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Keto Constipation: Causes & Remedies

The ketogenic diet can help you lose weight, improve your mental clarity, and boost your energy levels. But it’s not all sunshine and rainbows. The keto diet can also lead to uncomfortable side effects, and keto constipation seems to be a fairly common one.

The causes of constipation, in general, are wide and varied, but diet seems to play a huge role. A poorly planned keto diet can lead to nutrient insufficiencies and indigestion, all of which lead to constipation. But there are many other factors that play into keto constipation and which we discuss in this article.

Keep reading to learn what keto constipation is, what causes it, and how you can treat it.

What is constipation?

A common misconception is that you need to have a bowel movement every single day, otherwise you’re constipated. Normal bowel frequency is actually anywhere between three a day to two bowel movements a week .

Constipation is when you’re having difficulty passing stool in addition to having infrequent bowel movements. You can check whether you’re constipated by looking at the Bristol stool chart. If you are uncomfortable with the idea of looking at your own poop, then check for the following constipation symptoms.

  • Abdominal pain and discomfort
  • Bloating and abdominal distention
  • Difficulty passing gas
  • Hemorrhoids (with chronic constipation)

If this is you, then you just may be constipated. Keep in mind, though, that these symptoms are fairly nonspecific and could be a sign of many other digestive and metabolic issues.

As far as the causes of constipation are concerned, there are many factors that can cause it. Lack of dietary fiber, too much fiber, poor fluid intake, inactivity, irritable bowel syndrome (IBS), thyroid disease, imbalanced gut flora, and even neurological problems can lead to constipation.

Can keto cause constipation?

Any diet can cause constipation if it is deficient or imbalanced in certain nutrients. The same holds true for the ketogenic diet. But if your keto diet is well-planned, then you’re less likely to experience keto constipation and diarrhea, even. When you do develop keto constipation, it’s likely a result of one or more of the following.

Too much or not enough fiber

Increasing fiber intake is the first-line treatment for constipation no matter what diet you’re on.

Studies show that most adults following a typical Western diet are not meeting their daily needs for fiber . The recommended daily intake is around 25-30g a day, while the current average is below 20g a day.

Fiber is an indigestible carbohydrate that gives stool bulk, which makes it easier to pass. It also stimulates bowel movements and feeds friendly gut bacteria – all things important for normal bowel functioning.

But too much of it can also make you constipated according to some studies . So, if you’ve increased your fiber intake but are still constipated on your keto diet, make sure you are keeping fiber intake within the recommended daily limits.

Another important thing that many people fail to mention when talking about fiber is the importance of hydration. Soluble fiber absorbs water, forming a gel-like substance that helps with bowel movements. Without enough water, this type of fiber will not do much for your bowel health.

Low food intake

The keto diet is known for its appetite-suppressing effect, which makes you eat less. And while this can be a good thing when your goal is weight loss, it can also leave you constipated.

There are several reasons why a high-fat diet leads to lower food intake:

Fat is satiating

Fat can be quite satiating, and this is especially true with medium-chain triglycerides (MCTs), which are fats that are recommended on a keto diet.

Being in ketosis

Being in ketosis can also make you eat less due to the appetite-suppressing effect of ketone bodies.

Changes in blood glucose

The ketogenic diet leads to healthier blood glucose metabolism, helping stabilize blood glucose and insulin levels. This, in turn, can help regulate your appetite but may also lead to low appetite.

Not eating much reduces the frequency of bowel movements. This shouldn’t be a reason to worry unless you’re feeling uncomfortable and constipated. If that’s the case, then you may want to check if you’re eating enough.

Imbalanced gut flora

A healthy gut is home to billions of microorganisms.

These microorganisms keep the numbers of harmful bacteria and fungi low. They also help ferment fiber, produce short-chain fatty acids, make vitamins and enzymes, and support the immune system . These beneficial critters include different strains of bacteria such as Bacteroides and Bifidobacterium and the Candida yeast.

Friendly gut bacteria feed mainly on soluble fiber. If your diet is low in this type of fiber, the bacteria will starve, leading to something called dysbiosis, aka a microbial imbalance.

Dysbiosis leads to a range of digestive symptoms, and constipation is the most common one.

When lower fiber intake is combined with higher fat intake, it is most likely to lead to dysbiosis as found by animal studies . Besides constipation, microbial imbalances can also cause diarrhea and nutrient malabsorption.

The keto flu

The keto flu is a common side effect of going low carb. This set of flu-like symptoms usually happens during the induction phase of a ketogenic diet and includes headaches, fatigue, muscle cramping, brain fog, nausea, and keto bloating and constipation.

Keto flu happens because the ketogenic diet has a strong diuretic effect during its induction phase, meaning it makes you pee more. With increased urine output, you also lose electrolytes and this increases your risk of dehydration, and dehydration often leads to, you guessed it, constipation.

Other causes

Milk protein allergies, certain medications (codeine and antidepressants), inactivity, low thyroid hormones, and premenstrual syndrome (PMS) can all cause worsen constipation and even contribute to keto constipation.

What helps constipation on keto diet?

To know what will help treat keto constipation in your particular case, you need to get to the root cause. This can be a bit tricky. You may need to check with your doctor and see if an underlying health condition is contributing to your keto constipation. Other than that, try following these six simple steps to treat keto constipation.

1. Balancing your fiber intake

Eating the right amount of fiber and drinking enough fluids can make a huge difference on your digestive health. Current guidelines recommend 25 to 30 grams of fiber per day, with special emphasis on soluble fiber.

On a keto diet, you can get plenty of soluble fiber from coconut flour, avocado, broccoli, almonds, celery stalks, peanut butter, flaxseed, and other keto diet food. You can also take fiber supplements like psyllium husk and methylcellulose.

2. Taking probiotics

Probiotics are live bacteria and yeast found in fermented food but also sold as supplements. Good sources include cultured yogurt, kefir, sauerkraut, and miso. Combining fermented food with fiber-rich sources boosts probiotic survival in the gut.

One large systematic review found that probiotic balance gut microflora and help normalize bowel functioning . The most common probiotic strains studied are Lactobacillus and Bifidobacterium. Some strains also occur in symbiosis with fungi, and you can find these in kefir and sourdough.

3. Eating more and staying hydrated

A lower calorie intake is necessary for weight loss, but you don’t want to take it too far. A modest calorie reduction of 300-500 kcal/day is all you need to initiate fat burning on a keto diet.

While keto can make you lose your appetite, you need to ensure you’re getting enough nutrients to maintain ketosis, good health, and, of course, normal bowel functioning. Try increasing your intake of low-carb, but high-fiber keto veggies, other keto-friendly food, and increase your fluid intake.

A good way to start is by planning your meals. Make sure all of your meals contain enough fiber when working on improving your bowel health. Diet apps can also help with this.

Also, drink different liquids throughout the day to get enough fluids. Water, tea, smoothies, and soups all contribute to your daily hydration levels. It’s best to take liquids together with meals to improve digestion.

4. Staying active

Studies show that one of the most common causes of chronic constipation in adults is inactivity . Inactivity reduces blood flow to your GI tract slowing down digestion. Physical activity, on the other hand, stimulates the digestive tract. That explains why being bedridden leads to constipation and why exercising often causes an intense urge to poop.

Current guidelines recommend 150 minutes of moderate aerobic activity every week for optimal health and regular bowel movements. But you don’t have to limit yourself to aerobics. Any type activity that gets your heart pumping and your muscles working will do. This includes weight lifting, yoga, and high-intensity training.

5. Eliminate allergens

Keto dieters often find that limiting dairy helps with keto constipation. A probable cause could be allergies since research shows a strong link between chronic constipation and cow’s milk allergies . Milk allergies lead to inflammation inside the intestines preventing normal functioning.

Besides milk, other common allergens include eggs, peanuts, tree nuts, soy, seafood, and wheat. Note that many of these foods are high in protein, which makes sense given that good allergy is, by definition, an adverse reaction to food proteins. Try excluding different protein foods at different times and see if you could track a possible allergy. But a more reliable method, of course, is scheduling an allergy test.

6. Treating the keto flu

The keto flu is a common cause of short-term constipation on a keto diet. But even if it’s short-lived, keto constipation can be very uncomfortable. That’s why you need to treat it, and the best way to treat it is by drinking enough fluids, taking electrolytes supplements, and getting plenty of rest.

Does eating low carb make you constipated?

Going low carb, in and of itself, will not make you constipated. A low-carb diet can still provide enough fiber, fluids, and probiotics that help with normal bowel movements and the maintenance of healthy gut flora.

The problem with eating low carb is that it makes meeting fiber needs more difficult as it excludes many fiber-rich foods like whole grains, legumes, and starchy fruits and vegetables. Low-carb diets that are high in fat such as keto can also lead to an imbalanced gut flora duet to higher fat intake. And as already explained, going low-carb leads to the keto flu that lists constipation as a leading symptom.

How do you avoid constipation on a low-carb diet?

One sure-fire way to avoid keto constipation is by planning your diet well.

For example, aim for 3-5 servings of low-carb vegetable and keto-friendly fruit to meet your daily needs for fiber. This will help maintain healthy gut bacteria and support bowel motility. Include healthy MUFAs as these are less likely to cause dysbiosis. With time, your body will also start producing more fat-digesting enzymes, reducing the amount of undigested fat reaching your colon.

Dehydration from keto induction is also easy to prevent by staying hydrated and taking electrolytes. Some dieters also try to reduce their carb intake gradually to make transitioning to keto easier and side-effect free.

There are also foods and products that can help you control constipation on a low-carb diet such as:

Magnesium-rich mineral water

These are defined as having a magnesium content greater than 50 mg/l. Magnesium relaxes the bowels and pulls water into your intestines which helps relieve constipation. But if you take too much magnesium (more than 400mg), you could get diarrhea. Moderation is key when it comes to magnesium-rich water in preventing keto constipation.

Keto smoothie for constipation

Make fiber-rich smoothies a part of your daily diet. Using avocado as a base ingredient boost the fiber content of keto smoothies, but you can also make them with spinach, kale, peanut butter, and other fiber-rich ingredients. Optionally, you can add MCT oil to help fight intestinal inflammation and balance out gut flora.

Summary

Keto constipation is a common problem for keto dieters. Luckily, it’s easy to avoid and treat once you get to the root cause. From eating too much or too little fiber to lack of physical activity and food allergies, there are many causes of keto constipation. Finding out which one is the culprit in your particular case will help you address keto constipation successfully.

Try following our easy tips and tricks and see what works for you. The keto diet being restrictive in carbs means that inadequate fiber intake is the likely cause of your keto constipation. Boosting your fiber intake through low-carb keto plant foods or supplements. Drinking water and staying active also helps.

If you’ve tried everything and nothing seems to help, you may need to ask your doctor for help. Constipation lasting longer than a week likely won’t resolve on its own. Besides that, it puts you at risk of complications.

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Going keto can be great for losing weight, increasing energy, and improving your health, but when too much focus is on the macros, you can end up with keto constipation. Fortunately, keto constipation can be quickly remedied by increasing your consumption of low carb veggies like broccoli and cabbage and supplementing with key minerals like magnesium.

In this article you will discover:

  • Keto constipation cure #1: Eat more veggies
  • Keto constipation cure #2: Add key minerals

Keto Constipation Cure #1: Eat More Veggies

If you’re suffering from digestive issues like constipation or diarrhea, it’s likely you’re not getting enough fiber and fiber comes from vegetables on the keto diet.

It’s a common misconception that the keto diet consists of just meat and cheese. Yes, many veggies have carbs, but here’s the secret to getting tons of nutrient-rich veggies:

  • There are plenty of naturally low-carb vegetables to choose from
  • You count net carbs on a ketogenic diet and;
  • Veggies are a great conduit for delicious fats like avocado, olive oil, and MCT oil

Net carbs are calculated by taking the entire number of carbs per serving and subtracting the grams of fiber per serving.

Example: 1 cup of broccoli = 6 grams carbs – 2 grams fiber = 4 net carbs

And if you’re not into calculating net carbs, here’s an idea of some low-carb veggies to add to your meal plan:

  • Greens
  • Avocado
  • Squash
  • Bell peppers
  • Eggplant
  • Asparagus
  • Broccoli
  • Mushrooms
  • Lettuce
  • Green beans
  • Cucumbers
  • Celery
  • Cabbage
  • Radishes

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Keto Constipation Cure #2: Add Key Minerals

In addition to constipation, many brand new keto dieters find themselves experiencing fatigue, brain fog, and the dreaded keto flu. As you’re transitioning to using fat as fuel, it’s inevitable that you’ll experience some discomfort, but it doesn’t have to be debilitating.

