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Tuesday, August 4, 2020

Preparing to Succeed on the Keto Diet, Part Two

More Ways to Prep for Success on a Keto Diet

This is the third in a series of posts in which I will be reviewing my experience and insights after following a very low-carb lifestyle for more than a year.

Quick update: Since my previous post on the importance of preparation in setting yourself up for success on a ketogenic diet was published 2.5 weeks ago, I was surprised to discover that I have lost another pound. So, my total weight loss since May 25, 2019 is now 58 pounds.

Choose a Start Date

I was highly motivated to begin my new keto lifestyle, thanks to a medical scare that forced me to face the serious health risks of being both postmenopausal and obese, and of continuing to consume added sugar and highly processed foods. I understood the urgency of getting down to a healthy weight, and I was anxious to start lowering my risk for developing cancer, heart disease, diabetes or another serious illness as soon as possible. It was hard to resist the urge to just get started on keto as best I could, and figure things out as I went along.

At the same time, I knew how difficult it was going to be to overcome my food addictions, particularly to sugar and baked goods; cut out all grains, rice, and beans; and severely restrict my consumption of roasted carrots, parsnips, beets, white or sweet potatoes, and other root vegetables, which had been a staple of our weekly menus for years.

So, as impatient as I was to "get the show on the road," I understood the importance of preparing myself mentally, emotionally, and environmentally before committing myself fully to the radical changes that would be required—especially at the beginning, when my starch and sugar cravings would still be at their strongest.

Last but not least, I understood my need for a clear framework and road map to help me stay on track and make consistent progress toward any type of goal.

So, ultimately, I made the wise decision to choose a start date a few weeks out, so I could have the time to prepare myself properly and give myself the best chance of success.

When choosing the date for starting your own keto diet, I encourage you to consider your own fears and challenges, decide how best to prepare yourself to overcome them, and pick a start date that leaves you enough time to complete the preparations that will help set you up for success.

Decide Whom to Tell, and When

The ketogenic approach to eating is widely misunderstood, remains controversial, and tends to provoke strong responses, whether positive or negative, whenever the topic arises. I knew that switching to this radically different approach to eating was going to be hard enough without the added stress of dealing with unsolicited, well-meaning, but unwanted opinions, advice, or criticism about my decision to follow a ketogenic diet.

I chose to keep that decision private for as long as possible.When I started, no one except my husband (and my surgeon) would know. Once I became fat-adapted and overcame my cravings for high-carb foods, I would tell a handful of other people if, and when, they needed to know, e.g., telling my brother shortly before we flew across the country to stay with him for a week-long visit.

Down the road, when I was noticeably slimmer and people began to ask about how I achieved my weight loss, I would need to decide what, and how much, I wanted to share about my new approach to eating. But I would have at least a month or two to make that decision.

Unless you live alone, the other people who live with you—your spouse, partner, children, roommates, etc.—will likely be affected by your decision to radically limit your food choices and, obviously, will need to be told. If you tend to be very social, you may prefer to tell your friends, family members, and co-workers up front about starting keto diet and ask them to cheer you on and help you through the rough patches.

The important thing is to take a little time to think about and decide on a communication approach that will suit your individual needs and preferences.

Image by Dean Moriarty from Pixabay

Solicit Support From Family and Friends

To achieve my health and weight loss goals, I knew I would need help from my nearest and dearest. What I couldn't be sure of was how my family, friends, and colleagues would react to my decision to adopt a moderately strict ketogenic lifestyle, especially given how anti-keto I used to be before I became better educated about this way of eating.

Fortunately, when I gradually shared my news with more people, as situations arose when they would need to know, they were surprisingly supportive, especially after I explained the medical necessity for me to lose my excess weight safely but also expeditiously. Here's the approach that worked for me.

Think about the people whose support, or lack of it, could potentially bolster, or threaten, your commitment and progress the most, especially during the first few months, when you will be battling your cravings for sugar, baked goods, chips, candy, pizza, etc. before your taste buds adjust to enjoying and, perhaps, even preferring healthy, keto-friendly foods. In my case, my husband would be my entire support system (other than online groups) during most of that crucial initial transition period. But since we also would be spending vacation weeks with my brother and, later, my husband’s parents, as well as joining my sister and brother-in-law for dinner from time to time, and going out to lunch or dinner with friends, when the time came, I would also need to enlist their support—or, at least, understanding—about my dietary restrictions.

