KCP011: Keto Accountability Show Notes

After listening to episode 10 “The Carbohydrate Withdrawal” podcast, I noticed a few errors which need correcting. First, I mentionedthat the recommended amount of potassium per day was 3 to 4,000 mg per day. According to the National Institute of Health (NIH), the actual recommended amount of potassium required each day for an adult is about 4,700 mg per day. Second, The Diet Doctor website states that most people can safely supplement their diet with up to 1000mg of potassium per day (about 13meq). I apologize for any confusion or inconvenience this may have caused.

Terms In This Episode (01:46)

Accountability – As individuals we are accountable for not only our successes, but also for our failures. We cannot blame our lack of success on our partner or spouse, our physician, or our social or economic status. Only we can take responsibility for our own individual actions or lack of action. I realize that sometimes this is a bitter lesson to learn, to realize that we have created the situation that we are currently in. Just in case you wondering, the most common trait found amount unsuccessful people is lack of accountability.

That’s right unsuccessful people are always looking for ways or opportunities to get out of taking responsibility for their actions. They are always looking for a way to blame someone else for their problems. I will be honest with you, I have been there. For years, I refused to take accountability for my dietary choices. I blamed my diabetes on my genetics, after all many people including my maternal grandmother are diabetics. I would not take accountability for my own actions or disease process. For many years, I ate what I wanted and took no dietary advice regarding my diabetes. I was unaccountable. This lack of accountability put me in a metabolic crisis in which I had to start taking insulin as well as oral diabetic medications to control my blood sugar. And still, I remained unaccountable. It was not until these medications made me so sick that I had to go to the emergency room that I decided to take control of my life and finally become accountable for my actions. So why did I refuse to be accountable for my actions? Two words, which are the next two terms of today’s podcast: ignorance and or lack of knowledge.

Ignorance – Is simply a lack of knowledge, or a state of being unaware. You can be unaware of the specific facts regarding a situation or experience, that is to say you have no knowledge of the specific facts, this is known as factual ignorance. Or you may suffer from objectual ignorance because you are unaware of a specific object and or a procedure, this is known as objectual ignorance. And lastly there is technical ignorance which is the actual absence of knowledge of how to do something or perform a specific task.

Now, Ignorance has nothing to do with your social-economic or cultural status, it is simply a lack of knowledge. We are all ignorant of something, that is to say we cannot known how to do all things, and we are not always aware of all the facts, and we cannot perform every task that we wish. While it is often used as a derogatory term, ignorance is simply a lack of knowledge. Before listening to this podcast you may have been ignorant regarding nutrition and the advantages of the ketogenic lifestyle. But because you have the desire to learn more about this subject you have probably conducted some research about this lifestyle. Maybe you listen to both this any number of other podcasts regarding the ketogenic lifestyle. And over time, you have slowly become less ignorant regarding ketosis and the ketogenic way of living by not only acquiring a new skill set, but by acquiring more knowledge, and that is our next definition.

Knowledge – If ignorance is a lack of knowledge, or a state of being unaware, then knowledge is the opposite of ignorance right? Well, yes and no. Knowledge is an awareness, or understanding of the facts of a particular concept or skill which is acquired through experience and or education. Knowledge however is not all encompassing. That is to say, you may have the knowledge of how an artist paints a beautiful landscape, but you may not have the skill to do so. So while on one level you have the knowledge of the concept, you may not have the knowledge of how to perform the actual skill. So you can actually be both knowledgeable and ignorant regarding a specific topic. To put it in plain terms there are specific levels of knowledge, and some people are more knowledgeable than others when it comes to certain topics or skills. Keep in mind, that knowledge is not specific to ones educational level. A medical doctor may be able to diagnose your medical problems, but he may not have not the required knowledge regarding nutrition or physical fitness.

As human beings, to acquire knowledge we need to have the ability to communicate either by spoken or written word. We need to have the intelligence or the capacity to understand that which we read or hear, and we have to have the ability of active reasoning in order to determine if what we have read or heard is true or false. As you listen to this podcast, you have to use not your ability to understand what I am communicating to you, but also your powers of deductive reasoning to determine if the information I am providing you is not only factual, but reasonable. I hope that you do indeed find this information informative, practical, and reasonable, but only you can make that decision.

Main Topic (07:42)

I know I covered a lot of information in today’s terms on accountability, ignorance, and knowledge, but I want to dig a little deeper into those topics and explain how they are fundamental in helping you to find success throughout your ketogenic journey. The emphasis will of course will be on accountability.

Accepting accountability for your health and well being is the biggest step you will take towards being successful with this new lifestyle. By accepting accountability you are acknowledging that you and you alone are responsible for your health and well being. That does not mean that you become your own doctor, that would be both dangerous and foolish. What it does mean however is that you become an active member of your health care team. But what does that mean? Well, you become the researcher, the experimenter, and the potential educational force behind your health care team. If you are lucky, your physician, physician assistant, nurse practitioner, or whoever is your primary medical adviser is will have some knowledge regarding the ketogenic lifestyle. However the likelihood of this happening is very small.

