You can see previous parts of this series here: The Ketogenic Diet Part 1: What is Keto?, The Ketogenic Diet Part 2: Sugar, Insulin, and Inflammation
Ketones and Fat Intake
The obvious first step to being keto-adapted is to cut out sugar, and when I say sugar, I also mean starch. Complex carbohydrates are just glucose molecules hooked together in a long chain. The digestive tract breaks them down into glucose, AKA sugar. Therefore, a diet filled with “safe starches” like sweet potatoes is still considered a sugary diet. To become keto-adapted, you need to start using ketones for energy, not glucose.
So, what are ketones? They are a by-product of fat oxidation that are basically super-fuel for your body…sounds great, right? Ketones are created in the liver during beta-oxidation. Fatty acids are broken down into acetyl-CoA, which is then oxidized, and its energy is used for the production of ATP, the coenzyme used as an energy carrier in the cells of all known organisms — the body’s energy source. If excess acetyl-CoA is produced or inadequate quantities of a required precursor called oxaloacetate are present, the extra acetyl-CoA is transformed into ketone bodies. So you can actually produce ketones and oxidize fat for ATP at the same time. Fun fact: we all naturally go through a mild ketosis (keto-adapted) after fasting during a long night of sleep, if you don’t eat right before bed and after you’ve woken up. You need to not eat for over ten hours to be in mild ketosis.
To start producing ketones, my first suggestion is to start with a diet of less than 10 grams of carbohydrates a day. This may seem like an awful battle that you can’t win, but it really isn’t that hard to do. Simply favor fatty meats and spoonfuls of coconut oil in order to fuel your cells with the proper macronutrients.
In order to enter ketosis, you need to turn up your healthy fat intake to push yourself over the adaptation divide as quickly as possible (while reducing carbohydrates, of course). This gets your body used to metabolizing more fats for energy, including stored body-fat.
The amount of fat you need to eat in grams per day will depend on your caloric needs. The following is a good equation to determine the amount of fat in grams you need to consume: Fat grams = (total required calories * (0.8) / 9. For example, if you are shooting for 1400 calories a day with 80% of those calories coming from fat intake, then (1400 * 0.8) / 9 = 124 g of fat a day.
If you don’t like fatty cuts of meat, you can add medium-chain triglycerides (MCTs) to your diet. MCTs are mainly comprised of medium-chain fatty acids. MCT oils go directly to the liver to be converted into acetyl-CoA for energy and do not show up in cell membranes or adipose tissue. The ace-tyl-CoA to ATP pathway becomes overwhelmed, which causes the creation of ketones. Consuming MCT oils increases ketone production.
Medium-chain triglycerides (MCTs) are different than long-chain triglycerides. MCTs are absorbed more like carbohydrates and are used and burned quickly by the body; they are not stored in the fat cells, and any extra are converted into ketones. This is why I am very specific with my food recommendations, even with the salad dressings my clients use. It is always best to make your own dressing, because you can make them with MCTs rather than with vegetable oils. Vegetable oils are long-chain triglycerides and will not turn into ketones for fat burning. Instead of using long-chain triglycerides, which do go into cell membranes and can show up in adipose tissue, MCT oils are less likely to overwhelm the liver’s ability to make ATP. It is therefore better to prefer saturated fast like coconut oil and animal fats, which contain greater concentration of MCTs.
MCTs passively diffuse from the GI (gastrointestinal) tract to the portal system (longer fatty acids are absorbed into the lymphatic system) without requirement for modification like long-chain fatty acids or very-long-chain fatty acids. In addition, MCTs do not require bile salts for digestion. Patients that have malnutrition or malabsorption syndromes are treated with MCTs because they do not require energy for absorption, utilization, or storage. MCTs will speed up the ketone production process. On rare occasions, MCT oils have caused nausea in some of my clients if they take too much of it, so be cautious and start out slowly.
Appropriate Protein Intake
A ketogenic diet is an extremely low-carb, moderate-protein, high-fat diet. Do not get this confused high-protein diets. As we’ve covered before, too much protein will also become sugar in the blood, so you need to eat an appropriate amount of protein for your bodyweight without going overboard!
One question I get all the time from clients is, “How much protein is too much?” Well, everyone has a different tolerance, just like with carbohydrates. I work with lots of extreme diabetics who can’t eat more than 60 grams of protein a day (about 20 grams at each meal) or they will be kicked out of ketosis. A good rule of thumb is to get 0.7 times your lean body mass in grams of protein a day. So if you weigh 150 pounds and have 25% bodyfat then your lean mass is 105 pounds (150*0.75). So for your protein goal take 0.7*105 and you get 73.5g of protein a day.
Long story short, to become keto-adapted:
- Cut out sugar and starch: reduce carbohydrates to <10g per day
- Cut your protein intake to 0.7x your lean body mass in grams of protein per day
- Fill in the gaps with healthy fats from coconut, avocados, and animal fats.
It’s just that simple!