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Today we’re tackling your keto questions! I asked you all on social media to hit me with your questions about the ketogenic diet, and you guys had great questions! If you haven’t yet, check out my Keto 101 post to learn the basics of the diet first before getting into these questions.
Before we begin, I have to give you a little disclaimer. I am not a medical professional, so I cannot give you any medical advice. I just really like to research things I’m passionate about, and keto eating is one of those things! So I’m passing along information I’ve gathered, but you should check things out for yourself and talk to your doctor.
Here’s a quick table of contents so you can jump to your specific keto questions:
- Are there basic program “rules?”
- Do you have to cut carbs all at once?
- Is keto good for type 2 diabetes?
- Does keto have an effect on hypothyroid?
- How do you eat at other people’s houses?
- My husband has a demanding job. Will keto give him enough fuel to work?
- Is keto healthy long term?
- Can you eat keto and be vegan?
- I’m breastfeeding. Can I start keto?
- Is it possible to eat keto without spending a lot of money?
- What about eating keto with kids?
- Are low carb alternatives actually good?
- Is keto just another diet fad?
Are there basic program “rules”?
Devi asks, “I’m totally fine to try keto. What’s super hard about it is having to keep track of macros and take supplements like potassium. I would love a simple program with rules, probably why I like the whole30. It’s easy to follow. So the question I guess is, are there basic program rules?”
Yes! There are basic rules to the keto program. Keep your carbs under 20 grams, eat a moderate amount of protein, and eat enough fat to keep you satisfied between meals. I totally get that for some people, tracking is just soul sucking and feels like too much to think about. I really like the Keto Diet App for tracking my food because it’s built for a ketogenic diet. It does cost a little bit to download, but it’s just a one-time fee and it comes with recipes! It will also track your potassium, magnesium, and sodium intakes, which are things that are sometimes hard to get enough of on a ketogenic diet. I also find that after tracking consistently for a while, I get a feel for what it looks like and I don’t need to track all the time.
But if that still seems like too much for you, just eating from a keto-approved food list will keep you low carb. You may end up eating more than 20 carbs this way, but you’re likely to still stay within a moderate low carb diet. You won’t get quite as much benefit from it because you probably won’t be in ketosis, but you will still see many improvements. And making sure to eat foods high in potassium like spinach and avocado, and using high quality sea salt generously on a regular basis will help ensure your levels of electrolytes stay up.
Do you have to cut carbs all at once?
No! In my Make Keto a Cake Walk guide, I explain the different ways you can start keto. You can definitely decide to ease into it if you feel like that’s easier. Just make sure you’re actually moving toward fewer and fewer carbs.
Is keto good for type 2 diabetes?
Yes! A ketogenic way of eating is ideal for type 2 diabetes. My Keto 101 post goes into exactly why that is.
Does keto have an effect on hypothyroid?
Ok, this one is a little bit trickier. There’s not complete agreement on whether or not keto is good for hypothyroid. However, I will point you over to this article from the Keto Diet App blog. Martina, who is the creator of the Keto Diet App, has Hashimotos herself and finds that a low carb diet has helped her, but she feels better when she keeps her carbs between 30-50 grams per day rather than the stricter 20.
Leanne Vogel of Healthful Pursuit has also dealt with hypothyroid issues and has found that a ketogenic diet has helped her, but has also found that doing “carb ups” (occasional higher carb meals in the evenings) helps to keep her feeling good. Check out some of her (many!) articles and podcasts dealing with thyroid health here.
How do you eat at other people’s houses?
“What do you do if you’re invited to someone’s house for dinner and you get there and they’re serving sweet & sour chicken, rice, and corn for the vegetable? You can’t eat it, but you can’t not eat it.” – Courtney
Ok, so deciding to adopt a ketogenic lifestyle does make it a little tricky to navigate social situations at times. At restaurants, it’s almost always possible to find something you can eat that won’t kick your carb counts too high. But at someone’s home, it gets trickier. You don’t necessarily know what you’re going to be served, and in most cultures, it’s rude not to eat what your host serves.
