Frequently asked questions:
Can I have alcohol?
The short answer is yes (in moderation, because life’s too short…)
The long answer… Wine, prosecco, tequila, gin, vodka, and other relatively clear spirits are generally ok. You have to remember that alcohol is the most readily used energy source for the body and is absorbed very quickly. Many alcoholic drinks are very sugary, particularly liquers and flavoured drinks. The problem we have as ketoers and drinkers is that this information does not have to be displayed on the bottle. Pure distilled drinks like vodka, gin, tequila and whisky do not contain an awful lot of sugar per shot, however as previously stated, contain a lot of alcohol, therefore calories.
The best advice we can give is to avoid any beers (basically liquid bread) and try and stick to clear, unflavoured spirits with soda, or wine in moderation. The bonus is, you will find once you have been in ketosis for a while, alcohol has a disproportionate effect and you will get drunk very quickly. Beware!
Thanks to Debbie Saunders for the following:
Should I take ketone supplement pills?
Raspberry and other ketone pills are basically snake oil. The only way to enter nutritional ketosis is to follow a low carb/high fat diet, i.e. our plan. If you take ketone supplements they are simply excreted via the renal system, so if you test this way all they will do is show ketones in your urine, thereby lulling you into a false impression that you are in ketosis. Don’t use them.
Why am I losing inches but not pounds?
Some people starting on a ketogenic lifestyle experience a rapid weight loss in the early stages, whereas some don’t. Don’t worry if you are one of those who’s scale readings don’t change (see to weigh or not to weigh on this site). If you are losing inches rather than weight it means your body shape is changing for the better! If this is your goal, then this is a good thing surely? It is not unusual to convert fat into muscle, and muscle is more dense and weighs more than fat. Other reasons are increased bone density, hormones, inflammation, and water retention due to medication. Another reason could be thyroid dysfunction, which can make you retain more water. Other possible symptoms of this are fatigue, increased sensitivity to lower temperatures, hair loss, dry skin and depression. You might want to check with your doctor if these symptoms are present. If you are not experiencing any of these, and the only thing that’s bothering you is the scales not changing despite other positive changes in your body don’t worry – this means that you are eating your way to a fitter, healthier you. Persevere and you will get to where you want to be…
Help, I've gone off plan!
Okay so something went wrong, and you want to get back on it as soon as possible. We are all human and we have all been there. Here is what happens and your choices:
1.You want to eat ALL the food, cravings are on high alert and you are starving.
Have a very high fat day, bulletproof coffee, pecans dipped in cream cheese, belly pork, crispy chicken skin, olives etc. This helps to reset the hunger hormone (ghrelin) and massively reduces cravings. Start afresh tomorrow, no harm done.
- You feel sick and bloated, you can’t get off the toilet, you have stomach cramps.
In this case take the day to fast, keep your electrolytes in check, some bicarbonate of soda will ease bloating, you can try Apple cider vinegar in sparkling water. When you start again follow your macros, check what you have eaten that may have caused it for future reference though.
Know your triggers and be prepared in future. If you know a glass of wine is going to get you on the crackers, make some keto ones before you pop the cork! If Xmas has you dreaming of chocolate, make some fat bombs to help you resist. If you are going out for dinner check the menu first. These things will become habit in time.
What if I'm vegan/vegetarian?
You can follow a ketogenic way of eating if you are vegetarian or vegan. You will find it a lot more challenging as you will not be able to source your fats or protein from meat, dairy, soya, fish or eggs but it can be done, bearing in mind that all vegetable proteins come with carbs. Although we do not routinely cater for these lifestyles, we have mentors who will be able to assist you. See our mentorship page.
Keto and pregnancy
Ketogenic living during pregnancy is very controversial. We would recommend that you seek advice from a knowledgeable General Practitioner. They will want to know why you are considering this way of eating, and what you hope to gain from it without endangering your unborn child. Your body will change an awful lot throughout your pregnancy, and during breastfeeding. As an example, if you are breastfeeding, current guidelines suggest that you will need an extra 500 calories per day for your body to cope with the added burden. We would suggest that if you wish to embark on a ketogenic way of eating to lose your “baby fat”, you should wait until your child is completely weaned.
