERO effort, then there’s not much you can do, TBH. Horses to water and all that.

My sister was the same, but my wife’s success finally turned her around, and within a week her crazy blood sugars were under control, and so on. But it took a fair while before SHE DECIDED to get on with it.

#6

Agree. I’m not sure how you can simplify it much more than what @juice already has there. Are they looking for some eating plans, maybe?

There’s also this lengthier overview of keto from the 2 Keto Dudes:

http://pwop.com/download/TheKetogenicDietInANutshell.pdf

Diet Doctor recipes:

(karen) #7

Thank you. Sorry if I was cranky. I don’t have a lot of patience with people who come here and say “ok so I heard this word keto. What do I do. I should eat bacon, right?” I was hoping someone has taken it upon themselves to write a book or create a website that’s more like Atkins, totally step by step and you can read the big words or not. I think they’d be willing to pay if someone’s developed a complete protocol.

(Running from stupidity) #8

Man, if that’s you being cranky, be cranky all you want :slight_smile:

I don’t have a lot of patience with people who come here and say “ok so I heard this word keto. What do I do. I should eat bacon, right?”

It’s ALMOST like those kinds of people are one of the target groups I wrote those two parts for, so there was something to just point them at very easily :slight_smile:

(Bob M) #9

You could go here:

He’s a little overboard on grass-fed and technically not keto, but overall he’s succinct.

(MelissaH) #10

There are many very simply explained keto books for newbies. Maybe you could buy them a book. But boy do I understand that frustration!! My SIL wanted me to make her a weekly meal plan(doesn’t work like that) and then argued about everything I tried telling her. That’s what google is for lol

(Laurie) #11

Maybe the usual advice for newcomers, and tell her she has to start informing herself because everyone is different. Some years ago I lost lots of weight on Atkins, and looking back, I did many things “wrong” by keto standards. So you can have success even if you don’t know everything. Starting out simple would be good:

Eat meat, poultry, fish, and eggs.
Don’t be afraid of fat.
Instead of soy, canola, safflower oils, etc., switch to butter, coconut oil, and olive oil.
You can (but don’t have to) eat the following vegetables:

leafy greens
salad veg, e.g., celery, cucumber
broccoli and cauliflower
mushrooms
tomatoes and tomato sauce in moderation
onions in moderation

NO flour, pasta, bread, oats, corn. Nothing that grows underground, e.g., no potatoes. NO fruit or fruit juices. NO sugar; everything on this list is sugar:

Typical meals:

bacon and eggs (no toast, no potatoes, no ketchup)
salmon and mayo, maybe some chopped celery mixed in
steak (or any meat/fish/poultry) and salad
chicken (or any meat/fish/poultry) and cooked broccoli

Liquids:

Plain water
water with a squirt of lemon
coffee with real cream
tea–unsweetened!
diet pop/soda in moderation
NO milk

Supplements: make sure you get plenty of salt, potassium (e.g., NuSalt or No Salt brand), and magnesium.

If you feel hungry, eat more of the above foods, or try eating some cream cheese or nuts.

Avoid all “diet” foods, as most are low fat and high sugar, which is the opposite of what we’re trying to do.

Learn to read nutrition labels. Look at the carbohydrate content. If a “serving” is more than 1 or 2 carbs, don’t buy it.

I haven’t covered everything of course, but that should be enough to get her started. Good luck.

(karen) #12

I think the real reason for my frustration is that keto isn’t like other diets. You’re in ketosis or you aren’t. Lisa is the kind of person who will say, “I had pizza but I was really good, I only had one slice”, or “I had no carbs for lunch, but a couple of those little tiny snickers bars in the afternoon. And a margarita, but it was George’s birthday.” (Like your fat cells need to consider George before being so unreasonable.) When hubs and I were both keto MIL was constantly suggesting we should reward ourselves with a “little treat” for being so good, she just felt we were too ‘fanatical’, because she’s totally about calories. Cheating a bit is maybe ok for someone who’s been strict with the diet for a few months, but knowing Li, she’ll tell me the diet didn’t work for her - because she started behavior like that within a couple of days along with boosting her fat intake. Personally I think Lisa’s lifestyle needs a diet with more flexibility, but That is not my area of expertise.