One of the reasons you may not be feeling “regular” is a mineral imbalance. The keto diet can have a diuretic effect in the first week or so, which increases your excretion of key minerals like sodium, potassium, calcium, and magnesium.

To fix this, find a stevia-sweetened electrolyte supplement with magnesium, potassium, and calcium. Shoot for about 2,000-4,000mg of sodium, at least 300mg of magnesium, and 1,000mg of potassium per day to help alleviate constipation, fatigue and other symptoms. One of our favorite mineral supplements is Natural Calm Plus Calcium. It comes in unflavored as well as Raspberry-Lemon versions and it definitely “gets things moving” when you hit the right dose!

UP NEXT: Not Losing Weight on Keto? 4 Common Reasons You’re Not + Solutions

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Fix Keto Constipation: #1 Ingredient When You Can’t Poop

It’s an uncomfortable topic, but I’d be lying if I told you I didn’t search Google for “keto constipation” and “can’t poop on keto” during my initial weeks following the low-carb ketogenic diet.

The fact that you’re here tells me you’re in the same circumstance, and hopefully, we’ll solve this problem naturally 🙂

Skip to #1 Ingredient for Constipation

When you dramatically change your diet from carbs/starch to fat on keto, it’s reasonable to wonder how it’s going to affect your poop habits.

There are 3 common observations:

#1) You experience constipation in the initial weeks on keto

#2) You poop less (both volume and frequency)

#3) You become more “normal” once your body adjusts

There was also a disturbing find called the “keto glass poo” or affectionately known as the KGP.

Apparently, if you hold it for too long, your fecal waste becomes dense and literally crystallizes.

I don’t want to think about what this means for your asshole.

I’m happy to say I have never encountered the dreaded KGP. After reading such horror, I took my diet choices even more seriously.

Your main goal must be to eat the highest-quality foods that will keep your digestive health in order.

* DISCLAIMER: My results are not typical. Following this diet will not guarantee your desired results. Weight loss takes a dedicated, holistic, long-term effort and your success level will vary based on many factors. I have and will never give medical advice, nor will I personally advise how to cure or treat your condition/ailment/disease.

#1 Secret Ingredient to Avoid Constipation

You may know of it as brand-name Metamucil, but you can buy this 100% fiber dietary supplement under the plant-name, Organic Psyllium Husk on Amazon.

I throw this into keto recipes regularly, such as low-carb bread or cauliflower pizza crust to prevent constipation.

It comes in powdered form which is better if you’d rather drink it down vs. use as a baking ingredient where it provides texture.

Viva Naturals also offers capsules for the easiest solution.

The addition does WONDERS to remedy the quality and consistency of your bowel movements.

When it’s added to liquid, it begins to thicken and almost forms a gel. This is part of what works so well as it passes through your body.

Combining psyllium husk with adequate water consumption is the best natural laxative that I’ve ever experienced.

I don’t want to get graphic, yet I can’t help it…

Don’t be surprised if your turds don’t leave any poo residue on your bum.

Psyllium husk shits are one of life’s simple pleasures.

Keto Diet & Constipation

Your body takes time to transition to burning fat and new foods. You’ve likely trained it to process high carb foods, and to some degree, healthy foods may seem foreign.

A byproduct of this is you shouldn’t expect to feel like a new person 5 days into your low-carb experience.

It could take weeks for your body to adapt to its new diet.

I clearly remember days of feeling constipated and bloated at the beginning. During this time, it was difficult to eat a normal amount of calories.

Sometimes 600 calories would fill me for the day.

Eventually, this passed and I settled into an eating routine.

However, I didn’t begin feeling a major uptick in my energy level until 6-8 weeks after starting keto.

If you haven’t reached that point, I strongly recommend sticking it out despite any short-term negative symptoms.

The Science of Digestion

We can increase our understanding of pooping by learning about digestion.

The first thing to discuss is simple weight.

Let’s say that you are transitioning from a high-carb diet to the ketogenic diet for weight loss, as most of us do.

Assume you were eating 2500 calories before, and you are going to eat 2000 calories on keto.

Consider that fat provides 9 calories per gram, while carbs & protein only provide 4 calories per gram.

The high-carb diet:

  • 50% Carbs = 313 g
  • 25% Fat = 70 g
  • 25% Protein = 156 g
  • TOTAL: 2500 Calories = 539 g

For the keto diet, the breakdown might be:

  • 70% Fat = 156 g
  • 20% Protein = 100 g
  • 10% Carbs = 50 g
  • TOTAL: 2000 Calories = 306 g

This is a 20% reduction in calories, and a 43% reduction in food weight (excluding water).

With the combination of eating fewer calories, plus eating more calories from fat, you eat a much lower volume of food on the ketogenic diet.

My super scientific theory is less volume of food in = less volume of poop out.

We can also think about how your body digests different types of food.

Breaking food down into the macronutrients, it’s known that simple carbs are digested the fastest, and thus spike your blood sugar within minutes. Complex carbs and proteins take a bit longer to digest. And fats take the longest to pass through your stomach!

Not only are you eating less food, but the food you eat on the keto diet will take longer to pass through your body.

This explains why people don’t poop daily, or at least less often when they transition to keto.

Important note: Your stool should not look oily or contain fat. This is a sign that your body isn’t properly breaking down the fat and may be a cause for concern. Consult with a doctor if this is the case.

Improve Your Gut Health

One of the best ways to cure constipation long-term is by giving yourself a small dose of fermented foods every day.

Since they are alive, they contain healthy probiotics that help your digestion process and provide better nutrition absorption.

Popular fermented foods include: yogurt, sauerkraut, kimchi, kefir, apple cider vinegar, and kombucha.

Wine and beer also fall into this list – but they are not exactly keto-friendly!

My morning routine includes throwing back a half glass of water with a teaspoon of apple cider vinegar before having a cup of coffee.

My Pooping Experience

I poop daily. I try to poo around the same time, not long after waking up.

Every now and then, I’ll go to the bathroom for round #2 if I ate a lot of food the day before or ate late in the evening.

Compared to my high-carb self, I absolutely go to the bathroom on a more normalized schedule. My stomach feels better, and so does my entire body.

While eating carbs, I’d feel crappy throughout the day until mid-afternoon, and sometimes evacuated my bowels 3-4x per day.

This was a big factor for wanting to eat healthier outside of weight loss.

The older I got, the less I could handle unhealthy meals.

Other Factors

I’m a firm believer that health is not only about nutrition and exercise.

Sleep and stress also play a massive role in how your body operates daily.

Feeling your best is achieved through a balancing act of all the essential metrics to your overall physical and mental health.

A significant change in any one of them can negate progress made by following a low-carb diet.

Not to mention that it could contribute to subpar bowel movements!

How to Stay Regular

  • Eat Fiber – Some people are so strict with eating fat, that they purposely ignore carbs with a lot of fiber. Not me. I eat vegetables, leafy greens, nuts, chia seeds, flaxseed, psyllium husk. This equals around 20-30 grams of fiber per day.
  • Drink Water – Staying hydrated flushes a lot of bad shit out of your body, literally and figuratively. Your body requires water for digestion, so it’s especially important after you eat. My answer to almost every ailment these days is drinking more water. I usually feel noticeably better within hours.
  • Exercise/Walk – Staying in motion increases your metabolism, and keeps your body functioning properly. Take a few small steps everyday towards living an active lifestyle.
  • Drink Coffee – Almost without question, if I didn’t have a good poo upon waking, I need to go 15-60 minutes after having my morning cup of coffee! Whatever compound is causing this, I can’t say. But it works for me.

So there you have it. Don’t be alarmed if you aren’t pooping as much, especially at the beginning.

Do your best to eat some fiber, drink zero calorie beverages, and be active.

If you manage these important areas, you will keep constipation at bay and achieve better gut health on the keto diet.

P.S. Give organic psyllium husk (100% fiber) a shot to seriously end your constipation!

Is Ketosis Safe?

The truth is that we can’t say for certain that it is 100% safe.

Humans don’t understand everything under the branch of nutritional science and probably won’t for a very long time. As an individual, the only thing you can do is take a look at the research yourself and form your own conclusion.

Personally, through the reading I’ve done and the experience I’ve had with the Keto diet, I’ve formed my own conclusion that ketosis is safe.

Could I be wrong? Absolutely.

But I could also be right. I’m willing to take that risk in order to follow a diet which could maximize longevity, well being and function.

My personal conclusion shouldn’t matter to you though. You need to do your own research and come to your own conclusion. I’ve put together this post to organize all of the issues surrounding the safety of ketosis so that you can make your own decision.

In trying to prove something to be safe there are two ways to go about it.

1: Disprove the claims of danger

2: Show evidence which may be correlated with safety

This article will dispel the top 10 claims people make in an argument to label ketosis as dangerous.

Like I said, the science on ketosis is still quite immature.

The Safety Of Ketosis:

The following data is not meant to 100% prove or disprove the safety of ketosis. It’s merely the information we have available today which can help us form a nutritional strategy we feel is best for ourselves.

I’m not a doctor or a researcher.

Keto Posts On Reddit:

The following information is material I’ve collected in my attempt to feel confident following a Keto diet indefinitely.

Most of it is sourced from doctors or authors although I have also included anecdotal accounts from experiences posted on message boards and Reddit.

I know, much of the information here isn’t sourced directly from science journals. To be honest, the hard research on ketosis is currently lacking.

The best information comes from reputable doctors and authors who have years of experience with the diet.

In the end, you will have to take a slight leap of faith in placing your trust on the anecdotal experience of thousands of people who have experienced, benefited, and shared their knowledge of this diet.

Until hard research is funded and performed on the different aspects of ketosis I see no reason we cannot use the experience and results of others to assist us. Those alive today may all be dead before science proves the 100% safety of the Keto diet.

I’m not waiting for that day.

Life is about risk and reward. This is one risk I’m willing to take in order to reap the immense rewards of the Keto diet.

Claim 1:

The brain runs on glucose and a Keto diet does not satisfy this demand”

Reality:

The brain DOES need glucose but not very much; About 30g-50g/day . The body can synthesize this glucose from dietary protein through a process called gluconeogenesis . Carbohydrate not required.

But what about the rest of the brain’s daily energy needs beyond this 30-50g glucose requirement?

Most people are aware that the brain is powered by glucose. Very few are aware that it can also run on ketones and that ketones may actually burn more efficiently with less waste.

Once the body has become fully Keto adapted the brain gets up to 75% of its energy needs from ketones. The remaining 25% is obtained from glucose which as mentioned can be synthesized from dietary protein.

When I was taught about biochemical fuel-burning, I was taught that glucose was “clean” and ketones were “smokey.”

That glucose was clearly the preferred fuel for our muscles for exercise and definitely the key fuel for the brain.

Except here’s the dirty little secret about glucose – when you look at the amount of garbage leftover in the mitochondria, it is actually less efficient to make ATP from glucose than it is to make ATP from ketone bodies!

A more efficient energy supply makes it easier to restore membranes in the brain to their normal states after a depolarizing electrical energy spike occurs, and means that energy is produced with fewer destructive free radicals leftover.”

If you’re on a very high fat, very low carb diet – like a traditional Inuit diet – your brain will eventually be able to use fat-derived ketones for about 50-75% of its energy requirements. Most ketones are produced in the liver, but astrocytes in the brain also generate ketones themselves for use by neurons.

You think we’d have that kind of set up in our brains if ketones weren’t useful to have around? If all we could do was burn glucose up there, what would be the point of even having localized ketone factories?

Mark Sisson
Mark’s Daily Apple

If someone tries to tell you that ketosis is dangerous because you’re starving your brain of glucose you can either stop listening to them or you can educate them.

Claim 2:

The keto diet is incomplete and will result in dangerous nutrient deficiencies”

When followed correctly, the Keto diet is one of the most complete and nutritious diets on the planet.

Here’s the thing, the Keto diet can be executed in many different ways. The only requirement for achieving ketosis is to restrict carbs and limit protein so that the bodies glycogen reserves are depleted to the point that ketosis kicks in.

If you do that by eating hot dogs and margarine then I agree with this claim, you are on a dangerous nutrient-deficient diet.

However, if one chooses to achieve ketosis by eating fatty cuts of quality meat, dairy, nuts and plenty green leaves and fibrous vegetables-they are on a nutrient dense, complete diet.

