Six-Month Update: My Very-Low-Carb Ketogenic Diet
Well, after consistently consuming 30-45 grams of net carbs a day for six months, I have only positive things to say about my very-low-carb experience. Not only are my blood sugar readings exactly where they should be — less than 90 fasting and less than 130 an hour after eating — but I truly feel healthier, less stressed, and more balanced than ever. I’m hypothyroid, and although my T3 has declined in response to lower carb intake, I feel more energetic and not at all “hypo.” Is it the stabilization of blood glucose or being in a mildly ketogenic state that’s responsible for my renewed sense of well being? Perhaps a bit of both. There’s some interesting research supporting the beneficial effects of ketones on brain health, including depression.
I’ve mentioned several times that the reason I began following a VLCKD in the first place was strictly for blood sugar control. I didn’t want or need to lose any weight, and as a diabetes educator, I wanted to try it out to see if I could get my own numbers under control this way. Limiting my carbs to less than 45 grams a day has been surprisingly easy. My diet consists of plenty of fat from avocados, nuts and nut butters, olive oil, cheese, butter, cream, and coconut oil; moderate amounts of fish, chicken, beef, Greek yogurt, and eggs; and at least one serving of nonstarchy vegetables at every meal and a small serving of berries at breakfast. It’s truly a rich, satisfying, and luxurious way to eat. Although I’ve questioned the validity of a low-carb metabolic advantage in the past, I’ll admit that I’ve recently lost a couple of pounds while eating 200-300 more calories daily than before. While I still think calories count, I won’t dispute the fact that some people — although not all — can consume additional calories and lose weight at very low carbohydrate intakes. After many years of restricting calories, I just didn’t think I’d be one of them.
While doing research for my ADA low-carb article, I read many studies on carb restriction for diabetes and weight management, but I didn’t consider the beneficial effects of ketosis. At the time, I was still consuming close to 100 net grams of carbs a day and wasn’t ready to try anything as extreme as a ketogenic diet. But after having looked into the research on VLCKDs and experiencing their effects first hand, I’d like to see more obese and otherwise metabolically challenged people try them. Improved lipid profiles, slowing down of the aging process, and improvements in mood and cognition are just a few of the potential benefits attributed to ketogenic diets, along with weight loss and blood glucose control. In addition to the studies, I’ve read countless online accounts of how ketosis has changed people’s lives for the better. And I plan to continue eating this way indefinitely unless I develop problems, at which point I would make adjustments as needed. That’s how I got here in the first place, after all.
Now, as enthusiastic as I am about VLCKDs, do I realistically think that all dietitians, nurses, doctors, and other health professionals will come on board in the near future? Probably not, considering most of them think ketosis is unhealthy and that we need at least 130 grams (and preferably a lot more) of carbs at a minimum to support the needs of the central nervous system. But I am cautiously optimistic that the tide is starting to turn as practitioners begin to look at the research and listen to their patients’ accounts of success — or perhaps even test their own postprandial blood sugars. Carb restriction may not be appropriate in every case, but I defy anyone to objectively look at the evidence and deny how beneficial it’s been for so many, especially those who have struggled with weight and blood sugar issues for years.
References:
1. Murphy P, et al. The antidepressant properties of the ketogenic diet. Biol Psychiatry 2004 Dec 15;56(12):981-3
2.Dashti HM, et al. Beneficial effects of ketogenic diet in obese diabetic subjects. Mol Cell Biochem 2007;302:249-256
3. Dashti HM, et al. Long term effects of a ketogenic diet on obese patients. Exp Clin Cardiol 2004 Fall; 9(3): 200–205
4.Stafstrom CE, et al. The ketogenic diet as a treatment paradigm for neurological disorders. Front Pharmacol 2012;3:59
Disclaimer: The ideas espoused in this blog post are for general information only. Always consult with your physician prior to adopting a low-carbohydrate diet or making any other dietary changes.
