December 27, 2017

New to Low Carb? Feeling Lost? "Paralysis by Analysis?" READ THIS.





Hey Everyone,

As promised, here’s the follow-up to my post on taking an Information Vacation from social media if you're feeling overwhelmed and panicky from confusing keto information coming at you from all sides. Since there will no doubt be loads of people new to this diet in the new year, I figured this was a good time to put this out there.

If you’re new to low carb, or maybe haven’t even started yet, this one’s for you.

If the reason you haven’t started yet is that, despite being an intelligent, grown adult, you can’t seem to make sense of the eight thousand pieces of conflicting information you’ve read about low carb and ketogenic diets, this one is definitely for you.

If you have already started, and still can’t make sense of the eight thousand pieces of conflicting information you’ve read about low carb and ketogenic diets, this is also for you.

You are not alone!

Here’s a quick list of words and phrases extracted from emails I receive from people looking for help with low carb or keto:

  • Confused
  • Overwhelmed
  • Conflicting info
  • Stalled
  • Frustrated
  • No idea what to do!
  • Totally lost!

  
If you’re brand new to all this, I have to be honest: I don’t envy you. As I mentioned in a recent podcast interview (probably my most fun and controversial one yet), getting started with a low carb diet was much easier 17 years ago, when I first gave it a try. Back then, the internet existed, of course, but the contingent of people talking about low carb was much smaller. There were only a handful of low carb chat rooms and forums, virtually no blogs, and if I recall correctly, neither podcasts nor YouTube even existed. So there was a lot less information available to newbie low carbers, but ironically, that was a good thing. Because now, while it’s wonderful that low carb and keto have become so popular, and there are more blogs, books, Facebook groups, podcasts, and YouTube channels than anyone can keep track of, unfortunately, for every good, reliable, accurate piece of information about these ways of eating, there are four pieces of nonsense and falsehoods that have to waded through first.

Like I said, I don’t envy the newbies.  

When I was brand new to this, around the year 2000, I had two main sources of information: the bulletin boards at LowCarbFriends.com (which I’m delighted to see still exist, as I haven’t logged in in about nine years), and Dr. Atkins’ New Diet Revolution. (Linking to the 1997 version because the one that got me started—the 1992 version, with the blue cover—is apparently no longer available.)

That’s right: the Atkins book.


Atkins


The original “Atkins book,” Dr. Atkins’ Diet Revolution, was published in 1972. Over four decades ago, and I dare say few people have improved on it in the forty-plus years since. Every low carb or keto book that’s come out since then—every single one—has been little more than a slight variation on what the good doctor put on paper all those years ago.

In 1972, and then throughout the 1980s and 1990s, when updated versions of the Atkins book came out, there were no blood or breath ketone meters. MCT oil wasn’t available to the general public. There were no fat bombs, nobody was dumping 4 tablespoons of butter in their coffee, nobody was afraid to eat protein, and nobody who was using low carb for weight loss thought they had to follow the same kind of medically therapeutic diet as a child with epilepsy, with 80% of their calories coming from fat. And you know what?  

People did wonderfully.

People got great results.

The Atkins book was my own first introduction into the world of low-carb, and all these years later, I think it’s still a fabulous way for people dealing with obesity, type-2 diabetes, PCOS, cardiovascular disease, or any other condition stemming from insulin resistance, to start, especially if they feel overwhelmed by the hurricane of conflicting information out there now. Everything was so much simpler back then, and that was a good thing. (People who want to use a ketogenic diet as therapy for a neurological or neurodegenerative disorder might need a slightly different approach.) 

Yum.
So if you are suffering from “paralysis by analysis,” and you are so confused and uncertain that you don’t even know how to start, start there. That is my best piece of advice for you. Read the book and follow the plan as written. There are foods you can eat and foods you should avoid. There’s a systematic way to navigate the introductory “induction” phase, a period of ongoing weight loss, and a long-term maintenance phase. Just doing that will get you most of the way to where you want to be. (Seriously, read the book. If you think you know what "the Atkins diet" is all about, but you haven't read the book, I can almost guarantee you're working from stereotypes and misinformation.) 