What about the nutrients found in high carb grains, fruits and vegetables?

What are we missing out on?

The fact is that compared to many vegetables, fruit is actually a pretty poor source of vitamins and minerals. And grains?

Not only can the trace vitamins and minerals in grains be found more richly in meats, dairy and other keto friendly foods–there is speculation that phytates and tannins found in grains can block absorption of some vitamins and minerals.

Schlemmer U1, Frølich W, Prieto RM, Grases F.
PubMed

In practice most people who begin following a Keto diet actually end up eating many more servings of nutritional low carb fruits and vegetables than they previously were.

Once you cut out all of the candy, chips and soda suddenly tomatoes, avocados, olives, spinach and broccoli start looking a lot more attractive.

Unlike proteins and fats, there’s no such thing as an essential carbohydrate. There’s nothing a carbohydrate has to offer the body that couldn’t otherwise be obtained from fats and proteins.

In practice, you’ll probably consume more vitamins and minerals on a ketogenic diet than you did on a standard American diet (SAD), as long as you are eating whole foods (i.e., natural fats, meats, leafy green vegetables) and not packaged low carb junk food.

Ellen Davis
M.S. Applied Clinical Nutrition
Ketogenic Diet Resource

Meat is the only nutritionally complete food.

Animal foods (particularly when organ meats are included) contain all of the protein, fat, vitamins and minerals that humans need to function. They contain absolutely everything we need in just the right proportions.

That makes sense, because for most of human history, these would have been the only foods available just about everywhere on the planet in all seasons.

Georgia Ede MD
Diagnose Diet

This should put things into perspective: gram for gram, broccoli, kale and cauliflower all have more vitamin C than an orange. The high carb foods we famously believe to be the major sources of nutrients are often beat out by low carb meat, dairy or vegetable options.

Claim 3:

Ketosis can develop into life threatening Keto-acidosis”

It is physiologically impossible for anyone with normal pancreas function to develop Keto-acidosis.

The fact that Keto-Acidosis is used as an argument against the safety of ketosis is really a grand revealer of just how ignorant and lazy some pundits are in attacking the diet.

I can’t help but cringe when I think that the logic displayed here might be as lazy as “well they both have ‘keto” as their root word, ketoacidosis must be the result of ketosis“.

Even more cringe worthy are the numerous cases of TRAINED MEDICAL DOCTORS advising against ketosis out of fear for ketoacidosis. Com’on society, you can do better than that.

Unless you cannot produce any insulin from your pancreas (as is the case with type I diabetics, who do have to be much more careful with ketosis) you are at zero risk of keto-acidosis.

Here’s how Keto-acidosis occurs(or doesn’t) as explained by the venerable Peter Attia:

What is Diabetic Ketoacidosis?

When a diabetic (usually a Type I diabetic, but sometimes this occurs in very late-stage, insulin-dependent, Type II diabetics) fails to receive enough insulin, they go into an effective state of starvation.

While they may have all the glucose in the world in their bloodstream, without insulin, they can’t get any into their cells.

Hence, they are effectively going into starvation. The body does what it would do in anyone – it starts to make ketones out of fat and proteins.

Here’s the problem:

The diabetic patient in this case can’t produce any insulin, so there is no feedback loop and they continue to produce more and more ketones without stopping. By the time ketone levels (specifically, beta-hydroxybutyrate) approach 15 to 25 mM, the resulting pH imbalance leads to profound metabolic derangement and the patient is critically ill.

But this state of metabolic derangement is not actually possible in a person who can produce insulin, even in small amounts. The reason is that a feedback loop prevents the ketone level from getting high enough to cause the change in pH that leads to the cascade of bad problems.

A person who is said to be “keto-adapted,” or in a state of nutritional ketosis, generally has beta-hydroxybutyrate levels between about 0.5 and 3.0 mM. This is far less than the levels required to cause harm through acid-base abnormalities.

Keto-adaption is a state, achieved through significant reduction of carbohydrate intake (typically to less than 50 grams per day), where the body changes from relying on glycogen as its main source of energy to relying on fat.

Specifically, the brain shifts from being primarily dependent on glucose, to being primarily dependent on beta-hydroxybutyrate. This has nothing to do with what a diabetic patient is experiencing in DKA, but does illustrate how poorly informed and quick to react the medical community is.

DKA and nutritional ketosis (or keto-adaptation) have as much in common as a house fire and a fireplace.

Peter Attia M.D.
Eating Academy

If you encounter anyone who uses the ketoacidosis argument against Keto you can throw their credibility out the window right there.

(btw, when I say something like “throw their credibility out the window” I don’t mean to berate them during discussion. But you should know that once they use an argument like this, you are no longer in a debate.

(Calmly take the opportunity to explain the facts.)

Claim 4:

Ketosis can cause dangerous levels of dehydration and electrolyte deficiency”

Sort of true–although I would argue the use of the word ‘dangerous’ here. It is true that ketosis promotes water and electrolyte loss but this can easily be mitigated by ensuring adequate water consumption while making sure to consume foods rich in the key electrolytes: Sodium, potassium and magnesium.

By switching to a ketogenic low-carb diet, you are essentially transitioning yourself from a water-retaining diet, to a water-flushing diet.

There are a variety of reasons for this, including reduction of inflammation (water tends to be bound up in inflammation) and the depletion of glycogen stores (glycogen retains water) in your liver and muscles.

Because you are not eating a diet that causes you to retain water, you’re going to find yourself urinating quite frequently (maybe even once per hour or more when you start!).

As a consequence of this, you’re going to lose electrolytes. You’ll want to replenish them.

Often time people know when they are low on electrolytes because of various accompanying symptoms that may include a range of things including muscle cramps, low energy, headaches, difficulty concentrating, and more.

Michael O’Neill
Ketopia

The affects felt due to this flushing–affectionately referred to ask the ‘Keto flu’ are no more dangerous than mild everyday dehydration.

The solution is the same, Drink Water!

Claim 5:

A keto diet raises cholesterol and increases chance of heart disease”

Claims that diet has any affect on cholesterollevels is unfounded, obsolete and shows a lack of modern understanding. Peter Attia will confirm this below. Further, there’s burgeoning research for the argument that total cholesterol levels have little correlation with cardiovascular disease.

Cholesterol’s Relationship With Disease

The history and continued study of diet, cholesterol and cholesterol’s relationship with disease is truly fascinating. The whole thing plays out like a mystery novel that I just can’t put down.

If you’re interested in this topic and have an afternoon to spare I strongly urge you to check out Peter Attia’s series of cholesterol posts on his blog.

Most of the information I have here on cholesterol will be borrowed from Peter’s blog as I have zero credential in the area and I believe it’s only fair that you get the most up to date and accurate knowledge on this topic.

I’m going to attempt a layman’s description of the cholesterol story Peter has unfolded on his blog. Hopefully I don’t butcher it too badly.

How Cholesterol Works

1. Cholesterol is vital for life and it needs to be spread to different parts of the body in order to perform useful functions.

2. The amount of cholesterol in the system is actually tightly regulated by the body and is affected very little by the foods we consume. When the body needs cholesterol, it synthesizes it. When it needs to get rid of it, it excretes it

3. Cholesterol itself doesn’t flow freely in the blood.

4. Instead it needs to enter a vehicle which does flow in the bloodstream.

5. There are two such types of vehicles: High Density Lipoproteins (HDL) and Low Density Lipoproteins (LDL).

6. The two most relevant metrics of these cholesterol vehicles (lipoproteins) are the size of the vehicle and the number of vehicles.

7. Triglycerides also enter these vehicles to ride with cholesterol through the bloodstream.

8. When triglycerides increase, the total number of vehicles need to increase in order to transport the increased triglycerides.

9.However, when just cholesterol goes up, the vehicles simply increase size to accommodate the increase in cholesterol.

10: Here’s the kicker: new research shows that it isn’t total cholesterol that correlates with heart disease, rather it’s the number of vehicles (lipoproteins, LDL-p) which carry this cholesterol that correlates with atherosclerosis heart disease.

11: So it’s not the size of the vehicle, it’s the number of vehicles present.

12: It’s simple math, any given LDL particle is just as likely to stick to the artery wall regardless of its size or cholesterol content. More particles = more chances for sticking.

13: The higher your triglyceride count, the more particles needed to transport TG and cholesterol through the bloodstream.

14: The more particles moving through the blood stream, the greater the chances for buildup.

Ok, so I might have butchered that. Sorry Dr Attia.

Anyways, the takeaway is that diet doesn’t affect total cholesterol levels but it does affect triglyceride levels. The higher our triglyceride levels the greater our LDL particle count and the greater our risk of heart disease.

One of the biggest misconceptions out there (maybe second only to the idea that eating fat makes you fat) is that cholesterol is “bad.” This could not be further from the truth. Cholesterol is very good!

Peter Attia M.D.
Eating Academy

Eating cholesterol has very little impact on the cholesterol levels in your body.

This is a fact, not my opinion. Anyone who tells you different is, at best, ignorant of this topic.

At worst, they are a deliberate charlatan. Years ago the Canadian Guidelines removed the limitation of dietary cholesterol. The rest of the world, especially the United States, needs to catch up.

Peter Attia M.D.
Eating Academy

Blood levels of triglycerides are a major risk factor for heart disease and are directly correlated to the amount of simple carbohydrates in the diet (5, 6).

For that reason, it seems intuitive that low-carb diets would lead to a reduction in triglycerides, while low-fat diets should increase them.

This is indeed the case. Low-carb diets drastically reduce triglycerides, while low-fat diets either don’t improve them very much or literally make them worse (7, 8).

Kris Gunnars BSc Medicine
Authority Nutrition

So the takeaway from all of this is that triglycerides seem to be the biggest culprit in increasing chance of heart disease.

What affects does the Keto diet have on triglyceride numbers?

Here are a couple of anecdotal experiences from members on /r/keto:

Two cases of massive triglyceride reduction with the Keto diet!

I know it’s just two cases but I can confidently tell you that these these results are typical. The Keto diet (or any diet low in carbohydrate for that matter) is very effective at reducing your triglyceride numbers

Claim 6:

The Keto diet lacks fiber and causes constipation”

When followed correctly a Keto diet is actually very high in fiber.

Sure, if you’re just gonna eat hot dogs, cheese and margarine then sure, bring on constipation and a host of other ill effects.

There’s no diet in which you can eat poor, low quality food and expect perfect health.

Many Keto’ers claim to consume much more vegetables and fiber than they did on a standard American diet. After the effects of sugar overload wear off, your taste buds become reborn.

Suddenly tomatoes, peppers and cucumbers actually taste sweet. Vegetables become your source of carbohydrate satisfaction (to the tune of about 20-50g/day).

Let’s also get one thing cleared up, there’s a difference between not pooping and constipation. Constipation is obvious blockage and discomfort–there’s something there but it ain’t movin’. Not pooping is well, not pooping.

There’s nothing there to come out. When you produce less waste, you poop less often–and on Keto, you’re going to poop less often. The body is very efficient at extracting nutrients from meats and fatty foods. The result is less waste. So don’t mistake fewer bowel movements with constipation.

If you’re currently on Keto and having problems with constipation here are the top 3 reasons:

1.You’re not eating enough fibrous vegetables.

2.You’re not eating enough fat. Load on the coconut oil. For a real constipation weapon put a tablespoon of coconut oil into your morning coffee.

3.You’re not consuming enough water and electrolytes. Dehydration can lead to constipation.

Claim 7:

The keto diet causes muscle wasting”

There’s no science which supports that a low carb diet causes muscle loss. In fact, it might actually be the opposite. As more and more people adopt a ketogenic lifestyle the amount of anecdotal evidence in favor of ketosis as a great body building diet is growing rapidly.

The basis of the muscle wasting argument stems from a misunderstanding of the brains glucose requirements. If ketones didn’t exist the brain would require much more glucose than it does in the presence of ketones.

During a low carb diet the brain would be forced to break down protein to obtain this glucose. It would do this through either dietary protein or in the absence of sufficient dietary protein, it would go after body muscle.

Fortunately, once ketosis kicks in the brain is able to obtain 70-75% of its energy requirements from ketones. The remaining 25% is much more easily obtained from dietary protein and thus body muscle is spared.

If you want some real world evidence for the efficacy of ketosis as a body building diet, head over to Reddit and check out /r/ketogains.

This community is full of people dedicated to building muscle on a Keto diet. They have nothing to sell you and no reason to lie about their results.

