Adventures in Ketosis - Part 2: Adaptaion

In my last post, I discussed the basics of a Ketogenic diet, and what I was going to monitor while adapting to it. I've found very little about what to expect during the initial adaptation phase of the diet, other than to expect some lethargy and brain fog in the first few days, aka "Keto flu." So I decided to give a detailed account of my experiences.

I have no idea if mine are typical or not, they just are what I experienced. I'd love to hear if other people's adaptations were similar or different.

To begin, I should note that I am a bartender, so my work hours and lifestyle are atypical. I usually work 4 days a week, but could work 3 or 5 days. I usually don't work more than two days in a row, but could work five in a row during busy seasons. On weekdays, I usually go into work at 3:30 in the afternoon, and work until between midnight and 1am, depending on how busy we were and how long it takes to clean the bar. On weekends, my in-time is either 6pm or 8pm, and I usually leave about 3:30am. Which means I usually go to bed between 2am and 4am, even on nights I don't work. Mondays and Tuesdays and usually my "weekend."

I rarely set an alarm, and tend to wake up between 9am and 10am, but sometimes as late as noon, if I had a particularly rough night at work.

Because of the nature of the job, meals are also atypical. All employees share a "family meal" before we open week days, prepared by the cooks. It could be anything, chicken wings, lasagna, ribs, stew... No way of knowing before I get there, so I'll be packing my meals for that, to make sure I stay low carb and better count my macros and calories.

 At home, I use a digital kitchen scale for all my food, and track everything I consume with a the Cronometer app. I do a fair amount of meal prep. Since live alone, I tend to make something and eat the multiple servings over the course of several days. Which makes it easier to track. I love eating out, and thanks to my career, I have the "in" at some of the best restaurants in my city, however, I'll be forgoing that for the next few weeks at least (sad face).

On any given night, we're allowed to take a short break (10-15 minutes) around the time the kitchen closes (11pm weeknights/1am weekends) to eat, if we're not too busy (if we're busy, then no food, its the nature of the business). If I'm the only bartender working, I generally just grab a bite of food between serving guests. Meals are always on your feet. I'll be bringing snacks for this, since our menu doesn't have much keto friendly food, and the kitchen staff gets grumpy with elaborate custom requests from the staff 15 minutes before they want to go home.

My prefered exercise is weight lifting. Currently I'm on a three day split, usually Monday, Wednesday and Friday, for big lifts (Bench Press, Squats and Deadlifts). I'm also working a specific pull-up regimen which has me doing multiple low rep sets throughout the day, almost every day. I rarely do cardo, for a lot of reasons, but mostly because I hate it. If I do, it's HIIT, but I don't expect to do any during the next couple weeks as I'm not training for anything specific.

My unpaid work, my passion, is writing. Currently I'm working on a screenplay and try to put in at least a couple hours five days a week. The mental focus and cognitive boost ketosis is supposed to give is one of the main drives for me, as I feel it will improve my writing.

Week One

My first day in the diet was a Sunday, I had to work that night, but it was only a 4-5 hour shift, then I had two days off, so I figured that was going to be a good time to get through the worst of it.

My goal was to keep my carbs below 50g/day, in reality, I was below 30g almost every day. Most of my carbs were veggies, and since only net carbs (total carbs minus fiber) count, I set my tracking app to account for that.

Hunger was the first major hurdle. Filling up on fat based foods, like bulletproof coffee, and homemade bone broth (I kept the fat, didn't skim it off), didn't do much to stop the cravings for carbs. It was particularly bad at work where there's food in front of me constantly. But I kept at it.

I tend to drink at work, usually a shot or two after we close. I don't drink much or at all on my off days. Since I was monitoring my blood, I figured I'd see if it messed with me ketosis. It didn't. I drink straight liquor, usually whiskey, so no carbs from beers or wine or mixers.

On my second day, I worked out. It went well, setting a new person record for my bench press, in spite of feeling a bit lethargic.

