Step 1: Be less quantitative: Stop using your Urinary Ketone strips. I have patients who use these strips and are constantly stressed out because they did not see the expected increase in ketones.
Step 2: Don’t beat yourself up if you occasionally have higher levels of carbs: If you feel like having higher carbs on a particular day, or enjoying a dessert, go for it.
Step 3: For exercise, don’t stress if you consume carbs: If you are exercising, depending on the duration and intensity, and your adaptation to burning fats and ketones for energy, you may feel weak if you do not introduce some carbs (can be fast, higher glycemic carbs). Don’t stress, it is OK to exercise on a mixed-keto regimen and still be in ketosis.
Additionally, can you answer the following here (not in the document with the 3 tips as I’ll use your answers to create an intro/closing pitch):
1. Why do you think the keto diet is perceived by some to be stressful?
It is perceived as stressful, because in the USA and most developed countries, many, many foods and drinks are laden with carbs, fast-digesting starches, and sugars. So, going low carb or Keto (say 5-20 grams of net carbs per day; 5% of daily total calories as carbs) requires eliminating many foods from your diet. This in turn, requires discipline and regimentation.
2. Why is this a misperception?
This should not be characterized as a misperception in my opinion, because going keto does require avoiding many foods that Americans habitually consume. Once accustomed to consuming high levels of sugars in the diet, low carb foods can taste bland and bitter, and we will miss the “high” associated with a sugary drink or dessert. To give some chronologic perspective, about 200 years ago, the level of sugars consumed was 75 times less than that consumed per day (www.thediabetescouncil.com/45-alarming-statistics-on-americans-sugar-consumption-and-the-effects-of-sugar-on-americans-health/; www.dhhs.nh.gov/dphs/nhp/documents/sugar.pdf). If one is willing to eliminate most added sugars, and return to our more traditional and ancestral diets consisting of less-processed foods, and healthy vegetables, meats, and oils, then sure, it is easier to go low carb. Adding supplements like MCT oils and exogenous BHB salts can make it a lot easier to go Keto because it is easier to return to a ketogenic state when we have higher carb days.
3. What about the fear that once stopping keto, the weight will return? Any truth in that?
Yes. If you stop the Keto diet, there could be a compensatory increase in carbs and calories consumed that leads to weight gain. Also, there could be less satiation (more food consumed at subsequent meals) and increased appetite, both leading to weight gain.
4. If you could give one piece of advice for someone looking to start Keto, what would it be?
Go slowly, gradually, and follow our tips for making it less stressful. The diet has to be fun and flexible or you will quickly return to your old ways. If you are like most of us, when you first go Keto, you will be very strict and regimented. Eventually you will loosen up and consume more carbs on some days, but it is unlikely you will return to your prior low fat, high carb Standard American Diet (SAD).