Low carb and keto are so, SO much simpler than people make them out to be. I understand that you are feeling completely overwhelmed, and I don’t blame you. But I assure you, there’s no need to be scared, confused, or worried. This is all much, much simpler than people on social media would have you believe with all their acronyms, rules, and crazy calculations. This is a way of eating. It’s just food, not blueprints for the space shuttle. ;-)  I know it can seem like insanely complicated physics sometimes, but you absolutely don’t need to be a rocket scientist or have a PhD to figure out what to eat. I promise. It’s actually pretty simple.

Here’s a helpful comparison. (At least, I hope it’s helpful.)

Let’s say there’s a little boy who’s just learning how to ride a bike. He’s seen snippets of the Tour de France on TV, and maybe somewhere in the back of his mind, he’s thinking about racing someday. And ever since that little seed was planted in his mind, his thoughts have been going in a hundred different directions: What kind of racing bike will he need? What’s the best nutritional strategy to support that kind of physical exertion? Will his competitors be doping? Is he going to need to dope just to keep up with the pack? Should he train at a high altitude to strengthen his lungs? Who will his sponsors be?

And sure, if this kid really wants to be in the Tour de France someday, at some point, he’ll have to find answers to those questions. But for right now, when he’s just starting out learning to ride, NONE OF THAT MATTERS. This kid—this beginner—needs to master none of that in order to get on a bike and start pedaling.

In case my metaphor was too nebulous, here’s what I’m saying, straight up: if you’re confused or overwhelmed by low carb or keto, take a breath, stay calm, and just start. You don’t need to know anything about ketone meters, MCT oil, fat bombs, gluconeogenesis, making “keto” cookies, cake, or muffins from almond and coconut flour, or anything else, in order to take what is by far the most important and most effective step: eliminating sugar and starch from your diet.

If you do nothing else but that, you’ll be about 85% of the way to success on low carb. All the rest is just fluff.

You can think about your ratios of omega-6 and omega-3 fats after you’re off the blood sugar rollercoaster. If you have limited funds, you can think about spending a bit more to buy grass-fed meat and pastured poultry and eggs from a local farmer instead of regular supermarket food after your insulin levels come down a bit. (For the most part, though, regular ol' supermarket food is just fine!) You can measure your ketones sometime down the line if you want to—but most people don’t need to measure ketones. You can consider adding in some intermittent fasting after you’re well adjusted to your new fat-based metabolism (being “fat adapted”) and you can go comfortably for several hours without eating. You can get a degree in advanced calculus and figure out your fat, protein, and carbohydrate “macros” if you’ve been on the diet for a while and aren’t getting the results you were hoping for.      

But for the purpose of putting your game face on and just starting, NONE OF THAT MATTERS. What matters is that you stop eating sugar and starch.

You don’t have to start perfectly; just start.


(Caveat: If you have type 1 or type 2 diabetes and are taking insulin or other medications to help manage your blood sugar or insulin levels, or if you’re taking blood pressure medication, you will need to be monitored by a physician. This way of eating is so effective for type 2 diabetes that it is recommended that you reduce your insulin dose by half on the first day. [With physician’s clearance, of course.] Type1 diabetics will also need to alter their insulin boluses. If you have infertility due to PCOS, you might want to shore up your birth control regimen unless you are specifically looking to get pregnant, because “unexpected” and “surprise” conceptions have been known to occur in women with PCOS who go keto or low carb. ;-)  This diet is effective for radically improving health, and sometimes it does so very quickly. Be prepared for this. But as long as all the doctor stuff is taken care of, you can start. See my note at the end of this post for advice on finding a keto-friendly physician.)

I wrote a short blog post about this a while back, where I pointed out that there were only three things—three things—needed for a low carb diet: 1) water; 2) foods that are low in carbohydrate; 3) possibly electrolyte supplements (sodium, magnesium, potassium). That’s it.

Ketone meters, MCT oil, fat bombs, coconut flour, liquid stevia, erythritol, a Fitbit®, an InstantPot®, and seven hundred other things might be nice to have in your arsenal, but none of them—not a single one—is required. (Kind of like the kid and the bike: special cycling shoes, a bike-mounted water bottle holder, ergonomic cycling clothes and other gear would be nice for him, but he doesn’t need any of that to get his bum on the bike and pedal.)

