February 2, 2016

Being Fat Adapted Versus "In Ketosis" (Pt.3/3)






Now that the issues of fat adaptation and fat loss versus ketosis—or the lack thereof—have been clarified, let’s move on to a related issue that drives me crazy: newbie low-carbers freaking out if they eat something that not only takes away that beloved purple, but—gasp!—causes the scale to go up a few pounds.

When a low-carber who doesn’t understand some basics about human physiology gains weight after indulging in a pile of something sweet or starchy, they go absolutely apoplectic. Not knowing any better, they step on the scale the next day, see that their weight has gone up a few pounds, and they Just. Freak. Out. I can’t count how many times I’ve seen people post to forums and message boards either in tears or in a raging anger, because they ate a donut, or a bagel, or two slices of pizza, and gained, say, four pounds the next day. They then fall into thinking that their body is so fundamentally carbohydrate intolerant that after indulging in one carbohydrate-laden meal, they gained, overnight, four pounds of fat. (Never mind that the total weight of the amount of food they consumed for the entire day probably didn't even weigh four pounds, let alone that one bit of carb splurge, so I don't see any logic to how they think this works, but I digress.)

I’m not really sure how to talk about this without expressing grave concern over these well-intentioned folks’ ignorance as to the inner workings of their own bodies. (And by “expressing grave concern,” I mean, “shaking my head at the utter lunacy out there.”)

Time for a quick lesson in glycogen storage. 



Glycogen is the stored form of carbohydrate in our bodies. It is stored in the liver and in the muscles, but the muscles have a much greater storage capacity than the liver. For every gram of glycogen stored, the body also hangs onto about 2.5 grams of water. That’s right—over twice as much. If someone is following a low-carb diet, generally speaking, their glycogen levels will be lower than if they were eating lots of carbs. (Glycogen is never fully, completely depleted, not even when someone “hits the wall” or “bonks” during an endurance race.) So when they decide to indulge in a carbohydrate-heavy meal, their glycogen stores are champing at the bit to be refilled with all that nice carbohydrate. The obvious result will be a relatively quick increase in scale weight, thanks to all the water being hoarded along with the glycogen.

Remember, too, that insulin affects sodium retention in the body, and the physiology adage is that "water follows sodium." Higher insulin levels ---> more sodium, and therefore, more water, being retained by the body.  

This is NO BIG DEAL to people who understand that this is just water, and in a day or two of getting back to their normal low-carbing, it’ll be gone. Remember when you first went low carb and lost a bunch of weight rather quickly? Well, some of that was all the water being released as your glycogen stores were being reduced. The rapid gain of scale weight is simply this process happening in reverse. It’s not body fat, and it has not, in one fell swoop, completely undone whatever progress has occurred up until then. Most veteran low-carbers know this, and a bump of a few pounds here and there doesn’t worry us. It’s usually the newbies who feel completely dejected. My advice to them is: STAY OFF THE SCALE, SILLYHEADS! Now that you know a carb-fest will cause the scale to go up a little for a day or two after, why do that to yourself? Why subject yourself to the mental torture you know will likely ensue? Stay off the scale for a couple of days, until your body has let go of that very temporary extra water.

But that’s specific to weight. What about ketosis and fat adaptation? Well, the answer is different, depending on how long someone’s been low-carbing, and how well adapted they are to running on fat. The longer someone’s been at it, and the longer they’ve been fat-adapted, the less impact an occasional carb-fest will have. On the other hand, for someone who’s new to this, the more often they stray from low-carb, the more difficult it will be for their body to even become truly fat-adapted, never mind staying there in the face of a big carb onslaught.

As I explained in the previous post, ketosis is fragile and fleeting. Fat adaptation is hardier. It’s quite easy to get rid of ketosis. It’s much harder to undo years (or even several months) of fat adaptation.

To share another example from my own personal experience with all this (any of you getting tired of me talking about myself?), I’ll share with you what happened the first time I attempted a low-carb diet, and then what I’ve learned more recently, after having been a low-carber for several years.

The very first time I tried to lose weight via low-carb was in 2000. I was a college senior, and I guess I just wasn’t quite ready to really do it. I would start the day very well, but invariably, I would eventually be confronted with temptation. Whether it was someone bringing in cake at my work-study job, free cookies at an editorial board meeting for the literary journal, or just me being tempted by pretzels, rather than string cheese, in the campus grab-and-go snack shop, I don’t think I made it even two days in a row of sticking to low-carb. Not surprisingly, my body never got into that awesome zone where it was running primarily on dietary and stored fat. Every time I ate a cookie, or savored cake frosting, I was putting up a roadblock to my body becoming  a “fatburner,” rather than a sugar-burner.

Fast forward sixteen years, and I know far more about all this now than I did back then. I’ve been low-carbing for about twelve years now (having finally started and stayed with it since mid-2003). And while I have always made it clear that I am by no means super-strict all the time, overall, even on my highest-carb days, and through my longest bouts of slightly higher carb intake, I was and am still low-carb compared to anyone eating the standard American diet. So my body is quite well fat-adapted, whether or not I’m in ketosis. And the occasional carb bender really doesn’t affect me much. I don’t get a headache the next day, I don’t feel sluggish, there’s no brain fog, and I don’t crave yet more carbohydrate. Sure, I’ll be a little bloated, but that’s just water, and I know it’ll be gone quickly. (Even more quickly if I work out, with the intent to get rid of that glycogen & water asap.)

