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I’ve got a few questions on that over the last 2 weeks.  I’m going to first address WHY to do it.  This might put a lot of it into perspective for the drive to actually stick to it.

The main reason I started it was weight loss, and I uncovered SOOOO many things on top of that.  Now, I’m doing it for my long-term health.  The internet is filled with scores of happy people who have blasted their fat off with this diet.  I was in the midst of a 3 month stall on my healthy diet, so I said, “what the hell”.

What I uncovered was that fat doesn’t cause heart disease…or many other things.  They have found, conclusively, that sugar has been the root of most evil in the last 40 years.  They have found that a keto diet can prevent:

1. Diabetes – no sugar at all can reverse type 2 diabetes
2. Cancer – most studies are correlative, but Dom D’Agostino has been looking at cancer as a metabolic disease, not genetic.  Fascinating studies showing that cancers feed off of glucose and a ketogenic diet can starve many of these.
3. Heart disease – for most of you, you think that cholesterol and saturated fats cause heart disease.  Unfortunately, the entire science behind that 50 years ago was fudged and the root cause of this is sugar, inflammation, small LDL particles.  On ketogenic diets, you are reducing inflammation, allowing vitamin C to repair the cell walls, and reversing damage – and you produce harmless BIG LDL particles.  So your LDL number isn’t of concern, it’s the particle size of the LDL.  High sugar diets produce small LDL particles, and these are the “bad” cholesterol.  Dietary cholesterol has virtually no impact on your cholesterol in your blood.  Saturated fats have been demonized, and it turns out they aren’t the devil either.
4. Obesity.  Funny thing, we learned about calories in and calories out – which they are also finding is sort of a myth.  Weight gain all has to do with the production of the hormone insulin.  Read: sugar spikes your insulin, a LOT.  Over time, you get insulin resistance (IR) and your body needs to pump out more and more insulin to respond to your candy bar.  When insulin is in your blood, you CANNOT burn fat, it locks the fat cells to not allow them to burn fat.
5. Many others – there are links to other diseases like alzheimers.  Many of these advocates are feeling a lot of our modern disease as we know it is all caused by sugar, metabolic syndrome, and insulin resistance.  And they  make very, very, compelling arguments.

So that was the WHY.  Essentially, this appears to answer a lot of my problems why I’ve been overweight most of my life.  I exercised a ton, and played the following sports more than just in my garage or on video games: baseball, football, softball, wrestling, tennis, basketball, biking, running, swimming, weight lifting, martial arts, golf, hiking.  The list goes on and on, but I am definitive proof that exercise alone cannot make you thin.  In addition, I’ve tried every diet out there multiple times.  What you find on most of them (except my last one prior to this) is extreme hunger, weight loss, a stall, then you start to gain back.  Eventually, in disgust, you revert back to your baseline poor health habits.

The problem is, calories in/calories out is not what you think it is.  Energy balance.  Just eat less, and you will lose weight.   It works, for a short term.  Do you know why it doesn’t work for the long term?

Insulin.  When our bodies start to lose weight, it puts it into a state of shock and awe.  Our fat cells are designed to store energy for long, brutal winters without food.  Our bodies don’t know that we live 5 miles away from food abundance at all times.  The diet foods we eat all have sugars….this produces insulin – and bam.  Our bodies are sucking in the calories.  But because  we have insulin in our bloodstream, we cannot burn that stubborn belly fat.  We exercise, we cut calories….but still, we don’t lose.  We have the stress hormone cortisol floating about now, and that’s helping to store more.

Weight loss/gain is NOT a calorie in/calorie out problem, it’s a hormone problem.

Once you understand that, and you’ve had weight most of your life – this diet DOES become the magic bullet for weight loss.  The WHY then becomes much easier to understand.

But is this sustainable?

I’m going to break this down into 3 sub-categories here:

1. Short term
2. Long Term
3. Maintenance

Background:

To do the ketogenic diet, you essentially stop eating carbohydrates.  You have a max of 30 net carbs per day.  This is ALL carbohydrates minus fiber and sugar alcohols.  So, things like broccoli, spinach, cauliflower – they have carbs, but they also have fiber that reduces those carbs.  Bakers chocolate has 3 carbs but 2 fiber per serving.  Most meats/eggs have zero or less than one.  Cheeses have less than 1 per ounce.  Bacon (low sodium) has zero.