I’m partial to Atkins, because, as I said, it’s how I got started, and I honestly don’t think anyone has done much to improve on it. But times have changed—even if human physiology and biochemistry have not—and I recognize that people might be looking for something a bit more up to date. In that case, I recommend The New Atkins for a New You, written by three current-day prominent low carb researchers and clinicians, at least one of whom I know worked with Dr. Atkins, himself.   

And if you’d prefer not to shell out even two dollars for a used copy, you can get started 100% free by checking out the basic low carb get-started guide from DietDoctor.com, one of the top low carb sites in the world:


Beware the Keto Flu


During the first few days of a dramatic reduction of carbs from your diet, you might feel dizzy, light-headed, nauseated, get headaches (severe ones!), and experience other unpleasant issues. This is called “keto flu” or “induction flu,” and it’s totally normal. You need to understand that it’s totally normal, and be prepared for it. For people who are brand new to low carb or keto, I advise arranging your schedule so that you don’t have to go anywhere or do anything important on days 2 and 3 of this major dietary change. (If you work Monday-Friday, start on a Friday so days 2 and 3 fall on a weekend. If you have some other kind of schedule, arrange it accordingly. I know parents of young children never really get a day off, but at the very least, try to clear your calendar of major social obligations. Don’t plan to coach your kid’s basketball team on day 2, or play chauffeur to your preteen daughter and three of her friends as they gallavant all over town.)
No need to get fancy-schmancy pink, black, or red salt.
Regular ol' table salt is fine.
What you need is the sodium, and that's in all salt.
Since you'll be using a lot of it, you might as well
get a good one, but don't make yourself crazy over it.

Some people don’t experience keto flu, but most do, so you want to be ready for it. The way to ward off or minimize the headaches, dizziness, and other stuff is to get more salt. Be generous with your salt shaker! Do not be afraid of consuming more sodium. In most people, high blood pressure has zero to do with salt/sodium intake, and everything to do with chronically high insulin. (If what I just said is a surprise to you, read here for more on this topic.)

If you experience leg cramps or muscle stiffness not attributable to over-exerting yourself at the gym or in some other physical activity, supplement with extra magnesium and potassium.

The reason for these recommendations is that when you cut way back on carbs, and your insulin levels come down, it changes the way your kidneys hold on to electrolytes. And even when people eat a well-formulated, nutrient-dense ketogenic or low carb diet, it can sometimes still be difficult to get adequate amounts of these from food alone. This goes double for people who work out a lot and sweat a lot. The more you sweat, the more of those electrolytes you lose, especially sodium.

Here’s a helpful guide to the keto flu, so you can be prepared and sail through just fine:



What About Exercise?


Don’t make me talk about the kid on the bike again. If you’re not just new to low carb, but also new to exercising, don’t worry about doing the perfect workout; just do something.

If the most exercise you’ve gotten in recent memory is lifting a half gallon of ice cream out of the freezer, then guess what? Just walk. No gym membership required, and no fancy equipment to buy. Walking is free, and all you need is a pair of sturdy shoes. (Or, if you talk to the growing crowd of barefoot walkers, you don’t even need that!)

Would high intensity intervals be good for you? Probably.
Would lifting weights be good for you? Probably.

But if you’re at a point where a hardcore workout is so far off your radar screen it’s in another solar system, then just doing anything will be an improvement over doing nothing.

I’m not a personal trainer, so I’ll leave it there. Of course there are strategies that are more effective than others for losing body fat and building muscle mass. But if you’re brand new to exercise, or are getting back on the proverbial horse after years or decades of being away, you can worry about mastering the details later. For now, just move. The results you may be looking for in terms of blood sugar control and body composition—“looking hawt”—will come overwhelmingly from your diet, anyway. Exercise can help, but you know what they say: “Abs are made in the kitchen.”  ;-)  Plus, if you feel like you don't even have the energy to exercise, or joint pain and/or mobility issues hinder your ability to be more physically active, give yourself a few weeks to get adjusted to low carb. Once you're off the blood sugar and insulin roller coaster and you become “fat-adapted,” you’ll likely start noticing you’re more energetic overall, and you’ll have the desire to start moving more. (Read more about this here.) 