This general “muscle wasting” assertion often comes from trainers and dietitians who really have not studied the science on muscle preservation.

They will tell you that the brain requires at least 100 grams of carb per day and if you don’t get those carbs in the diet, your body will break down your muscles to get it. This is true when one’s diet is high carb, and no ketone bodies are available as an alternative source of brain fuel.

But for a person who is adapted to a low carb, ketogenic diet, ketosis provides fuel in the form of ketone bodies for the brain, and the requirement for glucose drops to only about 40 grams per day. The body can easily make this amount from dietary protein and glycerol from the break down of fatty acids

But for a person who is adapted to a low carb, ketogenic diet, ketosis provides fuel in the form of ketone bodies for the brain, and the requirement for glucose drops to only about 40 grams per day. The body can easily make this amount from dietary protein and glycerol from the break down of fatty acids.

Ellen Davis
M.S. Applied Clinical Nutrition
Ketogenic Diet Resource

Claim 8:

Ketosis damages the kidneys and can cause the formation of kidney stones”

The source of this claim comes from the misunderstanding that the Keto diet is high in protein. In reality the Keto diet places a limit on protein in order to minimize the conversion of protein into sugar.

Furthermore, the claim that high protein consumption can damage kidneys and form kidney stones may also be unfounded.

If someone tries to tell you that the Keto diet is dangerous because of high protein consumption you can pretty much stop them right there.

The calling card of the keto diet is “Low carb, moderate protein, high fat” and the recommended protein dosage usually falls between 60-120g/protein per day depending on your weight and lean body mass.

This is not a high protein diet. Anyone eating significantly more protein than they require is probably kicking themselves out of ketosis and is therefore not following a keto diet.

To further damage the strength of this claim, there’s no evidence that high protein consumption is the CAUSE of kidney damage and stones. The only correlation is that in people who already have kidney issues and a history of kidney stones, protein seems to exacerbate the issue.

Claim 9:

High fat intake on a Keto diet causes gallstones”

Reality:

Gallstones are actually the result of an inactive gallbladder. What increases gallbladder activity? Fat consumption!

When the gallbladder is active it will constantly be flushing out and replenishing its contents. If it is inactive the contents will sit idle and be prone to stone formation.

But what about the cases of people on Keto diets dealing with gall stones?

They eat a lot of fat and so their gall bladder should be flushed clean often right?

Well… what are many people on a Keto diet trying to do?

Lose Weight Right?

I would guess that prior to discovering the Keto diet many of these people were caught in the trap of low fat dieting. This lead to months or years of low fat intake and consequentially low gallbladder activity. The gallbladder wasn’t needed to digest fat and so it sat idle and stones were more likely to form.

Once they made the shift to a ketogenic lifestyle and their fat consumption increased upwards of 1000%, the gallbladder kicked into high gear.

If the previous period of low fat dieting had caused stone formation they are going to have to deal with flushing those stones out now while on a high fat Keto diet.

In a study of 51 obese people using an extremely low fat low calorie diet (just one gram of fat a day!) the gallbladder was examined by ultrasound before the diet and after one and two months.

After one month four of the 51 participants had developed new gallstones. After two months more than one in four (13 people) had new gallstones!

This on an almost fat free diet. Three participants needed to have their gallbladder removed during the study.

A third study compared an extremely low fat diet with a diet slightly higher in fat during 3 months.

More than one in two (6 of 11 people) in the group eating extremely low fat developed new gallstones. Nobody in the group eating more fat did.

Conclusion: Do you want gallstones? Avoid fat.

Claim 10:

My mom said that if I try the Keto diet, I could die.”

Ahh the fabled and legendary ‘Keto could kill you’ email from Mom. Those of us on Keto know that this email is pretty much a rite of passage. It’s only natural that mom worries about you, it’s what moms do. But the fact is that there are zero reported deaths as a result of ketosis. ZERO.

Let’s put that into perspective.

100,000 die each year from pharmaceutical drugs. 6 million each year from tobacco. 3.3 million each year from alcohol related deaths and an estimated 15-30 million each year from deaths related to excess sugar consumption such as diabetes, heart disease, and obesity related disease.

Surely the people who argue for the dangers of ketosis can better spend their time on issues which are actually dangerous to society?

Although we love them to death, our Mom’s typically have zero authority on the subject. When Mom heard you were going on a ketosis diet the first thing she did was head to google hell bent on finding any information about the dangers of the diet.

Sure enough, 10 pages into google she found what she was looking for…

Never mind the first 9 pages filled with information about the safety and merits of the diet.

Most of the information contained in those articles your Mom finds on google will inevitably be addressed by some of the issues addressed here.

Next time your mother or any of your family or friends to try tell you that ketosis is dangerous, link them over here and we’ll take care of them 🙂

Conclusion

Let’s leave off on this quote from Dr Eric Kossoff who was part of a 15 year study involving the long term safety of ketosis:

“Despite its temporary side effects, we have always suspected that the ketogenic diet is relatively safe long term, and we now have proof,”

says senior investigator Eric Kossoff, M.D., a pediatric neurologist and director of the ketogenic diet program at Hopkins Children’s.

“Our study should help put to rest some of the nagging doubts about the long-term safety of the ketogenic diet,” he adds.

The evidence is based on a study of 101 patients ages 2 to 26 years treated with the ketogenic diet for a minimum of 16 months and for up to eight years at Hopkins Children’s between 1993 and 2008.

At the time of the follow-up, patients were off the diet anywhere between eight months and 14 years.

Dr Eric Kossoff
Medical News Today

Sources:

http://en.wikipedia.org/wiki/Starvation_response http://en.wikipedia.org/wiki/Gluconeogenesis http://www.ncbi.nlm.nih.gov/pubmed/16174292 http://www.nutritionandmetabolism.com/content/2/1/25 Null, G PHD. (2011). Death by Medicine. Mount Jackson, VA: Praktikos Books.]

For some, the low-carb ketogenic diet is a quick way to shed excess weight. Although losing weight while eating tons of cheese, bacon, and fat may sound great, you’ll ultimately pay the price in another way: popping problems.

Although any diet change will throw off bowel movements, keto dieters are especially prone to diarrhea or constipation. If you’re thinking of trying the trendy diet for yourself, here’s a breakdown of what you can expect.

You may be constipated on keto

“Most people right away will get pretty constipated,” says Liz Weinandy, R.D. at The Ohio State University. This is especially true for people who are used to eating plenty of fiber from whole grains and fruits, which are limited on the keto diet. Carbohydrates are typically capped at 30 grams per day, making it hard to enjoy a bowl of oatmeal or an apple.

You could experience diarrhea on keto

Alternatively, some people may have the opposite problem. Barbie Boules, R.D.N., founder of Nyoutrition, previously told Men’s Health this occurs when people don’t digest all the fat they’re consuming. Plus, many keto-friendly foods contain non-nutritive sweeteners or sugar alcohols, which may cause digestive problems in some people. “Sorbitol in particular is notorious for causing GI upset,” she says.

Your poop will probably look different

Stool will have less bulk, due to lack of fiber, and be smaller in size, which isn’t exactly ideal. For reference, this would be level one on the Bristol Stool Chart.

“Ideal poop is soft but formed,” says Weinandy. “Not too lose and not too solid.”

Dr. John Whyte, M.D., MPH and Chief Medical Officer at WebMd says your poop also may be lighter in color due to the high fat content.

Your poop could smell different

Anecdotally, Weinandy says some patients say their bowel movements are more, uh, pungent. “I have quite a few patients who complain of it smelling worse,” she says. That’s because eating a lot of high fat foods makes stool move more slowly through the gastrointestinal track. As a result, stool sits in your system for longer periods of time and can putrefy more easily–particularly if you’re eating lots of protein.

You may see blood from hemorrhoids

Again, this is anecdotal, but some of Weinandy’s patients develop hemorrhoids from being severely constipated. Hemorrhoids are swollen veins in the anal canal that become inflamed from straining or sitting on the toilet for extended periods of time, Men’s Health previously reported. That’s because sitting all that sitting puts strain on the connective tissue that holds the veins in place. People with hemorrhoids may notice some blood when wiping.

So, how do you prevent these awful side effects?

Weinandy recommends drinking plenty of water and taking a fiber supplement like psyllium husk. Many keto dieters rely on magnesium powder or pills to poop, which Whyte advises against.

“I’m not a fan of just taking supplements or minerals without talking to a doctor,” he says. “Depending on one’s underlying medical condition, they can affect the kidneys or the heart when taken in excess.”

Or, you could just give up on being keto–like some of Weinandy’s patients.

“It could be a make or break deal for some,” she says.

Melissa Matthews Health Writer Melissa Matthews is the Health Writer at Men’s Health, covering the latest in food, nutrition, and health.

Keto Diet Constipation Is a Legit Issue—Here’s How to Deal

Unless you’ve been living under a rock the last six months, you’re well aware that the ketogenic diet is all the rage right now. While people are game to talk about the benefits of the trendy eating plan, its risks, and whether it’s a smart option for vegans, there’s one topic that still feels taboo: poo.

Before I tried the keto diet myself, I read everything I could about different keto food options, how to work out on keto, even common mistakes people make. I thought I was going into my month-long journey of ketosis with eyes wide open. But after the first few days—and while battling a mild case of the keto flu—I realized something pretty major: I had yet to experience a bowel movement.

For more on digestive conditions, check out our Digestive Health Condition Center

As someone who’s pretty, uh, regular in that department, I was concerned. I mean, nobody wants to experience any serious GI discomfort. So, like any millennial would, I did a quick Google search to see if keto constipation is a thing. Turns out it totally is.

If this über-trendy diet is supposed to be so good for you, then why does it back you up? Is there any way to avoid it, or are all keto-goers doomed to be constipated?

The Main Cause of Keto Constipation

Because the ketogenic diet requires a big shift in macronutrient intake, it causes problems if you’re not eating in a balanced way, says Zandra Palma, M.D., a functional medicine expert at Parsley Health.

While there isn’t just one element of keto that leads to people feeling backed up, for many, the lack of carbohydrates—including grains, fruits, and, yes, bread—could mean you’re eliminating your main dietary sources of fiber, says Dr. Palma. And fiber, as a broad category, includes prebiotic fiber, which is the food for our microbiome.

“Reducing prebiotic fiber can alter the composition and diversity of species of bacteria that live in our large intestine,” explains Dr. Palma. ” support our metabolic, immune, and cognitive health—and also help keep things moving.” (Fiber is super important for your health for all these other reasons too.)

Many people also shy away from plant-based foods while on the keto diet, either because the veggie’s carb count is too high, or because they’re turning to animal protein to help hit the high daily requirements of protein and fat. But veggies tend to be high sources of fiber, so quickly stripping those from your diet can lead to keto constipation, says Dr. Palma.

That’s why “the most medicinal way to approach a ketogenic diet is by embracing colorful, fibrous-rich vegetables and greens as the base for each meal,” says Dr. Palma. Try cruciferous vegetables (such as broccoli, cauliflower, and Brussels sprouts) and leafy greens, which are all very low-carb and high in fiber. “A doctor-recommended prebiotic supplement or insoluble fiber (such as psyllium husk) can be added if it’s difficult to reach your fiber goals is difficult while maintaining ketosis,” she says.

Whether you’re on the keto diet or not, it’s likely that you’re not hitting those daily fiber goals. The average American consumes just 16 grams of fiber a day, but the goal for optimal digestive support is closer to 40 grams a day, adds Dr. Palma. (Here’s what you need to know about getting enough—and even too much—fiber.)

Another reason to get more fiber: Animal studies suggest that the nutrient can help mitigate the potentially harmful effects of a high-fat diet like keto. In a study from the Journal of Microbiology and Biotechnology,researchers found that when mice were given insoluble dietary fiber from pears, it improved the structure of their gut microbiota and protected against the effects of a high-fat diet that could otherwise be harmful.

Why You Should Hold Off On Dairy

When people talk about the upsides of a keto diet, one of the main points is that foods that are typically banned on restrictive diets—such as butter, cheese, even yogurt—all get the green light thanks to their high amounts of fat. But “these foods are high in lactose, which is a naturally occurring sugar that is hard for most people to digest,” says Dr. Palma.

According to the National Institutes of Health, it’s estimated that up to 75 percent of the population is unable to digest dairy properly, partly because of lactose. Dr. Palma says this mucks up your intestinal health and, in turn, contributes to inflammation—which can cause all sorts of health problems if the inflammation becomes chronic.