Ketosis and Keto-acidosis
Ketosis and keto-acidosis are two completely different things.
Ketosis, as we have already said, is a naturally occurring process allowing the body to use fat for fuel and energy.
Keto-acidosis is a potentially life- threatening condition affecting diabetics who have had a very high blood glucose level for a significant period of time, and is treated with an emergency dose of insulin to bring blood glucose down.
There is no comparison between the two states.
What’s dirty/lazy/clean keto?
Keto or ketosis is quite simply putting the body into nutritional ketosis and keeping carbs under 20g will do this. We don’t really like the terms above, but they are in common usage… Clean keto is balancing your macros throughout the day using as few processed ingredients as possible, i.e. real food that you prepare yourself. It seems counterintuitive if you want to improve your health and encourage weight loss to continue eating the processed foods that got you here in the first place –
Dirty keto is when you know your macros, and what you eat to meet your targets for the day doesn’t really matter as long as you don’t exceed them. This make it possible to consume trans fats and processed foods with all the negative health implications. Lazy keto is when you may or may not know your macros, and don’t track them, but stick to the general guidelines of high fat, low carb (see “what if I don’t have an app?”). This works for plenty of people who are ready to maintain weight or conversely have just started and want to get a feel for it (there was no information about macros etc. in the early days of keto for weight loss, and this is how they did it…)
What is Keto? When you ask “am I allowed ” please consider this:
The reality is that “keto” is simply keeping the carbohydrates you eat to less than 20g to put the body into ketosis which in turn allows the body to use fat(including body fat) for fuel.
It has the added benefit of reducing the appetite. Simple, Yes?
Here’s the thing;
Plenty of people will be hugely successful eating anything they want within that 20g limit for a while, maybe forever but what we see, over and over again is Keto turning into yet another low calorie, highly processed food diet.
Here, we work on not just keto, but also good nutritional practice. For example, we don’t work to a calorie deficit because they are proven not to work long term. We discuss studies on artificial sweeteners, soy, peanuts, protein for optimum health, seed oils and numerous other things, sometimes testing on ourselves to help YOU make better choices.
We would encourage anyone to keep their diet as inclusive as possible within the realms of REAL food. However,
IF your losses slow,
IF you still experience joint pain,
IF you are having cravings and keep falling off the “wagon”,
IF you experience hair loss,
IF your mental health is poor etc
Then you may need to go cleaner. Real food cooked from scratch, none of the inflammatory foods mentioned above, limited alcohol and most importantly no calorie deficit to encourage healing.
Will all this fat raise my Cholesterol?
The short answer is yes but only temporarily.
The long answer is yes, and no. Read on…
LDL and HDL are lipoproteins that carry cholesterol (and triglycerides and proteins) in the blood. When you cut out carbs you force the body to unlock the fat in the cells to be used for energy but they can measure high on the cholesterol test. This is not something to be worried about. As your body becomes fat adapted and you reach a state of ketosis, the bad cholesterol LDL falls (this is the one that can cause heart disease, atherosclerosis and other health problems) whereas there is an increase in the good cholesterol (HDL) which is vital for every cell in the body.
i) It is virtually impossible to explain how vital cholesterol is to the human body. If you had no cholesterol in your body you would be dead. No cells, no bone structure, no muscles, no hormones, no sex, no reproductive system, no digestion, no brain function, no memory, no nerve endings, no movement, no human life – nothing without cholesterol. It is utterly vital and we die instantly without it.
ii) Cholesterol is so vital to the body that our bodies make it. The body cannot risk leaving it to chance that we would get it externally from food or some other external factor – that’s how critical it is.
iii) There is no such thing as good cholesterol and bad cholesterol. Cholesterol is cholesterol. The chemical formula for cholesterol is C27H46O. There is no good version or bad version of this formula.HDL is not even cholesterol, let alone good. LDL is not even cholesterol, let alone bad. HDL stands for High Density Lipoprotein. LDL stands for Low Density Lipoprotein. (There are three other lipoproteins, by the way, chylomicrons, VLDL and IDL).