The same is true for joint pain: the dramatic change in diet should help with joint pain and muscle stiffness, and you’ll be able to incorporate more physical activity into your life when those aches & pains are reduced. And the same may occur with obesity, too. If you are currently very obese, perhaps you can walk. Or maybe you can lift heavy things. Its not required that you engage in high-intensity activities or movements that will put a lot of strain on your joints. Let the diet do its thing for a few weeks or months first. Many people are not able to exercise at first, and thats fine. When your aches & pains are less, and when youve lost a little weight so the strain on your joints is less, then you can start moving around a bit more. Dont feel guilty if you dont exercise at first. Itll come in time. Like I said, the dramatic change in diet is where most of the results come. Exercise can help, but the diet is the primary thing here. 

To any readers out there who are physically disabled, and conventional “exercise” is not possible, no worries! Like I said, your results are gonna come primarily from diet. If you’re disabled or have an injury that prevents you from engaging in certain types of movement, you are welcome here, and you’ll still do great.



P.S. Are you balking at my recommendation for the good ol’ Atkins diet? Have false characterizations led you to believe that Atkins is nothing but bunless bacon cheeseburgers? 

Well:
  1. Even if it was, so what? Sounds like a pretty yummy and effective plan, actually. But…
  2. It isn’t nothing but beef and bacon. Not by a longshot. When I hear someone say that, I know that not only have they never actually read the good doctor’s book, but they have likely not even flipped through it and casually skimmed. Possibly they’ve never even held a copy in their hands. Because Atkins was adamant about vegetable consumption. Not starchy veg, of course, but salad greens, mushrooms, cucumbers, broccoli, cauliflower… You don’t have to eat vegetables if you really don’t want to, but if you are following the actual Atkins diet, as written, you will be eating plenty of vegetables, and possibly even small amounts of fruit, mainly in the form of berries, especially in the ongoing weight loss and maintenance phases. If anyone is interested, I'd be happy to write a follow-up to this post, wherein I can introduce the basic Atkins approach and describe the three different phases, because I am beyond tired of the ridiculous falsehoods I’ve been hearing about it. Those of us—the thousands, possibly millions—of people worldwide engaged in the low carb, keto, LCHF, or Banting movement—whatever your preferred word for it—owe Dr. Atkins a debt of gratitude, and I’m tired of hearing his name and his plan denigrated, even by people in our own community.
  3. I just re-read the book, to remind myself of all that Dr. Atkins had to say, and I am pleasantly surprised stunned at how far ahead of his time he was. Dr. Atkins' New Diet Revolution is a treasure trove of simple, uncomplicated, straightforward instructions on how to implement a low carb diet in a sane, rational way, so that you can sustain it for the long term. (And he walks you through the gradual, systemic reintroduction of certain carbs in case you don't want to spend your whole life at induction levels of carb restriction, since this is not necessary for most people.)  I disagree with him on a couple of very minor issues (for example, he promotes the use of soy protein), but those are almost negligible compared to the gold mine the book is in general.   


Find a Low Carb/Keto-Friendly Doctor or Nutritionist:


 If you’d like to find a physician or nutritionist friendly to low-carb, keto, and Paleo ways of eating, I recommend searching on these sites: 



P.P.S. If you want the angels to sing and for roses, rainbows, and unicorns to surround you for all time, then please, for the love of all that's holy, learn how to use an apostrophe when applied to dear Dr. Atkins' name. His name was Robert Atkins. He created the Atkins diet, it is the Atkins book, and the book title is Dr. Atkins' New Diet Revolution.






Disclaimer: Amy Berger, MS, CNS, 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.

29 comments:

  1. Really great post, Amy!

    How would you recommend tweaking Atkins for chronic migraines and epilepsy?

    Also: Grammer mavens rejoice on the correct use of the possessive and the gentle reminder for those who are uninformed!

