Keto FAQ
A keto diet is reasonably new and therefore the long term complications of this diet are not readily known. It is recommended that prior to beginning a keto diet, you read reputable studies and discuss this with a health professional to make an informed decision. Particularly those with diabetes, high blood pressure, kidney, liver or heart conditions, or those who have had a weight loss surgery (e.g. gastric bypass) as in these situations, a keto diet will require constant medical supervision.
If you are breastfeeding, a keto diet is not advised.
Am I consuming enough/too much protein?
It is important to acknowledge that protein is a very important and essential macronutrient. It is broken down into amino acids, which are the building blocks to help repair and grow our body’s tissues, build muscle, make essential hormones and support immune function. However, when provided in excess gluconeogenesis will occur, in which the body breaks protein into glucose (carbohydrate). Because of this, when following a ketogenic diet, your protein intake should be around 10 - 20% of your total calorie intake. This provides enough protein to maintain muscle, without preventing ketosis from occurring.
How do I know if I'm in ketosis?
Everybody is different when it comes to being in ketosis, but generally, it takes between 2-7 days of following a keto diet to get into a state of ketosis. This link provides insight as to how to go about using —and interpreting— blood ketone meters, breath ketone meters, and urine sticks.
I have been getting headaches, feeling dizzy, feeling tired, experiencing low energy, and/or feeling fatigued. Is this normal on a keto based meal plan?
These are all symptoms of the "keto flu," and they are typical of someone who is not getting enough electrolytes —sodium, magnesium, and potassium. Replenish your electrolytes through sticking to your meal plan, staying hydrated, and through supplementation. In time these symptoms should pass.
If symptoms persist, please contact your doctor.
Am I supposed to have a refeed day on my keto based meal plan?
No! As you're not supposed to consume carbs on a keto-based meal plan—only trace carbs! Remember, the carb guidelines whilst following a keto diet are 50g of total carbs or less, or 25g of net carbs or less.
Can I consume coffee, tea, or other low calorie drinks on a keto based meal plan?
Black coffee, tea, and the odd low-calorie beverage are okay to consume on keto. These items are ok because they do not possess a significant calorie or carb count. They more or less count as "trace" carbs only.
Be mindful around the addition of things like milk, sugar, and cream, as these items may increase the calorie intake to the point they shouldn't be consumed in addition to your meal plan (keto or otherwise).
Can I consume *insert food item here* on a keto based meal plan?
Regardless of whether you are on a ketogenic meal plan or not, it would be best if you were not consuming anything in addition to the meal plan. Consuming food items in addition to the meal plan makes it hard for us to track your progress, and give accurate feedback. The only exception to this rule is a post-workout whey protein shake. However you must remember you cannot consume additional carbohydrates on a keto meal plan, this includes, but is not limited to, things like bread, alcohol, sugary drinks, protein powder(that contains carbs), and fruit.
Is there an optimal ketone level?
If you’re following a ketogenic diet, then your primary goal is likely to produce ketones. Instead of using sugar as fuel, your body is converting fat into ketones, which are then used as fuel. The more ketones you have in your body, the higher the chances are that your body is in the metabolic state of ketosis. When you’re in ketosis, it means you are burning fat as your body’s primary energy source.
How to Tell if You’re in Ketosis
Ketosis is not a black and white thing, and instead you can achieve different degrees of ketosis. Nutritional ketosis begins when your blood ketones measure 0.5 mmol/L, with varying evidence surrounding the optimal fat burning range. However, it is advised to not exceed 3 mmol/L.
While there are a few different ways to measure your state of ketosis, none are particularly reliable in assessing one’s true ketogenic state for a number of reasons:
Urine Test Strip
The most common way people test their ketone levels is through urine test strips; however, these test strips are primarily made for type 1 diabetics and only use a colour chart as a means to approximately test ketone levels. Plus, this form of testing is meant to measure the acetoacetate in your urine, which is different from, say, measuring the BHB in your blood.
Plus, while these strips test your ketone levels, there is no way to tell how well your body is using those ketones. Which, if they were being used efficiently, then the colour strip would actually be lighter, not darker. Not to mention, certain medications, Vitamin C supplements, and your level of hydration can drastically affect the outcomes of your test. For example, if you’re well hydrated, your ketone levels will show as lighter than if you’re dehydrated.
One final note on urine test strips for ketone levels, is that if you’re ingesting exogenous ketones, then the majority of these are burned in the body, so very little is expelled through urine. And, when your ketones are high, there’s not an accurate correlation between what is found in your urine versus blood.
Blood Test
A blood test for BHB is therefore considered a more accurate representation of ketone levels, because it is able to detect an actual number than, say, a more subjective method such as colour. This test is quite similar to testing blood sugar. When performing a blood test, you will want your number to be in the range of 0.5-3 mmol/L for nutritional ketosis, encouraging optimal weight loss, athletic performance, and mental clarity.
However, if you’re just looking for signs that you’ve reached ketosis, you’ll be able to smell the acetone in your breath, which is hard to miss! Just don’t expect it right away, it can take upwards of 3-6 weeks to truly be in a metabolic state of ketosis.
Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes and requires immediate medical attention. Simply, the body is unable to produce insulin, so sugar cannot get into the cells, so the body goes into ketone production overdrive. There is no mistaking the symptoms of DKA and you can’t confuse whether you’re in a nutritional state of ketosis or a life-threatening state of ketoacidosis. Early symptoms of DKA are dry mouth, excessive thirst, frequent urination, fatigue, nausea, vomiting, and abdominal pain, and can increase your risk of coma or death if not properly treated in time.
If you’re fat adapted, you won’t have any sugar cravings, you will have low inflammatory levels, your mood will be stable, and you will have optimal mental clarity. Alternatively, if you’re hypoglycemic (a symptom of DKA), you will have sugar cravings, chronic inflammation, you’ll be tired and irritable, and unable to concentrate.
Should I Worry about DKA?
In theory, if you have a predisposition to diabetes and you’re restricting your carbohydrate intake for nutritional reasons, then it is possible for ketoacidosis to occur. This is why for diabetics following a keto diet, consistent medical monitoring should occur.
However, it’s important to understand that unless you are diabetic, it is virtually impossible to reach a state of DKA through diet alone.
When determining if your keto diet is effective, focus is better placed on energy levels and mental state, than the colour on a test strip or number on a blood test.
Unless of course, you are experiencing early symptoms of DKA, in which you should seek immediate medical attention.