Paleo Plan

Nutritional Ketosis Update

I’m on day 5 of my nutritional ketosis diet (details on the why and how of this experiment in my last blog post). That’s a scantily clad me over there to the right on my second day into this. A “before” picture, if you will. Hoping to look like a body builder by the end of this. No, not really.

Since this has already been such a dynamic experience, I’m going to start sharing some quick thoughts on it throughout this month, and perhaps beyond, if I continue to do ketosis after that.

Here’s the update.

I’m in ketosis (I think).
According to the urinalysis strips that test what volume of ketones you’re peeing out, I’m in the highest level of ketosis – the darkest purple reading. I don’t know how much I trust that, though. My blood ketone test kit should be arriving today, so I’ll know more soon.

I’ve lost weight.
I don’t care if I lose weight or not. I like my body – just want to be very clear about that.

In the last 5 days my 5’0″ frame went from 100 lbs to 97.8 lbs (I got my body fat tested so I can find out later if I’m losing muscle). It’s not easy for me to lose weight, so this is kind of a big deal. In the past, I’ve eaten 1,200 calories a day for a week or more and not lost any weight while being at Zone-like Paleo macronutrient ratios.

I feel fatigued sometimes.
Not all the time – just a couple times a day and eating fat makes it better. I also wake up with uncomfortably low blood sugar, which sucks. Usually I can go until like 11:30am without eating. Hopefully this will improve.

I’m eating enough calories.
My goal was to eat at least 1,500 calories a day, and yesterday for instance I ate 1,597. That was 69% fat, 14% carbs (no starchy ones), 17% protein. Which was 122 grams fat, 66 grams protein, 56 grams carbs (sorry – I don’t know the net carbs).

My recovery may be sucking.
I did the hardest leg workout I’ve ever done on my second day into the diet. One of my first pure leg workouts ever. I have been so sore for the last 3 days that I look crippled when I walk. Would I be this sore for this long if I were eating normally? And if I keep doing this, will my recovery get better?

I have to eat more often.
I thought it would be opposite! I’ve been so psyched that I haven’t had to eat very often for the past 3 months or so… Now I have to have a snack between breakfast and lunch (a couple tablespoons of coconut butter and a handful of frozen blackberries).

I hope my energy increases and I stop feeling so damn carb depleted. I know it’s just the first week, so I think a lot could change.

That’s all for now. I love your feedback, by the way!

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51 Comments

  1. You look spectacular!

  2. Dear you…

    “I feel fatigued sometimes. Not all the time – just a couple times a day and eating fat makes it better.”

    You should question why that is… SERIOUSLY :(

    “I also wake up with uncomfortably low blood sugar, which sucks.”

    Which also supposes that your body is running on “stress response” mode (increased adrenaline, cortisol, estrogen, etc.) in an attempt to get the necessary glucose from… Well, the only place left really… Your own body (fat AND lean mass).

    “I did the hardest leg workout I’ve ever done on my second day into the diet.”

    Bad, bad idea. Attempting to do any kind of hard work on so little carb is a recipe for disaster, meaning digging yourself ever deeper into that “stress responsed” hole…

    “Between breakfast and lunch (a couple tablespoons of coconut butter and a handful of frozen blackberries).”

    Eat some carbs!!!! Please do :(

    “I hope my energy increases and I stop feeling so damn carb depleted. I know it’s just the first week, so I think a lot could change.”

    It won’t happen. Fat adaptation is but a myth I’m afraid. Oh, you’ll “adapt” alright, but it will mean having to accept a lower metabolism. a lower activity level, a lower intensity level, etc.

    “In the last 5 days my 5’0″ frame went from 100 lbs to 97.8 lbs”

    I’m not that big a fan of the BMI but, it still acts as a good barometer for people who aren’t overly muscular or overly fat (which would be your case) AND, you are literally on the edge (by a few decimals) of being underweight… You needn’t go down that road. For your health’s sake, please consider another more valid long-term approach…

  3. This is very helpful! You’re doing great!!

    One question: are you shooting for a calorie deficit? If so, how much?

    (Am I right in understanding that you need to have a calorie deficit in order to force your body to eat stored fat?)

    • CWM – No, I’m absolutely not shooting for a calorie deficit. I wasn’t trying to lose weight. I’m eating as many calories as I normally do – maybe more. Without the carbs, no matter how much food you eat (within reason), you’ll need to burn fat, and some of that is going to come from your body fat.

  4. Listen to your body. You need carbs. Period. You are TINY. Any smaller and you may end up in the hospital.
    Seriously.

