The ketogenic diet has gained a ton of popularity in the last few years, but there are a lot of misunderstandings about it. I started a ketogenic diet about 5 years ago, and at first I hardly knew what I was doing or why I was doing it, like many others. I made a lot of “mistakes” at the beginning that left me feeling not so great, and I know many people have the same experience, which is why I think the more education there is around eating a ketogenic diet correctly, the better! The ketogenic diet was personally critical to my healing journey, and I stayed strict keto for about 3 years until starting to dabble in and out of it. I learned a lot about my body during that process! The ketogenic diet is simple to define, but it has many nuances, which is why I want to go back to basics and discuss what a ketogenic diet actually is.
What is keto?!
A ketogenic diet puts your body in a fat-burning state called ketosis, which is a metabolic state in which your body uses fat for fuel instead of carbohydrates. Keto is typically described as a high-fat, low-carb diet, but that’s technically it. You can eat a high-fat, low-carb diet and not be in ketosis. You are in ketosis if you are producing ketones.
This is one of the most common misunderstandings about the ketogenic diet. Just because you eat what you consider to be a high-fat, low-carb diet (people have very different ideas of what this means) doesn’t necessarily mean you’re in ketosis. Foods are keto-friendly, but not keto themselves. Ketosis is a metabolic state. Eating one high-fat meal doesn’t put you into ketosis. Does this make sense? We say things like “I’m keto,” or “this meal is keto” in everyday life, which is totally fine, but I think that language can also lead to some misunderstandings about what ketosis is.
There is a difference between being ketogenic and being low-carb, but many people use the two interchangeably. It’s possible to eat low-carb and not necessarily be in ketosis, and it’s possible to be in ketosis but not necessarily eat what someone might consider to be low-carb. There are plenty of health benefits to eating low-carb even if you’re not in ketosis, so it doesn’t necessarily matter unless you have to be in ketosis specifically for a medical reason. I’m pointing this out because many people who say they didn’t do well on a ketogenic diet weren’t actually in ketosis.
Now that I’ve explained that, a ketogenic diet typically is a high-fat, low-carb diet, at least to start. After someone has been in ketosis for a certain period of time, they can often adjust their macros to eat less fat, more protein, or more carbs and stay in ketosis, depending on their body type, their metabolism, their activity level, and so on. Other people do need to stick with standard ketogenic macronutrient ratios to stay in ketosis. Everyone is different! My main point is that ketosis is a metabolic state. You can’t tell if someone is in ketosis or not just by looking at their plate.
Just because someone eats a high-fat, low carb diet doesn’t necessarily mean they’re in ketosis, and just because someone eats lower fat and higher carb doesn’t guarantee they’re not in ketosis. There was a point when I was easily eating about 100-125 g carbs daily and was still in ketosis, but I had to eat far fewer carbs than that to initially reach a ketogenic state. What people typically think of as a ketogenic diet is the way of eating that most people have to follow when they first get into ketosis – a high-fat, low-carb, moderate protein diet.
The most important part of that description is the “low carb” aspect, because reducing your carbohydrate intake forces your body to search for another source of fuel. Adding more dietary fat can help make the transition process quicker and easier, but reducing carbohydrate intake is the most critical change to make the metabolic shift into ketosis. Your carbs need to be low enough that your liver will turn dietary fats and adipose tissue into ketones.
What exactly does this metabolic shift mean?
Glucose is your body’s go-to energy source. As long as you supply your body with glucose, that’s what it will use for energy. Your body converts the carbs you eat into glucose, which spikes your blood sugar and signals the pancreas to secrete the hormone insulin. Insulin moves glucose from the bloodstream into your cells to be used for energy. When you stop giving your body glucose (when you reduce your carb intake low enough), this depletes your glycogen stores (your body’s stored glucose), and your body has to look for another source of fuel. This encourages the body to burn its fat stores as fuel, converting fatty acids into ketones for energy. When your body is creating ketones, you’re in ketosis.
What are ketones?
Ketones are the byproduct of your body burning fat for fuel. When you’re in ketosis, ketones are now your body’s energy source instead of glucose. The advantage of this is that your body knows how to burn fat for fuel, so it can burn stored body fat for energy when food isn’t available. Whether or not someone stays on a ketogenic diet longterm, it can be very valuable to teach the body to burn fat for fuel at some point, so you have better metabolic flexibility in the long run. Metabolic flexibility refers to the ability to burn fat or glucose as fuel, and to easily switch between the two sources of energy.
What do you eat on a ketogenic diet?