I began the first post in this short series with a list of things urine ketone strips are not good for. So let’s end with what they are good for: 
  • Encouragement
  • A confidence boost
  • Visual confirmation that, at least to some degree, your body is burning fat. (They cannot tell you, however, whether it is the fat from your food, or the fat from your arse. [Or your belly, hips, thighs, upper arms, or second chin.])
  • Visual confirmation that your body “works.” (Meaning, it is doing what it’s supposed to do when you cut back dramatically on carbs.)
  • At least some feedback about the metabolic state of your body around the time you tested.

In conclusion, urine ketone test strips are not useless. They can be quite handy, provided we understand how to interpret the information they give us, and provided we use them as tools to help us reach our end goals, rather than using dark purple as the end goal, itself. (After having attended a conference on ketogenic & metabolic therapies this past weekend, I'll be posting an addendum to this series at some point, and I'll talk just a little more about how much we don't know yet about whether higher ketones [say, BOHB at 3-5mM, rather than 1.5-3mM] are important for anything except bragging about them on social media. They may or may not be helpful for managing certain medical conditions...a lot is as yet unknown, but we do know that higher ketones do not cause magic fat loss.)


For more on this topic, check out what other folks have to say (all of whom are far more succinct than I am): 



P.S. Regarding getting rid of water and glycogen after a little carb-up, whether intentional or unplanned: there are ways to speed up the process. First, drink plenty of water. (Yes, even though you’re trying to get rid of some.) Fasting will help, too, even just 12 hours or so. Just try to go several hours without eating. This will reduce liver glycogen. The extra weight & water you’re carrying, however, is mostly wrapped up in muscle glycogen, and the way to reduce that is through physical activity. An intense workout would be best—maybe some sprints, or something else hard & fast. (Umm...) You could start the morning with a fasted walk, which will help, too, but at some point during the day, something intense will be more effective. Your mitochondria will thank you.


P.P.S. I have never used a blood ketone meter, but I am most definitely interested in getting one, if any manufacturers out there want to send a meter and some test strips my way. ;-)  (To my Australian readers [if there are any of you] – I’m told you can get these much cheaper than in the U.S. If this is true, and you’re interested in a little deal, let me know!)








Remember: Amy Berger, M.S., NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

80 comments:

  1. Hey Isabel, welcome to my little corner of the low-carb world. :) It's hard for me to comment on your weight gain without knowing how much you weigh, your height, age, etc. It all plays into things, but the short answer is, yes, it is absolutely possible to consume too much fat on a low-carb or ketogenic diet. If your goal is specifically fat loss, and you are less concerned about maintaining a constant state of high-ish ketones, then generally speaking, going a little lower on fat will help. Make sure you're not skimping on protein. For fat loss, it helps to make sure you're getting enough protein (many women aren't), don't be afraid of fat, but don't go out of your way to add lots and lots of *extra* fat to things, and don't be afraid of non-starchy vegetables. I think the die-hard keto crowd is starting to do some of us a disservice by making people scared of protein and broccoli. Not all of us do so well with "MOAR FAT." Those extra Tbsps of butter and olive oil still have to *go somewhere,* and if you're not burning them, they might go to ... your hips, your belly, your thighs...

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  2. Replies
    1. http://www.tuitnutrition.com/2016/01/dont-be-a-ketard1.html
      http://www.tuitnutrition.com/2016/01/dont-be-a-ketard2.html

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  3. Hey Amy, if you're interested in a ketone/glucometer many manufacturers will send you one for free since they assume you're diabetic and buying strips for life, strips is the hard part since they're expensive in the US (about half the price online in Canada too, give it a google).

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    1. Yeah, it's not the meter, it's the strips where they get you. I'll give in at some point and get one. I don't plan to test often, but it would be nice to check once in a while, especially if I'm aiming for higher ketones at some point. (Not usually, but now and then.)

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  4. The Australian company is http://www.ketosistools.com/collections/ketone-strips
    However, after two months ago Dr. Ede ordered 150 strips for $165.90 including the shipping, saving almost 65 dollars, they have been sold out.
    Noora

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  5. Female newbies also panic as they approach that time of the month where there is some water weight gain. When I was cycling it was about 3 pounds each time, often followed by a "whoosh" after my period started that sometimes took off more than just the three pounds.

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  6. Thanks for this series, Amy. As usual, a broad assessment of the dynamics regarding being in ketosis and being fat adapted. Ketosis is a candidate for one of the more misunderstood aspects of LCHF. Your thorough treatment did this topic justice.

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  7. Check ebay in Australia. You can get them cheap there. Search for freestyle. If you get stuck, let me know I can organise one for you I'm sure.