Think about what types of support you might want to request from each of the people in your inner circle, and be as specific as you can about the actions they could agree to that would help you the most. For example, if you have a friend with whom you go out often for brunch, and your favorite restaurant serves a brunch buffet featuring pancakes, waffles, French toast, bagels, and other tempting, off-limits foods you would find hard to resist, you might choose to ask whether they would be willing to change up your routine and meet for lunch instead, and suggest trying a different restaurant (one whose menu you’ve already vetted first so you know it includes a variety of keto-friendly options). If you need to tell someone that you’re following a ketogenic approach to eating and anticipate a negative response, you could try to explain up front that you have done extensive due diligence, educated yourself about the potential risks as well as benefits of this way of eating, and spoken with your doctor before choosing this path, and that it would mean a lot to you if they would accept your decision without challenge or criticism and, if they can, support your efforts to lose weight and improve your health.

Consider Ways to Get Your Needs Met and Their Impact On Other People

Deciding to adopt a keto approach to eating also means accepting responsibility for making sure you have access to the types of foods you need to keep your commitment to yourself. At the same time, to quote Oliver Wendell Holmes, “The right to swing my fist ends where the other man's nose begins." So, throughout this journey, I’ve tried to think about ways to minimize the impact of my limited food choices on other people who had no say in my decision.

As an example, six months after I started keto, by which time I had lost 50 pounds and my entire family knew about my ketogenic diet, my sister and brother-in-law invited us to their house for Christmas dinner. She asked me to help her understand my dietary restrictions so she could tailor the menu accordingly. After thanking her for her thoughtfulness, I asked what she would make if my diet weren’t a consideration. I was able to suggest fairly minor changes that would make most of those dishes keto-friendly, such as serving the salad dressing on the side, making a marinade for the pork that didn't contain any fruit juice, ketchup, barbecue sauce, sugar, honey, or molasses, and replacing one of the two high-carb side dishes with grilled, roasted, or sautéed asparagus or broccoli with butter and herbs. I told her I would bring my own keto-friendly salad dressing and dessert. When she expressed her reluctance to serve foods she knew I loved but would no longer eat, I explained that it was important to me that my decision to severely restrict my own food choices had the least possible impact on what everyone else was eating, and that it would give me pleasure to see my nearest and dearest savoring one of her decadent desserts while I enjoyed my keto-friendly sweet treat. The dinner was delicious, and a wonderful and festive time was had by all. A win-win!

Unless you live alone, minimizing the day-to-day impact of your dietary restrictions on the people you live under the same roof with can be significantly harder. Our household consists of just my husband and me, and when I was considering the keto diet as an option, I discussed the idea with him at length, and he said he would be willing to help me in any way he could in my efforts to get down to a healthy weight. I told him about the challenges and potential obstacles that concerned me the most, and we worked together to come up with solutions that would work for both of us. For example, I worried that having baked goods, chips, and other addictive foods in the house would be an unnecessary temptation, and we agreed that he would try to keep and eat those foods mostly at his office or outside the house without me. We also designated the lowest drawer of our refrigerator and the cabinets above the fridge as food storage “for John’s eyes only,” and he agreed to consume those foods out of my sight for as long as necessary, until I could see them—and especially, watch someone else eating them—without craving them.

I’m blessed to have a very loving and supportive spouse, who was as invested in my success as I was. Many other people may have additional challenges, such as an unsupportive partner or having the primary responsibility for feeding the entire household, especially if it includes picky eaters, young children, or other people with different dietary restrictions. So, if you’re considering starting a ketogenic diet, it’s important to give some thought to what is and isn’t likely to be doable within the limitations of your individual situation, and to develop an actionable plan for how to get your own food needs met.

It’s worth explaining to your family members how important it is to you to lose weight, give up sugar, lower your risk for developing a serious disease, or whatever other goals you have for starting keto, and ask the rest of the family participate in brainstorming ideas with you on what they can, and are willing, to do to help you succeed, including agreeing to changes in how their own food needs have been met until now. You might be able to negotiate making meal preparation a shared responsibility, for example.

Be prepared for the possibility, or even the likelihood, that some or all of the other members of your household may be unwilling to inconvenience themselves or adapt to changes in the status quo to support your weight loss efforts. By the same token, they also might surprise you with willingness to help you achieve a goal that matters to you so much. your goals. Either way, accepting full responsibility for your own food choices will be the most important determinant of your long-term success.