    • Debbie and Eric – Thanks for your concern! Like I said, I’m doing this as an experiment. I will give it up if it’s really not working, but it hasn’t even been a week! When I first went Paleo, I felt AWFUL for the first 3 entire weeks. Fatigue, low blood sugar, weakness, the works. I was detoxing. I’m assuming I’m doing the same right now. I peed about 800 times on the second day, which is a tell-tale sign of adaption. I know what my BMI is and I don’t necessarily think the BMI is an amazing standard by which to judge health. I think it’s a very American standard. Nobody I know has every told me I’m underweight, and if it got to that point, I would surely do something about it. I’m not crazy! :) I’m trying to eat more today so I don’t lose anymore weight. It’s an experiment, like I said, and I’m playing with this experiment to see if I can get it right. Plenty of people live in ketosis, and plenty of people even train hard in ketosis. It’s possible, so please don’t tell me it isn’t. Again, I appreciate your concern, but I’m really ok. I’m functioning on a higher level than a lot of Americans right now, despite a little low blood sugar in the morning. I still have my period (always have) and intend to keep it that way. Jeez. Can’t a girl try something new?

  5. Neely be careful. Don’t keep your blood sugar that low for an extended time. it’s not good! It’s actually dangerous!

    • Kenny – I’m always careful! It’s my middle name :) I won’t do anything to hurt myself, I promise. It’s only really low in the morning right now, and hopefully that’ll stop happening.

  6. Thanks a lot for the reply, Neely, and for sharing this with us. I really appreciate it.

    I’m still wondering about the calorie deficit thing . . . if you eat 1200 calories one day, and your body burns 1200 calories that same day, why would your body turn to body fat? It seems to me that it wouldn’t need to. Can you help me understand that?

    Thanks much

    • CWM – I think that’s what researchers are trying to figure out right now. I’m not sure anyone knows really. There are a lot of factors like how well your body processes carbs, how stressed you are, how much you’re working out (too much or too little can inhibit weight loss), if you’re sensitive to some foods you’re eating and they’re making you retain water or keeping weight on you some other way, if you have adrenal issues, so your body is outputting too much cortisol, which inhibits weight loss. There’s a ton of reasons. That’s why a lot of people so whole heartedly have abolished the term “calories in equals calories out”. I do think it’s valuable to a degree, but sometimes it’s just not.

  7. Ah, OK. Thanks Neely.

  8. @eric.

    That’s nice of you to instruct Neely on what she’s doing wrong, but I have to ask, what are your credentials? Neely is a certified nutritional therapist with 4 years education and several years of eating pure paleo to support her decisions. I’ve met her, and she’s a bright girl who is very driven to achieve her athletic goals, I doubt she’d be doing anything that would jeopardize those.

    Also, you make a lot of claims, can you please provide some evidence or links to studies to support your claims?

    It’s great you’re trying to help Neely, but without any type of citations to support your warnings, they are somewhat empty and make you look a bit silly.

    If you read anything Neely writes, you’ll know she studies her ass off and when she does make a claim, can cite a source to back it up. Or, in this case, she experiments on herself and can determine how her unique body handles something. I have no idea how nutritional ketosis would work for me or you or neely, but Neely will be able to tell you exactly how it works for her because she’s doing it.

    And jeez, she’s 5 days in, give her some time to adapt. She’s making a massive change to her diet and her body may need a few days to sort out the differences.

  9. @Shane…

    I didn’t come on here to start a “paleo drama”, nor was I made aware that I had to state my sources or credentials over a blog comment?!?!? The points I made are based on sound and actually quite basic immutable physiological principles (a quick research on the topic of ketosis, RQ, glycogen stores, etc. at and for various levels of exercise intensities would rather quickly indicate to you what I was implying above…), especially in light of the symptoms and observations that were presented by its author.

    Arguments from ignorance, appeal to ridicule and appeal to “credentials/authority” usually lead us nowhere… I simply meant to voice my concerns, which I am quite certain I did very diplomatically; I apologize if this was misconstrued as anything else but…

    Would it reassure you if I was to inform you that I have 13 years of higher-level education, decades of attending various seminars, over a dozen years of experience with clients in nutritional counseling and strength training, over two decades of such experience on myself, that I have read an average of 10 scientific papers a week over the last 10+ years, coupled with countless professional experiences and countless examples of me having witnessed the devastating results of the approach outlined above?!?!? Then, would voicing my opinion on such matters be worthwhile to you?

    I am sorry for what seems to have been a waste of your and my time…

  10. Mark Swartz

    You’re a wild and crazy girl….I love it, you look amazing!!. If I was your age I’d be doing the same thing…especially the rock climbing!

  11. OceanBlue

    Eric, go read Volek & Phinney’s “The Art & Science of Low Carb Performance” in which they detail a well formulated ketogenic diet for athletes and quit being such a busy bodied naysayer. As for Neely, try salt loading with some broth whenever you feel fatigued to help you with your transition into ketosis. Natriuresis (all that pissing) will get you to dump a lot of sodium from your kidneys and the imbalance in your sodium level affects your electrolytes, thus the hypoglycemic feeling. Ketogenic dieters really need to up their salt intake and it’s why in not doing so some fail in their attempts and go running back to their “safe starches”…

  12. Hi all! Thanks for all the feedback and comments. I wanted you to know that I stopped the “experiment” yesterday, as I was feeling like death. I was eating enough calories and about 70% fat or more, but I was so fatigued, my legs were cramping, I was losing too much weight, and I was not doing well – to put it lightly – emotionally (as my husband will attest to). Maybe it would’ve gotten better with time, but I wasn’t willing to find out. Guess it doesn’t work for everyone :) I’ll write up a post on it very soon!