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  8. the group I'm in is always pushing fat.. I'm thinking I should cut it down... I usually eat 18-20 carbs a day and 70% of my diet is fat and 25% is protein...But I always feel hungry even tho I'm eating 1400 calories a day... frustrating

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    1. Unless there is a specific reason why you *need* to follow a medically therapeutic ketogenic diet, eating that was can be counterproductive for certain other goals. Why are you eating so few carbs? The goal is to feel well and be healthy; not to be perpetually in ketosis for the sake of being in ketosis. Re-evaluate your goals and ask yourself is this is the best strategy for you to achieve them. 18-20g carbs/day is probably far too restrictive for you and most likely completely unnecessary. Higher carbs, a little less fat, and maybe more protein. Protein should be a *gram* goal, not a percentage goal. Personally, I've always found that *protein* satiates me far better than fat. Please do not avoid perfectly good non-starchy vegetables out of some misguided terror of going over some completely arbitrary and ridiculously low daily intake of carbohydrate. I have an epic rant about this issue coming up in a few weeks.

      If you'd like to discuss issues further, please consider booking a phone session: http://www.tuitnutrition.com/p/services.html

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  9. Hey Amy! How long do you think one should eat strictly low carb to become fat adapted? I don't intend to cheat, but sometimes I'd like to have something more carby and don't want to obsess about interrupting the process or something. Right now I'm on week 2, I plan to be strict for 4 weeks minimum, but not sure whether to be strict longer.

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    1. It really depends. Probably at least 6 weeks, if not more. If you're athletic and very active, you probably have more leeway with eating carbs, whether you're fully fat-adapted or not. ;-) Just don't fall into the trap of being obsessed with chasing high ketones. As this series is intended to explain, you need not be in ketosis to have a fat-based metabolism and reap the benefits of low-carb. Most people really don't need to be as restrictive as 20-30g of carbs per day. I've been getting way too many clients lately who are following super-strict medically therapeutic-type ketogenic diets and *not* doing well. I have to convince people to eat *more* carbs! (Not like 200g/day or anything, and not necessarily from grains and sugar, but more like 40-70g, from larger portions of vegetables and a greater variety. No one ever became obese or diabetic from too much eggplant...)

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    2. Thank you Amy :) Honestly, I've been doing low carb for almost 8 months, but I've cheated every week or two and figured out I've never got truly fat adapted. I decided to "man up" and will try to do these 6 weeks at least, maybe 8.

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    3. I have been 6 weeks no lose. What's wrong. I am following it correctly

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  10. Wow! What a great article! I'm still a newby at this 10 weeks, and to have all of this information summarized so succinctly is very reassuring that what I have observed during this period of time is *all* normal!

    I've never really panicked about anything that I observed (except for that one period where I had a bad keto flu, started a new workout plan at the gym and couldn't remember anything that I had done the next time I went back) but I am curious about one thing:

    I bought the keto stix when I started my keto diet but only because I wanted to see them turn purple :) Everything I've read said that when I fat adapted and my body is burning ketones efficiently that the stix probably won't work any more. I still always show up as dark purple.

    Like I said, I'm not worried about it and after reading your article I'm really not worried about it, and I wouldn't be worried about it if they stopped showing purple altogether, but since I'm not cheating, should I expect them one day to not show up as purple or is dark purple just normal for me?

    Cheers!
    Ken

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    1. Thanks for reading, Ken. :) (And thanks for sticking through until part 3. Based on page views, it looks like most people read part 1 and then quit, which is a shame, because I think part 2 is probably even more important.) As for the keto strips, honestly, it varies. I know a lot of long-time low carbers who still show pink/purple after years of eating this way. Maybe not all the time, every day, but they'll see a color change regularly enough that they know they're still in a good place, fuel-burning-wise. Just remember that *any* color change is fine. No need to see dark purple all the time. Even just light pink shows you're running on fat -- and even if you *don't* see it, you could very well still be running on fat and just not excreting *extra* acetoacetate into your urine. Don't get too hung up on things either way. If you do see a color change on the test strips after months (or years), that's fine, and it's also fine if you don't. ;-) (There's nothing "wrong" with you if you continue to see the color change, even if strangers online claim that when you are truly fat- or keto-adapted, they won't change.)

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  11. very interesting, ive been keeping my macros to 80%fat, 15%protein and 5%carbs and after an initial drop my body fat has stalled the last month. I also realize now ive maybe gone a bit crazy panicking if i eat too much brocoli as my carbs will go up! will try relaxing my 20g total carb plan ive been sticking to :)

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    1. You might do even better cutting back a little on fat and increasing protein. Percentages are pretty meaningless for me without knowing what your actual *grams* of prtein, fat, and carbs are. I'm starting to see far too many low carbers skimping on protein because they've become afraid of consuming "too much protein" and causing gluconeogenesis. This is madness, and I have a post coming up about it. Please make sure you're not UNDER-eating protein. Depending on what your total calories are, 80% fat is quite high, unless you need to follow a medically therapeutic ketogenic diet. If your main goal is fat loss, consider increasing protein slightly and cutting back on fat. You want more of the fat that is fueling you to come from your stored body fat, rather than massive amounts of fat added to your plate. ;-)

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  12. Thank you!! As a race we are obsessed with bloody numbers!!! Money, time, measurements of all sorts! How on earth did the human race exist without numbers when they didn't have them LOL! I'm starting a new business that aims to help our ever growing nation get back their health and one of the things I have decided is that they will only weigh and measure once a month to try and get them out of this obsession! Being a Relational Psychotherapist I am constantly working with this obsession with numbers!

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  13. I have a question. I am insulin resistant and type 2 diabetic. I have always thought by not eating (fasting) my body will think it's starving and increase the resistance. Is this false?
    Also because of the insulin resistance will it take me longer to become fat adapted due to all the glucose I have to burn before burning fat?