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    1. For chronic migraines, I wouldn't change much unless someone was not noticing any relief with as-written Atkins. (I would give it several weeks to determine whether t seemed to be working or not.) An individual might also have specific food sensitivities that trigger migraines, so even if those foods/ingredients are acceptable for low-carb, someone might have to avoid them.

      For epilepsy, it really depends on how the particulat individual responds. Some people need very, very strict keto (like 4:1 or 3:1 ratio of fat to *combined* protein and carbs), but some people can do a more liberal version, like a regular Atkins diet, and believe it or not, for some people, just soing gluten-free and casein-free is enough to prevent seizures -- they don't even need to be keto. Others do well with the MCT diet or even just a low glycemic diet. People with epilepsy really do run the spectrum of different responses to different levels of carb restrction. I would probably start with more of an Atkins approach and tailor it as needed, depending on how the epilepsy responds. This is a good paper on that if you really want to dig into the details: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4617125/

      Most especially this image: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4617125/figure/fig2/
      (All of these approaches have proven effectve in children and adults with epilepsy, so it just comes down to the degree of restriction an individual requires in order to be seizure-free or at least have reduced seizure frequency and intensity.)

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    2. Thanks, Amy. This whole post is solid gold. Thanks!

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    3. Very well said!

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  2. Thanks so much for this breath of fresh air in a polluted low carb/keto community, Amy.

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  3. Glad I found you Amy. Love your way of thinking and waiting.

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  4. That was great plain talking advice Amy. A pleasure to read.

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  5. do you have a post that addresses high cholesterol, I am a sugar/carb addict, I know, so have been looking at this way of eating, but just found out my cholesterol is high, and have been ordered back for repeat bloodworm in 2 months, and don't want it to be higher...suggestions?

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    1. Hi Sheryl,
      This is what you want to read about cholesterol:https://www.amazon.com/Cholesterol-Clarity-What-Wrong-Numbers-ebook/dp/B00ESMDGE8/

      Bottom line: High cholesterol does not cause heart attacks or heart disease. People who have cardiovascular disease or who suffer heart attacks run the gamut from high cholesterol, to LOW cholesterol, and everything in between. Having lower cholesterol DOES NOT guarantee you protection from heart disease or heart attack, PERIOD. ;-) This whole cholesterol "thing" is so, so misunderstood and I can't even tell you. The absolute #1 biggest risk factor for cardiovascular disease is chronically elevated insulin, and the best thing to do for *that* is a low carb diet. ;-)

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    2. Where do you live? Depending on where you live, there might be a keto/low-carb friendly physician in your area who can help you understand your bloodwork in the the context of this way of eating, rather than reaching for the prescription pad for medications that often have very negative side-effects.

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  6. Amy, there's a reason I share your posts every time you write a new one. Your common-sense, no-nonsense, "Don't make this harder than it has to be" approach is my favorite. Keep doing what you do, ma'am!

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  7. Indeed, Amy!!!! When I started, I started out with Paleo, then branched into LC- with an AIP twist. (Hashimotos in '97) With my trusty glucose meter, 40 past years of obesity, and about 1-2 of weight maintenance- I took it from there. Once I figured out that eating too much fat, well, made me fat, I evened out a bit and experimented with Time restricted eating.

    The whole process took about 5 years. Now, folks get hit with 5 months of all that info. While I yearned for more info back in the day, getting it slowly meant me learning what did and didn't work. I'll celebrate 6 years of weight maintenance very soon.

    I'll be sharing your post very soon. :) Karen P. PS- when are you coming to Low Carb USA in San Diego so I can meet you in person???? :) Maybe? I can only hope.

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    1. Hey Karen! I'm a fan of yours! I'm flattered that you read my blog. :) I'd love to meet in person sometime. I don't attend as many of the low carb/keto events as others seem to, and there are more and more of them popping up now, it seems. It's hard to even decide which ones to go to, because heaven knows I can't afford to do them all. I think I might be speaking at KetoCon from Ketovangelist (June in TX), but that isn't for sure yet.

      You are so right, though: the new people have to make sense of all this from the get-go, which is almost impossible. (To be honest, very often *I* feel like I don't know what to think anymore!) I truly think it was so much easier a long time ago, when there was *less* information out there. Maybe it was a little harder to troubleshoot and personalize things for individual problems & goals, but I think it was easier to at least get started and go most of the way.

