Tonight’s edition addresses the often misunderstood concept of Low Carb vs Ketogenic diet vs being in Ketosis. These are NOT the same thing but the terms are often used interchangeably, especially among folks who think they’ve done the reading or are above average knowledgable about these things. If you’ve seen the other videos up to this point and or even read the other posts, you’ve noticed my . . . specificity. It’s worth understanding the difference particularly for the your long haul adventure. And if you see me mis-use the terms, jump on it. I want to know!
Top level definitions:
Low Carb – this refers to any diet that restricts the carbohydrate macronutrient. It does not specify which types of carbs nor is there a standard approach to what the carb limit is. Broccoli and Captain Crunch are both considered carbs.
Ketogenic Diet – this is the strictest form of Low Carb, High Fat diet (LCHF). The ketogenic diet is 90-93% fat, 7% protein and 0-3% Carbohydrate. This is VERY HARD to do. And frankly, not usually necessary unless you are repairing brain damage / brain tumors / seizure activity or just trying to get yourself into nutritional ketosis.
Ketosis – this refers to utilizing fat as a fuel source for your body. The ONLY WAY to know you are “In Ketosis” is if you measure. Repeat, the only way to know you are in ketosis is to measure. And it’s so damn easy, why not do it?! Pee sticks or finger pricks get you an actual real-time answer.
Why the Specificity?
A strict ketogenic diet is actually way overkill for the vast majority of us. Do you have a Partner or Parent with Dementia/Alzheimers/Parkinson’s . . . okay, go strict keto. Seriously. Within a few days to weeks you will be able to measure cognitive improvement. That’s huge when you want your parent’s quality of life to improve but you can’t be there to hold her hand or you are there to hold hands but she’s falling apart. It’s a very real and very measurable intervention. There are not many proof of work options in life but this is one.
For the rest of us, particularly for the sake of the BB experiment, we are interested in being in ketosis, specifically nutritional ketosis. It basically doesn’t matter how you get there as long as you get there and for the most part stay there.
Nutritional ketosis refers to the process by which your liver converts fat into ketone bodies for use as fuel by the rest of your body. We want to convert the fat we are eating or the fat we already have stored, aka your stored potential. This is easy to measure. If your pee stick turns even a little bit pink, congratulations, you have made ketones! The blood ketone measure is more accurate but the pee sticks are a fine place to start.
So how do you get into nutritional ketosis? Well, a ketogenic diet can help quite a bit. But it isn’t the only way and may not be the easiest way for you.
How to get into Nutritional Ketosis, some options:
- Eat a strict ketogenic diet.
- Eat low carb, but restrict your carbs to less than 20g per day.
- Eat a LOW INSULIN oriented diet. (see below!)
- Fast. Water (with salt) and nothing else.
- Fat fast. Water (with salt) and 100% fat – think butter, cream, coconut oil, calorie restricted or not.
- Modified fast – Water (with salt) and one small high fat, low protein, low to no carb snack (1/4 daily caloric intake)
I’ll get into far more detail about the Fasts – types, durations, comments and my personal experiments (not all was roses my friend) – next Sunday. Fasting for power has become quite an area of personal interest. For right now, don’t worry about fasting unless you have a very specific interest AND you have a doc on board with your plan. Poorly planned fasts can be problematic. This is amplified if you are taking anything: medicines OR supplements!!! Particularly if you’ve self diagnosed those supps…. Seriously, don’t F with it until you’ve really understood the challenges. Mineral levels are important and can get out-of-whack if you don’t know what you’re doing.
Which leaves us with . . .
Strict Ketogenic diet
For whom do I recommend? Those who need the biggest boost to get into ketosis and even then, only until you get yourself into ketosis for 3 weeks.
You can bring it down a notch after you’ve consistently been in ketosis. It can help to know that this is not forever. If you know (or reasonably suspect) that you are insulin resistant – perhaps you’ve gained weight along the way (anything over 5 pounds since growth cessation), you’ve yo-yo dieted or bulked before (the lose / gain weight cycle) even if for “muscle mass”, or you have had blood work done that indicates you are pre-diabetic or close (fasting glucose above 95mmol), you should consider starting with a genuinely strict ketogenic diet. Starting with. This part is not forever.