  13. Hi Neely!

    Nothing you have described is out of the ordinary, although mostly avoidable, and you are not different.

    Your rapid weight loss is 100% attributable to the depletion of your glycogen stores and the water these bind, and is in itself completely harmless. In a larger person, this would easily be a loss of over 4 lbs in less than a week. You mentioned losing a little over 2. Your hard leg workout depleted these stores much faster than otherwise. This helps explain peeing a lot day 2.

    The weight loss is harmless but the loss of water changes your electrolyte balance. This *must* be compensated for by eating much more salt during adaptation or cramping and fatigue is guaranteed. The salt intake alone can be the difference between feeling lousy or great. Your electrolyte loss was very rapid due to working out and this made things worse.

    Full keto-adaptation does not happen overnight or in just a few days. Your body needs to readjust over several weeks to be much more careful with the blood sugar and to fully use the ketones. While this is happening, one may experience temporarily low blood sugar and lower physical performance. We are not designed to flip quickly between carb based and fat based diets.

    Armed with more knowledge, for example by reading Volek & Phinney as suggested by OceanBlue, one can do the same experiment with little or no discomfort adapting, and go on to experience the benefits of nutritional ketosis.

    /Kurt

    Ever tried. Ever failed. No matter.
    Try again. Fail again. Fail better.
    –Samuel Beckett

  14. OceanBlue… I am very familiar with Volek and Phinney’s work. Thank you :) And, I assure you, if you also took the time to read not only their book, but their research, you would immediately be able to tell how biased it is to begin with and, how ridiculously low the intensity used in these studies are. We’re talking about 60% VO2max. Just to put things in perspective, even a long-duration relatively low-intensity event like the marathon is usually run at around 85% of VO2max (thus, 60% isn’t even the equivalent to a brisk walk!)… Given that, you will quickly realize how “performance” and “low-carb” just do not go together very well (making the title of their book somewhat of an oxymoron, unless you are talking about performance in very specific long-duration events, such as ultras). Like I said in my earlier post, you can think of yourself as “fat adapted” as you’d like, this will have but little bearing on RQs at rest and, although your RQ at any intensity will be lower (indicating a preference for fat), this will only serve to reduce your overall intensity or duration, usually both… Sorry to burst your bubble…

  15. Neely, I’m glad you listened to your body. You will hear a lot of ‘Oh, you were just DOING IT WRONG” and ‘You just didn’t wait long enough” (another version of ‘you’re doing it wrong’), but the FACT is, you were doing very well on your normal diet. Why mess with it? You are lean and fit and healthy, there’s no need to mess with something that is clearly working.

    Thanks for the update, keep up the good work!

  16. Thank you Eric for the voice of reason.
    Kurt, really???? She is UNDER 100 lbs.. and you want her to keep going. Wow.

  17. CarbSeine

    Neely: you’re listening to Jimmy Moore? I wouldn’t take advice on how to change a tire from this stooge – let alone make serious health/diet decisions. Look around the LC/Paleosphere – no one with any credibility takes JM even remotely seriously.

    • CarbSeine – I don’t understand why everyone is so negative about Jimmy. He’s having amazing success on his diet, which I think a lot of people in the LC/Paleosphere ARE taking seriously – look around. And if they’re not, they should because he’s struggled with his weight for a LONG time, as so many other have, and has finally found something that works for him.

      I considered doing a keto diet long before Jimmy ever started his, and I have read about it from many other sources as well. I’m inspired by Jimmy’s tenacity in his n=1 NK experiment, which I’ve followed from the beginning – so inspired that I wanted to try it for myself. Please go bash him somewhere else.

  18. CarbSeine

    You don’t understand? I’m sure that’s indeed the case. Jimbo’s like a dog whistle – some of us are unfortunately attuned to the annoying frequency, while most hear nothing.

  19. Nick Traxler

    Hi Neely,
    My wife and I have been on the four hour body diet and its made it’s one of the few that work for us. We did notice that in the morning we had very low blood sugar and quickly fixed that by eating celery and raw peanut butter just before going to bed, this helps regulate your blood sugar while you sleep.

  20. Jimmy has an ever increasing LDL-P now at 3400; I am not sure I would describe that as “amazing success.”

  21. Hi Neely,
    I’m a clinical exercise physiologist, 54yo, 5’3″, 123# (was 132#) i’ve been in nutritional ketosis (mostly) for 2.5 yrs (carbs below 50grams, average 2000-2500kcals/day, fat at 70-75% per food log analysis). Cured my adrenal fatigue & fibromalgia (in about 1.5 yrs) now training at high intensity Core & Functional Fitness, starting sprints – stabilized at 123# but the improvement in muscle mass development w/ exercise has been awesome. Recovery time 48 hrs. My lab work resembles Jimmy’s very closely – I’m not concerned either, there’s not enough evidence regarding the LDL-p, etc. I’ve worked in Cardiac Rehab for 30 yrs…. so I very familiar with the lab profiles & also w/ diabetes, cardiometabolic disorder – there have been some really bad theories promoted – again really bad data being used…. you’re on the right track…