 

But lets be honest, your physician is busy. They have a ton of patients to see each day. We all know how long the wait is to the waiting room to see your doctor or NP only to spend about 10-15 minutes with them in the room. In addition, while yearly continuing education is a requirement of every medical doctor and nurse here in the United States, nutrition is one of those topics that is almost never covered. You may recall back in my introductory episode KCP000 that according to the National Institutes Of Health, medical students receive on average 23.9 hours of nutritional training during medical school. In addition, the Association Of American Medical Colleges, states that medical students receive about 700 contact hours of training per year during their four years of medical school which comes out to roughly 2,800 contact hours. That means that when your doctor was in medical school they spent less than 1% of their education on nutritional related topics.

 

My point here is that taking accountability of your health means you will need to do some of your own research into this way of living. The responsibility of teaching or presenting information to your doctor, nurse, diabetic educator, dietician or nutritionist is up to you. I understand that is a big responsibility, and you may wonder who are you to speak up and teach your medical provider anything? After all they have a degree in medicine, nursing, and or nutrition and you do not. Yes, that may be true, but you are an integral part of the medical care team. You have the right to refuse, question, and inquire about any procedures, medications or regimens that involve your health. You are in the drivers seat so to speak. Your medical adviser makes suggestions and recommendations, but ultimately you make the decision to follow that advice. You are accountable for your action or lack there of, not your physician. You must take an active role in your care if you want to be successful with this lifestyle. This includes educating your health care team regarding the benefits of the ketogenic way of living and how it can not only improve your health, but also the health of others that your medical team may be treating.

If your medical team is unaware of the ketogenic diet, then you need to provide them with information so that they can help you to make a safe and informed plan of care. That dosen’t mean that you arrive at your next doctor’s appointment with a 3-inch thick three ring binder crammed with information regarding the ketogenic lifestyle and expect them to read it because they will not. They simply do not have the time and or the inclination. Rather pick one or two relevant medical studies that you can bring with you. Studies that follow good clinical research protocols such as the studies at the end of the show notes.

 

Remember you need to be courteous and tactful, you are dealing not only with a medical professional, but a person. Being thoughtful in your approach will increase your changes of having a meaningful and effective dialogue with your healthcare team. If you go in there guns blazing demanding or telling them they need to read this new research on the ketogenic diet, their natural response will be to take a defensive posture and refuse. If this happens, then no one benefits, neither you, the physician, or any other patients that they may be treating that may be suffering from diabetes, metabolic syndrome, or cardiovascular disease.

By educating your health care team you are not only helping yourself, but the impact of sharing your knowledge with them may help them to better serve their other patients. Just think, you could be actively responsible for saving not only your own life, but that of countless others. And that my friends is an awesome feeling. If you are fortunate, then your primary care physician or specialist will be open to learning about this way of living. But lets be honest, not every doctor or health care provider will be interested. If they are not open to suggestion or do not wish to learn about this way of living, then you need to find a new physician or health care provider that is willing to listen to your input regarding your health care needs. Remember, your physician or nurse practitioner works for you. You pay their salary each time you visit their office. If they are unwilling to listen to your concerns about your diabetes, your symptoms of metabolic syndrome and cardiovascular disease, or they simply want to prescribe you more medications, then you need to find another doctor that will listen to your concerns and work with you towards helping you meet your ketogenic goals.

If you need to find a new doctor, then do so, but until then you need to be under the care of a physician or medical provider when you embrace this lifestyle. Do not make any changes to your diet or medications without consulting your doctor. To attempt this way of living without proper medial guidance can be dangerous and lead to serious harm if you do not have someone who can help you monitor and make adjustments to your medications as you travel down this path. Remember only you are accountable for your actions or lack there of. While you need to be accountable for your actions, you do not need to travel this path alone. I am here for you, if you have any questions regarding this way of living don’t forget you can drop me a line at todd@ketoconfidential.net.

Thomas Gray wrote “where ignorance is bliss, Tis folly to be wise.” This last line in his poem ‘Ode On A Distant Prospect To Eton College’ is often misinterpreted to mean that being in a state of ignorance is blissful or preferred. That a person who is unaware of the facts or situation regarding his circumstances is somehow happier or more content that someone who has all the facts. In theory, if you are ignorant or unaware of the dangers that surround you, then I guess in some perverted way of thinking, you would be in a state of metaphorical bliss. But, ignorance will not reverse your diabetes. Ignorance will not reduce your symptoms of metabolic syndrome. And ignorance will not reduce your waistline. When it comes to your health, ignorance is not bliss, it is simply a recipe for disaster.

Please keep in mind that when I talk about ignorance, I am not talking about someone’s lack of intelligence, but simply their lack of the facts of the situation. Two years into this ketogenic way of living and I am still ignorant when it comes to many aspects of exactly how and why the ketogenic diet works the way it does, but I am learning more each day. By continuing to practice this lifestyle everyday I acquire more information and knowledge, thereby reducing my ignorance. And as I gain more knowledge about ketosis, and the ketogenic way of living I become more empowered. And when you become more empowered you are able to make substantial changes that can impact and improve your life dramatically.