There are many variations of the ketogenic diet, but the standard macronutrient ratios are about 70-80% of calories from fat, 15-25% of calories from protein, and 5-10% of calories from net carbs. Instead of thinking of it that way, many people prefer to focus on keeping their carb intake below 20 g net carbs or 50 g total carbs (although sometimes below 20 g total carbs for people who have more difficulty getting into ketosis). To get into ketosis, people usually have a carb limit and a protein goal (often 0.8 – 1.0 g per kg of bodyweight, although I prefer higher), and then fat makes up the rest of their caloric intake.
After starting with standard ketogenic macronutrient ratios, someone might move into a Targeted Ketogenic Diet, a Cyclical Ketogenic Diet, a High-Protein Ketogenic Diet, lazy keto, or another variation of keto. I won’t be diving into all of those in this post, but know that ketogenic diets don’t all look the same.
What does that actually look like on a plate, though?
There are plenty of people who live on keto bars and In-N-Out on a ketogenic diet, but I don’t recommend a ketogenic diet focused on processed foods. Nutrient density always wins!
On a nutrient-dense ketogenic diet, you’ll eat grass-fed and organic beef, wild-caught fish, pasture-raised poultry, pork, eggs, bone broth, and other animal proteins. Extra points for organ meats. The ketogenic diet can also include plenty of low-carb vegetables, like leafy greens, lettuces, cabbage, cauliflower, zucchini, mushrooms, asparagus, and celery. A ketogenic diet can be a very plant-heavy diet if you want it to be! You’ll also include plenty of healthy fats like extra virgin olive oil, coconut oil, MCT oil, animal fats, ghee, avocados, and avocado oil, as well as small amounts of nuts and seeds – special shoutout to macadamia nuts! Small amounts of organic, low-glycemic berries are also often included, like blueberries, strawberries, and raspberries. Some people choose to include dairy like grass-fed butter, heavy cream, yogurt, and cheese. You’ll also want to consume plenty of high-quality sea salt.
To shift into ketosis, you’ll want to avoid any foods high in carbohydrates, which includes refined carbohydrates (breads, pasta, etc.), sugar, grains, beans / legumes, high-sugar fruits, starchy vegetables / tubers, and alcohol.
Easy meals include eggs with bacon and avocado, a big salad with animal protein and extra virgin olive oil, and roasted low-carb veggies with some kind of protein source.
What are the benefits of being on a ketogenic diet?
Some potential health benefits include:
- fat loss
- reduced inflammation
- improved cognitive function
- reduced cravings
- more energy
- improved endurance for athletes
- better gut health / reduced IBS
- blood sugar regulation / improved insulin sensitivity
- improved levels of HDL cholesterol, LDL cholesterol, and triglycerides
- improved blood pressure
- improvement in serious conditions like Parkinson’s, Alzheimer’s, epilepsy, and some forms of cancer
Ketones can be very therapeutic, and the ketogenic diet was traditionally used as a treatment for epilepsy. Over time, people figured out that ketosis could offer health improvements for other populations as well. If someone needs to be in ketosis for a medical reason, like epilepsy, then it definitely makes sense to test ketone levels to make sure they’re actually in ketosis. If someone is interested in a ketogenic diet for weight loss benefits or blood sugar regulation, though, then it might not matter if they’re actually in ketosis or not, so testing probably isn’t necessary.
How do you know if you’re in ketosis?
Signs that you’re in ketosis are enhanced brain function, having higher levels of stable energy throughout the day, fewer cravings, a reduced appetite, better endurance, and potentially weight loss. Everyone is different, though, so you might not experience all of those. Personally, the way I know I’m in ketosis if I’m not testing is by my cognitive function. My brain feels incredibly clear – there is a noticeable difference in how well my brain works.
You can test your ketones by checking your blood with a glucose meter (I use a Precision Xtra), by testing your breath with a breath meter, or by testing your urine with a test strip. I don’t usually recommend urine test strips, though, because once you’re in ketosis and actually using ketones for fuel, you won’t pee them out. This means that you could very well be in ketosis, but your test strips won’t show any ketones. Urine strips are more accurate when you first start a ketogenic diet, but not very accurate after that.
If you’re testing, a reading in the range of 0.5-3.5 mmol/L indicates you’re in ketosis. Remember, though, most people don’t need to test unless it’s medically necessary. Testing can be expensive, and for most people what really matters is how they feel.
There are many people who could benefit from this way of eating, even short-term, but it’s not meant for everyone. I know some people who notice no difference whether or not they’re in ketosis. The ketogenic diet played a huge role in my own healing process, but there have also been times when it was better for my health that I was out of ketosis. Always check with your qualified healthcare provider before changing your diet to make sure there are no contraindications.
Have you tried a ketogenic diet? Do you have any questions about keto? Comment below!