    Kurt is correct on all accounts – electrolytes are REALLY important for muscle function/soreness/cramping- I didn’t have V & P’s book when I started NK). I started dreaming of dill pickles because my sodium go too low – lots of muscle cramps at night, magnesium helped…. and I was eating a lot of salt on my food … but I had to increase the salt – salt water (1/4 t / 8oz plus the magnesium citrate) worked wonders. What I discovered over the last 6mnths is that the salt is the greater factor than the magnesium. High intensity exercise significantly increased my sodium needs. My partner, Stephen & I both actually find the pickle brine off our home made dills very refreshing & energizing and drink some daily. What I’m trying to say is – you will probably need a lot more sodium than you may realize. Keto adaption keeps getting better over time – so even at 6 months to 1yr your body may still have metabolic changes that will benefit you. I love how I feel, I recover like I did when I was 35yo & look 10yrs younger (much healthier skin, better collagen tissue), easily gain muscle mass. I look forward to more posts of your experience.

    • Carmenj – Thanks so much for writing in. Are you eating that many calories with or without dairy? Would you care to share what you eat in a typical day?

      A lot of people have stressed the salt and magnesium to me, so if I do try it again I’ll definitely add even more salt than what I was eating. I stopped the diet as I was feeling AWFUL. Here’s my blog post on it: http://www.paleoplan.com/2012/11-12/ketosis-experiment-update-i-yield/

  22. Ketosis is not something I would experiment with without supervision. You do not look look like you have much at all for body fat.

    Ketosis puts you in a state, where due to a calorie deficit, you body goes into Ketosis and starts feeding on your stored body fat. No fat available, well it will start on your muscle. Keep in mind your heart is a muscle too.

    I am currently in ketosis on a Medically supervised Weight loss program to lose a large amount of weight. I see a Doctor through weekly visits to the program. I attend a class that trains you on how to do this program then monitors your progress weekly. I have blood drawn every 2-3 weeks and an EKG done as well to check for irregularity while on the program.

    On this program I eat 600 cals a day in the form of protein meal replacements….27g of protein, 10 carbs, 200 cals each protein packet. I drink a cup of bouillon 1 to 3 times a day. This helps with fatigue and headaches. Also I drink 4-5 quarts of water a day. As for exercise…. 60 minute of moderate walking is almost to much.

    As for weight loss, I average 4 lbs a week. This is done safely through the program. You are far to skinny to be even thinking of doing this even as a short term experiment. It is crazy to try this without medical supervision too.

    • Susan Moore – Thanks for your input. I just want to let you know that part of the reason you’re losing weight is because of the very low calories you’re consuming. There are a lot of people who live in ketosis and do not lose weight because they eat enough calories. That’s what I was going for, and perhaps I could’ve found a set point close to where I’m at now (I’ve since quit ketosis) if I’d stuck with it, and figured out how many calories and what macronutrient ratio I needed to eat to stay in ketosis and maintain my weight. Ketosis is not just about weight loss and that’s not the reason I was doing it. I was trying to level out my energy more, see if it would improve my athletic ability, and see if it would do anything for my PMS symptoms.

  23. “My lab work resembles Jimmy’s very closely – I’m not concerned either, there’s not enough evidence regarding the LDL-p, etc. I’ve worked in Cardiac Rehab for 30 yrs…. so I very familiar with the lab profiles & also w/ diabetes, cardiometabolic disorder – there have been some really bad theories promoted – again really bad data being used…. you’re on the right track…”

    Wow….so there is no evidence that a 99th percentile LDL-P might be a matter of concern, Particularly since it’s been rising in inexorably for five years? I highly doubt there is a cardio rehab lab anywhere in the world who would just dismiss a number like that. Even most sane people in the paleo world agree that this is not something to just blithely dismiss but if you want to stake your life on blog comments, well ….good luck.

  24. I”m really needing to do this diet, but for the life of me, how do you consume 70% kCal per day? I’ve been on atkins about 4 weeks, but this seems to make more sense.
    Can you send me a link for menu, shopping or particular books to read?

    Thank you!
    :)

  25. As a chiropractor (DC) I noticed right away how far out of balance your posture is in the photo. Your right hip and shoulder are up and you are putting more weight on your left leg. Your head is tilted down on the right also. If you are not going to a DC now that can help you with posture correction then go ASAP. Unless if was just an “off” photo. Check again in front of a mirror or get some one to look at you.

    • Davis – Ha! I know. I was wondering if anyone would catch that. I’ve had years of rolfing and chiro work done. My left hip is rotated inward quite a bit. The pain I used to experience is pretty much gone now, though, so I don’t think about it until I see a picture like this one…

  26. Good eye Davis… I’d noticed that as well, but didn’t dare go off topic :)

    I thought I would add this insightful article on the topic of low-carb mythology… http://anthonycolpo.com/tim-olson-another-low-carb-athlete-that-never-was/. This is in no way intended to spur on more controversy, but simply to stimulate some healthy debate/discussion.