Explore Online Keto and Low Carb Diet Support Communities

Since I had decided not to tell anyone about my lifestyle change who didn’t need to know, at least at the beginning, I checked out various keto support groups on Facebook. During the next few months, I joined eight or 10 of them, most for only a short time, and eventually winnowed those down to a handful that I still participate in roughly a year later, even after having met and surpassed both my original and "stretch" goals for losing weight. Searching for "keto group" on Facebook will return a dizzying number of choices. I recommend looking at the ones that have been around for a while and have successfully grown their membership, which is one indication that a lot of people have found the community to be valuable.

Screenshot of Facebook search results for "keto groups"

If you’re active on Facebook and are considering joining one of the many keto groups and communities, I suggest you start by thinking about which types of support would be most helpful to you. Are you most interested in:

Learning more about this way of eating to help you decide whether to try it?
Asking for and offering encouragement and help and celebrating success milestones?
Being with other people who are just starting out, or with a mix of newbies and people who have been following a ketogenic diet for a while?
Getting meal planning or recipe ideas?

Being clear about what you hope to get by participating in one or more Facebook groups will make it easier to find ones that might meet your needs. Reading the rules or membership guidelines as well as the "About blurb for a group you’re considering can provide helpful insight into its culture as well as its focus. Plan to try out at least a few different groups, and don’t hesitate to leave any that turn out not to be a good fit for your needs.

Tip: Don’t assume that, just because a Facebook group is sponsored by a brand or other business, it will be less helpful and more self-serving than peer-run groups. When I began my keto journey 14 months ago, it really bothered me that the groups I found most helpful, informative, positive, engaging, and worthwhile were created or sponsored by companies and entrepreneurs whose primary business was to produce, sell, and/or promote keto-related products or services. My perspective has changed significantly since then.

I am grateful that the people and brands behind many of my favorite keto-related cookbooks, websites, blogs, and products have chosen to invest financial and other resources to build, grow, and nurture a vibrant community of people sharing a common interest, create a continuous flow of new, informative, fun, and helpful content and activities, and provide knowledgeable, active, and helpful admins and moderators to vet posts, ensure compliance with the community guidelines, respond to questions and comments in a timely manner, and troubleshoot customer service issues. For example, Maya Krampf, the author of one of my go-to cookbooks, The Wholesome Yum Easy Keto Cookbook: 100 Simple Low Carb Recipes, 10 Ingredients or Less, and whose Wholesome Yum website is chock-full of helpful information and reference resources, as well as great recipes and keto-friendly products she has developed (including her Besti line of sweeteners), sponsors two terrific and very active Facebook groups.

Screenshot of Keto Low Carb Support & Recipes - Wholesome Yum Facebook Group

Cleaning Out the Refrigerator, Freezer, Pantry, and Other Food Stashes

I systematically went through our kitchen cabinets, shelves, refrigerator/freezer, and pantry, the huge chest freezer in our garage, and anywhere else where there might be a snack, pack of gum, cough drops, hard candies, a chocolate bar, crackers, dried fruit, etc., including the pockets of my coats and jackets, my handbags, my bedside chest of drawers, the bottom drawer of my desk, and even the glove compartments and center consoles of both our cars. Then, my husband and I decided what should be done with each of those items to make sure they would be out of both my sight and my reach before my keto start date.