To borrow a phrase from Emeril Lagasse “it ain’t rocket science”. That is to say, you do not need to be a rocket scientist to figure out how and why the ketogenic diet works. In fact, really all you need to know is that it does work, that it will reverse your diabetes, that it will decrease your symptoms of metabolic syndrome and cardiovascular disease, and that it will help you lose weight. But that kind of gets back to our “ignorance is bliss” quotation. Do you really need to know how ketosis works to be successful with this lifestyle? Maybe not, but by having more knowledge about how the diet works, and how it affects your body and your disease process you can tweak the diet to fit your individual needs.

Despite what many people believe, the ketogenic diet is not a one size fits all diet. It never has been and it never will be. While we all share the same genome, we are all individuals. And if we are all individuals, then we need to make small minute adjustments to our way of eating in order to maximize the benefits of the ketogenic diet. The only way we can do this is by increasing our knowledge of ketosis and the ketogenic diet. Thomas Jefferson has this to say about the politicians of his time “they do not generally possess information enough to perceive the important truths, that knowledge is power, that knowledge is safety, and that knowledge is happiness.”

Yes, knowledge is power. Having the knowledge about the benefits of the ketogenic diet will give you the confidence to make the necessary changes to your diet. Having the knowledge will allow you to take control and safely make changes to your lifestyle. To become an active member of your healthcare team. To actively reverse your type two diabetes. To reduce your symptoms of metabolic syndrome or cardiovascular disease. To reduce your waistline. And to become an advocate and educator so that your new found knowledge may help and or change another persons life.

In many ways this episode of the podcast has been more on the motivational than scientific. But in order to be successful with this lifestyle, I believe it is important that you are motivated and that you…Say it with me “ take accountability.” We all need to reduce our keto ignorance by increasing our knowledge regarding this lifestyle. I encourage you to actively fact check your sources. Do not believe everything you read on the internet or hear in a podcast, about the ketogenic lifestyle even this one. Check my facts, if I have made a mistake, then let me know, by sending me a email at todd@ketoconfidential.net. Like you I am only human and as human beings we often make mistakes, but the important part is that we take accountability for both our success and our failures. And that we use these success or failures as learning tool. We all need to reduce our keto ignorance by actively increasing our knowledge regarding this lifestyle. At the end of the day, you need to take accountability for your actions or your lack there of if you want to successfully reverse your type 2 diabetes, decrease your symptoms of metabolic syndrome and cardiovascular disease, and reduce your waistline.

During this week of Thanksgiving, I would like to thank all of you for listening to this podcast. I hope that you have, or will find this lifestyle exciting and enjoyable as I have. I would like to give thanks to my wonderful wife and keto buddy who has been my biggest supporter and confidant during this journey. I am also thankful that we live in a country in which we have free speech so that I can present this life changing information with you without fear of retribution so that you too can improve your life. And with that I would like to leave you with one final thought on this week of Thanksgiving. Jefferson wrote: “We hold these truths to be sacred & undeniable; that all men are created equal & independent, that from that equal creation they derive rights inherent & inalienable, among which are the preservation of life, & liberty, & the pursuit of happiness;

You’ve Got Mail (22:35)

If you have any feedback regarding anything you have heard in this or other episodes of the keto confidential podcast, or you just want to drop us a line with a question or two, or you just want to share your success story with us, you can send me an email at todd@ketoconfidential.net. Soon, I will be adding a Google voice number to our website so that you can call in and leave an audio voice message that will be incorporated into the podcast, so stay tuned for further information regarding this new feature.

Recipe Of The Episode (25:14):

For the most part I am a carnivore, and before I started keto, all my favorite vegetables were the ones that contained all the starches so getting in my veggies was a problem. My solution was to start preparing and taking my own keto version of a chef salad to work each day for dinner. I generally do not eat salad at home, but it was definitely part of my work related eating plan and it still is to this day.

Most people think that a salad is a really healthy choice, so they take all the time and care to prepare a great looking salad and then cover it in a salad dressing that is full of carbohydrates in the form of sugars, and guess what? Your healthy salad is now a poor dietary choice. So in today’s podcast I am going to share with you my version of a great keto friendly chef salad. To make this salad you will need the follow ingredients:

1 ½ cups of chopped green leaf lettuce

½ cup fresh spinach roughly chopped

¼ cup cheddar cheese

2 slices of bacon chopped

1 boiled egg chopped

1 tablespoon Parmesan cheese

Salad Nutritional Information

210 calories, 13.2 grams of fat, 17.8 grams of protein, and 3.5 grams of carbohydrates.