This is fantastic. As a dietitian myself, I often feel my views are a little controversial!! However, you can’t ignore the research and the success of others in order to blindly follow “conventional” wisdom. Well done for taking your stand, I’m with you all the way!! 🙂
Thanks so much, Melanie! It’s always great hearing from other supportive dietitians. Love your blog, by the way! 🙂
I started my low carb, high fat n=1 experiment in Aug 2012 as well. I fully relate to what you have describe as of the last 1week I have been ultra low carb with less than 30grams per day and my postprandial glucose and triglycerides confirm high fat intake stabiles them in a healthy range. The problem in healthcare is we are human and as such are particular influenced in opinion by what we have personally seen and experienced. The problem is most have only experienced eating a high carb diet and never attempting a 6mts nutritional ketosis diet. It is a pity as the effects can be dramatic and how is a doc going to understand the clear brain less stress feeling if they haven’t tried it. That’s why I had to do it. This way of eating is so simple and sustainable I feel it is a forever eating plan.
Thanks for relating your own experience, Gary. You make some great points. Definitely a forever eating plan!
I am thrilled, Franziska, with your analysis and conclusions. I also agree with all of them. I now eat <15g/day btw of CHO and have all the same outcomes: blood glucose control, weight loss, improved BP, improved blood lipids (esp. lower TG and higher HDL). And most interestingly and least quantifiably, I have lots and lots of energy, I feel really great, and I eat very well indeed (and am virtually free of hunger, even when I sit down to eat a prepared meal. So, just two or three very small meals a day is all I eat. If my weight loss stalls, I just skip dinner, or lunch AND dinner for a day.
PS: How's your TSH. MIne presently averages around 2 and I'm trying to get it down to <1. Any ideas?
Great to hear from you, Dan! So glad you’re having such success with VLC. It’s amazing how hunger ceases to be a concern with this way of eating. Keep up the good work!
My TSH has increased a bit to about 1.9, so I’m near where you are, but my internist is monitoring it rather than increasing my Armour since I feel so well. Previously mine was a little too low (0.3), but I feel less hypo now. Interesting to say the least! Not sure how to get it down, but since you’re having such good results with weight, lipids, and energy, I wouldn’t worry too much about that lab unless it becomes really elevated. That’s my plan anyway 🙂
I’m curious if you’ve measured your levels of blood ketones, with one of the meters that are now available, to confirm that you are in ketosis?
Hi Terry,
No, I haven’t measured serum ketones. Just out of curiosity, I’ve used ketostix several times and have always had trace to small ketones. According to a fairly recent study, urinary ketone concentration reflects serum ketone concentration: http://www.ncbi.nlm.nih.gov/pubmed/15800565
My goal, though, is to normalize blood sugar, regardless of whether I’m technically in ketosis or not. I eat at ketogenic carbohydrate levels but don’t want to lose weight.
Actually seeing a low amount of ketones on the ketosticks is what you want. As you become keto-adapted, your body is using ketones more efficiently and therefore you will not expell them. THis is a good sign.
Nice to see someone else taking the “red pill”. Welcome aboard!
It gets even better when you realise can include animal fats again not just advacado. Time to enjoy some bacon, tallow, etc…
This is not a criticism but an observaton, whenever I have come across a dietician doing a ketogenic diet they still seem to avoid animal fats which is very sad because animal fats are possibly the best fats while in ketosis. Bacon, tallow, lard “Grandma’s pantry fats” are where its at!
Thanks so much, Danny!
I don’t eat pork, so bacon is out, but I do eat other fatty meats and their tallow. The majority of my saturated fat intake is from dairy. I have some butter, sour cream, full-fat ricotta cheese, and various other types of cheese every day, so I’m definitely getting enough animal fat. But yes, I agree that dietitians are conditioned to prefer monounsaturated fats 🙂
Nice blog, by the way! Congrats on your weight loss and excellent biomarkers!
I agree. All saturated fats are a little frightening to many, even those actively doing this lifestyle. My fats come from fatty meat, cream, butter, coconut oil. I try to eat a whole avocado daily. I ocasionally add flax and cod liver oil. I probably should have some today. I do not think I overdo fats at all. As a matter of fact I think I need to eat more.
