On June 4, 2020, I kicked off a new series of posts reviewing my experiences during My First Year on the Keto Diet and sharing some of my insights and lessons learned over the course of my successful journey so far. Since that post was published, I’ve lost another pound, even though I’m no longer actively trying to lose weight, bringing my total weight loss since May 25, 2019 to 57 pounds. I am healthier and feel better than I have in decades. (Oh, and being able to wear shorts and sleeveless tops this summer without feeling embarrassed feels pretty amazing, too!)
|©2020 Margaret Schindel. All rights reserved.|
Last spring, after a serious medical scare when I learned that being obese and post-menopausal had put me at significantly higher risk for endometrial cancer, among other life-threatening diseases, my doctor stressed the importance of losing my 50+ pounds of excess weight. I had tried many times to strictly limit my consumption of the foods I constantly craved—sugars, grains, and other foods that are high in carbohydrates or highly processed—and failed just as many time.
After reading a lot about what causes those types of food cravings and how to lose weight without giving into them, I realized that I and many others with an obesity problem had become psychologically, emotionally, and in some ways, almost physically addicted to those foods, and in my case, it probably dated back to my childhood. Note: If you're interested in learning more about this phenomenon, the journal articles, "Food Addiction: Implications for the Diagnosis and Treatment of Overeating," Nutrients, September 2019, and "Sugar Addiction: From Evolution to Revolution," Frontiers in Psychiatry, November 2018, discuss it in depth.
The good news: I finally understood why all my previous efforts to lose weight and keep it off had failed. The bad news: Losing enough weight to meaningfully lower my risk for developing cancer and other life-threatening illnesses—and keeping it off—wouldn't be as simple as just cutting back on calories, sugar, and flour, and getting more exercise. Achieving those goals would require an all-in commitment to overcoming my roughly 60-year-long carbohydrate, processed foods, and sugar addiction for good.
Preparing for Success on the Keto Diet
From personal experience, I knew that no matter how badly I wanted and needed to succeed, or how hard I tried, desire and effort without the proper preparation would not be enough to make that success a reality. To quote legendary former college football coach Bobby Knight (who won 902 NCAA Division I men's college basketball games and knows a thing or two about critical success factors), "The will to succeed is important, but what's more important is the will to prepare."
Choosing to spend a few weeks preparing myself mentally, psychologically, socially, and environmentally before giving up the foods I was addicted to "cold turkey," whether temporarily or for good, was one of the best decisions I made.
Following the most important things I focused on during those weeks of preparation that helped me be successful on my keto weight loss journey.
Making a Serious Commitment to Losing Weight and Eating Better
I was overweight and, yes, clinically obese, for decades, and it made me miserable. It badly eroded my self-esteem. And as a former clotheshorse who worked in the fashion industry in New York City for many years, it was painful to try on beautiful clothes and see how bad they looked on me (or how bad I looked in them). In retrospect, even that constant pain and shame must not have been enough motivation to make the dramatic, long-term changes to my eating habits needed to lose the excess pounds, since my many attempts at dieting over the years had all failed.
This time, my serious medical scare provided a powerful enough motivation to make me commit 100% to fundamentally change my way of eating, and choosing better quality, more nutritious, and less processed foods. Without that kick in the butt, I doubt I would have succeeded this time, either. I encourage you to think about what your motivation is to commit to this much more restrictive way of eating.
Many people boast that they have lost a lot of weight following their own version of a ketogenic diet that includes "cheating" on a regular basis, or even a planned rotation schedule of being "on" and "off" keto. Others might lose weight using a less restrictive variation of the classic keto diet approach, such as so-called dirty or lazy keto. If that works for them, great!
I can only share what has worked for me, an approach that I chose based on
my own situation, goals, and self-knowledge based on past experience.
Everyone is different. As always, your mileage (and your choices) may
Researching the Keto Diet and Understanding Its Basic Concepts
Keto is a low carb, high fat, moderate protein approach to eating, often referred to as LCHF (low carb, high fat). Regardless of whether you follow this dietary approach or what foods you eat, losing weight requires a calorie deficit, i.e., you need to eat fewer calories than your body uses. On a ketogenic diet, most of your calories should come from healthy fats, a smaller percentage should come from from proteins, and very few calories should come from carbohydrates (and, ideally, mostly from low-carb vegetables and berries).
That's a very simplified overview, and I had to do weeks of extensive research and reading before I had a good grasp on all the most important aspects of this way of eating. Here are a few of the many resources that helped me educate myself on this subject.