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    1. No. If you have type 2 diabetes, the best thing you can do is a low carb diet (how low might depend on how severe your condition is). Fasting is simply one extra tool that some people find helpful, but it is not "required" in order to reduce blood glucose or insulin levels. Some people do find they need that extra little trick when a straight ketogenic diet and exercise don't get them all the way where they want to go, but it's not necessary for everyone. Just stick to a good, solid, low carb diet and don't drive yourself crazy over the details.

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  14. Wowza! This was a terrific set of articles Miss Amy!!! I was eating too much fat trying to adhear to so much info out there and when i did what you advise about lowering fat consumption and just bumping up protein a little higher i found the sweet spot for my body. Now my body is using the fat on my bum and elsewhere for its energy!!! Bravo for helping people trying to understand and for helping people succeed!!

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    1. :D I'm glad that helped. I, too, have decreased my fat intake and am focusing on leaner proteins. It's not as fun or as delicious, but *it works.*

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    2. You are so right! It works! That's the bottom line. Health and wellness and strength so we can go forward and accomplish what we were put on this earth to accomplish. Strength over time equals power. I wish I could give the author of that quote but I thinks its a true one! Much success to you for your future. Thank you for putting info out that truly makes a difference.

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  15. Indeed a very comprehensive post. Entertaining but maybe I am a newbie that's why I didn't quite remember all the key things.. I did enjoy reading it and understood the key points.. basically ketostix show ketone levels which may or may not come from body fat.. it may be dietary fat too.. do clarify if I'm wrong

    One suggestion though: Although it seems to me that for long form reading, long form blogs like these should have more images as it reduces stress on the eyes. I am a content writer and have my own blog where I follow the rule of at least one image every 300-500 words. The post would have had better comprehension rate if it had more images. I'm a voracious proofreader, I proofread everything I am reading and writing quite fast, even without that this blog would have stressed me hard.

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  16. I need to lose about 40 lbs to be at a healthy weight. I am type 2 diabetic, take 55 units of slow release insulin nightly. Have been following keto for 2 months and have lost nothing. Was wondering if it is because I am on insulin. Oh yes, and the strips were showing negative for about 6 weeks and for the last 2 weeks they are showing between a light and dark pink. How can I lose weight with this life style. I know its the best thing for my diabetes, but I have some weight to lose also for my health. I have been also trying to do the 80/15/5 % of 1400-1600 calories...Any ideas would be appreciated...

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    1. Hi there,
      I would recommend less fat and more protein. 80% fat is TOO MUCH if you are trying to lose body fat. I know this is different from what you have seen and read on many keto forums and groups. If you are trying to lose body fat, it is counterproductive to load up your plate with a lot of extra fat. Ditch the bulletproof coffee (if you're doing it), go very easy on added fats in the form of butter, heavy cream, oils, and go easy on or eliminate altogether nuts and cheese. They often get in the way of fat loss for many people. Please see this post. It's long, but will be worth it for you: http://www.tuitnutrition.com/2016/12/ketogenic-diet-rant.html
      It is much more important to focus on the "low carb" aspect of this than it is the "high fat."

      Also, for more detailed recommendations, please email me privately, using the "Contact Me" form toward the right on the website.

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  17. Hi Amy,

    Thanks for the series, it helps me a lot! I am new to the ketogenic way of life and I am soaking up all the information I can find to do this the healthy way.
    After reading 'Grain Brain' by David Perlmutter I started this way of life. I aim for clear MRI's (I have a braintumor) and a healthy brain. Because of my condition I sought help from a dietary coach, but she said low carb will make me loose too much weight and she advised to take light drinks and margarine (is that the word for the plastic 'butter' some people put on their bread?), so I decided that this coach was not for me. The hospital cannot provide any guidance because the effect of a keto diet on brain tumors has not been proven scientifically yet. I guess I have got nothing to loose, so I am going for it.
    Now I am on my own and trying to do the best I can with all the information available on the internet. Because of my condition I do aim for ketosis, but since I just started for some weeks now, I am first trying to get used to this way of life and to maintain my carbs as low as I can, without overdoing it by the way. Health comes first for me, so most important is to make sure I get all the minerals, vitamins etc. my body needs to be healthy, so I do take a lot of supplements. I already did before I started, now I just adjust to what I think is needed. Since I am not much of a meat eater, I bought Protein to supplement my natural protein intake.
    I notice that the goal for a lot of people is to loose weight and for me that is absolutely not the case. I need to maintain the way I am. A little is okay, but not too much.
    All recommendations are welcome...

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    1. I don't know if she is taking patients, but google Dr. Annette Bosworth (Dr. Boz). She does keto for health, specifically brains. She is an internist. She has a book, Any Way You Can where she wrote about helping her mom with cancer (brain) with a ketogenic diet. She is located in South Dakota, but does virtual appointments as well. Good Luck.

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  18. Love your writing style and your content! Thank you for the time and energy you give to all of us!

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  19. Great article(s)! Im a BulletProof coach and this explanation about Ketones and fat adaptation is where I'll send my clients to for a good explanation.