Preparing to Succeed on the Keto Diet, Part Two by Margaret Schindel

Posts About My Keto Diet Journey

My First Year on The Keto Diet

Preparing to Succeed on the Keto Diet, Part One

Preparing to Succeed on the Keto Diet, Part Two

Low Carb Muffins & Cupcakes: Treats to Enjoy on a Keto Diet

Low Carb Keto Chocolate Yogurt Granola Chip Pudding Recipe

Good Dee’s Keto Cookie Low Carb Baking Mix Review

Hamama Microgreens Growing Kit Review & Success Tips

My Favorite Hamama Microgreens Seed Quilt Accessories

Keto Cheddar Cheese Biscuits With Chives Recipe

The Ultimate Keto Hot Chocolate Recipe

The Best Low Carb Keto Gift Ideas: Keto Gift Guide

The Best Low Carb Keto Cinnamon Muffins

Wholesome Yum Keto Bread Mix and Yeast Bread Recipe

The Good Chocolate 100% Organic No Sugar Dark Chocolate Review

The Best Advice to Maintain Your Keto Diet Weight Loss

My New Irresistibly Delicious Keto Cheese Crackers Recipe

Luscious Low Carb Keto Triple Peppermint Cheesecake Brownies Recipe

Quick & Easy Livlo Blueberry Scones Keto Baking Mix Review

Snack Better With The Best Healthy Keto Cookie Dough Bites

The Best Quick and Easy Low Carb Keto Pizza Recipe

The Best Quick and Easy Low Carb Keto Shortcake Cupcakes Recipe

Comparing the Best Keto-Friendly Chocolate Hazelnut Spreads - No Added Sugars

The Best Low Carb Keto Sandwich and Burger Buns Mix

Blueberry Biscuit Scones — New, Easy, Low Carb Keto Recipe

The Best Keto Pizza Crust Mix With 0 Net Carbs

An Unusual, Delicious Strawberry Chocolate Tea With 0 Calories

Delicious Sugar-Free Keto Cookies That OREO Fans Will Love

Healthy Pistachio Cherry Chocolate Chip Marshmallow Cereal Treats Recipe

Easy, Decadent, High Protein, Sugar-Free Rocky Road Cottage Cheese Ice Cream

The Best Quick & Easy Low Carb Sausage and Ricotta Calzones

How to Make Refreshing Vanilla Italian Soda (With or Without Cream)

Reviews of the Keto Diet by Barbara C. (aka Brite-Ideas)

My Personal Keto Testimonial

How I Stayed Committed to the Ketogenic Way of Eating

Wednesday, July 15, 2020

Preparing to Succeed on the Keto Diet, Part One

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!)

Set Yourself Up for Ketogenic Diet Success

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 vary.

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)

"The Ketogenic Diet: A Detailed Beginner's Guide to Keto" (Healthline)

"What Is the History and Evolution of the Keto Diet?" (American Fitness Professionals Association aka AFPA)

Recommended Books

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

I also own two wonderful cookbooks by well known, highly respected keto diet author and expert Maria Emmerich and look forward to adding this book, which she co-wrote with her husband, to my growing collection:

"Keto: The Complete Guide to Success on The Ketogenic Diet, including Simplified Science and No-cook Meal Plans" by Maria Emmerich and Craig Emmerich

My Favorite Keto Related YouTube Channels

Ruled.me

Dr. Eric Berg

Thomas DeLauer

Ken D. Berry, MD

Dr. Josh Axe

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"
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 and allulose grams from the total carbohydrate grams.

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 About My Keto Diet Journey

My First Year on The Keto Diet

Preparing to Succeed on the Keto Diet, Part One

Preparing to Succeed on the Keto Diet, Part Two

Low Carb Muffins & Cupcakes: Treats to Enjoy on a Keto Diet

Low Carb Keto Chocolate Yogurt Granola Chip Pudding Recipe

Good Dee’s Keto Cookie Low Carb Baking Mix Review

Hamama Microgreens Growing Kit Review & Success Tips

My Favorite Hamama Microgreens Seed Quilt Accessories

Keto Cheddar Cheese Biscuits With Chives Recipe

The Ultimate Keto Hot Chocolate Recipe

The Best Low Carb Keto Gift Ideas: Keto Gift Guide

The Best Low Carb Keto Cinnamon Muffins

Wholesome Yum Keto Bread Mix and Yeast Bread Recipe

The Good Chocolate 100% Organic No Sugar Dark Chocolate Review

The Best Advice to Maintain Your Keto Diet Weight Loss

My New Irresistibly Delicious Keto Cheese Crackers Recipe

Luscious Low Carb Keto Triple Peppermint Cheesecake Brownies Recipe

Quick & Easy Livlo Blueberry Scones Keto Baking Mix Review

Snack Better With The Best Healthy Keto Cookie Dough Bites

The Best Quick and Easy Low Carb Keto Pizza Recipe

The Best Quick and Easy Low Carb Keto Shortcake Cupcakes Recipe

Comparing the Best Keto-Friendly Chocolate Hazelnut Spreads - No Added Sugars

The Best Low Carb Keto Sandwich and Burger Buns Mix

Blueberry Biscuit Scones — New, Easy, Low Carb Keto Recipe

The Best Keto Pizza Crust Mix With 0 Net Carbs

An Unusual, Delicious Strawberry Chocolate Tea With 0 Calories

Delicious Sugar-Free Keto Cookies That OREO Fans Will Love

Healthy Pistachio Cherry Chocolate Chip Marshmallow Cereal Treats Recipe

Easy, Decadent, High Protein, Sugar-Free Rocky Road Cottage Cheese Ice Cream

The Best Quick & Easy Low Carb Sausage and Ricotta Calzones

How to Make Refreshing Vanilla Italian Soda (With or Without Cream)