So what do you do? Well, when it comes down to it, a single high carb meal isn’t likely to do a huge amount of damage. I would try to eat the best you can with what you’re given– very small portions of rice and corn in the example above, and more of the chicken, with as little sauce as possible. If you think of it, bring a water bottle filled with water and a teaspoon or two of apple cider vinegar and drink it before you sit down at the table. Vinegar has an interesting (not fully understood) ability to improve insulin sensitivity to high carb meals. (Read more here.)
After that, I would recommend spending at least part of the next day fasting to allow the glucose from the previous day’s meal to be used up quickly so you can get back into ketosis right away.
My husband has a physically demanding job. Will keto give him enough fuel to work?
Yes! The way a ketogenic diet works is by switching your body from being a sugar burner to being a fat burner. Your body can only store about 500 grams of glycogen (carbohydrates are converted to glycogen so they can be stored in the liver and skeletal muscles) that can be used as fuel when you haven’t eaten. So if you’re a sugar burner and you don’t eat, there’s a limited amount of sugar your body can release to help you out. And if you’re not used to burning fat, it’s hard for your body to switch over to burning your stored fat.
But if you’re already a fat burner, when you’ve used up the fat from the food you’ve eaten, your body doesn’t have any trouble accessing your fat stores for fuel. And your body has the capacity to store a nearly endless supply of fat. But even if you’re a thin person, one pound of fat is 3500 calories. The estimated calorie expenditure from running a marathon is only 2600. So unless you’re running several marathons every day, you’re not going to be running through your fat stores at an alarming rate.
There are some endurance athletes who swear by the ketogenic diet exactly for the reason of fuel supply. For example, check out this article about the 100-mile American record holder who eats a keto diet.
Is keto healthy long term?
The long term effects of any diet are actually really hard to measure. This is because you can’t measure it in a clinical setting. No one is living 30 years in a clinic where every calorie is accounted for. So the research is based on self-reporting, which is notoriously inaccurate.
There have not been a lot of long term studies on the ketogenic diet. That being said, there are some encouraging results out there.
This study studied obese patients over the course of 24 weeks and concluded a ketogenic diet “significantly reduced the body weight and body mass index of the patients. Furthermore, it decreased the level of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol.”
There have been at least 3 meta-analyses of low carb studies showed that a ketogenic diet was not only beneficial for weight loss but for other health markers as well. You can find the studies here, here, and here.
As a side note, this study compared people in 42 European countries and their eating habits and found that those who ate the most animal protein and animal fat were at the least risk of cardiovascular disease. Those at most risk were the ones who ate the most carbohydrates.
What we do know is that elevated insulin is associated with atherosclerosis, heart disease, and even cancer, so getting your insulin under control is very important for long term health.
I think it’s very important that any diet, including the ketogenic diet, should contain a balance of nutrients. It’s important that you eat low carb vegetables and not just bacon.
Here’s a list of many keto scientific studies.
Can you eat keto and be vegan?
This answer is a “yes, but” answer. Yes, you can eat a vegan keto diet. But it’s not going to be easy. Both keto and vegan diets are somewhat restrictive, so combining the two is going to be difficult. From what I’ve read, you will likely have to eat a higher amount of carbs, like 50 grams instead of 20. But it can be done and there are people out there who are doing it.
Here’s a guide on how to do it.
I’m breastfeeding. Can I start keto?
You can eat a low carb diet while breastfeeding, but you should not eat a strict ketogenic diet while breastfeeding because in exceptionally rare cases it can lead to ketoacidosis. Diet Doctor recommends at least 50 grams per day.
Whether changing your diet like this will affect your milk supply is hard to say. I think it mostly depends on how much you cut carbs. I did find one study that studied breast milk in women on a liberal low carb diet of 150g per day. The women in this study did not have supply changes, but had higher levels of fat in their milk. They also had a greater estimated energy expenditure– meaning they burned more calories. They also had an increase in fat burning. So it’s possible that a liberal low carb diet could keep supply up while helping with post partum weight loss.