That being siad, I would like to list my favorite fats. I eat coconut oil, bacon, cream, butter, lard. I don’t bother with olive oil. To be honest, I think it tastes gross.
I should have added cream, butter, and coconut oil to the fats I eat and will do so now. Other than pork for you and olive oil for me, I think our diets are very similar 🙂
Thank you so much for taking on the experiment yourself instead of reading and parroting research that is flawed. I have been doing VLCHF die for many years and I use it to regulate my health. I am pre-diabetic however you wouldn’t know it by my numbers.
Thanks so much for your comments, Mary! Glad you’ve had such stellar results with VLC. We need more long-term research on people like you in order to convince the ADA and AND that it should be the standard treatment for prediabetes!
When I was diagnosed with pre-diabetes I was sent to a diabetic class that taught the opposite of what I do.Plus, they didn’t encourage testing blood sugar regularly. I met a doctor who encouraged me to tes postprandially to see how I reacted to different low carb foods. I also began taking ALA and magnesium. I think there should be more education on the need for magnesium in diabetes control and prevention.
Franziska, Our diets are very similar. I used to eat a lot of olive oil because that was my husband’s preference. After we parted ways I stopped buying it. I began this lifestyle on Atkins. I was between phase 1 and phase 2 but never went beyond phase 2. Eventually I just went just under phase 2 at about 15 grams of carbs. I proressed even lower to almost zero carb. I know there is no such thing as true zero carbs but I am quite quite low.Not only am I very low carb/ketogenic now, I’ve included intermittent fasting, which I like very much.
Yes, very similar, although I definitely eat more carbs. Each person needs to see what works best and modify their way eating as needed to achieve good results in blood sugar, weight, and overall well-being. Magnesium supplementation is important for PWDs and would also benefit most people without diabetes as well.
I would like to add this for anyone interested in trying it. Those of us who do this on a regular basis do not see it as extreme at all.
Thanks, Mary. If you’d told me a few years ago that I’d be following a low-carb diet someday, I wouldn’t have believed it. Now I can’t imagine eating any other way 🙂
Congratulations! I wish more people would self-experiment before giving advice, and that more people with metabolic issues would experiment with ketosis.
Thanks so much, George! Thanks also for the comprehensive research on LCHF diets for liver health posted on your inspiring blog 🙂
I enjoyed reading about your experience and would lke to know more about your average daily meal plan. What did you eat for breakfast, lunch, dinner?
Thanks, Renate! My day-to-day intake varies, but typically it’s something like this:
Breakfast:
salmon or sardines, cucumbers, tomatoes, sea salt, olive oil, and vinegar OR eggs and kale cooked in coconut oil with sea salt
1/2 cup berries with sour cream
almond butter
green tea
chai rooibos tea with half-and-half
Lunch:
bell pepper, plain Greek yogurt, guacamole, olives
mixed nuts
water
Dinner: chicken, beef, or fish with vegetables grilled in olive oil OR Caprese salad (mozarella cheese, tomatoes, olive oil, basil)
chia seed pudding with almond butter
chai rooibos tea with half-and-half
I don’t really eat in between meals but I do drink water (often hot) throughout the day.
I started a very low carb/ketogenic diet at the end of May, and I could not be happier with the results across the board.
I started as a “two week experiment,” believing I’d never be able to sustain it, but the results were so immediate and clear that I’ve never looked back, and have no desire whatsoever to “cheat.”
I’ve had several minor medical issues disappear, and a couple of major ones. I started this because I suspected I was insulin resistant, I have a family history of diabetes, and I also wanted to lose weight. The weight loss has happened, which is great, but the biggest benefit has been something I did not expect: my migraines disappeared.
It is an uphill battle to “defend” how I eat. I am questioned and criticized frequently. The whole experience has been very educational because it flies in the face of all the typical nutritional recommendations out there, and yet, I’m the healthiest I’ve been in years.
Interestingly, my doctor recommended I cut carbs a couple of years ago, but at the time, I was not willing to do so. She has been delighted by my results, as have I.
Thanks so much for sharing your story and excellent results, hilinda! It’s wonderful to hear about the many benefits you’ve encountered with low-carb. Keep up the great work!