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  20. hello! i really like your blog! it is very informative! could you please help me with something? i have been on keto diet since january... all four full months with only one time eating carbs... for the past two weeks i am aiming and achieving the 85-10-5% ratio.. however my ketastix are purple which as you said simply state that ketones are present but my blood meter never goes above 0.4mm/l which mean i am not using ketones as fuel... isnt four months a long time to get fat-adapted? i am in desperate need to loose weight for health reasons... do you have something else for me to try? thank you for your time and reply...

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    1. Hi Georgia, I'm away from my computer until tomorrow evening and I dislike writing long things using my phone. I'll write back to you tomorrow night or Sunday. In the meantime, consider booking a consultation. (See the "Services" tab on my website.)

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    2. You might want to read this post -- scroll down to sections 2 and 3:
      http://www.tuitnutrition.com/2016/12/ketogenic-diet-rant.html

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  21. I started with whole30 for a month and went for the ketoginic WOE 2 years ago. I have never got that acceleration in energy or piece of mind. I have lost about 70lbs, but most of that in the first year. I have only got above .7 a couple times on my blood meter. I really would like to see some energy.Any thoughts??

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    1. Yes: stop measuring ketones.
      http://www.tuitnutrition.com/2016/12/ketogenic-diet-rant.html

      For any more detailed advice specific to you and your goals, consider booking a consultation. Hard for me to give any recommendations without knowing more about you and your health history. (See the "Services" tab on the website.)

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  22. Thank you for a very informative article. This ketogenic lifecycle has been rather a big learning curve for me, and I have read all sorts of things, bought books, researched on the Internet, and this has finally made me understand more fully. I hvae around out that I am in ketosis, but I am not losing weight!! So I will follow the advice, continue with low carb until my body decides it's ready to use fat as fuel as a regular thing. Thank you!!

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    1. Hey Pixi, thanks for reading. :) If you're struggling to lose fat on a low carb diet -- assuming you do, in fact, *have* fat to lose (you'd be amazed how many inquiries I get from people who are *already* at a healthy weight), focus on getting enough quality proteins and cut back a little on fat. The more fat you load onto your plate, the less of a need your body has to tap into its own stores to use for fuel. This is especially true if you only have a small amount of weight to lose, as opposed to a large amount.

      Don't worry about being in ketosis. Focus on losing body fat -- they're not the same thing. As the guys at KetoGains say, "Chase results, not ketones." Check out their macro calculator: this is likely more protein and less fat than you have been eating. Excess protein "turning into sugar" is really such a misunderstood thing. Not to worry about for most people. https://ketogains.com/ketogains-calculator/

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  23. Thanks for the article! I won't lie though. I'm a little confused now. My doctor prescribed the Optimal Ketogenic Diet, but I feel a bit overwhelmed by the amount of fat (154 grams!) a day. I haven't been able to stick to 20g of carbs a day. I usually end up between 45 and 65 grams a day (mostly non starch veggies). My protein goal has 🐝 103 g a day. Even going over the carb limit my calories usually fall about 250 short. I exercise daily (30 min yoga, 30 min cardio/resistance). I haven't lost any weight. I feel confused! I have lost inches, but sometimes I feel so sick and dizzy. I don't even know what I am trying to ask! Foggy brained as usual.

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    1. Hard for me to comment without know more about you. Feel free to email me privately with more information. (Starting weight, any meds you're taking, specific issues you're dealing with other than stubborn fat loss, etc.) tuitnutrition (at) gmail (dot) com

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    2. Sick and dizzy? Make sure you are getting enough SALT. (More than you think you need, especially if you sweat a lot!) Don't force the fat if you're trying to lose body fat. Hit the protein target and don't gorge on fat if you're not hungry. Most people can do fine with carbs ~50g/day so I wouldn't stress too much about that. But again, I hesitate to say more without knowing more about your specific situation.
      I do consultations, y'know. ;-) http://www.tuitnutrition.com/p/services.html

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    3. Hi Amy. Great blog. I am Kenyan significance of which is that here we eat far less processed carbs than in the western world. I should know i lived in the UK for over 30 years.

      Anyway I've recently within the last 6 weeks gone keto and removed the carbs from my diet.

      I have a problem in that I am normally quite skinny and having lost some weight due to water loss I'm now at 65kgs. (5 foot 6 in tall). Unlike many I read about I want to put on about 5 it's. I am eating about 2000 calories per day largely fat, some protein and v few carbs. Can you say hard work ? Lol

      Anyway I love being fat adapted and the media is is a bonus. My family has a history of dementia so I will find out first hand if it alleviates the symptoms. Now what was I saying ? Just kidding. Thanks again.

      Charles

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  24. Well.....how bloody refreshing was this article to read?? VERY!!! You've literally covered all my thoughts, feelings and questions in a nutshell. Thank you for writing this. I'm going to share it far and wide in the UK low carb community as all I ever see is pictures of ketostix and gloomy faces from a one pound weight gain. It makes me want to scream and rant but I keep my mouth shut. Anyway I hope they read your three part article as it's absolutely fantastic!!
    On a side note, my ketostix have never even been remotely purple yet I've managed to lose 5 stone! Who would have thought eh?!