That doesn’t mean you have to shift these foods to the no-go list, though. Dr. Palma says it’s okay to enjoy dairy in moderation, but it doesn’t need to be a part of every meal and should be limited to one serving to help keep digestion in check.

How to Fix Keto Constipation

All of this is good to know if you’re trying to avoid keto constipation, but what if you’re already suffering? Dr. Palma suggests trying the following tactics to get your digestive system back to normal.

Add more fiber. This one’s a given. Other than eating more fibrous foods, Dr. Palma suggests sprinkling ground flaxseed into your meals or adding chia seeds or acacia fiber to a morning smoothie to help increase your daily count.

Drink lemon water + apple cider vinegar. When you first wake up, make a cup of hot lemon water mixed with 1 teaspoon of apple cider vinegar. Dr. Palma says it’ll help boost digestive function and help with hydration. Remember: You want to stay hydrated on keto; otherwise, you could experience a decrease in digestive and brain function along with lower energy levels.

Stretch first thing. “Taking time to stretch and connect with your body before a busy day helps activate your parasympathetic nervous system, which is where digestion thrives,” says Dr. Palma. (Try this yoga routine you can do without getting out of bed.)

Embrace mindful eating. That means taking two deep, conscious breaths before each meal, sitting down without distractions, and chewing well. “The secretion of enzymes to break down protein, fat, and carbohydrates occurs when we begin to think of and smell food,” says Dr. Palma. “In order to optimize digestion, we must slow down to chew our food properly.” She suggests setting small goals that help you eat more mindfully, like putting your fork down at least five times before your meal is done. (Here’s a full guide to how to eat mindfully.)

This article originally appeared on Shape.com.

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If you have Type 2 Diabetes and are overweight then you will almost certainly benefit from weight loss. However, you should not start a programme like the SlimFast 3,2,1 plan without first consulting your doctor, as your diabetic condition and any medication that you may be taking will need continuous monitoring and adjustment while you lose weight. If you are a Type 1 Diabetic (requiring insulin), this is a serious medical condition, and you must first discuss your weight loss plan with your doctor as your dosage of insulin may need to be adjusted as your weight reduces.

Can people on medication follow the SlimFast 3,2,1 Plan?

Whatever medication you take, for whatever condition, your doctor is likely to need to change the dose if you lose weight because of the metabolic changes that take place as you lose weight, some of which may make adjustment of medication important. Therefore, you should not use SlimFast or any weight loss programme if you are taking medication prescribed by your doctor, without first consulting your doctor.

If I am pregnant, can I still follow the SlimFast 3,2,1 Plan?

While some women become too heavy during pregnancy, which can create health problems. In these cases, SlimFast would be acceptable, but such advice should only come from a health professional. Pregnancy requires a very high level of nutrition, so you should never consider SlimFast or any weight loss programme without discussing the plan with your doctor.

Launched over 50 years ago, Slim Fast has since innovated the industry and is a fantastic weight loss brand you can trust. Easy to prepare! Nutritious and delicious! Check out our Slim Fast products today!

If you are considering the Slim Fast diet program, be aware of the possible side effects in order to decide if this is the program for you. There are some unpleasant side effects to drinking the shakes and eating the meal replacement bars, but many find that they are not troublesome enough to abandon the use of the products altogether. The side effects can range from headaches to bloating, and some even feel tired while on this plan.

Short-Term Side Effects of Slim Fast Diets

The purpose of Slim Fast shakes and nutrition bars is to replace two daily meals with lower-calorie substitutes. Unfortunately, many dieters rely on the meal-replacement products alone, resulting in a very restricted caloric intake, rapid weight loss, nutritional deficiencies, and health complications. Most side effects are temporary and will cease as the body adjusts to the diet.

Transient side effects of using Slim Fast include the following:

  • Constipation
  • Headache
  • Loose stools
  • Intense hunger
  • Gas and bloating
  • Abdominal discomfort

These side effects typically disappear with continued use of the shakes and bars, but may persist in some people. Dieters who are lactose intolerant may experience significant bloating and gas while using milk-based Slim Fast shakes.

Potentially Serious Side Effects

Serious side effects are typically a result of rapid weight loss, and rarely occur with proper use of the product. Some dieters report hair loss, gallstones, low blood pressure, abnormal blood glucose levels, abnormal QT intervals, ECG abnormalities, and cessation of menstruation.

Using the shakes and nutrition bars as directed will generally not reduce your total daily caloric intake to a dangerous level. However, if your dinner meal is inadequate in the amount of calories or nutrients it provides, you may experience potentially dangerous side effects to Slim Fast.

Health Complications

Doctors often recommend low-calorie and very low-calorie diets to obese patients at risk for weight-related health complications, such as diabetes, high cholesterol, and high blood pressure. When used as directed and under medical supervision, these diets are very beneficial. However, the National Institute of Diabetes and Digestive and Kidney Diseases warns that these diets can be dangerous when used by mildly or moderately overweight dieters.

Gallbladder Disease

Gallbladder disease is the most common severe side effect associated with rapid weight loss. According to the University of Maryland Medical Center, rapid weight loss increases the production of cholesterol by the liver, resulting in super saturation and an increased risk of gallstones. Losing more than 3 pounds per week impairs functioning of the gallbladder, decreasing its ability to contract and expel bile. This risk is as high as 12 percent following 8 to 16 weeks on a restricted-calorie diet.

Fatigue

Replacing meals with Slim Fast shakes may result in fatigue or feeling weak. This is because the body will have fewer calories available for use.

Stomach Problems

Slim Fast may upset the stomach of some people. This can be due to the change in diet or to the artificial sweeteners used in some types of Slim Fast.

Weight Gain and Fluctuation

Slim Fast only helps with weight loss if the user eliminates more normal food calories from their diet than the shakes contain. If shakes are consumed in addition to a normal diet, they can contribute to weight gain.

Using the products as directed can promote weight loss, but unless reduced calorie levels are sustained, weight can easily return.

Hunger

Slim Fast may cause feelings of hunger since the body may demand more calorie intake. The body often adjusts to reduced calorie intake over time

Muscle Loss

While very low-calorie diets cause considerable loss of fat, they also cause dangerous muscle loss. Moreover, it is very difficult to maintain weight loss once eating habits return to normal. Unless you commit to healthy eating, engage in regular exercise, and change your lifestyle, you will very likely regain the pounds you shed during your diet.

Seek Doctor’s Advice

If you are using Slim Fast products and experience any severe side effects, you should seek the advice of your doctor before continuing the use of these products. To ensure your weight loss attempt is successful, consult your doctor before beginning any new diet program and follow the program guidelines carefully.

Minimal Risk of Side Effects

Short-term use of meal-replacement products can help jump-start a weight loss program and offer a convenient way to shed a few pounds. When used as directed, Slim Fast provides numerous health benefits with minimal risk of side effects.

Let’s Talk About SlimFast and How Bad It Is

If you’re old enough, you may still remember the original TV commercials that aired in the ‘80s and ‘90s. “A shake for breakfast, a shake for lunch, then a sensible dinner.”

“Give us a week! We’ll take off the weight!”

It all seems too good to be true: a diet where you can chug milkshakes instead of eating fruits and vegetables and actually lose weight. It’s not too good to be true. It’s SlimFast. Also, yes, it’s definitely too good to be true.

Launched in 1977 by Thompson Medical Company, SlimFast was marketed as an alternative to the trendy weight-loss solutions at the time: grapefruits, Weight Watchers, and The Scarsdale Diet. The shakes were presented as a palpable and delicious solution to their weight problems. But what is the reality of this promise? Do these delicious smoothies live up to their expectations?

“SlimFast is terrible for you,” says certified nutritionist and a nutritional chef Melissa Eboli. “You’d be better off taking a scoop of sugar and adding it to water than drinking all of the chemical non-food, sugar-laden ingredients that make up SlimFast.”

Here’s how the meal-replacement shake is supposed to work: “Replace any two meals with SlimFast shakes, bars or cookies, enjoy one sensible meal of your choice and three 100-calorie snacks in between,” the company site says. While consumers shouldn’t be afraid to skip Sunday brunch, they should try to abstain from drinking sugar-sweetened beverages like juice and sodas. Along with this diet, the recommendations extend to drinking plenty of water and exercising regularly.

However, nutritionists have never backed SlimFast because of the myriad drawbacks that plague those who try the shake.

“Those shakes often contain less than 200 calories,” says Dr. Rachele Pojednic, a Boston-based Assistant Professor of Nutrition at Simmons College and former research fellow at Harvard Medical School’s Institute of Lifestyle Medicine. “This is often significantly lower than what most people are eating at a meal. The biggest problem with these kind of meal replacement diets is that they don’t tend to teach behaviors that people can stick to and rely on in the real world. Once they stop drinking the shakes, people tend to go back to eating meals that are significantly higher in calories, and they put the weight back on.”

Dr. Pojednic also says that fad diets such as these often don’t work because they aren’t sustainable.

“I believe that you should never do something with your diet that you’re not willing to stick to for the rest of your life,” Dr. Pojednic says. “You can cut calories in a similar fashion with nutrient dense foods like fruits and vegetables, and this way you are learning how to portion out real food rather than relying on expensive shakes that don’t really support healthy, long term behavior change.”

While we’d like to believe the magical solution to weight loss lies in a drink, the reality is much more complex. So what can be done to lose weight and maintain that weight loss? Diet and exercise. It’s the answer all those shake-sippers were afraid of hearing in the first place.

“Eat organic whenever possible,” Eboli says. “Stay away from processed foods, fried foods, and unhealthy food over all. Be conscious of caloric intake as well and don’t drink SlimFast. For starters, it is made from non-organic whey protein, which is inflammatory and turns into sugar once metabolized. The remainder ingredients are sugar, chemicals, and preservatives, which can definitely can contribute to weight gain.”

The reason SlimFast is often lumped into the “fad diet” category is because it is simply that: A fad diet that has somehow been around for 40 years. These kinds of weight-loss products, meal-replacement smoothies, and little cheats will always be around in some form. Just remember, if it seems too good to be true, it almost certainly is exactly that.

Thirteen home remedies for constipation

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Constipation is an incredibly common problem.

It’s thought to affect around 20% of Americans, resulting in 8 million doctor visits per year (1, 2).

It can be caused by foods you eat or avoid, lifestyle choices, medication or disease.

But for many people, the cause of their chronic constipation is often unknown. This is referred to as chronic idiopathic constipation.

Constipation is characterized by less than three bowel movements per week.

However, it can also involve other unpleasant symptoms, such as discomfort when going to the bathroom, abdominal bloating and pain due to stools being hard, dry and difficult to pass.

Unfortunately, constipation can have a serious negative effect on quality of life, as well as your physical and mental health (3, 4, 5, 6).

There are many natural ways to help relieve constipation. You can do these in the comfort of your own home and most of them are even supported by science.

Here are 13 natural home remedies to relieve constipation.

1. Drink more water

Being dehydrated regularly can make you become constipated. To prevent this, it’s important to drink enough water and stay hydrated (7, 8, 9, 10).

When you’re constipated, you could try finding relief by drinking some carbonated (sparkling) water to help you rehydrate and get things moving again.

Some studies have found sparkling water to be more effective than tap water at relieving constipation. This includes people with chronic idiopathic constipation or irritable bowel syndrome (IBS) (11, 12, 13, 14).

However, don’t start drinking more carbonated drinks like sugary soda, as they’re a bad choice for your health and may make your constipation worse (15, 16).

Bottom line: Dehydration can make you constipated, so make sure to drink enough water. Sparkling water may be even more effective.

2. Eat more fiber, especially soluble, non-fermentable fiber

People who are constipated are often told to increase their fiber intake (17, 18).

This is because increasing fiber intake is thought to increase the bulk and consistency of bowel movements, making them easier to pass (19).

In fact, one recent review found that 77% of people with chronic constipation benefited from supplementing with fiber (20).

However, some studies have found that increasing fiber intake can actually make the problem worse (21).

Other studies have found that while dietary fiber can increase the frequency of bowel movements, it doesn’t help with other symptoms of constipation. These include stool consistency, pain, bloating and gas (19).

This is because the type of dietary fiber that you add to your diet is important.

There are many different dietary fibers, but in general, they fall into two categories:

  • Insoluble fibers: Found in wheat bran, vegetables and whole grains. They add bulk to your stools and are thought to help them pass more quickly and easily through your digestive system.
  • Soluble fibers: Found in oat bran, barley, nuts, seeds, beans, lentils and peas, as well as some fruits and vegetables. They absorb water and form a gel-like paste, which softens your stools and improves the consistency.