I have been Very Low Carb to the ketogenic level for 8 years!! This is a great way to live.
Phil
That’s fantastic, Phil! I’m certainly enjoying it.
I too started vlckd 6 months ago and I have never felt better. I am a personal trainer and train very hard every session, 6 days a week. Since eating this way, I have made improvement across all my training areas and feel amazing!
Congrats on your success, Jo! Amazing how energized many people feel with a VLC way of eating.
I am eagerly following the comments on this blog and am reading other sources to learn more about very low carb dieting. For years I have tried to convince the dieticians and physicians who advised me that I cannot (successfully) follow a daily 135 gram carb diet and control glucose levels. Since I am not a nutritionist, I am finding it difficult to plan meals that are nutritionally sound — providing the proteins, fats, vitamins, minerals, etc. I would prefer not to take vitamin supplements. Could (would) you please provide a sample food plan (possibly for a week) and explain why you would choose the individual foods. Additionally, I wonder if adding more fat to the diet is appropriate for individuals with diabetes, hypertension and heart disease. Lastly, are you aware of workshops or conferences that offer more information on very low carb diets? I look forward to your response.
Hello Renate,
Thanks for your feedback. Unfortunately, having a full-time hospital job and other obligations do not allow me the time to create a week’s worth of menus. One of my recent blog posts “Response to How Low (Carb) Should You Go?” does have one day’s worth of sample meals (about 100 grams total carb, 80 grams net/digestbile carbs).
Here are a couple of low-carb books that have balanced, nutritious weekly meal plans (there are links to both in my “Recommended Reading” archive, “Best Books I read in 2011”):
1. The Art and Science of Low Carb Living by Dr. Steve Phinney and Dr. Jeff Volek (30-50 grams of carbs per day)
2. Diabetes Solution by Dr. Richard K. Bernstein (30 grams of carbs per day)
I feel getting a good amount of nonstarchy vegetables at each meal is optimal, but it’s best to choose the ones you like. Meal planning should be highly individualized.
I think consuming a high fat diet is good so long as you are also restricting carbohydrates. Choose a variety of fats but stay away from trans fats and excessive vegetable oils other than olive oil.
I’m not aware of any low-carb workshops or conferences at this time but will keep my eyes and ears open for future events.
Good luck to you!
Here is another health summit on the paleo lifestyle.
http://paleofoodcoach.com/2013/
There are several low carb based workshops. There is a paleo workshop that I believe is going on now in Texas. There is a low carb cruise that always hosts some of the most popular low carb doctors, physical trainers etc. It will happen in May. I used to have a low carb display/support meeting at a Whole Foods Market. There are Weston A. Price groups in my area. Renate, I would wager there is a Weton Price group near you.
Thanks, Mary. I didn’t mention these because with the exception of the Low Carb Cruise, these events are Paleo/Primal, which can involve carb restriction, although not always. WAPF is a wonderful whole foods organization but not really low carb.
Just thought of a low-carb “seminar” of sorts: Dr. Bernstein’s monthly teleseminar which can be accessed for free from home. Next one up is this Wednesday, March 27:
http://www.askdrbernstein.net/
Hi, I have to keep in mind that I have been doing low carb for many many years and some people have a hard time deciding what is low carb and what isn’t. I became committed to low carb through the Weston A. Price Foundation due to it’s support of traditional diets that are naturally geard towards low carb and high fats, as you will see on the link posted. WAP researched and support these diets which are a hunter-gatherer concept similar to the paleo diet. Paleo does not HAVE to be low carb but even the higher carb paleo diets are low carb compared to many of the standard Western Diet. Plus you can make paleo as naturally ketogenic as you want. I graduated to the ketogenic aleo diet as I became increaingly comfortable living on fewer carbs and more fats. I also consume a high amount of vegetables. Also, I eat n more than twice a day but I usually eat once a day. I rarely have more than 2 items on my plate, a meat/chicken/fisdh protein and or a vegetable or fruit such as kale and/or avocado. Today, I will have pork chops, collard greens and mashed cauliflower. I cook my veggies in a rich bone broth that is full of minerals. Here is the article on how native americans thrived on a similar diet. It is also the article from WAPF that solidified my beliefs in the low carb way of life.http://www.westonaprice.org/traditional-diets/guts-and-grease
I hope it is helpful. If you can get to a WAPF conferance, there is much to be learned and it will be very helpful in the fight abainst diabetes.