Reviews of the Keto Diet by Barbara C. (aka Brite-Ideas)

My Personal Keto Testimonial
How I Stayed Committed to the Ketogenic Way of Eating

Thursday, June 4, 2020

My First Year on the Keto Diet

When I began my keto journey on May 25, 2019, I could never have imagined how profoundly the ketogenic diet would transform my health and day-to-day life.

How Adopting a Keto Lifestyle Gave Me a New Lease on Life

Introducing My New Keto Review Series (By Popular Demand)

During the past 12 months, I've occasionally shared photos, progress updates, milestones, or musings about my new and evolving low carb lifestyle with family members, friends, and colleagues. I have been surprised and touched by the outpouring of encouragement, support, recognition and interest they have expressed regarding my ongoing keto journey

I have also received, and continue to get, numerous requests to share my advice, insights and tips for learning about, getting started with, and losing weight by following a ketogenic diet.

Last week, I celebrated my first “keto-versary,” and it seems a fitting time to launch my new series of posts in response to those requests. This first post is mostly designed to provide some context about how and why I made the commitment to completely change the way I eat for the foreseeable future. Future posts will get into more detail about the what, why and how of my experiences to day on the ketogenic diet.

What a Difference a Year Makes!

When I began this journey last May, I was an extremely sedentary, obese, 65-year-old, life-long carbohydrate junkie with the world's biggest sweet tooth.

Me 60 pounds overweight in May 2019, just before starting my keto weight loss diet

I had less and less energy or enthusiasm for the activities, places and experiences that used to bring me joy. I had gained around 60 pounds in the 20 years since my wedding, and every time I looked in the mirror, all I could focus on seemed to be my disappearing waistline, softening jawline, and growing double chin.

When I walked for more than a couple of blocks, my feet became painfully swollen. The chronic lower back pain I had lived with since my early 20s was now joined by chronic joint pain in my right hip, knees and shoulders, and my doctors were increasingly concerned about my high blood pressure and elevated cholesterol level.

Now, one year later, I and am one year later, looking so much better, being so much healthier, and feeling more alive than I have in a very long time.

Switching From a Low Fat, High Carbohydrate Diet to a Keto Diet Has Improved My Appearance, Health, and Quality of Life

My husband and me, Christmas 2020, after losing weight on a keto diet

The benefits I've experienced, thanks to my commitment to embrace this radically different approach to eating, have been nothing short of amazing.

When I look in the mirror, I see "the real me" again.

I have lost 56 pounds (to date).

I am leaner than I would have been if I had lost the same amount of weight on a higher-carb diet.

One of the key goals of the keto approach is becoming "fat-adapted," a metabolic adjustment that, among other things, makes your body very efficient at converting fat into ketones and using them as its preferred source of fuel (i.e., energy), and no longer defaulting to converting carbohydrates into glucose for quick access to fuel. (The article "What Does It Mean to Be Fat-Adapted" does a nice job of explaining this process and its significance in greater detail, in a way that's easy to understand.)

When someone becomes fat-adapted, the body uses more of the dietary fat they consume for short-term fuel, and there is less left over to be stored long-term as adipose tissue (i.e., body fat).

I have gone from wearing size 16-18 clothing to size 8.

I'm able to fit into (again) the handful of special outfits I've kept (for sentimental reasons) that date back to my 20s and early 30s, when I lived in New York City and work in retail fashion. Seeing myself wearing them again felt a bit surreal. Fortunately, my taste in clothing favors classic styles and fabrics. No one would guess they weren't new!

My hips are proportionally slimmer, so I no longer need go up a size when buying pants or slim skirts.

I'm able to wear leggings and a T-shirt out in public without feeling embarrassed.

Although I have always been fortunate to look significantly younger than my chronological age, several people have commented recently that I look significantly younger than I did a year ago.

I'm healthier, happier, and virtually pain-free.

I no longer have high blood pressure.

For the first time in my life, I’m actually looking forward to having a routine physical exam and getting my blood work done, so I can quantify other improvements in my health, such as lower cholesterol levels.