So you see a lot of meats/veggies on this diet.  This is what it looks like:

Side note: Understand the difference between omega 6’s and omega 3 fatty acids.  Omega 3s in olive oil = GREAT for you.  Omega 6s in vegetable oil = TERRIBLE for you.  So, no, not all fats are good on this.  Omega 6s create an inflammatory response, which causes a world of hurt inside your body.  Sugars are also a major culprit in inflammation – which is also what the keto diet affects.  It significantly reduces inflammation, and suddenly your body feels AMAZING!!

Short term

I would say “short term” would be a 3 month challenge.  This isn’t a thing, I made it up.  I’ve seen other challenges out there, so I just figured I’d have a 3 month challenge.   The first week on this can be hard.  You are giving up food as you know it.  That’s why, long term, I’d probably suggest a diet like I did for 6-12 months prior to trying this.  I lost a lot of weight, and I started trading out the breads/pastas a LONG time before I started keto.  Those of you going from a 3 snickers/6 mountain dews a day to this might have significant problems.  Also, I have done Atkins before, successfully, so I knew what I was getting into.

However, the real benefits of keto take 3-4 weeks to really kick in.  Month 2 for me I’ve been eating one meal a day during the week because my appetite is in check for perhaps the first time in my life.  The first 2 weeks, you’re kind of weak.  You need to avoid the keto flu – tons of resources on how to avoid that.  But you will start to drop weight rapidly.  Most of it is water weight, but in week 3-6 your water weight comes back where  the fat loss kicks in hard core.  I’m 2 months in and down 24 pounds, at a rate of 3 pounds per week or so weight loss.  I think this will eventually level off at 1-2 pounds per week, but it’s nice to see it continue to move after I had a 3 month stall.  My hope is 6-8 pounds per month while “sedentary” and 10-12 pounds a month when highly active.  With my upcoming activity in mind, I would not be disappointed then with 8-10 pounds of loss per month.

So, can you do this for 3 months?  Most definitely.  With this diet, you can’t exactly have a cheat meal or cheat day – because if you do, it kicks you out of ketosis and then you have another 4-5 days to get back into ketosis and burning fats.  So one candy bar can derail you for 5 days.  However, there are some really good substitutes.  More on ways around this in the LONG TERM section.

What you want to do on your 3 month challenge is start to understand the diet and there is no cheat day.  WHY to do it.  What things have sugar in them?  How much?  How does my body FEEL?  What foods can I eat?  What substitutes do people have?

Probability you can do this for 3 months?  20-40%.  Higher if you’ve been on a diet that has watched your carbs previously, and even higher if you’ve already given up most breads/sugars.  Even higher if you want to cure your pre-diabetes and fix your resting glucose levels.  Get a lipid test before and after your 3 month challenge.

Long term

Let’s look at this over a 1 year span?  Can you do this for 24x7x365?  This starts to get infinitely harder.  Why?  Holidays, special occasions, going out with friends, vacations.   Life pops up.  I would say if you have significant weight to lose, like myself, and weight has been coming off, AND you’re feeling amazing – then yes, you can do this for a year or more.

One big secret to doing this long term would be opening up your playbook on food and finding good substitutes.  Let me tell you something.  6 weeks ago, at 42 years old, I never had cauliflower in my life.  It stunk.  Why would people eat that?  Well, glad I tried it.  I tried it as a mash – in a food processor.   Let me tell you that on a keto diet, you can have butter…and olive oil.  And let me tell you that adding that and heavy cream to the mash with some salt and garlic powder comes out AMAZING.  It is not low fat nor low calorie, and tastes, to me, EQUAL if not better than mashed potatoes.  This is a great side for my steaks.  This is not a shitty substitute, this food is now part of my life!!

Another secret is a majority of your calories come from fats, so there’s two things at play here.  Fats make everything taste amazing, AND they are ridiculously high on the satiety index.  Combine that with moderate proteins and you have yourself a diet where you are rarely hungry.