Here is information on the low carb cruise
http://www.lowcarbcruiseinfo.com/
Thanks so much for all the information and links, Mary. I’m a WAPF member and get the quarterly periodical, and I also have the Nourishing Traditions cookbook by Sally Fallon, but I’ve never attended a conference. Maybe someday! It’s always great hearing from someone like you who’s had such great long-term success with low carb 🙂
I too launched into the world of VLCD when menopause struck, the weight ballooned, and my fasting BG readings were getting over 100 (with no history whatsoever of diabetes in the family). After meals was well under 140, then under 120.
Turns out it’s the whole menopause thing! I learned a heck of a lot from a brain book about how to control hot flashes without succumbing to conventional wisdom and Pyramid-style eating.
I stick to an equivalent of the Atkins Induction diet, eat twice daily, get lots of Omega-3 and Vitamin E, and take chromium piccolinate before bed to help kill the sugar overnight.
Thanks for your comments, Wenchypoo! I’m 46 and perimenopausal, so I have no doubt that hormones were a contributing factor. I’ve not had any hot flashes yet but have heard that LC women experience them less frequently and with less intensity than with higher carb intake. One more benefit of low carb 🙂
According to Dr Larry McCleary, authur of “The Brain Trust Program” hot flashes causes are more similar to that of an epileptic seizure. It is this diet that has treated many epileptic children and adults to calm and even cure their seizures. Similar causes = similar treatment. Dr. McCleary is a neurologist. He also wrote the book “Feed Your Brain Lose Your Waist”. He is a very strong supporter of the ketogenic diet. I strongly encourage anyone interested in learning about many of the known limits and accomplishments of this diet by reading The Brain Trust Program.
Thanks so much, Mary! You always provide such a wealth of useful information 🙂 I will definitely purchase Dr. McCleary’s book.
Hi im so happy to finally find someone else that do this type of diet all the content that ive been reading here its amazing im from mexico and im a nutrisionist , im been doing this diet for one year orden nore and im very happy im a bodybuilder to rigor no im doing target patógenos diet and im reading máximo of carbs of 100 gramos, im very happy stronger i lío leaner and im trying for my patience try to do this lifestyle its very dificultades but i hope i can mad it 🙂
Thanks so much, Roberto! Glad you’re having success on low carb. Stay focused on all you’ve achieved and hang in there! Best of luck 🙂
While I enjoy what you have written here I am not happy to see they use of net carbs nor that 30-40g of carbs a day is referred to as VLCHF.
I have been VLCHF for 4 years and low carb for 8. By that I mean 15g or less carbs per day.
Of the over 6000 people in two Facebook groups concerning ketogenic diet for diabetics I have yet to find net carbs works. There are too many variables in peoples reaction to carbs so we advocate sticking to counting carbs period.
Also of all these people who struggle with a keto diet lowering their numbers every single time it comes down to less then 15g of carbs per day and then they really see results. Now yes some folks can stray as high as you but they usually struggle with control. For those who continue to have issues at less then 15 per day the next step is 10 per day AND lower protein intake. Next to glucose this is the second most important contributor to BG spikes.
Now the bad news from this way of eating. After everything is all and good and many people will see their diabetes reversed even but over time fasting BG readings creep up. Turns out we become physiological insulin resistance. It is theorized this has something to do with when our ancestors would have to go several days between kills. LOL
Thanks for your comments, Jeff, but I respectfully disagree.
This is such a helpful post to me. I will be gradually lowering my carb grams as time goes on. I am enjoying this journey! The constant hunger I’ve felt my whole life? GONE! And I’m losing weight on delicious food. This website is a blessing.
Thanks so much for the great feedback, Sheryl! Best of luck going forward.