    Carmenj, I have trouble understanding how, as a clinical exercise physiologist, you would recommend someone remain on/try to achieve ketosis on a regime of intense exercise. Unless you are not concerned with performance, or with the long-term consequences on health, I’m really having trouble understanding your reasoning. There are many ways to solve fibromyalgic symptoms (as well as what you called “adrenal fatigue”, a “diagnosis” that gets thrown around a lot and that is mostly bogus; how was yours ‘diagnosed’, if you don’t mind my asking? – On that topic, and to that effect, you might be interested in reading the work of Constance Martin and Hans Selye, among others, which would prove useful in demonstrating how reductionnist an approach it is to be blaming anything on “adrenal fatigue”…) and, I suspect that, at least in part, the very fact that eating a low-carb diet actually limits performance in and of itself might be the biggest reason for a reduction in the overall stress imposed on the whole organism. That, and other dietary/lifestyle modifications you might have not accounted for…

    Respectfully,
    Eric

    • Eric – Thanks for linking us all to Anthony Colpo. I’d heard of him but never read anything by him and he’s possibly my new favorite blogger. The whole carbs for athletes debate is fascinating for me, and I’m spending an inordinate amount of time researching it right now. After all, I started my whole ketosis experiment as research for an ebook I want to write, partly because I knew it would spark more personal interest for me if I did. I recently did an interview with CrossFit Endurance’s founder, Brian MacKenzie, who uses very low carb/high fat with his athletes and I’ll write that out very soon. It was interesting for sure. I just read Volek and Phinney’s book, but I need to do more research on them. I mean, if what Colpo is saying about Phinney is true, then he’s a pretty unscrupulous guy and there are a lot of holes in his claims. Anyway, I just wanted to say thanks for your input again, and don’t judge me too harshly for my crooked posture! :)

  27. Hi Neely, While it might get a bit lengthy, based on Klaatu’s, Mary’s, Eric’s & other comments – I’ll take this opp to give you the whole nutrition picture -since like you, weight loss was not my primary goal…. getting healthy & “curing” a variety of inflammatory issues that were accelerating as I got older – despite an organic, whole grain, high omega 3 meat, wide variety of organic veggies -ie a very nutrient dense diet. I’ve NEVER been on high sugar or SAD type diet.
    I follow an “ancestral” based nutritional program – incorporating the research from paleo, traditional foods, current research particularly in celiac & autoimmune & cardiometabolic, biologic/botanical science as well as evidenced based from the natural world (ie how did a “viking” ever get olives or avocados). Based on all that & personal/prof. experience – I do use raw dairy (very little whole milk tho) – mostly dairy fat (organic, pasture fed) – it’s easily available, has some great medium chain fatty acids – so I use dairy fat daily – whole cream, sour cream, butter, homemade kefir). high fat cheeses. So far, out of my client base of over 150, only 2 have had a problem w/ unclarified dairy fat- both of them do use ghee however. NO grains or legumes (biochemically they are toxic, regardless of the paleo/neolithic arguments). No Omega 6 “veggie oils”. Generous servings of low starch veggies (following a 3 veggie mix – sulfurous, brightly colored & green leafy &/or seaweed) – mostly braised in fat for better nutrient absorption; plus fermented or pickled veggies – again to improve nutrient absorption. My meat includes my own grass fed beef, lamb/mutton, pasture pork, minimal amount of poultry, seafood weekly &- ALL the organ meats, including stomach/intestines, brains, sweet breads, etc. I make my own lard & tallow – which really helped me get more & better quality fat in my diet otherwise – I use dairy fat or coconut oil.
    Regarding the health & performance implications: Nutritional ketosis is not hypo-caloric – ketosis is achieved via high fat/low carb. My diet runs 2000-2500kcals – eu-caloric to hyper-caloric…. I just make sure it’s high fat. It’s the insulin/fat deposition factor.
    I am unable to go into the depth & detail & this isn’t the form to do so. As a very brief summary: cardiometabolic, inflammatory disorders as well as all diseases are increasing at epidemic rates. Though I had followed an organic, high nutrient dense diet & been a regular exerciser my entire life – I had a range of metabolic disorders including hypoglycemia/”pre-diabetes”/insulin resistance, accelerating heart arrhythmia, fibromyalgia/adrenal exhaustion/poor recovery from exercise/severe menopausal issues (ie hormonal dysfunction) , borderline/high lipid/glucose labs, IBS, frequent/severe bouts of URIs, allergies, depression (despite good sun exposure)…. Etc, etc. My overwhelming lack of health, as well as the current state of poor health that is becoming the norm across all populations is indicative of a broad based issue… my postulate is it’s mostly malnutrition. The diet I ate for most of my life allowed me to target the nutritional issue a bit more distinctly than the broad brush excuse of the SAD. Reviewing basic biology & physiology – it was rather clear that fat is the primary energy source for H.sapiens, animal fat is the most readily available for a hunter-gather, in a completely natural environment (if you will, “wild” human). The most readily bioavailable & best source of essential nutrients is found from animal sources & most nutrients require or are better absorbed in a lipid medium. Therefore, primary caloric & nutrient sourcing should be from animals, etc. Ketosis is the normal state for H.sapiens….Carb based metabolism is the problem along with toxins from the grain/legume based sources (mostly improper preparation) and dangerous hybridization. Not that we can’t survive on carbs but I prefer to live beyond reproductive age & be healthy while I do so.
    Long story short – based on a nutritionally ketotic, animal based diet w/ healthy veggies – no more hormonal dysfunction, back to exercising vigorously, normal blood glucose, high lipids (Tot Chol 280-365),a triglyceride/HDL ration of .66, HS CRP .4, homocysteine 8.4, HgA1c 5.4, APO E ¾ genotype. Recovered from all previous health issues 2.5 yrs out on aforementioned nutritional program. Biggest issue – get LOTS of salt. (maybe that aquatic ape theory of evolution has merit?). Oh – I’d highly recommend reviewing the videos from AHS 2012, it was a great conference – there were numerous informative presentations regarding high fat nutrition & performance. (Eenfeldt, Gedguadas, Pendergrass, Rosedale, Ben-dor, Welbourn, Lalonde, Taubes). Viva Vida!