Now, you can combine the ingredients however you like, but I put my cheeses together in a small square rubbermaid container. I then sit this container into a large square rubbermaid container and will the larger container with the salad greens. I separate the bacon and egg into two different zip lock bags and toss that on top of the salad greens and close the lid. You do not have to go to the trouble of separating all of the ingredients if you do not want to. But sometimes I get busy at work and do not get to eat my salad, thank goodness for fat adaption right? Anyway, by keeping the cheese, bacon, and egg separated until I am ready to eat the salad. If something happens and the lettuce gets old before I eat it, I haven’t wasted the other ingredients.

Looking good so far, but what good is a salad without a good dressing? Not a whole lot in my opinion. That’s why I will be adding an additional salad dressing recipe to each of the future episodes of this podcast. That is of course until I have covered just about every kind of salad dressing I can think of so that you will have a wide variety of keto dressing options. Today’s salad dressing recipe is one of my favorites, Thousand Island.

To make this dressing you will need:

¾ cup homemade LCHF mayonnaise or Hellman’s mayonnaise
¼ cup tomato sauce
2 tablespoons dill pickle relish

1 teaspoon apple cider vinegar

1 teaspoon pimentos, minced

3 drops of liquid sucralose (equal to 1 tablespoon teaspoon Splenda)

½ teaspoon salt

½ teaspoon onion powder

¼ teaspoon garlic powder

1/8 teaspoon paprika

1/8 teaspoon white or black pepper

Combine all the ingredients into a medium sized bowl and mix with a wire whisk until thoroughly combined. Then add the minced/mashed egg and mix again until thoroughly combined. Check the seasonings and adjust the salt, pepper, and sweetness to meet your individual tastes. Place the dressing in the fridge for 12 to 24 hours before serving. The dressing is good for 10 – 14 days depending on the ingredients that you used to make it. This recipe yields about 1 ¼ cups or 20 tablespoons. The nutritional value is as follows.

Total Recipe – 1,352 Calories, 142 grams of fat, 8.53 grams of protein , 10.7 grams of carbohydrates.

Per Tablespoon – 68 Calories, 7.1 grams of fat, 0.4 grams of protein , 0.53 grams of carbohydrates.

Just for comparison, one tablespoon of Kraft Thousand Island dressing contains 40 Calories, 3 grams of fat, 0 grams of protein, and 1.5 grams of carbohydrates. While 1.5 grams of carbohydrates dosen’t seem like much, keep in mind most people put about 3 to 4 tablespoons of dressing on their salad. Using the Kraft Thousand Island dressing would add 4.5 to 6 grams of carbs in the dressing alone. Using my recipe your salad dressing only contains 1.6 to 2.1 grams of carbohydrates. That’s 67% less carbohydrates. So as you can see making your own salad dressing is definitely work the small amount of time it takes to make.

Nutritional Information

Chef Salad (No Dressing)

210 calories, 13.2 grams of fat, 17.8 grams of protein, and 3.5 grams of carbohydrates.

Keto Thousand Island Dressing (1 Tablespoon)

68 Calories, 7.1 grams of fat, 0.4 grams of protein , 0.53 grams of carbohydrates.

Chef Salad (3 Tablespoons) Keto Thousand Island Dressing

414 calories, 34.5 grams of fat, 19 grams of protein, and 5.09 grams of carbohydrates.

The End (30:59):

Well guys, that’ it for this episode of the Keto Confidential podcast, if you have found this content useful, then please subscribe, and take a few seconds to rate this episode in iTunes, and write a quick review so that others may benefit from this information. More importantly, If you know someone that is struggling with obesity, metabolic syndrome, or type 2 diabetes, then please share this podcast with them so that together we can help them reverse their diabetes, and reduce their complications of metabolic syndrome and obesity. Once again, I would like to thank you for listening. So until next time, be safe, and stay keto strong my friends.

Links:

Keto Thousand Island Dressing

References and Studies:

Bhanpuri, et al, Cardiovascular Disease Risk Factor Responses To Type 2 Diabetes Care Model Including Nutritional Ketosis Induced By Sustained Carbohydrate Restriction At 1 Year: An Open Label, Non-randomized, Controlled Study. Cardiovascular Diabetology, 2018.

Halberg, Volek, Phinney, et. al, A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes. Diabetes Therapy, February 7, 2018.

McKenzie, et. al, Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study. Journal Of International Medical Research (JIMR Diabetes), 2017.

Phinney, Stephen M.D., Volek, Jeff, Ph.D. (2011). The Art And Science Of Low Carbohydrate Living. Beyond Obesity LLC.

Phinney, Stephen M.D., Volek, Jeff, Ph.D. (2011). The Art And Science Of Low Carbohydrate Performance. Beyond Obesity LLC.

Status Of Nutrition Education In Medical Schools, National Institute Of Health, American Journal of Clinical Nutrition, April 2006; p.83-84.