      Thanks for reading!

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  8. I love your articles and would love to see your take on the different Atkins stages.
    Keep up the sanity!
    Cheers from sweden!

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  9. As a totally overwhelmed Keto newbie thank you, thank you thank You! Back in July my PCP advised me to find a ketogenic diet after my most recent fasting blood sugar came up at 108. He said, you have just turned pre diabetic. I want you to find a ketogenic diet and do it. It's the quickest and best way to lose weight and also drop your blood sugar. When he said "ketogenic " I immediately thought of Atkins'. Just like you my first foray into low carb WOL was in 1999-2000 when I read that same Atkins' book with the,blue cover and began to follow the Atkins' diet. I stayed in induction a long time because I lost well on it. I never did find my carb threshold during OWL but I know it's low. It was easy to learn how to eat low carb. I was on that same board you said is still there. I lost 60lbs and felt great. Then got married and slowly lost my discipline. 5 years ago a naturopath diagnosed me via labs with gluten, caesin, whey and egg white severe intolerance and we did an elimination diet to reset me. I was able to re introduce a limited amount of eggs and gluten but not dairy. I even thought that maybe because of all the eggs and dairy I ate on Atkins' is why I became intolerant to them. Two years ago I did a W30 3xs lost weight, 22lbs, and felt great. Then transitioned to Paleo but my weight loss stopped. After my doctor told me to go Keto I googled it and since Atkins' didn't come up I didn't consider it. I looked at a few and decided to go with Dietdoctor. I lost 20 lbs and my blood sugar responded now down to 95-98 but the more I read about Keto in an attempt to learn the more overwhelmed I became. People bashing Dietdoctor and saying u need to count macros and eat certain percentage of fat and protein. I started thi king "boy this keto is getting harder the more I learn about it". Blogs saying Atkins approach is too high protein and it caused you to lose muscle not fat got me worried, "did I really hurt my body afterall?" So I froze and went off Dietdoctor meal plans and had no discipline over this holiday season. What u are saying makes sense to me. Maybe I have come full circle? Maybe I should just go back on what I know best and worked best for me, Dr. Atkins diet? If you were me would you start with a January Whole30 or just go for induction instead? The one problem I had with Dietdoctor meal plans and would with Atkins is I need to be dairy free now. My gut did not do well with most of tge dietdoctor recipes.That's why W30 worked well for me I learned about Almond and Coconut milk and cooking dairy free from them. Yes, please do a follow up on the different Atkins stages and can you speak to those of us who need to be dairy free as far as how to get the calorie and fat intake in? Thank you I am so happy I stumbled across your blog while trying to get more Keto information. You did a good thing for a lot of us. I never doubted Dr. Atkins my weight loss and great cholesterol back when I was on it was always my argument to those who told me I was killing my heart eating low carb.

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    1. Re-read your own comment, Barbara. ;-) Why make this any more complicated than it needs to be? Get a copy of one of the older Atkins books, re-read it to remind yourself of what the true parameters of the program are, and then do it, as written. I'm glad I re-read it, because induction is much, much stricter than I remember it being! Just do Atkins, as written, starting with induction, *as if you have never, ever done it before.* Read the book and approach it as if you're brand new to low carb. And go from there. Atkins--including induction--can be done without dairy and eggs, if those are still problematic for you. It makes things more difficult, yes, but not impossible.

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  10. Hi Amy, loved your simple approach to LCHF. I did it for several months last year but then discovered when I had an ultrasound of my liver that it was moderately fatty. I panicked and stopped teh keto. I'd love to do it again but I'm worried I'll end up with a non-alcoholic fatty liver. Would appreciate any advice or info.

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    1. Well, it's hard for me to comment without knowing more about the situation. Low carb/keto, for most people, is actually very good for *reversing* fatty liver, so my first question would be, dd you have any bloodwork or other testing *before* starting to eat this way? Because it's possible that your liver was in *worse* shape prior to starting, and it's actually been *improving* with keto. (Meaning, your liver is "moderately" fatty, as you said. But what was it before? Maybe it was severe, and things are getting better.)