Fat and cholesterol are not water soluble so they need to be carried around the body in something to do their vital work. The carriers of such substances are called lipoproteins. We can think of lipoproteins as tiny ‘taxi cabs’ travelling round the blood stream acting as transporters. So, lipoproteins are carriers of cholesterol – oh – and triglyceride and phospholipids and protein. All lipoproteins carry all of these substances – just in different proportions. LDL would more accurately be called the carrier of fresh cholesterol and HDL would more accurately be called the carrier of recycled cholesterol.
iv) The standard blood cholesterol test does not measure LDL – it estimates it. The fasting blood cholesterol test can only measure total cholesterol and HDL. There are two other unknowns in a four variable equation – LDL and VLDL. The estimation is refined further using the Friedewald equation (named after William Friedewald, who developed it).
Total cholesterol = LDL + HDL + Triglycerides/5
As any mathematician will tell you, one equation, with four variables, only two of which can be measured, is a fat lot of good. We need at least one more equation or known variable, to avoid circular references. This also means that:
– All other things being equal, LDL will rise if a) total cholesterol rises and/or b) if HDL falls and/or if c) triglycerides fall.
– All other things being equal, LDL will fall if a) total cholesterol falls and/or b) if HDL rises and/or if c) triglycerides rise.
No wonder an inverse association is observed between LDL and HDL – it is by definition. More surprising is that a fall in triglycerides, which would be welcomed by doctors, would be accompanied by an automatic increase in LDL, all other things being equal, which would not be welcomed by doctors. And you thought that this was scientific.
v) Statins stop the body from producing the cholesterol that it is designed to produce. They literally stop one of our fundamental body processes from being able to function. The intelligent view on statins is that in the very limited arena where they appear to have some ‘benefit’ (men over 50 who have already had a heart attack), they ‘work’ by having anti-inflammatory properties and that the fact that they lower cholesterol (by stopping the body from being able to produce this vital substance) is a very unfortunate side effect. (Drug companies should work on developing something that has the anti-inflammatory benefit without this huge and damaging side effect – it’s called aspirin).
One in 500 people have familial hypercholesterolemia and may have a problem clearing cholesterol in their body (rather like type 1 diabetics who can’t return their blood glucose levels to normal). For anyone else to be actively trying to lower their vital and life affirming cholesterol levels is deeply troubling.
vi)Cholesterol in food has no impact on cholesterol in the blood and we’ve known that all along.
The real question is, “Why does high cholesterol matter?” It’s vital to life – if you don’t get it from food then your body makes plenty of it and if you do get it from food then your body makes less of it. Clever body! Under normal circumstances the body will not manufacture any substance which will cause it harm. There are links in the reference sources to fully explain. If you have any concerns please read or watch some of them so that you are armed with the knowledge you need when discussing it with your doctor.
Eating out and takeaways:
Amazingly some fast food have embraced those following a ketogenic diet and offer a topping only pizza or meat- based pizza. This is great with a caveat that many bulk bought cheeses are not actually cheese and simply a hydrogenated trans fat and milk protein concoction. This is the equivalent of elmlea (not cream) and margarine i.e. not fit for human consumption. Ask if this is the case before you order!
Chinese is difficult because of the high hidden sugar content, Duck is likely deep fried in unsuitable oils as is almost everything else, meat is usually velveted using cornflour, so at a push egg foo yung may be suitable.
Indian food fares better as they generally cook in ghee, but dry items like tandoori chicken or prawns and a sag paneer (spinach and Indian cheese) side will suffice, some also do a mushroom, okra or aubergine side dish. You could ask if your favourite curry has added sugar. The more we all do this the more chance we will eventually be catered for.