Helpful Online Guides and Articles
- "The Ketogenic Diet - A Keto Guide for Beginners" on ruled.me is one of the best places to start familiarizing yourself with the keto or low carb approach to eating. It contains lots of helpful, actionable, easy-to-understand information and advice, including explanations of macros and net carbs.
- Wholesome Yum's "Low Carb & Keto Diet Guide" is another excellent, informative, and easy-to-understand resource for newbies.
- "A Ketogenic Diet to Lose Weight and Fight Disease" (Healthline)
- "What Is the History and Evolution of the Keto Diet?" (American Fitness Professionals Association aka AFPA)
Here are a few other articles I found helpful in understanding the benefits and risks of this type of diet:
Although I focused primarily on cookbooks, some also contained helpful information, explanations, and inspiration for anyone interested in living a low-carb lifestyle, like these:
- "Simply Keto: A Practical Approach to Health & Weight Loss, with 100+ Easy Low-Carb Recipes" by Suzanne Ryan
- "Beyond Simply Keto: Shifting Your Mindset and Realizing Your Worth, with a Step-by-Step Guide to Keto and 100+ Easy Recipes" by Suzanne Ryan
- "The Keto Diet: The Complete Guide to a High-Fat Diet, with More Than 125 Delectable Recipes and 5 Meal Plans to Shed Weight, Heal Your Body, and Regain Confidence" by Leanne Vogel
- "Keto: The Complete Guide to Success on The Ketogenic Diet, including Simplified Science and No-cook Meal Plans" by Maria Emmerich and Craig Emmerich
I also own two wonderful cookbooks by well known, highly respected keto diet author and expert Maria Emmerich. I'm also looking forward to adding this book, which she co-wrote with her husband, to my growing collection:
My Favorite Keto YouTube Channels
Strict vs. Lazy vs. Dirty Keto
As I explained in my previous post, there is no such thing as "the" keto diet (or ketogenic diet) outside the context of certain medical treatments. There is only "a" keto/ketogenic diet, which is a low carbohydrate, moderate protein, high fat approach to eating based on achieving a metabolic state called ketosis the majority of the time, which enables the body to become fat-adapted.
Despite this, there are countless self-proclaimed "keto experts" (aka "keto police") who have lost weight using this approach and are on a mission to "educate" (i.e., lecture) everyone else on the "rules" about what they (or another keto "expert") are convinced is the right or wrong to follow a ketogenic diet. They often will argue passionately with other self-appointed "keto police" about whose rules are the "real" rules, which is ridiculous and, more important, extremely confusing for newbies to this way of eating who are trying to figure out whom to trust as a reliable source of information and advice.
People often break out the high-level differences in ketogenic diet strategies into three groups. (Again, what each approach is called and how those labels are defined can vary, depending on who is doing the labeling and defining.) Most commonly, these three approaches are:
"Clean Keto" aka Strict or Classic Keto
The "clean keto" approach focuses on high quality foods and optimal nutrition to support a healthy lifestyle.
Lazy keto" usually refers to tracking carbohydrates and limiting them to 20-25 net carbs per day, without calculating/tracking macros or calories or eating specific types of foods. However, some people use this term to mean simply eating only keto-friendly foods—no calculating or tracking macros or calories.
"Dirty Keto" aka IIFYM (If It Fits Your Macros)
"Dirty keto" is basically eating anything you want, as long as it fits within your daily carbs and calorie limits, protein target, and fat allowance. This approach focuses exclusively on weight loss, simplicity, and freedom of choice, without concern for nutrition or food quality.
Choosing and Personalizing an Optimal Ketogenic Diet Strategy
"Lazy keto" and "dirty keto" would have taken less work and were tempting options. Ultimately, however, I decided that the best strategy to help me kick my food addiction and lose the weight I needed to at a reasonable pace would take a mostly "clean keto" approach, but slightly less strict. I would focus primarily on cutting out all added sugars and refined carbohydrates, eating more whole foods, choosing grass-fed, organic, and/or non-GMO foods whenever possible, cutting way down on processed foods, and increasing my daily consumption of fresh, low-carbohydrate vegetables.
I also decided to track my dietary fiber intake and supplement what I was able to get from food with a safe, gentle, osmotic laxative like MiraLAX, which an endoscopy nurse I met during my most recent colonoscopy visit told me she takes daily to stay "regular." Sometimes I buy an equivalent product from a different brand, such as Member's Mark ClearLAX or Amazon Basic Care ClearLax, that has the same active ingredient (polyethylene glycol 3350) but costs less per dose.