 

 

KCP010: Carbohydrate Withdrawal (A.k.a. Keto Flu) Show Notes

Correction: There are two corrections that I would like to make in the show notes that I did not notice until this podcast was already produced and released for publication: First, I mentioned that the recommended amount of potassium per day was 3,000 to 4,000 mg per day. According to the National Institute of Health, the actual recommended amount of potassium required each day for an adult is about 4,700 mg per day. Second, The Diet Doctor website states that most people can safely supplement their diet with up to 1000mg of potassium per day (about 13meq). These corrections have already been made to the show notes. I apologize for the inconvenience.

Terms In This Episode (0:35):

Addiction – Ia a chronic condition of “brain reward” in which a person is dependent or addicted to a particular substance. It is characterized by the inability to consistently abstain or control one’s cravings. While you can be addicted to any number of substances, for the purpose of this podcast we will be talking about carbohydrate addiction. As mentioned in an earlier episode, Gary Taubes in his book ‘The Case Against Sugar’ explains that carbohydrates and sugars stimulate the same pleasure centers of the brain that cocaine does. Thereby creating an addiction or need for more carbohydrates and sugars. While carbohydrates and sugars are in no way as destructive to your body as cocaine, they are still highly addictive substances. For most people this is not a problem. However, if you are a diabetic and or suffer from metabolic syndrome, then this addiction can cause you significant problems.

Withdrawal – Is the stopping or removal of a service or substance. In the context of the ketogenic lifestyle, withdrawal is the removal or severe restriction of dietary carbohydrates which leads us to our next definition.

Carbohydrate Withdrawal – Also known as the “Keto Flu” carbohydrate withdrawal is a series of symptoms similar to those felt by people who have contacted the flu virus. Because the symptoms of carbohydrate withdrawal mimic those of the flu, you may suffer from headaches, muscle aches and pains, chills, weakness, and irritability. While the symptoms are similar to those of the actual flu, it is important to note that you will not, or should not experience any fever.

 

Main Topic (2:38):

So you have been researching the keto lifestyle for some time now, and if you are like me, probably for to long. But you have finally decided to give it a try. The reasons why you chose this path are really not relevant at this point. Maybe your diabetic, suffer from metabolic syndrome, or morbid obesity. Maybe you just want to give up processed foods and sugars. There are a ton of different reasons to embrace this lifestyle, but the biggest hurdle to your journey is getting started. If you have not already listed to my previous episode KCP009 “Getting Started On Keto” then click on the hyperlink “Getting Started On Keto” to listen that episode.

So you have gathered your basic supplies and keto food stuffs and your excited about getting started. I know I was. And even though I had collected a massive amount of information about the ketogenic lifestyle, The one thing I somehow overlooked was the process of going though carbohydrate withdrawals. I am not sure if I was so focused on the benefits of this lifestyle that I did not see the forest for the trees so to speak, or if no one was simply talking about these symptoms. Nevertheless, like anyone who restricts dietary carbohydrates, I experienced these same withdrawal symptoms. For me personally the symptoms of carbohydrate withdrawal or keto flu lasted about 4 days. My wife on the other hand did not experience any symptoms of carbohydrate withdrawal. That brings us back to one of the main points that I have been making throughout this podcast. That is while we are all share the same human genome, we are individuals and our bodies each respond differently to specific foods, drugs, hormones, and stressors.

Personally, I experienced carbohydrate withdrawal symptoms for about about 4 days. I started my ketogenic journey on a Thursday night, by Saturday morning, I was experiencing all the symptoms of keto flu. Lethargy, muscle pain and aches, headaches, brain fog, and lack of energy. For me, these symptoms lasted until sometime Sunday afternoon. I remember this because I started my ketogenic journey on the weekend that I was off work, and by Saturday evening, I was really hoping that I would feel better before I had to return to work on Monday. Fortunately by Monday, I felt quite a bit better, but I was not feeling 100% until about Tuesday. My wife on the other hand, never seemed to have any symptoms of carbohydrate withdrawal. It is possible that I had these symptoms and she did not was that I used to eat a really heavy carbohydrate based diet. Probably more than 300 grams per day, and I restricted myself to 20 grams of less net carbs and continue to maintain this amount even two years later. My wife on the other hand, shot for a goal of 100 grams of net carbohydrates per day. So my carbohydrate restriction was five times greater than hers.

Did the severity of my carbohydrate restriction lead me to have these symptoms of carbohydrate withdrawal while she cruised through this transition without any effects? It’s possible. The thing is, while the majority of people will experience some of the symptoms of carbohydrate withdrawal, not everyone will. I believe there are two major factors that affect how your body reacts to the restriction of dietary carbohydrates. The first being, the amount of dietary carbohydrates you eat each day prior to starting this way of eating, and second, the severity of carbohydrate restriction you impose upon yourself.