Better restaurants are a good option generally as they tend to want to please the customer, ask to substitute the carbs for vegetables or salad. Pub grub is usually fried in cheap oil.
Surprisingly late- night kebab shops can often produce a grilled chicken or lamb kebab with lovely salad vegetables. No pitta or sauces of course.
Do I need to cook?
The short answer is yes. This way of eating means that you need to be avoiding additives, sweeteners, hidden sugar and all the other nasty stuff that pre- prepared packaged food comes with. Ingredients matter as much as carbs. You will really struggle to find a reliable source of pre- cooked food that is suitable. The other element is that if reading food labels in the supermarket is your idea of a good day out then go for it – you know what’s in your own, home cooked food already. You can’t beat the taste of a nice piece of meat simply fried in butter, or fresh vegetables cooked to your own taste. There are plenty of keto friendly recipes on the internet that are quick and easy to prepare.
Can I have chocolate?
The best options for chocolate are: Montezuma 100%, Hotel Chocolate 100%, Callebaut cocoa mass 100% and Madagascar 99%. You must check the labels however as many contain soy, sweeteners or other nasties. High percent cocoa chocolate can be very bitter until you get used to it. Try working your way up from an 85% one, whipping them into cream or melting them with cocoa butter until your palate adjusts. One square will then be like a feast!
What oils should I avoid?
It would be easier to list the oils you can use, but you should eliminate refined vegetable oils which were originally developed to lubricate engines and machinery. These are the plastic containers of oil you see in the supermarket. Corn, soy, palm, canola, rapeseed, sunflower to name a few.
They are high in Omega 6. Good health relies on a ratio of 1 part omega 6 to three parts omega 3 oil. In the modern diet, this is being hugely reversed to 20 parts omega 6 (due to cost and processed food) to 1 part omega 3. Another major contributor to the obesity epidemic…
Can I have protein shakes?
Protein shakes are generally made from whey or pea protein, these are incomplete proteins and often don’t contain all the amino acids necessary to utilise the protein effectively in the body. Its as easy to quickly blend a shake with real protein foods like eggs, cocoa butter, chia seeds (milled if you dislike the texture) cream or coconut milk and a few berries or cocoa powder for flavour. Remember keto is a moderate protein way of eating.
Do I need a ketone monitor?
Are you looking to change your life for the better and eat well? Will peeing on a stick or drawing blood or breathing into a monitor enhance your life or create extra stress? The choice is yours however, if you do want to measure the most accurate is a breath monitor. Pee sticks only work in the early stages. Once your body is using ketones efficiently it won’t excrete them in urine.
How do I know if I'm fat adapted?
So you’ve been through the downside of ketosis, like bad breath, constant peeing, thirst and smelly urine and here come the rewards – becoming fat adapted gives you a mental clarity, a surge of energy, reduced appetite and you will rarely see ketones in your urine if you were measuring as they are now being used to give you all that lovely energy. Conversely, there is often a deep sense of calm and mental stability as an added bonus.
What Apps should I use?
We’ve done a basic guide in case you don’t want to track everything but the apps most used are My Fitness Pal and Carb Manager. These are not infallible though and often set poor macros or incorrect food properties. Please double check, especially if they set your calories at under 1500.
Can I do Keto without a gall bladder?
Many people do very well on it without their gall bladder but we would caution to increase your fats slowly otherwise you may suffer from diarrhoea. Increase fats and reduce carbs proportionally until you are at a comfortable level. You may be lucky enough to have a keto friendly doctor who can advise you more specifically.
Dreaming about Carbs?
Yes, it’s a thing – you dreamt you ate something full of carbs and woke in a panic. Everyone does this during the early stages it seems. We don’t know why.
Is blurry eyesight normal on Keto?