  28. What are we supposed to conclude from all of this?

    • Klaatu – Ha! Your conclusion is as good as mine at this point. There’s so much research out there to support and refute all kinds of eating for performance, and then there’s the fact that everyone’s bodies are so unique. I’m just going to continue to experiment and help others experiment with their own bodies for now :)

  29. HI Neely,
    Your original post was about seeking a healthier state via NK. I shared my current results regarding a normal weight female who has been on NK for close to 3yrs. That nutritional ketosis a healthy, metabolic state and may impart significant health benefits. It is NOT dangerous but does require adaptation from carb metabolism, that the adaptive period can have discomforts, especially since nutrient needs change from the carb to keto metabolic state (ie more salt) and real adaptation may take 8 wks to 6 months. What one eats matters & I shared an outline of that… And, healthy, biologically appropriate nutrition is more than NK. Like you, I seek to help others find a healthy base of nutrition …if you would like more didactic info- there is a grocery list & other info on my website.
    We are on the cutting edge of nutritional investigation – we are exploring the current nutritional theories. The current dominant paradigm is heavily biased towards carb metabolism & there is very little good research on anything else. Normative data on keto adapted humans is lacking…. We do not have base line blood or metabolic lab data for this metabolic state. Using current lab norms is making a big assumption that maybe erroneous. (What little population data comes from research done by Weston Price & others – on the Maasi, Iniut, etc. And a little from the Nutrition & Metabolism group, ie. Volek & others) As Cordain as pointed out – we have been on an evolutionary discordant diet for at least 10k yrs. I find it ironic that H.sapiens seems to be the only animal that doesn’t know what to eat. If you are interested in doing further reading – I have a decent reference list on my website (wildrenz.com). Viva Vida!

    • Carmenj – Thanks for posting. I looked at your grocery list and noticed it includes dairy. So for me and many others who are sensitive or intolerant to dairy, it doesn’t really apply. I do think it would be way easier to do NK with dairy, but I don’t see how having dairy in your everyday diet translates to your theory that this is how hunter gatherers lived, as they most likely didn’t keep milking animals until recently. Also, are you an athlete? How often do you exercise, at what intensity, and what type? I’d love to know how your diet supports that. Also, it seems that a lot of people claim to be on an NK diet, but they’re eating quite a few carbs, so are they really in ketosis? I noticed you have starchy carbs, grains, and sweeteners on your grocery list, which means a person could easily get up into the 100+ grams of carbs a day on your diet. Do you test your ketone levels or are you just on a LOWER carb diet (like I am) than a typical American?

  30. Hi Neely,
    I’m not a food nazi & not all neolithic food strategies are evolutionary discordant …. we are omnivores, moreso on the carnivorous side – it just helps to be smart or wise about our choice of foods & the toxic load that might be present….
    Most dairy intolerant folks do just fine on ghee -its the carb & proteins that cause the problems. As I indicated, dairy fat is just an easy source of animal fat (very renewable) & has been utilized by the Maasi, Mongols, Kurds, etc. It’s just one adaptive strategy H.sapiens has used to feed themselves – we are mammals & dairy fat contains numerous healthy fatty acids. Coconut oil, lard, tallow & organ meats can do the same. I can’t tolerate egg whites but many folks do. The idea is that we are H.sapiens, basically carnivorous omnivores – our uniqueness comes from genetic proclivities based on our ancestry… that’s where we get to play a bit for our n=1. :)