Studies examining the effects of insoluble fiber as treatment for constipation have been inconclusive (22).

This is because insoluble fiber can make the problem worse in some people with a functional bowel problem, such as IBS or chronic idiopathic constipation (23, 24).

Some fermentable soluble fibers may also be ineffective at treating constipation, as they are fermented by bacteria in the gut and lose their water-holding capacity (25).

The best choice for a fiber supplement when constipated is a non-fermentable soluble fiber, such as psyllium (26, 27, 28, 29, 30). Various brands are available online.

To prevent constipation, you should aim to consume a mix of soluble and insoluble fibers. The total recommended fiber intake per day is 25 grams for women and 38 grams for men (25, 31).

Bottom line: Try eating more fiber. You can also supplement your diet with a soluble non-fermentable fiber such as psyllium.

3. Exercise more

Studies on the effect of exercise on constipation have shown mixed results.

In fact, many studies have shown that exercise does not affect the frequency of bowel movements (32).

However, a recent randomized controlled study on constipated people with IBS found some interesting results. It found that exercise significantly reduced symptoms (33).

Other studies have also found similar results for this group of people (34).

While many studies have found that exercise does not affect the number of times people go to the bathroom, it seems to reduce some symptoms of constipation (35).

If you are constipated, then try going for regular walks. It’s definitely worth a try.

Bottom line: Exercise may reduce the symptoms of constipation in some people, although the evidence is mixed.

4. Drink coffee, especially caffeinated coffee

For some people, coffee can increase the urge to go to the bathroom. This is because coffee stimulates the muscles in your digestive system (36, 37).

In fact, one study found that caffeinated coffee can stimulate your gut in the same way that a meal can. This effect is 60% stronger than drinking water and 23% stronger than drinking decaffeinated coffee (38).

Coffee may also contain small amounts of soluble fibers that help prevent constipation by improving the balance of your gut bacteria (39, 40, 41).

Bottom line: Coffee can help relieve constipation by stimulating the muscles in the gut. It may also contain small amounts of soluble fiber.

5. Take Senna, an herbal laxative

The herbal laxative Senna is commonly used to relieve constipation. It is available over-the-counter or online, and can be taken orally or rectally (42).

Senna contains a number of plant compounds called glycosides, which stimulate the nerves in your gut and speed up your bowel movements (43, 44).

It’s usually considered safe for adults to use Senna for short periods of time, but you should consult with your doctor if your symptoms don’t go away after a few days.

Senna is usually not recommended for people who are pregnant, breastfeeding or have certain health conditions, such as inflammatory bowel disease.

Bottom line: The herbal laxative Senna is a common remedy for constipation that is available over-the-counter. It can stimulate the nerves in your gut to speed up bowel movements.

6. Eat probiotic foods or take probiotic supplements

Probiotics may help prevent chronic constipation.

People who have chronic constipation have been shown to have an imbalance of bacteria in their gut.

It’s thought that probiotic foods could help improve this balance and prevent constipation (45, 46).

They could also help treat constipation by producing lactic acid and short-chain fatty acids. These may improve gut movements, making it easier to pass a stool (47).

A recent review found that probiotics seem to treat functional constipation by increasing the frequency of bowel movements and improving stool consistency (48).

To include probiotics in your diet, try eating probiotic-containing foods. Examples include yogurt, sauerkraut and kimchi, which contain live, friendly bacteria.

Alternatively, you could try a probiotic supplement. It is usually recommended to take it daily for at least 4 weeks to see if it has any beneficial effects (49).

Bottom line: Probiotics may help treat chronic constipation. You can try eating probiotic foods or taking a supplement. Supplements should be taken daily for at least 4 weeks to see if they work.

7. Over-the-counter or prescription laxatives

You can speak to your doctor or pharmacist about choosing an effective laxative (50, 51).

They may recommend one of the following types:

  • Bulking agent: These are fiber-based laxatives used to increase the water content of your stool.
  • Stool softener: Stool softeners contain oils to soften the stools and ease their passage through the gut.
  • Stimulant laxative: These stimulate the nerves in your gut to increase bowel movements.
  • Osmotic laxative: Osmotic laxatives soften your stool by pulling water from the surrounding tissues into your digestive system.

However, most of these laxatives shouldn’t be taken on a regular basis without first speaking to your doctor.

Bottom line: Try speaking with your doctor or pharmacist about an effective laxative. There are many types of laxatives that can work.

8. Try a low-FODMAP diet

Constipation can be a symptom of irritable bowel syndrome (IBS).

The low-FODMAP diet is an elimination diet that’s often used to treat IBS. It could be effective at treating your constipation if IBS is the cause (52, 53, 54).

FODMAP stands for fermentable oligo-saccharides, disaccharides, monosaccharides and polyols. The diet involves limiting high-FODMAP foods for a period of time before reintroducing them to determine which ones you can tolerate (55).

However, if you have constipation-predominant IBS, the low-FODMAP diet alone is often not enough.

You will probably need to pay attention to other aspects of your diet, such as getting enough water and fiber, to experience relief from your symptoms (56, 57).

Bottom line: If you have IBS, following a low-FODMAP diet may help your constipation. However, that alone may not be sufficient to provide relief.

9. Eat shirataki noodles or take a glucomannan supplement

Glucomannan is a type of soluble fiber. It has been shown to effectively treat constipation (58, 59, 60).

One study in children found that 45% of those taking glucomannan experienced relief from severe constipation, compared to only 13% in the control group (61).

However, another controlled study found no significant effects (62).

As well as improving bowel movements, glucomannan has been shown to function as a prebiotic and improve the balance of good bacteria in your gut.

If you’re constipated, try including more glucomannan in your diet. You can achieve this by taking a glucomannan supplement or by eating shirataki noodles, which are made with glucomannan.

Glucomannan supplements vary in their benefits by brand, so it is important to compare them before making a purchase.

Bottom line: Glucomannan may effectively treat constipation in some people. You can get it by supplementing with glucomannan or eating shirataki noodles.

10. Eat prebiotic foods

Dietary fiber increases stool consistency and bulk, both of which can improve bowel movement frequency.

Another way that some fibers may help treat chronic constipation is through their effects on your digestive health.

Prebiotic fibers improve digestive health by feeding the friendly bacteria in your gut. This can improve the balance of your gut bacteria (63, 64).

In fact, prebiotics like galacto-oligosaccharides have been shown to help increase the frequency of bowel movements, as well as make stools softer (65, 66, 67, 68).

Foods that are high in prebiotic fiber include garlic, onions and bananas (63).

Bottom line: Foods that contain prebiotic fibers can improve your digestive health and the balance of friendly bacteria in your gut. This can often help relieve constipation.

11. Try magnesium citrate

Taking magnesium citrate is a popular home remedy against constipation. It is a type of osmotic laxative that can be bought over-the-counter or online (69).

Taking moderate amounts of magnesium supplements can help relieve constipation. Higher doses are sometimes used to prep and clean out the bowel before surgery or other medical procedures (70).

Bottom line: Taking a magnesium citrate supplement can help against constipation. It is available over-the-counter.

12. Eat prunes

Prunes and prune juice are often touted as nature’s remedy for constipation – and for good reason.

In addition to fiber, prunes contain the natural laxative sorbitol. This is a sugar alcohol that has a laxative effect (71, 72).

Studies have shown that prunes may be more effective than fiber. If you’re constipated, prunes could be the easiest natural solution available (73, 74).

The effective dose is thought to be around 50 grams (about 7 medium-sized prunes) twice a day (73, 75).

However, you may want to avoid prunes if you have IBS, as sugar alcohols are known FODMAPs.

Bottom line: Prunes contain the sugar alcohol sorbitol, which has a laxative effect. Prunes can be a very effective remedy for constipation.

13. Try avoiding dairy

In some circumstances, a dairy intolerance can cause constipation due to its effect on your gut movements (76, 77, 78).

In some cases, children intolerant to cow’s milk protein and adults with lactose intolerance may experience constipation (79).

If you think that you may be intolerant to dairy, then you could try removing it from your diet temporarily to see if it improves your symptoms.

Just make sure to replace the dairy in your diet with other calcium-rich foods.

Bottom line: Being intolerant to dairy or lactose may cause constipation in some people. If you suspect dairy is a problem, try removing it for a short period of time to see if that makes a difference.

Anything else?

Constipation is an uncomfortable problem with a number of underlying causes.

If this is a problem for you, then you should definitely speak to your doctor to identify the potential cause and find an effective treatment protocol.

That being said, many of the natural home remedies in this article can also provide significant relief.

Read the article in Spanish

Top Five Natural Remedies for Constipation

While most people will experience constipation at some point in their lifetime, it is estimated that about 20% of the U.S. population suffers from chronic constipation. This means over 63 million people are suffering from constipation on a regular basis. Prevalence is higher among the elderly, especially elderly women. Having daily bowel movements that are easy to pass is very important for the health of the colon, getting rid of waste (the ultimate full-body detoxification), and reducing the risk for certain cancers. Everyone’s bowel pattern is different, but ideally you should be moving your bowels every day.

There are many possible causes of constipation including: a low-fiber diet that is high in dairy, processed food and added sugar; not drinking enough water; lack of exercise; imbalance of gut bacteria; avoiding a bowel movement when you have the urge; change in routine and travel; certain nutrient deficiencies; overuse of laxatives; sluggish motility; psychological stress; some iron supplements; and certain medications such as opiates and antidepressants. Constipation may even be an early sign of certain neurological conditions such as multiple sclerosis or Parkinson’s disease.

Over the counter and prescription laxatives are the most common conventional treatments, but constipation is not a Miralax deficiency. Constipation is a symptom of something else that is out of balance and it is important to identify the root cause. While there are many potential causes, adopting a few key strategies can be very effective at alleviating constipation for many people.

Here are my top five suggestions for you to try:

  1. Drink up! You’ve heard it before—drink more water! But have you taken the time and effort to actually drink more non-caffeinated fluids? Not only is dehydration the most common cause of constipation, but it can make you feel terrible in many other ways. You can read more about the importance of staying hydrated in my blog here.
  2. Fiber. Soluble fiber helps water remain in your stool so that it does not become hard. Insoluble fiber adds bulk to your stools, which speeds up the movement through your bowels. Getting a combination of both is important. Fortunately, most whole, unprocessed fiber-rich foods contain a combination of both. Some of the best choices include seeds, especially ground flax seed (try getting two tablespoons daily), organic berries, green leafy vegetables, nuts, prunes, figs, and psyllium husk. Be careful to avoid processed foods that have added fibers (such as cereals), which tend to be high in sugar, less nutritious, and the fiber may actually cause gas, bloating and discomfort. Bonus points for removing dairy from your diet, which can be constipating for many people!
  3. Position matters. Humans did not evolve using toilets! Our ancestors were forced to squat when having a bowel movement. This worked well because when your knees are above your hips, it creates the optimal angle to pass a stool with the least amount of strain. You can put a stool under your feet or even try the Squatty Potty.
  4. Exercise. Not only does regular exercise reduce the amount of time it takes for stool to pass through the large intestine, it also acts as a stress reliever. Remember, psychological stress is one major cause of constipation. A variety of exercises can help, but there are certain yoga poses that can be particularly effective at getting things moving. Check out this Art of Living post for five poses (with pictures) that will support your bowels, and your entire body for that matter.
  5. Magnesium and vitamin C. Many people with constipation have a deficiency in magnesium. Supplementation with magnesium citrate can act as a natural and gentle laxative. As with any dietary supplement, I recommend you “start low and go slow” by taking a small amount and gradually increasing the amount until you are able to have a soft, easy to pass bowel movement. If this is not enough, also supplementing with vitamin C can be helpful.

While many people prefer not to discuss their habits in the bathroom, identifying your daily bowel patterns is essential for cultivating good health. Toxins need to be removed from the body in order for it to function at its best. If you’ve been struggling in this area, try these easy tips to get things moving. And don’t be afraid to talk about your bowel movements with your healthcare practitioner, this area of the body deserves support and care, too, so don’t neglect it! Your whole body will thank you for taking care of your bowels.

7 Reasons You’re Not Losing Weight on Keto

How to get into ketosis

In order to reach ketosis, you must keep a close eye on your macronutrient consumption – how much protein, fat, carbs you eat daily. While calorie intake won’t affect ketosis, it may impact how much weight you’re losing (more on that later).