No, but a lack of Thiamine or vitamin B1 can cause this. You were probably getting plenty from the fortified bread pasta, and cereals you used to eat so you need to get it from beef, liver, nuts, eggs and seeds now. If any abnormal symptoms persist you should of course visit your GP/Optician.
Other names for sugar:
Sugar is present in many forms in processed food – there are around 50 different euphemisms for sugars used by food manufactures, including syrup, nectar, diastatic/barley malt, Florida/fruit crystals, galactose, dextran, maltodextrin, caramel, Diatase, fructose, glucose, maltose, ethyl maltol, dextrose, lactose, panocha, honey, fruit juice concentrate among others. Read the food labels with care!
Should I eat if I'm not hungry?
Should I eat if I’m not hungry? Do I need to hit my fat macro?
These questions arise again and again and I fully understand how unhelpful it is to be told yes by some and no by others so let us clarify for you.
When you first start a ketogenic lifestyle you often lose your appetite so you naturally eat less but you are then in danger of simply following yet another calorie restricted diet which studies show ALWAYS results in weight regain.
Let us simplify this:
If you reduce the calories you eat the body will automatically reduce the calories it uses.
This is a fact. The body is efficient. You should aim to keep calories high without raising insulin, as fat is the only macronutrient which doesn’t instigate insulin release, the bulk of calories should come from fat. Insulin is the fat storage hormone remember.
To do this well and without the bloating and discomfort that came from overeating previously we recommend this:
Divide your protein and carb allowance into 2 or 3 meals and work out the calories from those. This rarely exceeds 500 calories so you know you are not overeating. You can add around 200 calories that come from fat WITH the carb and protein sources like cheese, meat, avocado etc. You now need to find roughly 100g of fat which sounds daunting, but is really only 5 heaped tablespoons(obviously depending on your macros)
1.Oil, butter or cream in coffee or hot chocolate is a meal without carbs or protein.
2.Olive, avocado or walnut oil on salads with mayonnaise or cream cheese.
3. Cook in butter, ghee, lard, bacon fat or beef dripping.
4. Eat fatter cuts of meat like pork belly, chicken thighs and beef shin.
Some sources of fat if you need it are:
2 egg yolks are 10g fat, use them to thicken cauliflower mash or disguise in hot drinks.
Half a cup of pecans with cream cheese gives up to 60g fat, or buttered pecans with salt.
10 olives is 5g fat
Iceberg lettuce or spinach drizzled liberally with a good oil is 20g fat
In the blender use ice, a strawberry, cream and walnut or hemp oil with a tsp Apple cider vinegar for a refreshing cold drink, 20/30g fat.
Try to mix things up, doing/eating the same thing over and over is not only tedious but the body adapts. It WANTS to maintain it’s weight and calorie expenditure.
Caveat: if you are very large with a lot to lose, the gradual reduction of your protein macro and corresponding fat macro will keep you eating enough while bringing calories to an acceptable level.
Can children do Keto?
It is important for children and young adults to receive good nutrition from high quality protein and fats. Just cutting out processed food and sugar will make a huge difference to your child’s long-term health and happiness and will give them a good basis for a healthy relationship with food in later life. Intermittent fasting is definitely not recommended for children.
What is Keto Flu?
The dreaded Keto flu is something you may or may not experience – everyone reacts differently to a change in diet. Some people may experience one or more of the following symptoms:
- Muscle weakness/lethargy,
- Leg cramps,
Maintaining a proper fluid intake is vital, along with taking your electrolytes. This will help alleviate the above unpleasantness. As always, if serious symptoms persist you should visit your GP.
How do I maintain once I've reached my goals?
You’ve reached your goal -excellent news! You may have lost weight, improved your health or both and we couldn’t be happier for you.
So what happens now? You should find your carb level at which weight gain resumes/symptoms occur. Do this by increasing your carbs by 5 grams per week, weighing at the end of each week. When your weight starts to rise, or symptoms return you have reached your carb level – Stick to this (or slightly under) and you will be fine. Well done!