I wrote about this yesterday.  Any diet must address two items:

1. Controlling hunger/compulsion to eat
2. Controlling satiety to not overeat

What I have found on keto is that most of the foods I’m eating are whole foods.  This has also helped me feel full when I’m eating.  My “normal” diet there was no off switch.  There’s a plate of food, I’m STARVING, and I eat the plate and seek out more.  There’s no off switch.  I don’t know why that is, perhaps it’s the sugar, perhaps it is chemicals in foods.  But I’m finding these days that there’s an “off switch” that I’ve never had before and it hits me pretty decent.  I’m rarely hungry, and when I am hungry, it’s gentle pangs and not some ravenous lunatic frenzy to find the nearest McDonald’s.

But for long term, I’m going to add a 3rd criteria for any weight loss plan to be successful:

1. Controlling hunger/compulsion to eat
2. Controlling satiety to not overeat
3. Ability to work in “cheat” days

With the keto diet, you can’t really have over x number of carbs or else you go out of ketosis.  Now, some people like Jason Wittrock have shown that if you have a cheat meal out one night and don’t go overboard, you can be back in ketosis the next morning.  He’s also been on the diet for 3 years.  In an experiment, him and a buddy went out and had 500+ grams of sugar one day to see how they felt – and it was predictable.  They felt like dog shit.  It then took them 2-3 days to go back into ketosis.

What is of interest here is that when you first go into ketosis, it will take about 4-7 days.  Your body is eating through its stores of sugar in your liver and muscle glycogen stores.  This makes you feel weaker, in the short term.  There’s a lot of grams of carbs for your body to burn off.

So, the short term keto would NOT be good for a cheat meal/day.  The longer you are in ketosis, the quicker your body can bounce back from a cheat meal.  At that point, I’d look at a cheat day.

Enter cyclical ketogenic diets.

This is where you are on a keto diet MOST of the time and some of the time you are not.  You get 95% of the benefits of the keto diet without the lifetime of never having a piece of bread again.  If you watch someone like a Jason Wittrock, he might have a carb day once every 3 weeks.  It will kick him out of ketosis for a day, and he goes right back into it.  This is practical for most of us.  Weddings, birthdays, holidays, special work functions.

So – if you plan out a cheat meal or day, the likelihood of long term success is raised.

When I did Atkins when much younger, my biggest failure was food boredom.  I had a VERY, VERY limited numbers of foods I ate, and I was a machine eating the same thing day in and day out.  I took off a good 60 pounds.  What was interesting with this was I kept it off for 4 years…let’s look at the below.

Maintenance

When you “go off” an atkins/keto diet, even for 1-2 days, your body sees the carbs, and binds with water to put it into muscle glycogen stores.  You get REALLY thirsty, and when you step on the scale the next day, you will be 4-5 pounds heavier.  When you do go back to your keto ways, the weight comes right back off in 3-5 days.  So if you are doing this where you have a cheat meal/day once every 3 weeks or so, essentially 2 out of those 3 weeks you are losing weight and one of them you are holding steady.

If you are to “leave” the diet completely, I’d advise slowly re-adding sugars and not just going back to 400g a day.  Your body could have a severe yo-yo effect and put on 20 pounds in the first month.  Rather than living like a monk for 6 months, I would advise scheduling a cheat day or weekend once every 3 weeks.  Anything you felt you are deprived of, try some of it during this window.  This then allows the special events of your life for you to eat normal at.  This means the rest of the time you are punching into the gym clock of your structured eating.  This is about fueling your body for life and avoiding disease.  Not finding ways to eat cake every weekend.

One thing I also did on Atkins, which I will probably do on keto.  I exercise, like a LOT.  I might be in one of the top percentiles for exercise for a guy my height/age/weight in the country, if not more.  I don’t think there’s many people like me out there with exercise and weight/endurance that aren’t currently paid by the NFL.  It’s not a badge I wear lightly, but my point is that I don’t think they are used to 300 pound people biking 16 miles then running 2 immediately afterwards.   What I used to do on atkins 10-15 years ago was after I got done biking, I’d stop at the gas station and get berries.  I’d eat the berries, then I’d go running for 2 miles.

If you look on the keto food pyramid, berries are allowed.  I didn’t know this then, as I was winging it.  Let me explain something.