Sample day for 150 pound person:
- Bacon and eggs cooked in butter with coffee with cream
- Salumi with cheese crisps and coffee with cream
- Keto meat pie: cottage cheese, shredded cheese, ground beef or lamb
Low Carb diet
For whom do I recommend? Those who are not necessarily insulin resistant. You’ve been steady weight since you stopped growing. You have blood work that puts your fasting glucose in the 65-85 range. Start with low carb to push yourself into ketosis unless you like to measure with more than the pee sticks. 😉
The ideal for the Low Carb is to restrict ALL CARBS – yes, the carb portion of veggies too – to less than 20g total per day. It’s very do-able, but requires a bit more attention than the youtubers would make it seem. And if in your inquiries you discover net carb versus total carb, let me be clear, I mean TOTAL carb. Ignore the net carb idea for now. It’s shenanigans for youtubers to obsess over for more clicks. It’s not worth your time. Focus on total carbs if you go this route. You will probably be able to go to 50, maybe even 100g carbs/day once you’re in ketosis. But you need to get into ketosis first then measure what knocks you out.
for 150 pound person:
- 2 Scrambled eggs cooked in butter
- 6oz chorizo with creamed (butter and heavy cream) cabbage
- 1/2 pound zucchini noodles with cream sauce (heavy cream, butter, cream cheese) and 4 oz smoked salmon
Low Insulin Diet
The low insulin diet is my term and deserves some explanation. This is more and less complicated than simply low carb. When insulin levels are up, your ketones are down. And we want ketones up. Anything above .5mmol for ketones is “in” nutritional ketosis. As you make ketones you’ll get increasingly higher numbers until your body figures out how many you actually need and then the levels will come back down to some steady state. Anything over 0.5mmol on the blood ketone meter is a-okay.
Insulin effectively shuts off ketone production. Insulin is a master hormone. It is absolutely vital for life so you want it working. We’re not trying to get rid of insulin. But we are trying to tame it. The Low Insulin diet is the eating pattern for you that keeps your insulin spikes down.
And this is where I ethically bribe you. You may be able to have your (real) cake and eat it too.
But you won’t know until you measure. This is more complicated than Low Carb and strict keto because it is based on you. You have to measure your responses.
Yes, you MUST measure your responses to individual foods and meals and the only reliable, real time way to do that is through the Pricks! After what feels like a lifetime of teaching NYC finance dudes I can assure you I never thought I’d recommend pricks, but here we are. You can measure this very efficiently with a finger prick for your blood ketone/glucose monitor.
You measure both ketone and glucose responses after the food in question. Want to test your Sunday night Lasagna made with proper noodles not some faux noodle? Yes, do it. I did! Here’s how:
- Eat the lasagna.And the wine if you’ve already tested your wine response…. Enjoy the lasagna. Love the lasagna. Wait, where was I?
- Then 30-45 minutes later, test your blood glucose level and your ketone level. Ideally the blood glucose should be elevated above your fasting level, but not too high, <150mmol or < 8 ml/dl, and your ketone level may be reduced but not zero. If so, kudos this might be a win. But wait, you are not done.
- Test again 2 hours later and . . .
- Again 4-8 hours later.
- You can now chart your response to the lasagna. Did blood glucose spike up and stay up or spike up late? Did ketones drop to zero or drop but then go back up?
Your response to individual foods gives you the best low insulin-response foods for you. It is far more flexible – once you’ve tested foods admittedly – than either the low carb or ketogenic diet, but there’s a time investment and commitment to discovery necessary. If you like food or like specific foods #Champers!, it’s worth the energy. If you want what looks easy on the surface, go with a prescribed diet. It’s your call. Ultimately knowing what foods help you stay in ketosis versus the ones that you know will knock you out will help you create something more livable for you.
Artificially restricting foods is kind of silly. Restrict the ones you get too much of an insulin response from and smooth sailing. Your brilliant body, it’s crazy smart. Time to lean on it.
