3 Must-Have Tools For a Successful Ketogenic Diet
Dr. Taylor Krick
As the ketogenic diet continues to gain popularity, more and more people are trying to implement the diet. As a wellness physician who has prescribed low-carb diets for years and done a ketogenic diet personally for several years with a lot of bio-hacking, here are 3 things I would not suggest doing the ketogenic diet without. These are photos of my actual products that I use regularly and recommend.
If you are unfamiliar with the terms ketosis, ketones, ketogenic, fat-adapted, or keto-adapted please download and read my eBook The Real Health Guide to the Ketogenic Diet and watch the webinar of the same title.
Blood Ketone Meter
I do not recommend doing a ketogenic diet without measuring the ketone levels in your BLOOD!
I have seen many people implement what they call a ‘ketogenic diet’ and begin to reduce their carbs while boosting their fat intake. Inevitably, they begin to feel better and they come to me and say “I think I’m in ketosis!” but when we measure their blood, they are disappointed to find out that they are in fact NOT in ketosis, or at most they are in mild ketosis.
Although you do need to monitor your macros (carbs, fat, protein) to achieve ketosis, a keto diet is very hard to do by measuring macros alone and virtually impossible to do by simply monitoring the way you feel. Depending on the diet and lifestyle you are accustomed to, practically everyone can expect to feel better when they reduce their carb intake and their blood sugar begins to regulate. Everyone’s metabolism is unique however, and some people can become fat-adapted at 50g of carbs/day while others will have a hard time breaking into ketosis at 30g of carbs/day, and after following the diet some can maintain ketosis at 100g carbs/day. Measuring is the only way to know how your body is truly responding.
I recommend the Precision Xtra from Abbott which can be bought on Amazon for $25, and I personally get my strips on eBay ($20 for a 10 pack is a great price).
The reason I suggest the blood meter is because 1) it’s inexpensive (the Precision Xtra costs $25 on Amazon) and 2) it gives you an exact number to work with. Using urine strips can tell you whether or not you are in ketosis, but it doesn’t give an exact number, and from what I have seen it can be misleading. It’s also possible to be creating ketones that are immediately excreted in the urine but the blood would indicate that those ketones are getting to the brain. Because the blood strips are expensive, a good combination would be to use urine strips while keto-adapting and then begin measuring the blood to know your exact numbers.
Using a blood meter can tell you how ‘strong’ or ‘weak’ your state of ketosis is. You generally want to be between 0.5mmol and 3.0mmol of blood ketones. If your blood meter shows a ketone level of 0.4mmol, you know you are almost into mild ketosis, whereas if it shows 1.5mmol you know you are in ketosis, and if it shows something like 2.8mmol you know you are in strong ketosis and your body is mobilizing lots of fats. Likewise, if you are eating 40g carbs per day and you are in strong ketosis, you may be able to increase your carbs to 50g or even 60g and stay in strong ketosis, and you can only know this by monitoring your blood levels. This can help you fine-tune your keto diet to get you into the strongest ketotic state! You can see in the picture below that around 11:30am my blood sugar was 77mg/dL and my ketone level was 1.1mmol. My highest readings are around 3, I have clients who have gone above 8mmol during extended fasting periods. Above 3.0 there is not much further therapeutic benefit.
All fats can be ketogenic to a degree, but there are good, better, and best keto fats. Medium Chain Triglycerides, best found in an MCT Oil, are the best. These fats, found in coconut and palm oil are able to be converted to ketones fastest, and have also been shown to improve weight-loss, decrease cravings, and preserve lean muscle mass.
Triglycerides are made of 3 fatty acid ‘chains’ attached to a glycerol backbone. The length of the ‘chain’ can be short, medium, or long. The shorter the chain, the less effort your body has to put into breaking down that triglyceride. Medium chain triglycerides have chains of either 6, 8, or 10 carbons.