The amount of carbs you can eat while staying in ketosis varies from person to person. If you’re following a strict ketogenic diet, your carb intake will be lower (about 20 grams) than if you’re following a cyclical ketogenic diet like the Bulletproof Diet, where you have one carb-refeed day a week. Adding intermittent fasting to your keto diet will also allow you to eat more carbs and stay in ketosis.

Related: Why Keto Is More Effective With Intermittent Fasting

Though keto carb calculators offer only a rough guide, they can be useful in figuring out where to start. On a Bulletproof keto diet, aim to eat fewer than 50 grams of carbs a day, and eat them only at dinnertime. Stricter, regular keto diets generally recommend no more than 20 to 30 grams of net carbs (total carbs minus fiber) per day. Read more on how to find your ideal carb intake here.

How to know if you’re in ketosis

When you’re in ketosis, your liver produces large amounts of ketones to supply energy to the brain and body. One way to determine if you’re in ketosis is to measure the presence of ketones in your bloodstream. There are several ways to test for ketones, though some are more accurate than others.

Urine strips or sticks: Ketone urine strips indicate ketone quantity on a color-grading scale. Urine tests are affordable and easy to use. However, be wary of inaccurate results. Urine tests only monitor leftover, unused ketones in your body. That’s why the strips will be darker, indicating more ketones, when you’re new to the diet. As you adapt to ketosis, your body uses more ketones, so there will be fewer ketones expelled through your urine.

Ketone breath meters: The breath test method, where you blow into a meter, measures acetone levels in the breath. Acetones are one of three types of water-soluble ketone molecules; and in this type of test, the more you have, the farther you are into ketosis.

Blood meters: In Bulletproof founder Dave Asprey’s opinion, blood meters are the most accurate way to assess your level of ketosis. Prick your finger, draw blood and get a reading of the ketones in your blood. The downside is that these meters and blood strips are expensive.

If you don’t want to go the testing route, these signs of ketosis may indicate that you’re on track:

  • Strong metallic or fruity-smelling breath, aka “keto breath”
  • More energy and increased focus
  • Fewer hunger or sugar cravings
  • Weight loss

Pro Tip: Kick-start ketosis with a teaspoon or two of MCT oil, like Bulletproof Brain Octane Oil. MCT oils are medium-chain triglyceride fats that bypass the lymphatic system entirely and are uniquely absorbed by the liver in much the same way as carbs. In the liver, they are quickly converted into ketones, so they’ll put you into ketosis much quicker. Plus, MCT oil helps you burn fat and gives you much more energy and focus, which is especially helpful when you’re adjusting to keto.

Shop Now: Shop MCT Oils in the Bulletproof Store

Reason no. 2: You’re eating too much

To lose weight on the keto diet, you still have to watch your calories. You don’t necessarily have to cut them, but you can’t go hog wild and eat three times the amount you used to. Overeat and you won’t lose weight on the keto diet. Keep in mind that fat has twice the amount of calories per gram than protein or carbs do. So it’s a good idea to track what you eat in a diet app like MyFitnessPal while you’re getting started.

“If a patient asks to go on keto, I calculate their basic calorie needs to sustain their body and lifestyle,” says Davoodi. “It’s a myth that everyone can eat the same amount and not be affected differently. , it’s true that a 200-pound person and a 150-pound person should not eat the same amount.”

As you lose weight, you won’t need as many calories to sustain you as you once did, says Davoodi. “It’s helpful to reassess your needs after every 10 to 15 pounds lost. Otherwise, it’s possible you’ll hit a plateau.”

Pro Tip: While calories matter, your ratio of macronutrients (carbs, fat, and protein) are most important. Aim for 5 percent of calories from carbs, 20 percent from protein, and 75 percent from fat. Davoodi adds that drinking plenty of water to break down fat is particularly important on a high-fat diet like keto.

Reason no. 3: You’re not eating enough

If you’ve cut calories excessively, your body thinks it’s in starvation mode. That’ why super low-calorie diets stop working. Your metabolic rate drops to protect organs and normal bodily functions. Likewise, in an effort to conserve itself, your body slows down in response to insufficient energy levels or excessive exercise.

So while you may think you’re making great strides toward your weight loss goals by eating significantly less, you might be setting yourself up for failure. Your body needs the right amount of high-quality food in the right proportions to reach a healthy weight. And contrary to popular belief, calorie quality matters more than quantity. Focus on hitting your macronutrient goals (high fat, moderate protein and low carb) and eating nutrient-dense, whole foods — not just bacon and butter.

Pro Tip: Use a food calculator to estimate how many calories your body needs to lose one pound per week and stick within that range. Hit your macro goals by eating high-quality keto fats like coconut oil, avocados, grass-fed meats and eggs from pasture-raised chickens.

Reason no. 4: You’re eating too much protein

It’s a common misconception that the keto diet is a high-protein diet. It’s a moderate-protein diet in which about 20 percent of your calories come from protein. Too much protein can actually kick you out of ketosis, says Davoodi, through a process called gluconeogenesis, where your body converts extra protein into sugar (carbs!). Your body will reach for the glucose first and no longer burn fat for fuel.

On the keto diet, you want to eat moderate amounts of complete proteins, which are proteins with meaningful amounts of all eight essential amino acids. Meat, fish and eggs are all complete protein sources. Incomplete proteins from nuts, vegetables and starches are helpful, but they aren’t enough on their own.

Pro tip: Carefully calculate your protein needs, advises Davoodi. Too much and you won’t stay in ketosis; too little and you’ll lose muscle. Here’s a quick-and-dirty guide: calculate your ideal protein intake

How much protein to maintain body weight

A good starting point is 0.4 grams of protein for every pound you weigh. A 120-pound woman, for example, would eat 48 grams of protein a day (120 x 0.4 = 48).

If you’re healthy and sedentary, this should be enough protein for maintenance. In fact, some studies find that 0.4-0.5 grams per pound is enough to maintain lean muscle for people who are working out. At this level, you probably won’t gain muscle, but you won’t lose it, either. Notice that this is far less protein than many diets recommend.

How much protein to build muscle

If you work out hard or lift heavy, opt for about 0.8 grams of protein per pound of bodyweight. Rebuilding torn up muscles takes a lot of amino acids. You want to provide your body with plenty of raw material to grow.

Again, you don’t need to overdo it. A study of people doing heavy strength training 90 minutes a day, six days a week, found that they didn’t benefit from going above 0.75 grams of protein per pound. On top of that, a 2011 review of research on optimal protein intake for athletes and bodybuilders settled on 0.82 grams per pound as the ideal amount for muscle-building.

How much protein to burn fat

If you’re looking to lose weight, increasing protein may help. Studies suggest keeping protein between 20-30 percent of your daily calories may help you burn fat. A good rule of thumb to get in that range is about 1 gram of protein for every pound you weigh.

How does it work? Protein is satiating, which means you may feel fuller, faster. It also increases thermogenesis, meaning you’ll burn more fat if you higher amounts of protein.

If you start craving sugar, scale back your protein a bit. You need glucose to break down protein, and you don’t need cravings standing in the way of your goals.

How much protein to speed up recovery

When you’re injured, your body uses extra protein to rebuild damaged tissue. The amino acids glycine, proline and hydroxyproline speed up wound recovery and support joint, bone and tissue damage. Collagen has in all three. To get back on your feet faster, shoot for 1 gram of protein per pound of body weight a day total, with approximately 30 grams coming from hydrolyzed collagen.

This is a starting point. You have to take your own biology and lifestyle into account when determining your individual protein needs. With some experimentation, you’ll zero in on what works for you.

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Reason no. 5: You’re eating too many carbs

Carbs can be tricky on keto, particularly because they are hidden in many unexpected foods like cruciferous veggies, green beans, dairy and nuts. Because these are keto-friendly foods, eat them moderately.

Another common misstep: Misjudging how many carbs you’re eating overall. It can be difficult to gauge exactly how much food equals 20-50 carbs a day, for instance, which is typical of the keto diet. You can also calculate how many carbs are in each food with the help of a food tracker app. Learn more about the best keto diet trackers here.

To keep your carbs in check:

  • Fill up first up on low-carb vegetables like leafy greens, cucumbers, asparagus, avocado and zucchini — these should fill your entire plate at every meal.
  • Be mindful of higher-carb veggies like broccoli, Brussels sprouts, cabbage and cauliflower.
  • Reserve keto-friendly fruit, like berries, for the occasional dessert.
  • Focus on high-fat proteins. Pair an egg, grass-fed burger or wild-caught salmon with a green leafy salad and avocado for an easy and filling meal.

Also, take special note of sugar alcohols like sorbitol, mannitol, xylitol and isomalt. Sugar alcohols are derived from plant products (fruits and berries), though their carbs are uniquely altered through chemical processing.

While sugar alcohols provide fewer calories than table sugar, people often overeat them because they are labeled as “sugar-free” or “no sugar added” foods. This is problematic because they can still spike blood glucose levels due to their carb content. You still need to account for them in your diet plan. Your best bet is to go with erythritol because it doesn’t cause blood sugar or insulin spikes. Learn more about alternative sweeteners.

Pro tip: Until you can identify on your own how many carbs are in each food, use an app like MyFitnessPal. You’ll be able to see how many carbs each food contains, and keep track of your daily macros.

Related: Pitfalls of the Keto Diet and Why Carb Cycling Is Better (Cheat Day!)

Reason no. 6: You’re intolerant or allergic to something you’re eating

Roughly 15 million Americans have food allergies. The most common food allergies are to milk, eggs, peanuts, tree nuts, wheat, soy, fish and crustacean shellfish.

While food allergies are serious business, food intolerances can plague you, too. While not life-threatening, food intolerances cause imbalances in the gut leading to inflammation, which may affect the number you see on the scale.

Pro tip: Talk to your doctor to find out if you’re allergic or intolerant to a particular food. A nutritionist can test your blood and recommend next steps, such as an elimination diet, in which you eliminate all suspect foods and then slowly reintroduce them to see how you react.

Reason no. 7: You have leptin resistance

You have a “stop eating!” hormone that plays an instrumental role in your hunger and weight management, and it’s called leptin. It puts the brakes on hunger by sending a signal to the brain when your body’s energy needs have been met.

If you have leptin resistance, the “I’m full!” signals don’t transmit properly across the blood-brain barrier. Leptin resistance is triggered by irregular sleep, stress, overeating and calorie restriction.

Leptin resistance can also affect your thyroid, which secretes hormones that influence metabolism, growth and development. The amount of leptin available to your brain has a major influence on how many thyroid hormones are released into the body. Leptin resistance can throw a wrench in your thyroid function, leading to a slower metabolism and stalled weight loss.

Pro tip: Studies suggest that you may be able to manage leptin levels by having good sleep habits and cutting back on sugar and high-lectin foods.

How to boost your keto results

Make these simple tweaks so you can get the most benefits out of your keto diet.

Try intermittent fasting to accelerate weight loss

Intermittent fasting isn’t a requirement on the keto diet, but it’s a powerful way to help your body create those valuable ketones.

With intermittent fasting, you eat all of your daily calories within a shortened period, typically 6 to 8 hours, and fast for the remaining 14 to 16 hours. Fasting drains your body of its glucose reserves, so you switch over to burning fat for energy — aka ketosis.

In a 2014 study, adult mice who ate all their food within a 9- to 12-hour period put on less weight and had less fat mass than mice that ate whenever they wanted.

That’s why you typically skip breakfast most days on the Bulletproof Diet. Luckily, there is a hack to keep hunger away.

Drink Bulletproof Coffee

When you drink Bulletproof Coffee in place of breakfast, you remain in ketosis without the distracting hunger pangs. Instead of milk or sugar, each cup contains grass-fed butter and Brain Octane oil (C8 MCT oil). These smart fats may keep you full for hours, and C8 MCT oil raises ketones over three times more effectively than coconut oil. That means you can power through your morning — without feeling hangry. Get the official Bulletproof Coffee recipe here.

Practice cyclical ketosis (aka carb cycling)

On the standard keto diet, you’re eating very few carbs (less than 50 grams of total carbs a day), all the time. But restricting carbs for a long period can create issues like fatigue, thyroid problems, insomnia and dry eyes. Your body needs some carbs to perform at its best.

On the Bulletproof Diet, you follow cyclical ketosis and eat more carbs on one day of the week (called a carb refeed day). The other six days are identical to the standard keto diet. By upping your carb intake periodically, you satisfy carb cravings, support your sleep and keep the weight off. Be sure you’re eating clean sources of carbs, like squash, sweet potatoes, berries and carrots.