    Many Thanks

    Ashley

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  25. Amy, I've read these three articles maybe three times by now. First when I was contemplating low-carb/keto dieting (and knew nothing) and a couple of times since then. I think it makes more sense every time I read it, so thanks! Also read your book recently and found it fascinating. Some of it over my head, but still so interesting and eye-opening. My initial goal for doing this was weight loss after menopause, which had just become impossible. I've now lost about half the weight I put on since then, but it's not my main focus any more. I think that the overall health benefits and remaining independent for as long as possible are my reasons to continue. My energy level is great (like in my MUCH younger days!) and my hope is that long-term I will age well, stay healthier longer, and maintain my mental acuity. Thanks to you my focus is on fat adaptation rather than aiming for a color on a stick. I'm in for the long haul!

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  26. Hi Amy,

    What a great blog! I follow keto as I have high fasting blood sugar and my mother has type 2 diabetes. I'm fairly healthy and lean (5'7" and 150 lbs, 25% body fat). I'd like to lose 8-10 lbs and lift 5-6 days per week. My weight doesn't budge much (maybe 2 lbs in a month), but I know I've lost some inches and my face looks slimmer.

    I am concerned because I see on keto Facebook groups that they advise, what seems to me, extremely low calories. I am talking like 1100-1300 max for women. When cutting, I am more in the 1650 range. Do you think it's advisable to go that low? I don't want to lose muscle by going too low - which happened when I did an NPC competition. I am at 110 protein, 120 fat, 40 carbs (which i almost never hit).

    TIA!

    Amy

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    1. Hey there, thanks for reading! It's really difficult for me to comment on calories without knowing more. Sorry. I really dislike giving numbers to people *at all,* let alone someone I'm not working with on a more formal basis and have more comprehensive information for regarding current health, history, etc.
      I recommend the macro calculator here -- you can choose a particular caloric deficit to encourage the fat loss but maybe not choose an extreme one so you're comfortable with the total amount...it can be a little complicated to fill out so let me know if you need help: https://ketogains.com/ketogains-calculator/

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    2. Thank you for responding! I wasn't wanting numbers, just an idea of extreme vs non extreme. I'll check out the calculator!

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  27. Hi Amy

    I am new to this and I really like your article so hard to find good information out there

    When I first started about 6 weeks ago I had the terrible Keto flu and feeling like crap all the time

    The worst part is that I am not sleeping at all since this diet but still stuck to it and I have done the blood test and getting about 2.7mmol but feeling the worst I have ever felt in my life. Am definately not fat adapted but in ketosis I think

    Still not wanting to quit started reading more and I think I have adreanal fatigue where my energy level is up and down then too wired to sleep. But yet I am still losing weight well body size. I don't have much to lose but really enjoy the low carb diet.

    Would you have any advise about Keto and adrenal fatigue

    Thanks
    Nadine

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    1. Hi Nadine, if you have severe fatigue, then your priority right now should be resting and restoring yourself, not losing weight or inches, especially if you are already at a healthy body weight. When you eat a very low carb diet you have to absolutely make sure to get enough salt/sodium. This is true for anyone doing a low-carb diet, but it is even more true if you feel that you have adrenal fatigue. you must not be afraid of salt. You need a lot more of it than usual when you are on a very low carb diet and especially when you have adrenal fatigue.

      Do not waste your time measuring ketones. You do not need high levels of ketones to feel better and to do well on this way of eating. you might need to eat more protein. You are probably skimping on protein and not realizing it. There's a good chance you're not getting anywhere near enough total calories. But I would not purposely add a lot of extra fat. You might need significantly more protein. you have probably been led to believe that you need to have a very high percentage of fat on this diet and to limit your protein intake. This is not true for everyone. In your situation and because you do not feel well I recommend much more salt and more protein.

      Check out this post: http://www.tuitnutrition.com/2017/07/gluconeogenesis.html

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  28. Hi Amy,
    Just discovered this series in a link from another group, really informative! I am debating avoiding all the internet groups currently, for all the 'keto police' out there :)
    I've only been doing this about a month, and predictably am 'cheating' a bit as I try to get into new habits but really just trying to make sure the new habits are the right ones, not ones that are going to turn me into a crazy person.
    I'm not lying, fat loss is definitely not something I'm going to turn down in this process, but I'm also hoping it will help with my somewhat intractible epilepsy. Unfortunately while I had a previous neurologist recommend Modified Atkins (all neuros seem to have agreed full keto - in a medical sense definition I guess - is impossible for adults). But my current neuro just kind of rolls his eyes, calls it too hard, and tells me to feel free to try while offering no help. So I'm feeling my way through on my own here, any sensible sounding advice is appreciated!

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    1. Hi Penny,
      Thanks for reading. I definitely have some suggestions for you, but I'd rather communicate via email or not in the comments here on the blog. Please feel free to contact me: tuitnutrition@gmail.com
      (And if you write to me, remind me you're the one who left a comment asking about keto/low carb for adults with epilepsy.)

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  29. Hi Amy! I noticed that one of the points you made was that you weren't hungry and you took that as a sign of being fat-adapted. I've noticed that if I have breakfast at 10am I could go until dinner time without eating anything, infact there have been times when I have to force myself to eat something. This will be week 4 of keto for me, SW:180 CW:170-173 depending on the day. I initially lost 10lbs in week one of keto with no trace of ketones with the ketostix. I haven't had any weight loss since and i was expecting to since my ketostix levels range from large-larger (dark purple). There aren't many articles explaining that you can be in keto and not be fat-adapted and losing weight. I also noticed on of the comments above you said it takes 6 weeks to become fat-adapted. Would you recommend I wait it out?

