Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet (29 page)

The initial stages of adopting a ketogenic approach can sometimes lead to significant sodium loss, which can produce hunger, short-term headaches, temporary fatigue, and weakness due to transitional issues related to fundamental energy substrate changes prior to becoming fully keto-adapted. This is easily remedied by adding more full-spectrum salts to the diet, preferably Himalayan sea salt.

– Nora Gedgaudas

When hunger pangs come on strong, the foods we crave tend to be processed carbohydrates. Instead of giving in and indulging in carbs, try feeding your body dietary fat instead. Nothing will zap hunger more quickly than fat (and maybe a little bit of protein, too)! One of my favorite ways to stop hunger is to eat a slice of full-fat cheddar cheese rolled up with a few pats of butter in the middle.

For people who are used to the dieting world, shifting to a low-carb, high-fat, ketogenic diet can be difficult. Most don’t eat enough fat or food to completely satisfy their hunger. Skimping on fat will result in more hunger and cravings, and all the other side effects we’ve described already throughout this book. It’s the perfect way to set yourself up for failure, so before you blame the diet, heed the advice in chapter 7 and eat more fat. You’ll find that your hunger is completely satisfied, and of course you can’t get into and sustain ketosis without eating enough fat. Ditch your fat phobia once and for all.

The old stigma that fat is unhealthy is the greatest impediment for people pursuing ketosis.

– John Kiefer

Failing to eat enough food when you are starting a ketogenic diet can also—unsurprisingly—bring on hunger pangs. So when hunger hits, it’s time to eat up and enjoy the bounty of delicious and nutritious foods that are at your disposal on a low-carb, high-fat diet (a list of these satiating and mouthwatering foods is included in chapter 19). After you consume a meal like this, don’t feel like you have to eat again the next time a “regular” mealtime rolls around just because of the time of day. If you’re not hungry, then don’t eat! It seems like a no-brainer, but far too many people succumb to the societal pull to eat by the clock and not by their need for food.

There are plenty of people like me who can comfortably eat one or two meals daily thanks to ketosis. Others may prefer to eat multiple times throughout the day. How much and when you eat is a personal decision; just monitor your progress and eat when you’re hungry. Remember, carbs make you hungry while fat (with a little protein) fills you up and keeps you satisfied. Learn to listen to your body and eat accordingly.

There are many reasons for eating other than hunger: we often eat when we’re bored, anxious, depressed, or worried; we eat with friends to be social; we eat as part of holiday celebrations; we eat because we’re in a setting that we associate with eating (like eating popcorn at the movies or hot dogs at a ballgame). Some people may feel a stigma in social situations where everyone else is eating and they are not. For example, pastors, rabbis, and priests face an occupational hazard when they visit someone’s home as a guest and are expected to eat whatever is prepared for them. The important thing to remember in these cases is that gathering together is about fellowship, not food. Simple phrases like “Thank you, but I just had something to eat” can keep feelings from being hurt, and in the worst-case scenario, eating “just a taste” may satisfy your host. Of course, be sure to say how wonderful the small taste was! And removing the eating aspect from socializing actually frees you up to engage more with others. You won’t miss it if you are properly adapted to being fueled by fat and ketones.

Some roadblocks people encounter when attempting to follow a ketogenic diet include peer pressure to eat “normally” when they are with family and friends. But that is why I am so passionate about re-creating these favorite foods, such as protein noodle lasagna and healthy, sugar-free, extremely low-carb desserts—so clients don’t feel the need to cheat.

– Maria Emmerich

Emotional eating is extremely common because carbohydrate-containing foods or beverages temporarily make us feel good. The good news is that bacon can become a comfort food just like macaroni and cheese, without the unintended consequences of weight gain and other health effects—but there is no question that most Americans have been raised to consider sweets and starches to be comfort foods. Fortunately, that changes over time when you embrace a low-carb, high-fat lifestyle.

Many people feel the urge to eat or hear their stomachs gurgling or growling at certain times of the day and assume that these feelings mean they’re hungry. These feelings are not hunger; the brain simply draws that conclusion because we have eaten at that time of day for so long. It’s a Pavlovian response: just like Pavlov’s dogs, who learned to associate the sound of a bell with feeding time and began salivating anytime they heard a bell, we also unconsciously become accustomed to eating at certain times, and our bodies generate stomach movements and secretions in response—but that’s not true hunger. After you become keto-adapted, stomach noises and urges to eat that are associated with a certain time of day quickly fade away.

DOCTOR’S NOTE FROM DR. ERIC WESTMAN: I grew up celebrating holidays with the typical mountains of sweets: candy bars at Halloween, candy hearts on Valentine’s Day, cookies at Christmas, and so on. The last sweet to go for me was jelly beans at Easter—it took me ten years to finally give them up!