How to start with the insulin sensitivity diet? Start low carb and then start testing foods you come across often or that you like. You like lasagna (clearly I do)? Test it. You like Chorizo breakfast tacos from a local taco truck? Test it. You might be delightfully surprised what you can fit. That said, for best results, get yourself into a steady keto state for at least 3 weeks before you start testing. A little bit of a cheat, but we want things to work here. 🙂
Some extra notes – knocked out of ketosis:
If you know you’ll be at an event where you cannot control the food or you really want that thing that will knock you out of ketosis, go for it. Choose a life you can live with. The point of this endeavor is not self flagellation. You may need a little early sacrifice to get in the game, but once you’re in, your body will actually help you stay in.
Now that you know what knocks you out and you know how to get back in, being in ketosis is not random. That’s the beauty of the nutritional ketosis. It is not random. You can absolutely measure it. You can see it real time with pricks and you’ll see the benefits in your blood work at your next physical. Prepare to wow your doc. Plus, if you have mental fog, it will lift. If you have extra weight, it too will lift. Your gym performance will also improve. But these things take more than a 30-day window. Expect at least 6 weeks to get back up-up. Then watch as you break your own records.
Your goal is to stay in nutritional ketosis. And you know I don’t mean by guessing.
Why does this work or what’s the reason for insulin focus?
If you’ve gained weight over the years, you’ve probably developed some insulin resistance. This means (over-simplified!) your body makes more insulin than it used to for the same meal load. That’s why you may react differently to foods you used to consume without penalty. This can happen to skinny people and not skinny people. But may be easier to see with those who are overweight. We are all built a bit differently, but consider this rule of thumb: if you’ve gained weight after you stopped growing (age 12-15 for ladies, 15-19 for gents), and you are not a competitive athlete (as in nationally ranked athlete, not rando gym rat), you very likely have some insulin resistance. If you’ve been told you are pre-diabetic or have type 2 diabetes, that is the definition of insulin resistance.
When you eat, insulin is secreted by your pancreas to push the glucose around either into muscle cells for fuel storage or into fat for long term storage (i.e. refrigerator versus freezer storage). Insulin stores stuff. If you are insulin resistant, the cell receptors don’t respond as well to insulin attempting to store so you have extra glucose circulating – often too much – so your pancreas creates even more insulin to get that excess glucose out of the blood. It can become a vicious cycle. This cycle is exacerbated if you have too short a time frame between insulin spikes, aka meals and snacks. Carbs or no carbs.
While you have insulin resistance you want to particularly focus on getting your insulin sensitivity back. Restricting carbs and things that act like carbs (protein!! when you are insulin resistant, no joke, but protein acts like a fat when you have insulin sensitivity back) with respect to insulin responses is the key. Very quickly you can turn that boat. It can become life or death, but it takes decades to see the negative outcomes which is why you don’t know about this yet. Insulin resistance in the brain is highly correlated with many forms of cognitive decline most of which start 20+ years before we see symptoms. Do your kids a favor, reverse that resistance now.
Or make your own plans for your elder care.
In any case this is an Insulin Dude – very serious research – listent o what he shares at min 25 +/-. It’s all about insulin
Ben Bikman min 25–>
I like his stuff and his original research focus was insulin. He’s now shifted to the ketone side because he sees profound therapeutic impact of ketones, but do your own digging on his work. A few videos are included in the BB Playlist (left sidebar!!).
I get it. 1. Insulin is crazy importante. 2. You can do ketosis without crazy food restrictions if you measure stuff. 3. Kate loves you just as you are. 4. You’ll be smarter, faster, stronger if you get your body internally bathed in ketones. 5. Get into ketosis or get your elder plans worked out. Children can’t be trusted with that.
Go be even more awesome.
Need recipe ideas with real nutritional breakdown – Try DietDoctor.com No need to join at first – over 700 recipes before the paywall, but once you get the hang of it, you may want to support the mission and or appreciate the shopping list convenience. The apple store app is kinda sh*t though. Desktop is where they have game.