If you are a carb-o-holic, and you consume a ton of carbohydrates each day, and you severely restrict your daily carb intake to 20 net grams of less a day. Then you are going to feel some of the effects of the “keto flu”. So there are two basic strategies that you can use to decrease the effects of carbohydrate withdrawal. The first is to start slowly and restrict your dietary carbohydrate intake to 50 – 100 grams of net carbs per day. The idea behind this strategy is, the less you restrict dietary carbs, the fewer and less severe the symptoms. The second strategy is to go what I call ‘full on keto’ and restrict your dietary carbs to less than 20 net grams per day. My personal recommendation is to go full on keto and restrict yourself to 20 grams of net carbs per day. Why? Because restricting yourself to only 50 – 100 net carbs per day does not guarantee that you will get into ketosis. It also dosen’t guarantee that you will not experience any symptoms of carbohydrate withdrawal or that they will be less severe. Remember, the choice is yours, but the sooner you get into ketosis, the sooner you will begin to reduce your symptoms of metabolic syndrome, reduce your Hgb A1c, and reduce your waistline.

So you have made the decision to start embrace the ketogenic lifestyle, you have chose a strategy of carbohydrate restriction. So what should you expect to happen next? Well, when dietary carbohydrates are restricted, the insulin levels in your circulating blood will begin to drop. As the circulating level of insulin decreases, your body begins to diuresis. In other words, you “pee more”. So as your urine output increases, your excrete more sodium. And generally, where sodium goes, potassium and magnesium follow. So your body will begin to lose sodium, potassium, and magnesium, while calcium and phosphorus levels are usually not affected. The result of this decrease in sodium, potassium, and magnesium levels in your blood creates an electrolyte imbalance which is generally harmless, it does however cause you to have flu like symptoms. Because of these symptoms the common term “keto flu” is often used when describing carbohydrate withdrawal.

So what exactly is the “keto flu”? It is simply your bodies reaction to the restriction of dietary carbohydrates. Because you are restricting the number of carbohydrates you consume, your body has less energy in the form of glucose to use for it’s metabolic functions. When your body does not have enough glucose to burn for energy, it has to find an alternative source of energy to supply your brain and other essential organs. This time frame from which your body begins the transition from being a sugar burner to one that burns ketones for energy is when you will experience the symptoms of carbohydrate withdrawals.

Most people will begin to experience the symptoms of carbohydrate withdrawal sometime around the 24 to 48 hour mark. The most common symptoms of carbohydrate withdrawal include: headaches, muscle aches and pains, chills, weakness, irritability, and dehydration. Other less common symptoms you may experience include: sugar cravings, brain fog, sore throat, nausea, insomnia, constipation or diarrhea. The severity of the symptoms vary per individual. While I experienced the more common symptoms, as I mentioned my wife did not have any symptoms of carbohydrate withdrawals. There are however a few things that you can do to help you through this transition period.

Earlier I mentioned that you will experience an increased loss of sodium, potassium, and magnesium do to the increased diuretic effect of transitioning to a ketogenic diet. One of the ways to minimize your symptoms is to actively take part in managing your electrolytes, and that is what I want to discuss next.

Common signs and symptoms of sodium deficiency include: fatigue, headaches, weakness and difficulty concentrating (aka brain fog). As you can see, these are some of the most common symptoms people experience. On average, your body needs 3,000 to 5,000mg of sodium each day. That translates to about 7 to 17 grams, or 1 – 3 teaspoons of salt depending on the type of salt. Making sure you get plenty of sodium each day while you are in this transition period is not difficult.

A few cheap and easy fixes to increasing your sodium intake is to drink one to two cups of bone broth each day, be liberal with the salt shaker when eating, and or add some common able salt to water and drink it. If you need a good bone broth recipe, click on the hyperlink for ‘The Banting Diet’. If you do not have any bone broth available you can make some instant broth or bouillon by using the powder or cubes. To make one cup of broth, you add one teaspoon of powdered chicken or beef bouillon to one cup hot water. The Knorr brand powdered chicken bouillon contains 870mgs of sodium per teaspoon, the beef 840mgs per teaspoon. Most commercial bouillon powders fall somewhere within this range. If you need to buy some for your pantry, just make sure you do not buy the ‘low sodium’ version as this kind of defeats the purpose. You could of course just mix one teaspoon of table salt which contains 2,325mg sodium in a glass of water, and drink it, but most people just do not like to do this.

Some common signs and symptoms of potassium deficiency include: muscle cramps, muscle twitching, and heart palpitations. On average, your body needs about 4,000 to 4,700mg of potassium each day. Which translates to about 4 to 4.7 grams. While the majority of your potassium should come from your diet, during this transition period the ‘Diet Doctor’ website recommends that a supplement of 1000mg per day is generally safe for most people as a dietary supplement. Most multivitamins contain about 100mg of potassium, and that is why a good multivitamin is recommended when you start on your ketogenic journey. There are a lot of different potassium supplements out there and almost all of them contain 99mg per tablet, no matter what the label on the front of the bottle states. Make sure you check the nutritional facts on the back of the bottle before you take any supplement to verify it’s strength.

Potassium supplementation is one of those things that you need to take care with, especially if you are taking a potassium sparing or potassium retaining diuretic as part of your daily medical regimen. If your potassium levels get to high you can start to have heart rhythm abnormalities. That is why at the beginning of each episode I mention that you need to see your primary care giver before starting this way of eating. For most of you the risk of this happening with potassium supplementation will not be a problem if you keep it below 400mg per day. Again, when in doubt check with your primary care giver.