    Yes, I include “safe” starches – AND instruct to keep the total carb load to 50 grams per day or to 10% of total calories. This will keep most folks in NK. But as Jimmy discovered he needed to drop to 5% or less of carbs to get his metabolism to shift. I also use intermittent fasting (IF) & only eat 2 meals/one snack per day on average. IF is easy (18-24hrs) when one is keto adapted. I also don’t worry, now, about eating a bit more carbs on occasion – shifting back & forth from ketosis to a mild carb metabolism – attempting to keep my metabolism flexible….. but I never get more than 75 grams per day at the very most. If my results weren’t as overwhelmingly positive in all realms I would definitely change my nutrition BUT as I said in my first post – I really am so much better that I am still amazed. There are other variable like- leaky gut from grains but I assume you are off all grains & legumes. Beer is one of the things I miss the most but I don’t mess w/ grains (exception of a little white rice on occasion) so I drink hard cider, factoring the carb value into my daily carb totals. I really focus on low toxic load & avoid that which might mess up my gut.

    I am a recovered competitive athlete (road & mountain bike, xc ski & previous road runner, track (400m /400m hurdles) & soccer, body building & martial arts. I did a lot of cross training. Probably contributed to advancing the inflammation I experienced). I exercise, now, for functional fitness & health – using principles from Boyle (Functional Training), Core, sprinting/HIIT & am progressing into Olympic lifting; train at 3-4 days/wk, 75-100% intensity via heart rate/RPE (30-60min sessions). Besides managing a Cardiopulmonary rehab program, I manage the hospital employee wellness program where I lead some core & FxFit classes & use my personal training staff to assist my training. I also snow board, mountain bike, ride & train horses & run my small ranch. My biggest problem is getting enough sleep & recovery time =). I recover quickly (or I’d of collapsed by now) and have found it EASY to gain muscle mass – which has always been hard for me since I am a small boned, slender female. Tx for the great questions & dialogue. Hopefully this helps.

    • Carmenj – Thanks for the feedback. Again, I really don’t know how I’d do it without dairy. I know all about the benefits of dairy, what fatty acids are contained in it, etc. But I can’t even eat ghee, and there are plenty of other people out there who can’t either. Everyone seems to think that ghee and fermented dairy products are universally benign foods and they’re not. I got eczema, yeast infections, and asthma when I was eating pastured ghee and raw homemade yogurt. I also know all about the Maasai, etc. who use dairy and are quite healthy. I think they might have that gene that allows them to produce more lactase than I ever will. Yes, for whatever reason, some people can tolerate dairy, but many can’t. Anyway, do you supplement with sodium? And if so, how much and do you time it according to your training schedule? Do you use “SuperStarch” or vespa any of those other products that NK athletes use? And how long did it take you to transition to NK when you first started and how painful was that process for you? And finally, do you have any athletes on NK who don’t eat any dairy?

  31. Hi Neely,
    It’s not easy to answer your questions in brevity & do you justice… generally we recommend 3-6months of coaching (including myself, we have 5 coaches trained & using the OHN) because the “pitfalls” are numerous & it isn’t easy, at first. I put this out as a disclaimer, & I’ll do my best to share what I think might help you & try to be brief (ha!). I do collaborate with (a dietitian) who cannot not tolerate any kind of dairy & who is following this program. She loves ketosis because as we both experienced from the beginning: “For the first time, hunger is not a constant problem” (ie hypoglycemia which necessitated frequent snacking). We share with each other daily (I work with her) and we “coach” each other, we are both over 50.

    Because there is no “formula” that fits everyone, I focus on a basic “safe” macronutrient range that will decrease insulin levels/ inflammation & provide satiety (70% fat / 20% protein / 10% carb) and then assist, w/ adjusting each person’s individual nutritional needs from there. As you know, eating healthy in our modern world can be really challenging & takes real perseverance. Nutrition gets a bit complicated because we really have forgotten what to eat &/or how to prepare it safely. All foods have substances that can cause problems when ingested. Though we have identified some of the worst offenders [gluten based grains, other grains, legumes, nightshades, cruciferous plants, numerous modern additives (MSG, malto dextrin, trans fats, etc), veggie oils, eggs, dairy] – not everyone is sensitive to the same thing. Based on the clinical evidence –leaky gut may be the biggest problem – by allowing whole proteins & complex carb molecules into our blood stream that normally wouldn’t get past the gut wall barrier. Healing our gut is probably the first step to being healthy. It may take up to 3 years on a very “clean” diet & “clean” varies depending on what affects your body. We have found that as our gut healed (2yrs out, we aren’t as sensitive to some foods as we were. Tho, egg white still cause me 6 hours of severe stomach spasms if I inadvertently eat some).