The reason chain length is important is because longer chain (12+) triglycerides have to be broken down in the liver, while shorter chains (MCTs) can bypass the liver and become immediately available as energy, especially to your brain. This means that a medium chain triglyceride can be turned into ATP (the energy that all of your cells use) in only 3 steps, while sugar takes 26 metabolic steps. This means it becomes energy faster and easier than other energy sources and creates fewer by-products.
Think of a longer chain fat like a whole fruit or vegetable, and a shorter chain fat like a smoothie - it’s already broken down. That is why shorter chain (MCT) fats can be quickly and easily be made into ketones!
The 3 triglycerides that truly act as medium-chain TG’s are:
C6 - Caproic Acid - not much found in coconut oil
C8 - Caprylic Acid - around 6% of coconut oil - the best for the brain!
C10 - Capric Acid - around 8% of coconut oil
It’s important to note that coconut oil is a good source of MCTs, but 80% of what is referred to as MCT in coconut oil is Lauric acid, which is 12 carbons long. This is misleading to be labeled as an MCT, because Lauric acid does in fact have to stop by the liver for breakdown, so it behaves more like a long-chain triglyceride. So coconut oil is a great source of MCTs, but MCT oil is better, and a C8 Caprylic Acid source is the best option. Lauric acid is still incredibly healthy, it just doesn’t have the same fast-acting energy benefits as the shorter-chain MCTs.
MCT oil can be added to your diet in many ways. A great way to start your day with a quick burst of good ketogenic fats is by putting MCT oil in your coffee, popularized by the Bulletproof brand, who make really great MCT products. I put MCT oil and grass-fed butter into my coffee each morning (the key is to blend it!). Not only does it provide ketogenic fuel first thing in the morning, but I love the taste and the frothy texture from blending. MCT oil also makes a great salad dressing, and can be put on virtually any keto meal. Here are two brands that I have been testing and comparing. They each have their benefits, but I like the Now brand better because it contains only C8 and C10 MCTs, while the Onnit brand contains C12 Lauric Acid.
Real Salt (Sea Salt, Pink Himalayan Salt, Celtic Salt, Mineral Salt, etc)
One of the benefits of a low-carb diet or going into ketosis is the reduction of insulin. This is a great result, because elevated insulin causes insulin resistance, weight gain, diabetes, inflammation, and shortens life span. However, insulin also tells the kidneys to retain sodium, so lowering insulin can reduce sodium levels and cause electrolyte imbalances. The best way to combat this is by consuming more than your typical amount of sea salt.
Common electrolytes include sodium, chloride, potassium, and magnesium. While initially low-carbing or ‘keto-adapting’, it’s not uncommon to go through a few days of feeling sick - low energy, dizziness, brain fog - known as the ‘keto flu’. This is caused by electrolyte imbalances and can easily be avoided with the right action steps. Keto-friendly electrolyte-rich foods help to balance electrolyte levels while on a low-carb diet including nuts, fish, avocados, and dark leafy greens, but the best way to combat electrolyte imbalance and avoid the keto flu is by adding more real salt.
Typical table salt is only sodium and chloride, while real salt contains 60-80+ trace minerals and electrolytes in their natural ratios, which can replenish sodium and balance electrolytes. This can be Himalayan pink salt, Celtic Sea salt, Real Salt, etc. I suggest a variety of salts! Sea salt should be added to foods and can be taken with water. A good rule of thumb is 2 teaspoons of additional salt each day.
I personally will add additional salt to all of my meals, will add it to my keto coffee in the morning (not too much, it ruins it!) and when I feel like I need to I will dissolve a teaspoon in a cup of water.
All three of these are simple, inexpensive action steps that I would not recommend doing a low-carb or ketogenic diet without. This diet is not easy, but with the right tools you can make it work for you and continue to burn fat, reduce inflammation, fuel your brain in the healthiest way. Make sure you check out www.RealHealthResource.com for all your other ketogenic diet resources and other podcasts, articles, and webinars for Real Health!