      Second, I would have to know what you typically eat, to see if anything might be affecting fat buildup in the liver. If you consume a fair bit of alcohol, that would be the first thing to eliminate. (A little bit here and there is okay, but if you consume a lot of it, that really does a number on the liver.)

      Feel free to email me privately for more suggestions. I can't say more without knowing anything else about you and your health status. (Contact form is in the right sidebar.)

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  11. Hi Amy, thanks so much for this. I read it back when you first posted it, and went out and bought the New Atkins book (the original Atkins book wasn't available at my B&N and I wanted it RIGHT AWAY), then I got hit by a bad stomach virus and lost all the water weight I would have lost during the induction phase. (-_-)

    But, I managed to read through most of the book last week, and when I went to Diet Doctor to get some recipes, I saw that they were doing a free 2-week Keto Low-Carb Challenge with everything planned out. It's such a simple plan -- really perfect for me.

    ANYway, all that to say... thanks for this post. I've felt so overwhelmed by it all. I have lots of friends doing keto, and they're testing their blood and peeing on sticks and telling me I need to watch my macros... and it was all just so much. I felt paralyzed by it -- I didn't know where to start. Your post helped ground me.

    I'm doing this primarily to lose weight (goal: 40 lbs). My LDL was also high -- and I had them check the numbers of the "good fluffy" kind against the "not so great, inflammation-causing kind" ... and it wasn't good news. So, I need to get that in check. Insulin levels are great.

    Here's my question for you: When I started the Keto Challenge, I started using Carb Manager to track my daily food intake just to better understand how much fat/protein/carbs are in the types of foods I regularly eat. My net carbs are on target... BUT THE CALORIES!

    It stresses me a little, the number of calories I consumed yesterday (and, yes -- it was all real food with great healthy fats). Once I'm through this 2-week keto introduction (and especially if I see no weight loss)... should I worry about total calories, or just focus on keeping net carbs at 20 gr or less?

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    1. Hey Cecily, thanks for reading. :)
      It's hard for me to comment about calories without knowing more about you. I wouldn't count anything unless it's been *several weeks* and you've seen no movement on the scale *or* in your size/inches. (Sometimes one changes without the other, so don't go solely by the scale. Either take your measurements every 2 weeks or so, or find an old pair of pants or something that's tight or doesn't fit, and see if it gets closer to fitting as time goes on.)

      Just try not to fall into the fatty coffee trap, fat bomb trap, etc. It *is* possible to over-consume fat on a low carb diet, to the point where your body won't need to tap into its own fat stores for fuel. But I wouldn't worry about any of that for the first few weeks. Just try to eat real foods, and don't feel like you need to go out of your way to drown everything in extra fat & oil. You should absolutely *enjoy* fatty foods, but you don't have to add a ton of extra in order to arrive at some crazy "keto ratio" like you might see online somewhere.

      If you have trouble after a while, email me and I can give you more personalized advice. In the meantime, though, give this a read, because you should be prepared for the *normal and expected* stalls and hiccups along the weight loss journey: http://www.tuitnutrition.com/2017/02/fat-loss-new-perspective.html

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    2. Hi Amy,
      is it suitable for someone on dialysis? he is hypertensive, borderline glucose level (not diabetic). really motivated to lose weight. we should we consider before starting?? medical environment at the dialysis centre are very old fashioned so we are basically on our own. any advice

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    3. I cannot comment on the dialysis issue. Where is this person located? Maybe we can find a low carb/keto-friendly physician in his area. Honestly, the very worst things for kidney health are chronically high glucose and insulin. (Hypertension is almost always due to an underlying chronic hyperinsulinemia; usually has nothing to do with sodium/salt in the diet.) You say he's not diabetic because his glucose is normal, but has he had his INSULIN checked? This is huge, huge, huge. Many people have a seemingly normal fasting glucose and A1c, but those things are only normal because sky-high insulin is keeping them in check. If this is the case for this individual, then he's gotta get his insulin down, and yes, a very low carb diet is a great way to do that, bt the dialysis does complicate matters, and I would insist that a knowledgeable keto-friendly physician help guide you in doing that.