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    1. Hey Margaret, the adaptation period is really an individual thing. There's no exact amount of time that it'll take. It sounds like you're actually doing just fine.

      It's very normal to lose a lot of weight very fast at first, and then it slows down. Don't judge your progress solely by the scale. Sometimes your body will shift and change, but it takes some time for that to be reflected on the scale.
      I think this will help explain:
      http://www.tuitnutrition.com/2017/02/fat-loss-new-perspective.html

      You're probably doing great, but there's also a chance you're overdoing it just a bit on dietary fat if you're not losing weight, but if it's only been 4 weeks, and you've already lost 10 pounds, really, you're doing great. This happens magically overnight for some people, but not for many of us. For some of us, it's just a slower process. Don't feel discouraged by other people's progress on social media. People lose weight at different rates.
      This might help a little too:
      http://www.tuitnutrition.com/2017/08/how-to-cut-fat-on-keto.html

      For some reason, my blog doesn't publish hyperlinks in the comments, but you can copy & paste those links in your browser.

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  30. This is, by far, the most helpful thing I've read regarding keto for fat loss. Thanks so much!!
    I'm just at the very beginning, into week 2 so just past the headaches and slight nausea, but a nice surprise on the scale at the end of the week from all the water loss.

    I feel a lot better equipped to use the ketostix as a tool and understand how to watch overall fat and calories.

    Thanks for this group of articles!

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  31. Great series of articles. I have been fat adapted for a few months and the weight loss has been slow but steady. I feel great and have consistent energy all day. I only eat when I'm hungry, and usually fast from 7pm until 1pm then have a protein shake and then dinner about 6pm, sometimes I fast 23 hours, and sometimes I eat breakfast. I keep my carbs between 20g -30g and work to get 100g-120g protein daily.

    My question is do I need to eat 70%+ fat or can I just monitor my carbs and protein and not worry about eating enough fat?

    Thank for your blog and response.

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    1. If you're happy with the results you're getting, then NO, no need to worry about pushing a high amount of fat. As long as you feel well and are getting the results you want, carry on! And thanks for reading!

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  32. How do you feel about MCT oils? Do you think they help?

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    1. Help with what? Becoming fat-adapted? No, probably not. The best way to become fat-adapted is to have a very low carbohydrate intake so that the body has no choice but to transition to being fueled primarily by fat. The way to do this is not by adding more fat, but by decreasing carbs.

      That being said, I've heard reports from people that MCT oil can help -- *at first* -- with this transition. Some people also notice a cognitive/mental boost from MCT oil, likely owing to the ketones fueling the brain. So I think MCT has beneficial effects in certain circumstances, but it is absolutely not required to become fat-adapted or to be successful on low carb/keto for the long term.

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  33. Hello! First of all, THANK YOU for your blog posts! This information is so helpful and easy to read. Question- I am part of a Keto forum and I responded to a post saying that when my Keto strips are dark, I feel great and that’s when I experience the most loss. Someone commented on my post “when your strips are that dark, you’re just pissing them out”. Is there any validity to what she’s saying?

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    Replies
    1. No it's all good. I feel my best when my urine strips are noticeably pink/purple too! ;-)
      You might be excreting those ketones, but there's likely plenty of ketones in your blood being used, too.

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  34. Hi Amy! Thank you for creating such a well written, informative post. I’ve read all 3 parts and have learned a great deal, even after living La Keto Loca for the past 2.5 years.

    I have a question. I’ve tried to stick to a pretty strict keto diet (vs low carb) over the course of the years. I may cheat a few times a year, if that. What I have personally experienced, is that when I have a high carb day, I become physically ill. Almost immediately after consuming a high carb meal, I get stomach pains like no other. In addition to the normal bloating and weight gain one experiences, I also experience nausea, bubble gut, stomach pains - almost like a stomach flu/food poisoning. It’s lasts for a day or so, and it only happens when I cheat. It’s to the point that I’m afraid to cheat because I feel like crap when I do. I’m basically out of commission for about a day.

    I’ve read up on this and have found that some long time keto dieters also experience these symptoms. An explanation I read stated that after your body has gone a while without the presence of carbs, the machinery that is used to break carbs down shuts off. So when you reintroduce carbs into your diet, the symptoms you experience is essentially your body trying to figure out how to process the onslaught of carbs you’ve just consumed. It made sense to me, but I wanted to know your thoughts. Have you ever heard of this happening to anyone?

    Thanks again for such an awesome blog! Really wished I found this when I was a newbie.

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    1. Hmm...I'm not really sure why that happens. I've heard of people just not feeling so well if they go on a carb bender, but that's more like headaches or low energy. I haven't heard of the kind of pain and intestinal distress you're talking about. If I had to guess, I wouldn't think it's coming from the carbs, per se, but maybe from something you're sensitive/intolerant to, that you don't normally consume, that comes along when you do eat more carbs. Some kind of additive or other ingredient that isn't necessarily because of the carbs, themselves. I can't say for sure though.

