Keto questions

[Cooper27]

I've been hearing a lot about keto recently, and I'm planning to give it a go. I have a few questions, and figure this is the best place to ask!

1. Should you do anything to prepare for keto? I've heard people say it's a good idea to preceed keto with a period of 16:8 fasting, to regulate insulin levels and achieve ketosis faster.

2. How long should you follow keto for? I've heard all sorts of answers! Including some saying it's better to keto/carb cycle (so you eat carbs on weekends)

3. I could use some breakfast ideas, as I don't like straight eggs, and most recipes are egg/omelette based. I also struggle to digest dairy, which doesn't help!

I follow a loosely paleo diet just now, so I don't think it will be a huge leap for me, but I eat lots of potatoes, root veg and fruit, so am still a moderate carb consumer.

[TheAwfulToad Ambassador]

Just curious what your reasons are for trying it? To some extent it makes a difference to the answers.

1) Meh. A keto diet, by definition, induces ketosis (and achieves insulin regulation etc), so I don't really see any point in "preparing" for it by fasting or whatever. OTOH I won't knock it if you want to give it a go. Bodies do funny things and for all I know it may help. The problem is, on a sample of 1, you have no way of knowing if it actually does help or not

2) Until you get bored with it. Most people have had enough after a couple of weeks, because there are so many restrictions. Some people need to maintain strict keto for much longer to achieve weight loss, but in general you can transition to a "weight loss" phase after 2 weeks. That basically means you can introduce a few carbs in the form of carrots, milk, and suchlike, but it's best to stick to 25g-50g net carbs per day ... unless you're not concerned about weight loss, in which case you can probably ramp up quite quickly to the 50g-100g range.

3) All dairy? Some people find that, on LCHF, their "allergies" miraculously disappear, because the carbs were making things worse. Of course dairy intolerance is pretty common, but even people with full-on lactose intolerance can sometimes cope with Greek yoghurt or cheese; possibly cream. It's worth giving it another go, cautiously, once you've done the induction phase.

If you really don't get along with eggs or dairy, there aren't any rules about what you can have for breakfast. Have anything you like. Maybe just a coffee. Or a salad with bacon. A grilled sausage. Or nothing at all. Personally I used to enjoy having a huge breakfast when I first started, but I tend to eat somewhat less now. Once you get into it, you only feel hungry maybe twice a day.

It depends what you mean by "lots of" of potatoes etc - you might be surprised how much you rely on carbs to fill out your meals. The main annoyance with making the transition is filling the space left on your plate, where the carbs used to be. Broadly speaking, you substitute other vegetables (cooked in oil or cream etc), but you end up having to think quite differently about meal construction. Have a look on dietdoctor for some recipe ideas.

[Cooper27 in reply to TheAwfulToad]

So although keto regulates insulin levels, I think the logic of fasting first, is that you start keto already beyond that phase (or that that phase will be shorter), so you can get the same benefits in a shorter window.

I'm wanting to try it because my thyroid is a bit temperamental, and my weight has been creeping up steadily recently, which I need to nip in the bud. I'm thinking I'll try the diet for about 2 weeks initially, then I might consider extending that.

Yup, unfortunately dairy just seems to make my stomach very acidic - especially yoghurt! It's a shame, because I love cheese and greek yoghurt! But I think I should listen to my stomach and avoid it.

Carbs wise, I'm not too bad with filling the gap on my plate, but I think it will be weird having larger portions of protein and fat there. I'm usually veg heavy (I know that's carbs, but not as concentrated). I have a small portion of potatoes or rice (a few tbsp's) a few times a week, because it's easy

Thanks for the advice

[TheAwfulToad Ambassador in reply to Cooper27]

Actually most of what's on your plate will still be veg. There's no need to load up on meat; that just happens to be a fairly convenient source of fat, but it's by no means the only one, or the best one. Green veg are usually "not counted" in your net carbs total, precisely because the carbs are so dilute. The trick is to find new ways to cook them that incorporate butter or fats/oils.

[Suzy1954 in reply to TheAwfulToad]

I’ve been on a LCHF regime now for 6 months after being diagnosed type 2 diabetic. I had a A1c test which was 51. After 3 months I got that down to 49. Today doctor said it’s 48. Which I’m glad about but in that time my cholesterol has risen from 4.9 to 5.6! Doctor wants to put me on statins but has agreed to test again in 3 months. She said to tweak the diet and eat less fat. I thought you had to up the fat on a LCHF diet? Seems you can’t win 😩

[Praveen55 in reply to Suzy1954]

Hi Suzy1954

First of all, congratulations! Your HbA1c is responding well on LCHF diet.