      You'll want to read this post in regard to normal glucose but high insulin:
      http://www.tuitnutrition.com/2015/09/its-the-insulin-1.html

      Part 2 mentions all the health problems that come from high insulin -- with OR WITHOUT high glucose -- including kidney problems: http://www.tuitnutrition.com/2015/09/its-the-insulin-2.html

      My posts are very long, but educational.

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  12. Thank you I will definitely read that. Also can you please write about underweight. It seems like every body is talking about obesity: losing weight. But what about people who can’t gain weight?. I already eat high fat high protein but struggling with low carb part. And I eat mostly real whole food.

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    1. To be honest, I really don't have much experience with people trying to gain weight. For people who are underweight, I think it's probably most often an unrecognized/undiagnosed malabsorption issue. That is, this person could eat and eat and eat, yet they won't gain weight, because their body is not properly absorbing and assimilating nutrients. (Or energy/"calories.") I think some people just have constitutions to be on the thin side, even if they eat a lot of extra food. And there's really no problem there as long as they're healthy and they feel well. But for people who are severely underweight, and they have health problems or frailty because of it, that would be my first suspicion -- malabsorption. (And there are dietary protocols to fix that.)

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  13. Hello! I started a low carb diet in early November. I had no bad side effects. Actually, I felt amazing. Acid reflux completely disappeared, my energy level was way up and I needed less sleep.
    In December, i noticed a rash. I have never really had one before. The itching was insane and miserable. I made a list of anything and everything I could think of that would be causing this and started researching. The LAST thing I looked for was "low carb" and "rash". BINGO! Apparently keto rash is a thing, and when I added carbs back in it went away immediately (almost as fast as all the good results went away). Do you have any thoughts or advice on this? I want to resume low carb eating, but am a bit hesitant because that rash was a BEAST!

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    1. Hi there...thanks for reading. I've heard of the keto rash, but unfortunately, I really don't know what to do about it. There are a lot of websites out there that cover it...perhaps they have some tips?
      https://www.dietdoctor.com/keto-rash-people-itch-low-carb

      http://theketorash.com/

      https://www.drberg.com/blog/what-is-keto-rash

      I'm sorry I'm not more helpful. I just have very little experience with this.

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  14. Hi Amy

    This blog post is speaking to me...it really is! Diagnosed with Type 2 diabetes about 18 months ago....I have ever since been on a quest to find the optimal nutrition to help me back to my glory days of health and well-being. I read and follow many blogs and Twitter feeds for all the latest diet news. I’ll certainly be keeping an eye on this blog. My problem is that I am absolutely bamboozled by all the contradictory, baffling and confusing dietary and nutritional info and “research” out there. I can’t eat ANYTHING without deeply pondering the potential insulin effect within my body or the inevitable blood sugar rise. I have my glucometer that I use daily, I have started to obsess over the numbers. I really need to calm down and get back to basics. To be honest, I’m actually doing well. I knocked back the docs Metformin and have decided to nail down my diet and try rectify the metabolic mess within. A1C is down from 10.5 to 6.5 without meds. Just need a final push to get below 6. I find intermittent fasting and strict low carb (keto) a little too rigid and structured. I have started listening to my body very carefully and eating as consciously as possible. Some days I may have 3 small meals. Some days, I feel satiated with 2 larger meals. The refined carbs, sugar and starch obviously had to go but I’m trying to be more flexible with some other things. I eat when I’m hungry and try to space meals out as much as possible. On weight lifting days, I may eat slightly more especially before or after my workout. Again, I will listen to my body very carefully. I’ll ask myself if I am REALLY hungry or is this some false signalling within the body. I’ll eat when the body needs the fuel. Just wondering what your thoughts are on this method of eating? Following the natural rhythms and signals of the body. The structured 3 meal eating pattern has been ditched for this more natural style of eating. What to eat, when to eat and how much to eat. These are the vital questions! Keep up the good work. Joe

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    1. If it’s working and you’re getting the results you’re looking for, and things are moving in a good direction, then all is well. Don’t overthink things and make then more complicated than they need to be.

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  15. Great post! I also started Atkins back in early 2000 and it changed my life. Things really did seem simpler back then.

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