#13

If she’s just looking avoid insulin she may be able to get away with a more liberal low carb diet.

www.diabetes.co.uk is one of the better websites for supporting diabetics who eat low carb & the forums are very active/helpful. Perhaps direct her there?

(Laurie) #14

@kib, for some of us, flexibility is the kiss of death. Speaking only for myself, I try to stay away from the mindset of “How much pizza/Snickers/birthday cake/diet chocolate/nuts/keto baking/favorite vegetable can I cram into my 20 g quota every day?”

(karen) #15

Yes, that’s how I am too. I think I’m struggling to find an answer for them because they want to be told moderation and flexibility is the key. For me, it wasn’t. I’m much more flexible now, but I’m in weight maintenance and I don’t care if I’m in ketosis from day to day (I’ve also never had high blood sugar or diabetes, sugar may not be my friend but it wasn’t trying to kill me). But Lisa is about 130 pounds overweight and I don’t think “moderate and flexible” is going to do her a bit of good. OTOH I don’t think she’ll stick to a diet that’s not moderate and flexible. Soooo …

(karen) #16

Thanks, I think that might be perfect.

(Banting & Yudkin & Atkins & Eadeses & Cordain & Taubes & Volek & Naiman & Bikman ) #17

I believe Dr. Westman has a four pager that basically explains everything. I believe that Dr. Eenfeldt also has a nice visual webpage of what to eat and what not to eat.

I think I gave both of those to my wife. My wife is not going to do this for real until she hits some crisis and she may never do so.

(Banting & Yudkin & Atkins & Eadeses & Cordain & Taubes & Volek & Naiman & Bikman ) #18

Sorry, I should have link hunted:
Dr. Westman, from the back of one of Gary Taubes books.

and here’s Eenfeldt:

Diet Doctor doesn’t draw it up quite as I do it, but I think he’s got a TON of free material on the site for as casual or as deep a look as anyone wants.

I would also recommend the King of Low Carb infographics, Ted Naiman, but Bob has already linked him 3 times AND he’s very much into hard core movement, which may not be necessary for Lisa and your MIL. But a ton of easy to understand infographics (also, not exactly how I cut it, but good enough for government work… incase you missed the link, Burnfatnotsugar.com.

Lastly, as recommended above, Diabetes.co.uk is fantastic.

(Carl Keller) #19

"The “keto” in a ketogenic diet comes from the fact that it allows the body to produce small fuel molecules called “ketones”.This is an alternative fuel source for the body, used when blood sugar (glucose) is in short supply.

Ketones are produced if you eat very few carbs (that are quickly broken down into blood sugar) and only moderate amounts of protein (excess protein can also be converted to blood sugar).

The liver produces ketones from fat. These ketones then serve as a fuel source throughout the body, especially for the brain.

The brain is a hungry organ that consumes lots of energy every day, and it can’t run on fat directly. It can only run on glucose… or ketones.

On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off.

This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.

When the body produces ketones, it enters a metabolic state called ketosis. The fastest way to get there is by fasting – not eating anything – but nobody can fast forever.

A keto diet, on the other hand, can be eaten indefinitely and also results in ketosis. It has many of the benefits of fasting – including weight loss – without having to fast."

(karen) #20

Thank you. Maybe you’re right, they may not need such a hard core program. I totally embraced keto, and IF, and EF. And it actually worked, I actually lost every pound I wanted to get rid of. And now, I just don’t know what to say to anyone else! The part that made it possible for me is a combination of finding the science so interesting, loving n=1 discovery, and delighting in my discipline. I didn’t want to, but wow, I did it, yay me! For someone who’s more like “I don’t want to … so I won’t, so there” … I got nothin’.