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    2. I have this same problem and you are correct, it's not the high amount of carbs, but food sensitive. If you were to eat high carb by overindulging in say vegetables, then there likely wouldn't be an issue. For me it's grains that make me sick, mostly wheat although corn products can cause my stomach a little uncomfortable. I too have seen where high amounts of fat are being recommended to low carbers and after reading what you said about not pushing that if weight loss is your goal was very informative for me!

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    3. It's probably a SIBO bloom. I get that with too many carbs.

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  35. I love you. Thank you!! Thank you!!! Thank YOU!!!!!

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  36. I love you! Thank you SO much!!!

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  37. Hi Amy - here is another compliment to your blog and the information provided does make sense, especially when it came to carb and water retention = weight gain using scales. I am coming up to my 3rd month on the keto/IF plan and feel great with no signs of “keto flu”.
    I also started on the keto urine strips in the first 4 weeks and felt positive when results showed the darker ketone levels but I also read that it may indicate more to do with the ketones excreted via or kidneys rather than nutrition intake which contradicts my lower blood reading results (0.2-0.5 in the morning).
    Being vegan as well places extra consideration on macro sources which at times can be restrictive but automatically amps up my carb intake via fresh vegetables and occasional bean dishes.

    Regardless, kudos once again. For those that are starting, hang in there and as long as you feel good and healthy, listening to what your body tells you and not focus on numbers, you’ll reap benefits!

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  38. What if someone has been on strict keto for a while and theie strips are still dark purple?Considering they give information and don’t provide answers, eventually shouldn’t they not pick up ketones ?

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    Replies
    1. This is not a problem. There's nothing wrong with this. For some people, the urine strips will always show ketones; for others, they seem to not register anymore, even if the person is in ketosis (as confirmed by a blood or breath measurement). It's okay if the urine strips still turn pink/purple if someone has been keto for a while.

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  39. Hi Amy,
    Thanks SO MUCH for this series of articles! It confirms my actual experience. In the early part of 2018 I went to 50/30/20 fat/carbs/protein and felt gradually better (I have ME/CFS) but was never able to fast. I then went back to a regular carb diet (ie not keeping track) and gained ten pounds in 8 months. With the New Year i decided to buckle down and have been maintaining 70/15/15 while not worrying if a meal or a day is 60/20/20. I have been able to fast without difficulty which is amazing since I was once a three meals three snacks person. I have definitely lost weight but no scale where I am at to say precisely but so what right! Anyway, I could go on but EVERYTHING you say FITS with my experiences. I will try 60/20/20 gradually to see if that will work.

    One question. I am on my 22nd day, definitely in ketosis, Stix are purple all the time, I have had a few better days but the energy is still mostly quite low. Do you have any experience with ME/CFS sufferers trying keto? I intend to stick with it and pray my mitochondria will increase and become fat burning machines! Your thoughts and comments would be greatly appreciated.
    Zopa

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    Replies
    1. Thanks for reading. :)
      If you're in deep ketosis (purple sticks) and have flagging energy, make sure you're getting enough SODIUM/SALT. *Do not* skimp on salt. I can't comment without knowing anything else about you. You might have some underlying nutrient deficiencies/insufficiencies that are contributing, for example, B12. (Much more common than is acknowledged in the medical world.) How's your sleep quality & quantity? And what about your weight? Are you specifically looking to lose or gain any weight?

      You might consider an organic acids test. They can be very informative when you're dealing with difficult issues that are hard to get to the root causes of: https://www.greatplainslaboratory.com/organic-acids-test/
      I think you need to order this through a professional, so if it piques your interest and you'd like to do one, feel free to email me: tuitnutrition@gmail.com

      (If you have it done, you get a free 30-minute consultation with the lab's experts to help you interpret the findings and explain to you what everything means, and the implications for diet, lifestyle, and supplement interventions.)

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    2. Thanks for your reply Amy!
      With my research on ME/CFS I already am supplementing B12, salting liberally, NUUN tablets, L-Carnatine, CoQ10 and more! My weight is not a concern, it was when I gained recently but I can tell by my belt notches it's ok. My sleep was definitely a problem when I first got I'll but I have worked on that and it's good now.

      What iam lokingl for is to recover from this chronic fatigue and get a semblance of a life back. That's my goal.

      I will definitely look into the organic acids test. I'm in Canada so we'll see if they can work it. I looked into the DayTwo microbiome test (after reading 'A Personalised Diet') they can't do it outside the USA.

      I will keep you posted if I can get it done or if I get some results with LCHF, low carb or full Keto.

      Thanks SO MUCH for your input .

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  40. Been reading more of your blogs! Saw you prefer quantities so....
    Right now maintaining ~60g of carbs (35 to 40 net) 55g protein and 125g of fat. Just had a late breakfast so fasted 18hrs and could have done more. This breakfast was 40g protein, 22g carbs and 33g fat so only 54% fat but I will probably still have a purple Styx tonight lol!

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  41. Excellent article Amy, and funny too. Thank you.

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  42. Excellent Write up. I have been on low-carb and Intermittent Fasting (mostly OMAD) for a couple of years now, and can totally relate to everything you have nicely captured here.

    A lot of it is strikingly similar to how i observed and understood about Ketosis and Fat-Adaptation!

    This is an article i would probably written myself in another couple of years or so (well most of it, minus Amy's Flair and Style :-).

    Thank you for sharing your thoughts so well!

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  43. Thank you for this wealth of information

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