The “at rest” is 30g of net carbs per day for keto to be in ketosis.  However, if you read the Atkins book, which is slightly different than keto, it walks you up the amount of grams of carbs you can have some day for maintenance.  Lots of top athletes today are switching over to the keto diet.  But guess what?  Many of these guys are having 70-100g of carbs per day.  What?

Well, it all has to do with exercise and burning things for fuel.  Your body will prefer glucose every time over fat.

What happens when you eat berries is insulin will come out to play and ask what to do with the berries.  Store them in liver glycogen or use them for fuel?  When you are fat like I am at 278, you probably just want your body to burn fat.  This is why I like my long distance biking/running for this diet over my weight training – which I still want to do of course, but I’m capitalizing on the fat burning at the moment.  So when you have LOTS of fat to burn, use your fat stores.  These top athletes are at 12-15% body fat and might need some assistance.  I know that my endurance is pretty good, but yeah, the berry pick-me-up really kept me going much longer than fat alone.

But with high performance athletes doing keto, they get into ketosis, then go out and do explosive things – AND need endurance.  So with most people who are sedentary, you can be in ketosis with 30g of net carbs.  But in my experience with atkins and long distance sports, you CAN get away with more carbs per day when you are really pushing it and stay in ketosis.

For example, my biking of 16 miles or so back in the day, I’d get done that on a hot day and be drained (in this example, I was 311 pounds).  I used a lot of my fat – but I also used my glycogen stores in my muscles and liver.  I would have berries, and I’d then have the energy, almost immediately, to go out and run.  I don’t know what this was – maybe the fructose from it hit my bloodstream and I was using that?  Maybe it refilled some of the tanks enough to get running going?  I then, a few times, AFTER my biking…then running – played 1-2 hours of tennis later in the day.  If any of you are good at tennis, I’m seeking out partners this summer!  I played some college tennis and was the 4th flight on the team until I was kicked off for pledging a fraternity, so I had some skills.

On days where I was SUPER athletic, I was not overly concerned with my 30g marker.  On days like that, I might have hit 50-70g.  But with the amount of energy I exerted, I’d wake up the next morning in ketosis.  This is how I might have had super energy for the weekends, then during the week back in the office, go back to 30g.

So for maintenance, I have some of the below criteria:

1. Controlling hunger/compulsion to eat
2. Controlling satiety to not overeat
3. Ability to work in “cheat” days
4. Ability to be flexible on highly athletic days to maximize performance

If you evaluate all of those criteria – I believe the keto diet can be highly sustainable during a maintenance period.  The big thing I’d caution here is you need to open up the playbook on food variety and try a lot of new things.  I never had cabbage before 8 weeks ago, now that and chicken/pot roast I CRAVE.  Never, ever would have thought that.

In closing –

I feel I plan on using the keto diet until I hit my weight goal of 190.  So, about 88 pounds to go, 94 in the books.  I will have my struggles at times.  I feel that this diet can help reverse years of damage with sugars.  I feel this might take me another year to 18 months to get to where I want to go.  I feel this summer, being the lowest weight I’ve been since COLLEGE, that I will be doing a LOT of biking/hiking/running.  I feel that this summer is going to melt weight off of me.  So I might be hitting some goals early.  In ADDITION – I now have really good clothing to exercise when cold out, which I didn’t ever have before.  So, I now have biking/running/hiking in the playbooks for 45+ degrees and don’t have to wait until it hits 65.  Which means all next week I’m going to be starting.

Once I hit my goals, I honestly don’t know if I’d continue on keto, but I see it mostly as a massive tool to lose weight and get healthy.  I would probably do maintenance on it for a time, then gradually bring carbs up and perhaps do an atkins-like maintenance for a period of time.  The diet I ate prior to this I felt was point for me.  It was really good, sustainable, and healthy.  My main problem with it was the levels of insulin I was producing wasn’t taking the weight off.  Once I hit a 180-190 mark, I feel weight loss isn’t going to be as much of a goal but maintenance is.  I will ALWAYS take with me the lessons on the dangers of sugar, and I will ALWAYS keep in mind the glycemic load of foods.  Yes, I will eat fruit at some point in the future, with the fiber, at one serving per day.  But I don’t think I will ever again abuse sugars like I did as I now have seen the dangers and the addictions it creates.

To heal someone like me, you need to address insulin.  Nothing else.  The rest will take care of itself.