My chronic lower back, hip, knee and hip pain are gone, and my feet no longer become swollen and painful are a few short minutes of standing or walking.

This has begun to expand my horizons significantly, and allowed me to start being less sedentary, which has been one of my goals for a number of years.

Two months ago , my husband surprised me with a pair of Segway Ninebot MiniPRO personal transporters that he had bought as our birthday gifts to each other this year. Now that the weather is finally becoming more spring-like here in New England, he and I have been having a blast riding them around our quiet and very pretty neighborhood for 20 to 25 minutes, two or three days a week. A year ago, my foot and knee pain would have prevented me from riding one for more than 3 or 4 minutes.

I feel wonderful!

I have much more energy and enthusiasm.

I am once again finding joy, satisfaction and inspiration in the beauty of nature and in creative pursuits, such as designing and making one-of-a-kind jewelry making and new skills and techniques.

I am filled with more optimism and gratitude than I have felt in decades.

I am feeling proud of this major accomplishment, and have a newfound confidence in my ability to fully commit to, and follow through on, making positive, sustainable behavioral and lifestyle changes if I'm not happy with the way things are.

The Medical Scare That Motivated Me to Get Serious About Losing Weight and Fat

Last April, shortly after celebrating my 65th birthday, I experienced abnormal vaginal bleeding, the primary symptom of endometrial cancer. My doctors found several uterine polyps that my OB-GYN would need to remove surgically, in an operating room. After the operation, the polyps would be sent out for biopsy so she could determine whether they were benign, precancerous or cancerous.

After asking a lot of questions and doing a lot of follow-up research online, I learned that I had several of the known risk factors for uterine cancer. I was over 50, had never been pregnant, was clinically obese, and had high blood pressure. My husband and I were terrified (especially since his older brother had passed away in his early 50s from colon cancer, which his primary care doctor had failed to diagnose correctly until my brother-in-law was in the late stages of the disease).

Although I couldn’t do anything about the first two risk factors, my obesity and elevated blood pressure were within my control. I got serious about developing the habit of practicing meditation daily and committed myself to lose weight and, more importantly, body fat as quickly as possible, since fat tissues tend to produce excess estrogen, especially after menopause, increasing the risk of endometrial cancer for older, overweight women.

Challenging My Outdated Preconceptions and Misinformed Prejudice Against Keto

I’m old enough to have been around when Dr. Atkins launched The Atkins Diet. At the time, the program focused primarily on rapid weight loss rather than health. It promoted excessive consumption of red meat, including bacon cured with nitrates and other heavily processed foods, which caused kidney damage in many of the diet's early adopters. Vegetables were not emphasized in the early days, and the diet was so restrictive that it was unsustainable. Most people who followed it lost weight rapidly but also gained it back – and more. That had been my first – and only – introduction to a diet grounded in achieving and maintaining ketosis, and the original version of The Atkins Diet was met with universally critical reviews and warnings from medical and nutrition experts.

When a couple of our family members decided to start following keto a few years ago, I was very concerned for their health and was extremely surprised when they not only lost a substantial amount of weight, but also lowered their blood pressure and bad cholesterol. After a bit of online research, I found out that although the Atkins Diet shares some similarities, it is by no means the same as the actual ketogenic diet, an eating strategy originally developed in the early 20th Century as a treatment for epilepsy that, more recently, has emerged as a potential treatment for autism spectrum disorder.

Even so, I likely never would have considered trying the keto diet myself if I hadn’t discovered that that my excess fat had put me at significant risk for endometrial or uterine cancer, and been scared and desperate enough to look at all my options for getting rid of that dangerous blubber fast.

Rethinking the Conventional Wisdom Around Healthy Approaches to Weight Loss

My previous efforts at eating healthier and losing weight had been shaped by doctors’, nurses’ and nutritionists’ typical advice to eat a diet low in fat and high in nutritious complex carbohydrates, including whole, fresh fruits and vegetables and whole grains, and consume significantly fewer calories than you burn. It wasn’t until I had been eating keto for several months that I understood that my mostly low-fat, high-carb diet was contributing to my weight gain, joint pain and high blood pressure, among other problems.

Even after hearing my friends talk about the improvements to their health after following a keto diet for an extended period, I was still skeptical. Wishful thinking can have a powerful placebo effect.