    I focus on eating “primary” foods that provide nutrient density & higher fat – these are animal based foods – organ meats & fats, fatty muscle meats w/ bone, tendon & joints, bone broths, etc. Fish.
    Cooking most veggies in animal fat (lard or mutton/lamb fat is luscious), soups, stews. All plants contain lectins that may cause problems – cooking denatures most of them. Saturated fats may actually provide protection (Cordain’s own words) based on recent research. Much paleo based nutrition depends too heavily on lean muscle meats. We started raising our own pasture animals & harvesting them w/ a specialty butcher so that we had fattier meat, tallow/lard & all the organs (the whole animal – so we could increase our animal fat & decrease our dependence on dairy fat. Tho, we still use it & fermented dairy ‘cause we can & it tastes good. I am seeking that fine line between health & pleasure =). Coconut, macadamia nut, palm kernel, sesame & olive oil are great healthy plant fats. I recommend coconut milk (from a can), much richer for use in teas, coffee & creamy dishes, thai curries, cream soups/stews; and coconut “butter”….. adding salt to coconut oil & butter improves their flavor (like in salted vs sweet butter). Coconut fat is mostly medium chain fatty acids that are easily absorbed directly into the bloodstream (forgoing the longer bile acid digestion)& is great as a snack food – REALLY helps when adapting to ketosis. It’s one of our secret weapons to make it easy to stay in ketosis. But once you get keto adapted – long stretches between meals gets easy & coconut milk is easy to carry as an “energy” drink.

    Then there is the BIG issue w/ salt: low sodium symptoms = morning headaches, malaise, undue fatigue, constipation, orthostatic hypotension…. Start w/ ¼ t salt in 8 oz of water & adjust for your taste , keep a bottle w/ you – drink a bit throughout the day. I keep sea or “real” salt at work & add it to my tea or water after working out (much of the herding peoples serve salted not sugared beverages).

    I don’t know where you are located: but specialty or custom butchering is getting very popular (or if you are in an area where hunting is popular- there are always private butchers) where you can get your meat cut the way you want (my grandma took this for granted, neighborhood butchers had their own little shops) or you can get good beef tallow & pork fat (rendering is easy). In some locales fresh cooking tallow & lard are already made at these shops. Coconut milk smoothie (I just use a good “green powder”) & dilute to my taste preference – is the best “breakfast” to start a day. Then 2 good meals w/ 4 oz. fatty meats & fatty veggies. Perhaps tea w/ coconut milk or couple tablespoons of coconut butter in the evening. Rule of thumb – if you are hungry w/in 2-3 hrs of a meal – you need to increase your fat.
    Sorry to write so much but the picture is more complicated than a simple formulaic diet program. Vive Vida!

    • Carmenj – Thanks! And how long did it take you to transition into NK?

  32. 4 weeks, of which the first 2 were a bit uncomfortable due to still having carb metabolism and some hypoglycemia – we drank coconut milk & used coconut butter – we were very strict w/ our carbs (50 gram/day or less) AND we allowed ourselves all the low carb, fat drenched veggies we wanted – to fill our stomachs which were used to being fuller due to the bulk of carbs. The quicker the transition the easier it is. This is a great post from Dr. Eades: http://www.proteinpower.com/drmike/saturated-fat/tips-tricks-for-starting-or-restarting-low-carb-pt-iii

    • Carmenj – Yep, I’ve read that – thanks. I’m just interested in individuals’ experiences, so I wanted to know more about yours. Thanks for all your information – it’s really helpful to me and my readers!

  33. The “references” on the website are nothing more than pop science books from the usual suspects- Taubes, “wheat Belly”, etc. Again, do you want to base your life/health on assertions from somebody who uses Protein Power in a bibliography ?

    Once again, good luck.

  34. Anonymous

    So glad to see there is drama no matter where you go to read how people are doing and reacting to trying Paleo.

  35. You don’t need carbs. Typically as long as you’re below about 50 g of carbohydrate (for most people) and under 1.5 g/kg of lean body weight for protein, you should have no problem driving enough production beta-hydroxy-b (ketone) for your brain to feel good. Check Volek & Phinney’s latest book “The Art and Science of Low Carb Performance. ” Also, Dr. Peter Attia’s website: http://eatingacademy.com/
    Is a must. Lastly, try supplementing sodium and maybe even some magnesium if sodium doesn’t make you feel better right away. On very low carb diets, you dump a lot of fluid and sodium and some potassium as a result. Supplementing with sodium is usually the first place people fail with low carb. Cheers and good luck. I’ve been vlc

  36. You are feeling those things because you are not keto adapted. 5 Days is not enough time.

    You go through a transition, everyone enters a state of ketosis in sleep usually, but that does not mean you are where you are seeing the benefits yet of Keto. it can take a a month or two to become highly keto adapted.

    You should not do much working out the first week, your body is confused and still looking for sugar because for so long you have been dosing yourself with sugar.

    Even being at less than 10% body fat, your body still has a ton of fat to feed from, so that is not true about what another said it will go after muscle because not enough fat.

    Second, your body goes into catabolic state from relying on sugar, your brain breaks down muscle for amino acids, this wont happen as you become more keto adapted.

    The energy means you are not in ketosis, berries have sugar, most keto don’t eat any fruit, and a mostly above ground vegitables, mostly leafy greens as onions have carbs and sugar, tomatoes do too etc.

    Some get “keto flu” in the first week as their body begins the learning process.

    I could go on and on but, don’t stop keto, did you hop on a bike the first time and ride like a pro? you will fall off ketosis a few times as you learn and adapt.

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