You can learn more about the benefits of carb cycling and how to do it here.

Add MCT oil to your coffee and food

Using a high-quality MCT oil like Brain Octane oil throughout the day — in your coffee, or drizzled over your salad and vegetables — raises ketone levels. A blood ketone level of 0.5 is enough to suppress appetite. Learn more about how MCT oil and keto work together to boost your results.

Check the quality of your fats

Keto is a high-fat diet, but you want to make sure you’re tucking in to good-quality fats.

There are different types of fat in food, and some are more anti-inflammatory and stable than others. In general, you want to eat foods that contain saturated fat, monounsaturated fat and a bit of polyunsaturated fat — think grass-fed beef and lamb, wild-caught fatty fish, grass-fed butter or ghee, avocados, MCT oil and pasture-raised eggs.

Avoid vegetable oils and trans fats (found in fried foods, candies, stick margarine and packaged baked goods), which can contribute to diet-induced inflammation.. Learn more about dietary fats.

Hit your weight loss goals

Sign-up for the Bulletproof Weight List newsletter and receive tips, recipes, and advice on how to keep the pounds coming off.

  • Despite seeing success story after success story, you may be frustrated if you’re not losing weight on keto. You were expecting an immediate “whoosh,” but after dropping an initial couple of pounds, your weight loss is stalling.

    The ketogenic diet can be tough to master if you don’t know the right steps to take to get into ketosis. And once you’re in ketosis, it can be a challenge to stay there. How do you set yourself up for continuous weight loss on the keto diet?

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    Here are the top 10 reasons you might not be losing weight on the keto diet.

    #1: You’re Not Actually in Ketosis

    Have you been following the ketogenic diet for a while but have no idea if you’re in ketosis? This is where testing your ketone levels comes in.

    You’ll only truly know whether you’re in a ketogenic state when you test your ketone levels.

    How do you test your ketones? There are three ways to get a good measurement:

    1. Urine testing
    2. Breath testing
    3. Blood testing (the most accurate)

    Urine Testing

    A urine strip indicates the concentration of ketones in your urine by changing color. While this type of testing is the most affordable, it does not always yield the most accurate results.

    Urine tests only measure the flushed out ketones that your body didn’t use for energy. When your body becomes more adapted to ketosis, it will be using more ketones for energy — meaning you may not have any signs of ketones in your urine at all once you are fat-adapted.

    Breath Testing

    Breath testing is considered a little more reliable than urine testing, but still not the most accurate.

    The ketones that show up in your breath are acetone, not beta-hydroxybutyrate (BHB). Breath testing can be done by blowing into a Ketonix breath analyzer, which gives you a reading based on the level of acetone it detects.

    Blood Testing

    Blood testing is the most accurate way to measure your levels of BHB. All it takes is pricking your finger with a blood meter. The Precision Xtra meter is a great option for blood testing.

    This is considered the most accurate way to test your ketone levels because there’s nothing that can dilute the results, and you see the exact amount of blood ketones in mMol/L.

    If you’re not losing weight on the ketogenic diet, the first checkpoint is whether you’re even in ketosis. If you have that covered, there are a few other reasons you may not be losing weight on keto.

    #2: You’re Not Eating Satiating Meals

    One of the keys to weight loss is eating at a calorie deficit, but it’s also important to pay attention to the quality of the calories you do eat to make sure you’re satisfied.

    Eating at a calorie deficit doesn’t mean you have to be hungry all the time. In fact, being hungry will only make you miserable, less likely to stick to your diet, and more likely to give in to cravings.

    You can eat a calorie deficit and feel satisfied by eating the right kind of keto-friendly foods.

    Satiating healthy fats — especially saturated and monounsaturated fats — are the cornerstones of the ketogenic diet. If you want a high-quality keto diet, you’ll need abundant sources of high-quality fats. MCT oil is particularly helpful because it’s more satiating than coconut oil and boosts ketone production, so you can enter fat-burning mode faster.

    One study found that MCT oil can make you feel fuller than coconut oil over the three hours after breakfast.

    High-quality proteins are also important. Fatty cuts of meat (like a ribeye steak), as well as wild-caught salmon and other high-fat fish, are excellent at keeping you satisfied.

    You don’t need to shy away from protein — it won’t kick you out of ketosis like you may have heard. The belief that too much protein triggers gluconeogenesis (glucose production from non-carb sources) and therefore lowers your ketone levels is just a myth.

    The truth is, gluconeogenesis (GNG) is crucial for maintaining ketosis because it fuels those cells that can’t use ketones (like red blood cells) and keeps your blood sugar in a healthy range. Without it, ketosis would not be possible.

    Eating more protein than you’re used to won’t increase the rate of GNG enough to put you out of keto because GNG is an extremely stable process.

    Studies show that even when there’s an abundance of raw materials for GNG (including protein), the gluconeogenesis rate stays about the same.

    Excess protein won’t increase gluconeogenesis the same way chocolate cake increases your glucose levels.

    #3: You’re Missing Hidden Carbs

    Veggies, dairy, nuts, and nut butters are on the keto food list, but the grams of carbs can add up fast if you’re not tracking.

    Both dairy and nuts should be eaten with caution on a low-carb diet. One common mistake people make on keto is overeating dairy and nuts to feel satisfied, but too much of these foods can increase both your carb intake and calorie count without you realizing it.

    Other possible hidden carbs can be found in some cruciferous vegetables including cabbage, cauliflower, broccoli, Brussel sprouts, fennel, and turnips. You also want to limit your intake of fruit due to its high sugar content.

    #4: You’re Eating Too Much Fat

    Another major mistake people make when starting a keto diet is thinking they can eat an endless amount of fat. Yes, it’s a high-fat diet plan, and there are tons of great fat bomb recipes out there, but that doesn’t mean that you can eat unlimited avocados and bacon drizzled in olive oil.

    Overeating fat can create a surplus of total calories that prevents weight loss. Here’s one way to look at it: one pound of body fat stores roughly 3,500 calories. This would lead you to conclude that cutting 500 calories a day for a week would result in roughly one pound of weight loss.

    Going overboard with fats could get tricky.

    Fats contain more than twice the amount of calories as carbs or proteins, so it’s crucial you count how many grams of fat you’re eating and remain mindful of your fat intake.

    This is another way the Perfect Keto Macro Calculator comes in handy. It takes into account your age, height, weight, body fat, activity levels, and how much weight you want to lose (or maintain) to measure your exact keto macros.

    Overall calorie intake depends on your individual needs. If you’re not eating the correct amount of calories, you won’t reach your weight loss goals no matter how low your carb count is.

    #5: You’re Not Eating Enough Calories

    This is usually not the case if you’re struggling with losing weight on the ketogenic diet. But along with being unaware of eating too many calories, not getting enough calories can disrupt your weight loss.

    When you don’t eat enough, your metabolism slows down to conserve energy in response to inadequate energy levels or excessive exercise.

    Make sure you’ve created a calorie deficit that your fat stores can still cover. Otherwise, your body will begin to use lean mass to get the energy it needs.

    If you create a deficit that’s too large, your metabolic rate will drop significantly in order to protect organs and normal bodily functions.

    Again, you can use the keto calculator to figure out your individual calorie needs.

    #6: You’re Getting Too Much Exercise

    You know the saying “you can have too much of a good thing.”

    That applies to exercise too. Exercise is crucial for improving overall health. However, there is a healthy limit for everyone.

    The main type of exercise abused by those trying to lose weight is chronic cardio. Repetitive aerobic training increases your appetite because your body feels deprived and wants those calories back.

    And in a battle between your willpower and your biology, your biology will always win. You’ll end up overeating to compensate for the excess calories burned.

    While all effective exercise creates some type of acute inflammation, chronic exercise can create systemic, internal inflammation as well as oxidative stress.

    #7: You’re Experiencing Stress

    Stress is a significant factor when troubleshooting weight loss. When you’re emotionally or physically stressed out, your body produces a hormone called cortisol.

    The Role of Cortisol

    Cortisol is a signal hormone known as the stress hormone. It’s one of the top hormones your body releases when you’re under pressure or in a fight-or-flight situation. Cortisol has the ability to channel glucose to the muscles during your body’s response to stress.

    It plays a major role in keeping you alert, awake, motivated, and it’s necessary for survival.

    It’s also responsible for storing fat around your stomach area, making weight loss a challenge. It’s also directly connected to insulin production.

    The real problem kicks in when cortisol production becomes chronic due to constant stress, so the fat around your stomach starts to increase. Too much cortisol pulsing through your bloodstream on a regular basis could eventually lead to insulin resistance, a metabolic condition that could trigger chronic medical conditions like type 2 diabetes.

    #8: You’re Not Sleeping Enough

    Often an underestimated factor, not sleeping enough can stall or prevent weight loss.

    Lack of sleep can throw off your circadian rhythm and increase the risk of metabolic problems. All of your organs follow a certain timing (known as your internal body clock), and disrupting it can put you at a severe disadvantage. Maximum fat loss can only be achieved with adequate sleep.

    Sleep is also essential for balancing hormones — especially hunger hormones. Sleep regulates both ghrelin (the hormone that makes you feel hungry) and leptin (the hormone that makes you feel full).

    Your ghrelin goes up and your levels of leptin go down when you don’t get enough sleep, which is bad news for weight loss.

    #9: You Have Food Sensitivities

    Even if you are following your macros and tracking your calories, food sensitivities can still contribute to not losing weight on keto.

    Many people have food sensitivities they don’t even know about — the most common being dairy products. Dairy includes cheese, cream, butter, yogurt and ghee.

    When your body is sensitive to a particular nutrient in certain foods such as lactose, casein, or gluten, those compounds can cause imbalances in the gut — which then leads to overall inflammation.

    Inflammation prevents weight loss and increases weight gain. If you think you may be sensitive to a certain food, it’s important to experiment and pay close attention to what foods make you feel better or worse.

    #10: Leptin Resistance

    Leptin is a fat-controlling hormone that tells your brain when your body is satiated, so it can know when to stop eating. Leptin is produced by your fat cells. It’s mainly responsible for regulating how many calories you eat, how many you burn, and how much fat you carry on your body.

    Leptin resistance happens when you have plenty of leptin, but the messages aren’t being received. The major causes of leptin resistance include:

    • Funky sleep patterns
    • A diet full of processed foods
    • Overeating
    • Stress

    It’s not that obese individuals don’t have enough leptin — it’s that the signals leptin is sending to their brains aren’t being received. The brain is resistant to the message of satiety, creating snacking habits and overeating that eventually leads to weight gain.

    The Solution to Not Losing Weight on Keto

    So, how do you figure out the root cause for not losing weight on keto?

    The most important thing to remember is that everyone’s body is different and will react differently to each of the variables.

    Figuring out which foods and habits work best with your body will take some trial and error, but it’s worth it. Run through the reasons above and take note of anything you may be missing.

    I’m not exactly new to dieting (though I don’t particularly like that term). What my boyfriend affectionately refers to as yo-yo dieting, I prefer to call “my nutrition hobby.” I love the science of nutrition and have tried many different eating styles over the years, from veganism to Atkins and everything in between. When the ketogenic diet became all the buzz, I knew I needed to try it.

    It took me a while to commit to going full-on keto. My nutrition philosophy has always involved eating relatively low to moderate levels of carbohydrates. I lost about 40 pounds when I was a senior in high school by adhering to a low-carb diet and have kept the weight off for all of my adult life.

    But while eating low-carb isn’t particularly new to me, adding in fats — obscene amounts of fat, actually — definitely is. As a self-proclaimed nutrition nerd, I approached keto with a balanced philosophy. My goals were:

    • To increase my energy levels and regulate my blood sugar by eating a diet that doesn’t trigger an insulin response.
    • To lose a little bit of weight (roughly 10 pounds, which I had gained over the past couple of years as a result of straying too often from my usual moderate-carb ways).
    • To eat healthy, wholesome fats on the keto diet (not greasy burgers, processed vegetable oils, or tons of cheese).
    • To obtain the benefits of the keto diet without tracking calories.
    • To eventually add carbs back into my diet, having by then “adapted” to ketosis and therefore being able to simply burn through carbohydrates before reverting to fat-burning mode.

    I successfully ate keto, adhering to macronutrient ratios of roughly 70 percent fat, 20 percent protein, and 10 percent carbohydrates, for 30 days before beginning to add carbs back into my diet. Here’s how it went.

    Constipation on keto diet

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