But after my conversations with my doctors about my elevated risk for endometrial or uterine cancer, my friends’ reports made me cautiously optimistic. But after reading, watching, and listening to reliable sources discussing the potential benefits and risks of following a ketogenic diet for certain individuals, but not for everyone, and supporting their claims and perspectives with scientific explanations and credible proof points, I finally decided that committing to this approach for 4–6 months might well be my best shot at getting rid of my dangerous, excess fat as quickly as possible.

At that point, I could decide on a more nutritionally balanced and varied diet to maintain that weight loss long-term.

It Wasn't Easy...

I understood in advance that easing into this radically different way of eating a little at a time wasn't an option for someone with a longstanding addiction to sugar and refined carbohydrates. It would also be self-sabotaging, since my goal was to become fat-adapted as quickly as possible, which meant starting the process of severely restricting my carbohydrate consumption over a sustained period of time on Day One.
The prospect of making a decisive, clean break from carbs was daunting, and preparing myself for this dramatic change—mentally, emotionally, environmentally and socially—was one of the keys to making that transition successfully.

The first few months were certainly challenging, as I knew they would be. There was a huge learning curve and a lot of contradictory information and passionate opinions about the "right" or "wrong" ways to follow the keto diet. I was confused by jargon like "macros" and "net carbs," didn't understand the concept of the three primary macros as targets, levers or limits, and had no idea how to calculate them initially or adjust them as I lost weight. (If all this sounds like a foreign language—or even advanced calculus—never fear. I'll explain them as simply and straightforwardly as I can in a future post in this series.)

Curbing my cravings for bread, rolls, pasta, cookies, cakes, and other favorite foods that were high in carbs or otherwise incompatible with my new keto lifestyle took time and effort. So did finding healthy, low-carb, keto-friendly alternatives for some of my favorite baked goods that also tasted good, and safe, healthier, low-carb alternatives to artificial sweeteners like Splenda (sucralose) and Equal (aspartame) that didn't leave a bad aftertaste or cause gastric distress. (I had used these sweeteners for decades, unaware of their potential effects on insulin levels, blood sugar levels, cholesterol, triglycerides, and blood pressure, among other things.)

But It Was Absolutely Worth It.

Making a commitment to following a ketogenic diet turned out to be one of the best decisions of my life. The dramatic, positive improvements to my health, happiness and overall sense of well-being have been been so profound that for me, keto has become a long-term lifestyle choice, rather than a diet.

Paying It Forward

Although the initial impetus for starting this new series was the ongoing requests for me to write in greater detail about my experiences to date on the ketogenic diet, I also wanted to express my gratitude to the friends who inspired and encouraged me to join them on this journey of transformation by paying it forward.

One of the people who ultimately inspired me to take the plunge, and who continues to be my biggest cheerleader, is my very dear friend and fellow Review This Reviews contributor Barbara C. (aka Brite-Ideas). Barbara's keto journey began on May 4, 2019, three weeks before mine. As of her one-year keto anniversary four weeks ago, she had lost approximately 60 pounds, virtually eliminated the formerly frequent, extremely painful flare-ups triggered by Rheumatoid Arthritis, and won her "mind-over-body battle" to remain committed to the ketogenic way of eating.

I highly recommend Barbara's first annual review of her weight loss progress on keto as well as her personal keto testimonial from two months earlier to anyone who is interested in reading an inspiring weight loss success story.

Your Mileage May Vary

This new series of posts about my keto diet and healthy lifestyle journey will reflect my personal experience, which has been extremely positive. It is not necessarily typical or indicative of how this dietary approach will work for, or affect, anyone else.

Similarly, I will be sharing some of the strategies and techniques that have helped me lose a significant amount of weight and remain committed to a healthy, low-carb approach to eating for the long term. It is my hope that others may find this information helpful. It is being offered with the caveat that what has worked well for me may not necessarily work well for someone else.

Anything I write in this or future posts is not intended, nor should it be construed, as a substitute for medical advice or medical treatment or an attempt to persuade other individuals to follow a low carb or ketogenic lifestyle.

I disclaim any and all liability of any kind with respect to any act or omission, wholly or in part, in reliance on anything contained in this and future posts about the keto diet.

I have neither medical or nutritional education, training, professional experience, credentials or other qualifications to offer advice or opinions regarding the safety or advisability of following a ketogenic diet for any individual. You should consult with a healthcare professional before starting any diet, exercise or supplementation program, before taking any medication, or if you have or suspect you might have a health problem.