Common signs and symptoms of magnesium deficiency include: muscle cramps, and muscle twitching, the same symptoms noted when you have a potassium deficiency. According to the National Institutes of Health (NIH) The recommended amount of magnesium you need each day is about 400mg a day. The majority of your daily magnesium requirements can be acquired from your diet. Foods such as green leafy vegetables, nuts, and seeds contain sufficient amounts of magnesium for most people, however some supplementation may be required. For people suffering from muscle cramps during this induction or even while on a low carbohydrate diet Phinney and Volek in their book “The Art and Science of Low Carbohydrate Living” recommend taking three (72mg) tablets for a total of 215mg of magnesium per day of “Slo-Mag” magnesium supplement. They also recommend similar generic brands such as “Mag Delay” which comes in 72mg tables and “Mag 64” which comes in 64mg tablets which are equally effective and somewhat cheaper.

Now, I have see many recipes for homemade “keto aide” on LCHF or keto forums and Facebook groups that use magnesium citrate as an ingredient to help with magnesium supplementation. On average, magnesium citrate contains about 300mg of magnesium, and 80mg of potassium per one fluid ounce. On the surface, that sounds pretty good, however, the problem with using a liquid solution such as mag citrate is that it is used to relieve constipation. In fact, on occasion, we use magnesium citrate in the hospital to relieve constipation. So in many people the liquid magnesium citrate can cause diarrhea, while the slow release magnesium tablets will not have this same effect. So if you are already at risk for dehydration during your transition, and you are drinking fluids such as a homemade “keto aide” electrolyte replacement drink made with magnesium citrate that can cause you to have diarrhea, you can become even more dehydrated. Which can increase the severity of your symptoms. This is why I do not use a magnesium supplement such as mag citrate in my recipe for a keto safe electrolyte replacement drink.

Now that we have covered electrolyte replacement, let’s look at some key things that you can do to help minimize or decrease your symptoms of carbohydrate withdrawal: 1) increase your fluid intake. Because of the diuretic effects of transitioning from a sugar burner to a fat burner causes diuresis, increasing your fluid intake is important. Good old plain water works great, try and stay away from diet drinks or energy drinks that have caffeine or other ingredients that cause diuresis until your transition period is over. If you want a good keto friendly electrolyte replacement drink, keep listening for he recipe I have been using for more than 2 years which I will be discussing in the recipe section of this podcast. 2) Increase your sodium intake. Drink some bone broth or even powdered bouillon, be liberal with the salt shaker, eat more salty foods, or you can go hard core and mix 1 teaspoon of table salt (2,325mg) in a glass of water and chug it down. Remember the recommended daily amount is 3,000 to 5,000mg of sodium a day. 3) Take a good multivitamin. This is a good and cheap way to make sure you get the necessary and additional vitamins and minerals you need during your transition period. 4) If you are having muscle cramps, or muscle twitching you may need to take a potassium or magnesium supplement. On average, your body needs about 4,700mg of potassium, but keep your supplementation at 1000mg (13.4meq) or less per day. The recommended amount of magnesium you need each day is about 400mg a day, so take no more than 200 – 215mg per day in pill form. The majority of your magnesium supplies should come from the food you eat each day. 5) Avoid strenuous exercise until your transition period is over. Exercise can increase the severity of the symptoms that you are experiencing. And 6) eat more fat.

I just want to add one word of caution here. I have talked a lot about vitamin and mineral supplementation in this episode. And yes, I do recommend a good multivitamin as part of your daily regimen and I have taken one for many years before I began keto. Having said that, before I began my ketogenic journey, I did not know about mineral supplementation and how it could possibly decrease my symptoms of carbohydrate withdrawal. So I did not supplement my diet with sodium, potassium, or magnesium. If like me you take a multivitamin, then you need to take the tie to read the label and look at the amounts of vitamins and minerals supplied. Then if you want to supplement with potassium or magnesium, you need to account for the amount of each in your daily multivitamin so that you do not take to much each day. So take your time, do a little math if necessary, and remember if you are taking any diuretics you need to consult with your medical practitioner before engaging in this lifestyle. They may not agree with your choice, but you need to at least give them the opportunity to guide you safely through this process.

 

Recommended Daily Electrolyte Needs for Adults:

Sodium – 3,000 to 5,000 mg per day.

Potassium – 4,000 to 4700 mg per day.

Magnesium – 400mg per day.

 

You’ve Got Mail (21:18):

There is no listener mail today, but I wanted to use this section of the podcast today do some house keeping work so to speak. When I first started this podcast, my goal was to create a weekly podcast, but what I have found is that over time, it takes me about 10 to 14 days to write, record, edit and produce each episode. Because I have a full time job, and a small farm to run, I simply cannot get everything done that I would like in seven days. So the Keto confidential podcast will be going to a scheduled bi-weekly release date. If and when I can produce the podcast in less than 14 days I will go ahead and release it for syndication. I just wanted to be up front and honest with you as for some people not having the podcast come out every seven days per my initial goal is somewhat inconsistent.