With so much weight to lose, and a powerful and urgent motivation to do lose it and also lower my health risks, I decided that I didn't want to "cheat" when eating out, or for holidays or special occasions, or when I was under a lot of stress. To support that goal over a long period of time, I knew I would need to be proactive in preventing myself from feeling deprived, and decided to plan homemade or purchased keto-friendly treats, made with high-quality, nutritious, and some minimally and, occasionally, moderately processed ingredients, into my daily menus.
When I chose to get started on keto, my short-term goal was to lose the weight I needed to in a way that I could sustain as long as necessary. I made a commitment to myself to do whatever it took, for as long as necessary, to achieve that goal. The strategy I chose to follow turned out to work extremely well for me, based on my individual needs, challenges, and goals. Someone else might do better with a significantly different approach.
I encourage anyone who is seriously considering a ketogenic approach to losing weight to be brutally honest with themselves about how much, how, and for how long they are willing to change their eating habits, and then define their own personal guidelines/rules for their unique keto journey and modify them over time, if needed, as they discover what is and isn't working well for them.
Consulting With a Doctor
When the surgeon explained that my being both obese and postmenopausal were the most likely factors in my developing cervical polyps, she also told me that losing my excess body fat was one of the best ways to reduce my risk for developing either additional polyps or uterine cancer. During my pre-op follow-up visit, I told her that I had family members and friends who had lost weight successfully on keto, and that I was considering a "clean keto" diet, with a focus on making healthy, nutritionally sound choices and losing pounds at a moderate rate. She said it sounded like a reasonable approach and one worth trying, at least for a period of time. So, I was fortunate to have her support. Clearly, the risks of obesity appeared higher than any risks associated with such a restricted diet.
Some medical or nutrition experts, however, are not in favor of a ketogenic diet for weight loss. Some also have misconceptions about keto, and many advise against it because it is so restrictive. But most support adopting a low-carb diet as a permanent lifestyle change. In fact, I don't know of any medical or nutrition professional who would not encourage patients to either cut out or restrict sugar, refined carbs and processed foods from their diet.
It's also important to understand that keto is not always the best option, or even a good one, for every person. If you have a health condition, eating a very low carb diet might help, but it also could make it worse. So, it's best to have this conversation with your doctor, and to discuss what things should be monitored, how often, and whether you can monitor them yourself or will need a medical professional to run periodic tests.
Note: If your doctor isn't aware of recent evidence-based studies and their findings regarding the potential health and medical benefits of a keto or LCHF approach to eating, you might consider sharing either of both of the following articles published in professional journals:
- "Ketogenic Diet: A New Light Shining on Old but Gold Biochemistry" (2019, Nutrients)
- "Evidence that supports the prescription of low-carbohydrate high-fat diets: a narrative review" (2017, British Journal of Sports Medicine)
Determining a Daily Calorie Target and Calculating Macros
Like many other people, I found the not only the concept of macros but also how to calculate what mine should be extremely confusing.
In the context of keto, "macros" is short for macronutrients: carbohydrates, protein, and fats. A person's macros refers to 1) the relative percentages of their target daily calories allocated to each of those macronutrients, and 2) the number of grams of net carbs, protein and fat that person can/should eat daily.
One of the most common macronutrient ratios is 5/25/70, i.e., 5% of the person's daily calories come from "net carbs," 25% come from protein, and 70% come from fat. To clarify a common misconception, this does NOT mean that for someone who chooses a 5/25/70 macro ratio, 70% of the amount of foods they eat on keto will consist of fats. Fats have 9 calories per gram, while proteins and carbohydrates each have only 4 calories per gram. So, allocating 70% of your daily calories to fat translates to a much smaller percentage in terms of weight (in grams).
For daily tracking purposes, what matters is the daily number of grams of carbohydrate, protein and fat consumed, as well as your total calories.
Net Carbs vs. Total Carbohydrate Grams
Most people on keto base their macros calculations and tracking on net carbs, rather than total carbs. The reason is that dietary fiber, most sugar alcohols, as well as two of my favorite keto-friendly sweeteners, Allulose and pentose (e.g., BochaSweet brand sugar replacement) are not digested, so they aren't metabolized and used by the body for energy. This means they don't affect achieving or sustaining a metabolic state of ketosis (which is the core of a ketogenic diet approach).