It’s best to talk to your doctor before trying a change in diet. Make sure you’re still eating enough calories (cutting calories can definitely decrease milk supply either way) and drinking enough water. It’s also important that your diet is a well-formulated one either way to make sure you’re getting all the proper nutrients.
Is it possible to eat keto without spending a lot of money?
“I want to start, but feel like I will break the bank with changing to Keto.” -Mel
I’ll be honest. Eating keto the way I do is more expensive. But that’s partially because I’m a food blogger! It’s important to me to experiment with lots of different kinds of ingredients and see what’s possible on this diet.
But it doesn’t have to break the bank. Eggs are very inexpensive and are a perfect keto food. You can buy inexpensive cuts of meat rather than fancy ones. Low carb vegetables are not more expensive than other vegetables. And while it’s better to eat organic when you can, and to eat grass-fed meat when possible, you will still see benefits from a ketogenic diet if you can’t afford organic.
Overall, the simpler you eat, the cheaper it will be.
Diet Doctor has several recipes in their “Keto Budget Meals” section that can give you ideas.
If you want to learn more about keto ingredients, check out my Keto Pantry post where I explain the different ingredients you might come across and whether they’re really necessary.
What about eating keto with kids?
I love this question! Here’s the deal. Kids don’t need to go as low in their carbs as adults. But the Standard American Diet (SAD) is way higher in carbs than is necessary. So in our house, I just work on reducing the amount of carbs in their day without applying the same strictness I do to my own diet. I only make one dinner and we all eat it. Our weekday breakfasts are low carb, but they get a little bit of cereal on the weekends.
We’ve cut a lot of processed snacks, and I buy low carb fruits like berries. We’ve switched to full fat greek yogurt. And my kids have actually not complained at all. Like, at all. Having options like low-carb pancakes are a definite bonus. There’s more work to be done, but we’re getting there.
If you’d like an action plan for reducing carbs in your kids’ diet, check out this post on Diet Doctor. It’s written by Libby Jenkinson. She also has a great section on kid-friendly recipes on her blog Ditch The Carbs.
Are low carb alternatives actually good?
Erin asks, “I’ve done some looking around on Pinterest but dessert, baking, treats, and bread…are there QUALITY subs? Do you miss them?”
My totally honest answer: It depends. I’ve tried a lot of low carb pinterest recipes, and some are awesome and others are huge disappointments. I actually find desserts to be the most reliable. I usually cut down a lot on the sweeteners or swap out 85% dark chocolate for sugar free just because that’s my taste preference. You still have to be wary of what ingredients are used in these recipes because some people use ingredients that are questionable.
As far as bread goes– I have found the most success with mozzarella dough (“fathead” dough) recipes, like in my low carb pizza and cheese bread. I also have had great success with these rolls from Low Carb Maven. But I’ve yet to make a successful loaf of bread.
Do I miss them? Eh. Not really. I find this diet to be so much more satisfying than any other way of eating. I can walk past free samples of cookies or doughnuts on the brunch table at mom’s group and I’m not even tempted. For real. I would like to figure out an easy way to make a keto grilled cheese sandwich, though.
Is keto just another diet fad?
I don’t think so.
And here’s why: When I eat this way, I feel like my body is finally running the way it’s supposed to. Like it’s not holding me back anymore.
That being said, like any diet that gains popularity, there are plenty of questionable products coming out to try to jump on the bandwagon. From exogenous ketone powders to meal bars to supposedly low carb syrups that spike blood sugar more than sugar– you name it, it’s there!
I’m not saying all of these products are bad or unhelpful, but they are expensive. Don’t get sucked into the hype! Check ingredient labels religiously and don’t buy something unless you think it could really make your life easier without bankrupting you.
There are people out there who will jump on the keto bandwagon without understanding the science behind it, and they probably won’t stick to it long term. But I plan on eating this way forever, adjusting as needed if necessary. But the drastic difference in the way I feel tells me this isn’t just a fad.
I can’t remember feeling this good in my adult life so I’m going to keep eating this way.