As I mention in episode 9 ‘The Getting Started‘ podcast, you need to set yourself goals when you embrace this lifestyle. Then you need to reevaluate your goals, and make changes as necessary to meet those goals. So following my own advice, my new goal is to produce a new episode of the keto confidential podcast every two weeks. I appreciate all the kind words and your continued support. Having said all of that. If you have any feedback regarding anything you have heard in this or other episodes of the keto confidential podcast, or you just want to drop us a line with a question or two, or you just want to share your success story with us, you can send me an email at todd@ketoconfidential.net. Soon, I will be adding a Google voice number to our website so that you can call in and leave an audio voice message that will be incorporated into the podcast, so stay tuned for further information regarding this new feature.

 

Recipe Of The Episode (23:03):

This weeks recipe is my version of homemade Gatorade called “Frugalade” that I created back in 2012 way before I was keto. I has about the same electrolyte replacement as Powerade and Gatorade drinks 270mg sodium, and 55mg potassium per 20 ounces and it cost about $0.29 per gallon to make at the time. My keto friendly version which I call “Frugalade F2” has all the same electrolytes, but uses a keto friendly sweetener so it contains no carbohydrates. To make my Frugalade F2 you will need to following ingredients:

2 packages store brand or Kool-Aid powdered fruit punch

½ teaspoon liquid sucralose (or keto sweetener equivalent to ½ to 1 cup sugar)

¾ teaspoon Morton kosher salt (1440mg sodium)

1/4 teaspoon Morton Lite salt (290mg sodium, 350mg potassium)

Add the salts, sweetener and powdered drink mix or kool-aid to your one gallon container. Then heat a pint (2 cups) of water in your microwave, or ‘hot shot’. Then add the hot to the one gallon container and shake until all the salts are dissolved, then top off your container with water to make one gallon. I divide the Frugalade into old 20 ounce Gatorade bottles and refrigerate for easy portion control, but you can just leave it in the one gallon container. Once cold, drink it as you would any sports electrolyte replacement drink. That’s it, takes less than five minutes to make, and costs you less than $0.30 per gallon compared to about $6.00 for a gallon on Powerade or Gatorade

How does it compare to Gatorade or Powerade?

Frugalade F2 (20 ounces)

Calories – 0, sodium 270mg, potassium 55mg

Gatorade G2 © (20 ounces)

Calories – 0, sodium 270mg, potassium 75mg

Powerade Zero © (20 ounces)

Calories – 0, sodium 250mg, potassium 57mg

To use a sports metaphor, I think that’s a slam dunk win for my Frugalade F2 when compared to the commercially produced Gatorade G2 or Powerade Zero products. Keep in mind that if you are using my recipe or Gatorade G2 or Powerade Zero during your transition period, these drinks all contain sodium and potassium and you need to account for that if you plan on using other oral mineral supplements. For more information regarding this recipe, you can click on the following hyperlink ‘Frugalade F2’ and it will take you to the complete article on my keto food blog, ‘CulinaryYou’ where you can find step-by-step instructions as well as pictures of the recipe featured in this episode.

 

The End (27:05):

well guys, that’ it for this episode of the Keto Confidential podcast, if you have found this content useful, then please subscribe, and take a few seconds to rate this episode, and write a quick review about it so that others may benefit from this information. More importantly, If you know someone that is struggling with obesity, metabolic syndrome, or type 2 diabetes, then please share this podcast with them so that together we can help them reverse their diabetes, and reduce their complications of metabolic syndrome and obesity. Once again, I would like to thank you for listening. So until next time, be safe, and stay keto strong my friends.

 

Recipe Links:

Frugalade F2: A Keto Electrolyte Sports Drink

Bone Broth Recipe (As featured in KCP002 ‘The Banting Diet’)

 

References:

Atkins, Robert, M.D. (1972). Dr. Atkins’ Diet Revolution: The High Calorie Way To Stay Thin Forever. New York, NY: David McKay Company Inc.

Do You Need Electrolyte Supplementation On A Keto Diet?, www.dietdoctor.com, Accessed October 2018.

Magnesium Fact Sheet, National Institute Of Health: Office Of Dietary Supplements, Accessed October 2018.

Magnesium Citrate, Michigan Medicine: The University of Michigan, Accessed September 2018.

Potassium Fact Sheet, National Institute Of Health: Office Of Dietary Supplements, Accessed October 2018.

Phinney, Stephen M.D., Volek, Jeff, Ph.D. (2011). The Art And Science Of Low Carbohydrate Living. Beyond Obesity LLC.

Phinney, Stephen M.D., Volek, Jeff, Ph.D. (2011). The Art And Science Of Low Carbohydrate Performance. Beyond Obesity LLC.