The most common way to calculate "net carbs" (and the formula I use) is:
Total Carbohydrate - Fiber - (most) Sugar Alcohols - Allulose or pentose (e.g., BochaSweet) sweetener = Net Carbs
Some people only subtract the dietary fiber. Others subtract only half the sugar alcohols and/or Allulose or pentose (e.g., BochaSweet). Still others track total carbohydrate grams rather than calculating net carbs, which is much more restrictive (or is based on a higher percentage of carbohydrates).
Keto Calculators / Macro Calculators
When I was preparing to get started on keto, I had no idea how to choose a ratio for my macros, how many calories my body burned, how to decide on a calorie deficit percentage, or how to calculate how many grams of net carbs, protein and fat to eat each day. Fortunately, there were lots of articles and calculators to help.
Ruled.me's ketogenic macro calculator is one of the most user-friendly of those I've tried. It's a good tool to help you figure out your daily calories target for weight loss and your starting macros, both the ratio (as a percent of calories) and, most importantly, the number of fat, carbohydrate and protein grams and calories you will consume daily on keto).
Downloading Carb Manager or Another Good App to Track Calories, Macros, and Other Key Nutrients
The thing I resisted most when starting my keto diet journey, and also the one I knew would be critical to my success, was committing to track every bite of food and every sip of drink that went into my mouth before I consumed it. Lots of people lose weight on keto without doing this. I can only share what was important to my weight loss success on this diet.
There are a number of good apps for tracking your macros and calories. Some can also help you track other key nutrients. If you have high blood pressure, for example, it might be important for you to track your sodium intake. For me, tracking my fiber intake was a high priority, since many foods that are high in fiber are also high in carbohydrates and/or calories, which makes it hard to get enough dietary fiber daily for gastrointestinal health (and to avoid constipation!).
My favorite tracking app, which I use every day, several times a day and recommend highly, is Carb Manager. The free version of this app has everything you need to track your macros, other nutrients of your choice, and calories. (I subsequently upgraded to the paid, premium version because it offers additional features I find helpful, but it's absolutely not necessary for keto.)
Carb Manager has a huge library of foods (many of which were entered by other users, so I always check user-entered nutrition data against the manufacturer's nutrition data from the package label). You can make a custom entry for any food, either by manually entering the nutrition data from the package label or manufacturer's website, or by pointing your camera at the barcode on the packaging, if available, to see whether the data for that product can be imported into the app automatically (or has been entered already by someone else).
Note: Carb Manager automatically calculates net carbs by subtracting fiber and sugar alcohol grams from the total carbohydrate grams. However, it doesn't yet include Allulose, which is a relatively new keto-friendly sweetener, in its calculations. Also, the USDA doesn't require manufacturers to list Allulose in the nutrition data, so it's not always clear how many grams of Allulose are in some products that use it. Fortunately, when you enter or edit the nutrition information for a food in Carb Manager, you have the ability to choose to enter carbohydrate grams as net carbs or total carbohydrates. Net carbs are often printed on the packaging for foods containing Allulose.
One of the things I love about Carb Manager is that it has a macro calculator with adjustment sliders that can help you see in advance how changing your macro percentages would affect your daily fat, protein and carbohydrate grams, or how increasing or decreasing your desired calorie deficit percentage would affect the number of calories and net carb, protein and fat grams you can eat and the estimated length of time to reach your weight loss goal.
Another great aspect of the Carb Manager app is its "Smart Macros" feature option that, if you turn it on, will automatically adjust your daily macros and calories over time, as your weight changes. The app also allows you to enter and track your body measurements, BMI, and other types of metrics to gauge your progress, a feature that I use and find extremely helpful, since the numbers on the scale can (and usually do) fluctuate regularly, often for no apparent reason, but a tape measure doesn't lie.
This terrific app has many more features and capabilities than I can go into in this post, but the website has a very robust database of articles that explains each feature and how to use it. You can also take a brief tour of the Carb Manager app to get a sense of how it works and what the user experience is like before you download it.
We're only halfway through the list of things I did to prepare myself for success before starting my keto diet journey. I'll cover the rest in my next post, Preparing to Succeed on the Keto Diet, Part Two.
"The best way to predict your future is to create it." 〜 Abraham Lincoln
Preparing to Succeed on the Keto Diet, Part One by Margaret Schindel
Posts In This Series About My Keto Diet Journey
Reviews of the Keto Diet by Barbara C. (aka Brite-Ideas)
Read More Reviews About Health and Wellness by Our Review This Reviews Contributors
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