It’s worth noting that some members of the online health community have questioned whether women should engage in intermittent fasting, citing concerns about hormonal dysregulation. But as long as fasting occurs in response to the natural satiating effects that come from being in a state of ketosis, there’s no reason to avoid it. That said, it’s definitely worth talking to your doctor if you have any specific concerns about this. And of course, pay attention to how you feel while fasting and make any needed adjustments. If you’re hungry, that’s your cue to eat!

With my affinity for doing tests on myself during my yearlong n=1 nutritional ketosis experiment, I was curious to see what would happen if I attempted a one-week fast, eating nothing and drinking only water. I had engaged in a one-week fast with water, diet soda, and chicken bouillon cubes in 2011, putting the words of cancer researcher Dr. Thomas Seyfried to the ultimate test. In my podcast interview with him on
The Livin’ La Vida Low-Carb Show with Jimmy Moore
in November 2009, Dr. Seyfried noted that fasting for one week each year may be a great cancer prevention measure. The theory is that we can kill cancer cells by not feeding them sugar and carbs, and that the high amount of ketones generated during a weeklong fast may act as a protective measure against cancer. It took me a while to work up the gumption, but I tried it for the first time in April 2011. Dr. Seyfried even honored my willingness to give it a go in his 2012 book,
Cancer as a Metabolic Disease
.

Once my body had been running efficiently on ketone bodies (beta-hydroxybutyrate) for ten months in a row, I wanted to see if I could replicate that same one-week fast but with water only, forgoing the diet soda and boullion cubes I consumed last time as well as exercise and all my usual supplements. My goal was to make it for an entire week. With nutritional ketosis, regular eighteen- to twenty-four-hour fasts were already very natural and easy for me, but what would happen once I got beyond this time period? Of course, our hunter-gatherer ancestors went through regular, extended periods of deprivation when food was not readily available, but what would this feel like in the modern world? I wanted to find out for myself.

The ketogenic diet has been effective in my practice in the treatment of obesity and chronic disease without hunger or deprivation.

– Dr. Keith Runyan

Since I wanted to see what changes were happening to me during the entire week, I decided to test blood ketones and blood sugar every waking hour on the hour while observing everything that was happening in my normal routine. This would allow me to assess precisely how the fast was affecting all my numbers and state of health in real time. I promised myself and my wife that if at any point I started to feel bad beyond just simple hunger, or if my blood sugar dipped into the lower 50s for more than a couple of hours, I would end the experiment immediately.

During my first couple of days without food, my blood sugar began dropping slowly, until the bottom fell out in the early afternoon of the third day. That’s when my blood sugar hit 59 for over two hours—and it was accompanied by a headache. Other than that, I felt pretty good. But even when my blood sugar rose back into the upper 60s again, my headache persisted.

My blood ketone levels followed a similar pattern but in the inverse. I saw normal readings of around 1.0 to 1.5 millimolar in the first couple of days, and then BOOM: it was 4.6 after forty-nine hours of fasting and slowly ticked up from there, to a high of 5.8 millimolar seventy-one hours into the fast. This coincided with my blood sugar dipping down to 59 for a couple of hours. As I’ve stated before, I wasn’t at all worried about my blood ketones going that high because it coincided with a simultaneous drop in my blood sugar levels (I can’t emphasize this point enough: diabetic ketoacidosis occurs only when
both
blood ketones and blood sugar are elevated to extremely high levels; nutritional ketosis produces higher blood ketones and lower blood sugar).

Because of the persistent headache, I decided to officially end the fast at 5:30 p.m. on the third day. Within an hour of eating a pretty sizable meal, the headache completely disappeared. I’m thinking now that my electrolyte balance was off; the bouillon cubes were a lot more effective in helping me sustain the fast in 2011 than I realized. It was a lesson learned for the next time I attempt to do a one-week fast. I can’t help but wonder how much higher my blood ketones might have gone had I continued the fasting experience for the entire seven days. Incidentally, the night after I ended my three-day fast, I had difficulty sleeping, waking up after just a few hours.

Here are a few observations I made after my three-day fast was over:

• My first meal after fasting for seventy-two hours was pretty substantial.
  
• Despite eating a large amount of food, hunger persisted for a while, and I had to resist the urge to keep eating and eating.
  
• For a while after the fast, I felt hungry more often than I did before the fast began.
  
• Morning fasting blood sugar levels rose into the 90s in the days that followed the fast.
  
• Blood ketones dropped back down to normal within three days.
  
• When I went back to the gym, I still had full strength.
  
• My weight predictably rose several pounds after the fast ended.
  
• My sleep took a couple of days to become uninterrupted again.
  
• My mental clarity remained unchanged throughout.
  

You don’t need to completely fast for days on end when you get into ketosis; I did it just to see what would happen. My conclusion is that you can get all the benefits of fasting by letting it happen naturally when you consume a low-carb, moderate-protein, high-fat diet with ample calories. Ketones give you the luxury of fasting that way, without even thinking about it.