Sorry, but I do not agree with your Doctor regarding your Cholesterol number. Total cholesterol value in isolation is meaningless. One should not be prescribed statins based on TC results.

To assess the risk factor, you should insist on monitoring complete lipid profile which includes TC, HDL, TG and LDL ( LDL being the estimated value).

What is important is TG value and ratio of TG/HDL. This gives most accurate risk assessment for heart health. One can also see TC/HDL ratio.

On LCHF diet, HDL increases ( good) and TG reduces significantly, thus improving TG/HDL ratio.

You have been on LCHF for three/four months only, your TC may take a while to stabilise. Slightly higher TC is significantly offset by the increase in HDL. Overall risk factor drops. There is no need to reduce dietary fat. It is the excessive carbohydrate which is the culprit. Make sure that you consume healthy fat. Please talk to your Doctor. You win on LCHF, that is for sure!

[Suzy1954 in reply to Praveen55]

Thanks for that. How do I know that the next cholesterol check will monitor complete lipid profile? I thought they would take HDL and LDL into consideration before giving you a result! Also GP said it’s more important than ever to be on a statin when you are diabetic 😩

[Praveen55 in reply to Suzy1954]

Not next test, you should get the test done now. You have to talk to your GP and explain that you would like to know your complete lipid profile. You have to be on overnight fast (about 10 hours) for this blood test. Finish your last meal of the day before 10 pm and get an appointment with the nurse for blood sample in the morning after 8 am. You may include the fasting blood glucose test also ( FBG).

Unfortunately, like many of the GPs your GP is also following outdated rule book. Anyway, you need to be little tactful in convincing him/her to order this test first. Once you get the test results, it will be easy to convince him/her. I am not saying one should never take statins, but at the the moment there is not enough evidence that statins need to be prescribed. Let us get the additional test results and then decide if it is required.

Are you overweight? Losing some weight will be quite helpful for T2D as well as lipid profile.

[Suzy1954 in reply to Praveen55]

Getting a blood test straight away at surgery is a joke TBH. I could probably get a complete lipid profile privately. I have never been overweight fortunately. Even so I have lost a stone since going LCHF which is a bonus. My blood pressure is good at 120/80. Thanks for your advice. Makes me feel better 👍

[Praveen55 in reply to Suzy1954]

You are as such doing quite well on LCHF. Everything seems to be working perfect. In the next three months, you will most likely hit non-diabetic HbA1c level ( < 42). Losing 1 stone not only makes you feel good, it improves insulin sensitivity also. You have done well.

Yes, you can get a complete lipid profile privately, but let that be the last resort. With your condition, (T2D + TC) you should be able to get this done on NHS. Please do not give up. I am sure your GP will agree. You must try. Wish you all the best.

[Cooper27 in reply to Suzy1954]

I heard a few people (incl. 1 GP) recently talking about statins for women, and it was a bit controversial.

I think one situation called them a feminist issue, because they were primarily tested on men, and the men's results were applied to women too, but when women were looked at in isolation, the side effects and effectiveness were completely different.

The GP seemed to suggest statins offer very little benefit for women, I think. It was several weeks ago, so don't take what I'm saying as gospel! However I think it warrants further reading (specifically of the benefits/side effects for women) before you consider taking them.

I'm glad they've agreed to recheck it in a few months before they consider putting you on medication for life!

Also if you wish to get a full panel, I can give you a discount code to get it tested privately for around £20.

[Suzy1954 in reply to Cooper27]

Thanks for that Cooper 27. Yes I think the GP is jumping in too quick. A discount code would be very helpful thanks 👍

[JiminyCricket]

I dont like eggs for breakfast, or really anything cooked. I have soya yoghurt as the base of my breakfast. Then a spoonful of mixed seeds on top , plus about 20g crushed nuts (walnuts, brazils, almonds) , maybe a strawberry or 2, and a dollop of cream. Its filling and light and tasty. You could replace the cream with more nuts?

[Cooper27 in reply to JiminyCricket]

This is maybe worth trying, although I might try coconut yoghurt if it's not too carb-y, as I also try to limit soya intake. Will go investigate

[JiminyCricket in reply to Cooper27]

Let me know what you find!!

[Allikay]

Hi that's great that you're giving it real go! I myself haven't tried keto or anything else for that matter but I still find this all very interesting, And I found this very healthy subsription-based, no carbs, non gmo and all the good stuff, Chicken and beef. I Highly recommend it. And it tastes awesome. And you can see it for yourself here for more info farmersbox.com/A3096592 Hope all goes great !!!!

[Cooper27 in reply to Allikay]

That sounds good! I love veg box schemes, but the meat boxes don't tend to work for us, as we have allergies that they can't accommodate safely.