Day three is when the worst hit me. I woke up feeling like crap. It took supreme effort to drag my ass out of bed. I loaded up on high fat foods, but basically, I sat on the couch all day doing nothing. It was a little better the next day, but still pretty tired and lacking focus. My workout suffered from either lack of strength or just lack of will power to push through.

I also realized I had to stay off my motorcycle, and limit driving altogether for two days. My focus was so bad it scared me to be on the road. My mind kept drifting, and I had one close call.

My glucose was staying low, sub 90, but my ketones were also low, staying below threshold (0.5mM), until Thursday, when they suddenly jumped to 2.7mM and continued to say in the 2 to 4mM range.

By day four, I was feeling pretty good, but every time I did anything that required real physical exertion, I drained quickly. On Friday, I was able to set a new personal record deadlift, but literally could not do a single power clean after. My HRV score tanked the next morning, which I would normally expect after a deadlift workout, so not surprise.

The biggest issue the first week, besides the couple days of lethargy and brain fog, were hunger pangs. It gets easier to walk by carb loaded foods as long as I have snacks (Cheese, nuts, avocados, etc.) available, but I still feel hungry a lot, despite having eaten plenty of calories.

In the middle of the week sleep was an issue also. I would have a hard time getting to sleep, I'd lay in bed tossing and turning. That lasted a few days, but seems to have stopped.

The other thing I notice is I feel tired, like I've just run out of energy. Which I normally associate with not eating enough in a given day. But I know I've eaten plenty of calories, and I feel better after I've eaten a snack. I'm assuming this is because my body still isn't burning the available fat, is looking for carbs, and in the end settling for food that just came in rather than stored energy.

The mirror tells a tale, too. Years ago, in preparation for a photo shoot, I did a crash no carb diet, followed by carb loading, similar to what body builders do before competition to look swollen. As the carb stores in my muscles was depleted, I began to look smaller and scrawny. I'm seeing that again. Hopefully, its a temporary side effect.

Body weight and body fat stayed consistent over the course of this week. A lost a bit in some of my measurements, which I expected as the carbs and water drained out, but nothing too significant.

Week Two

Had a rough night on the bar Saturday night, then woke up very sick Sunday morning. Not Keto flu, but genuinely ill. I rarely get sick at all. Its been a few years since I can remember anything worse than a runny nose. So this was out of the ordinary, and I felt really terrible.  HRV was in the basement (expected if I'm ill), but Ketones and glucose were good, so the diet is on track. I felt better Monday.

The whole second week, my workouts suffered. I failed all my major lifts, but easily got all my warm ups (up to 90% of target), so I feel like I'm at least maintaining so I'll be able to get back on track once I'm through adaptation.

I have no endurance for anything physical. I'll feel fine, then do something physical, like change a keg (which weighs less than half what I just deadlifted a few days ago) and I'll be out of breath for 5 minutes.

That lack of strength and endurance  lasted all week, and its depressing as hell. I'm nearing the end of a 12 week workout cycle and I've been breaking personal records for a few weeks, and suddenly that's stopped. Its a big temptation for me to carb load pre-work out, but I believe this is temporary and will pay off in the long haul, so I'm sticking to the diet.

Mentally I feel pretty good, but still feel like I'm hitting the wall when I should not be. For example, I went to work Saturday night at 8pm. By that time I'd already eaten over 2500 calories, about 80% fat, 21g carbs, and around 100g protein. My daily minimum is 2300 calories to maintain weight. I try to get about 500 more than that to help gain muscle mass. So I was well within my normal range, and should have been fine all through the shift.

But by 11pm, I felt like I was hitting the wall -- tried, mentally unfocused and starving. I ate some cheese and that helped, but I had to eat again an hour later. I at a whole avocado, and more cheese. All in, my calories for the day were over 3400, (almost 150% normal!) but I still was hungry and feeling like I hadn't eaten enough.

Coming to the end of two weeks, its clear I'm still not adapted. Hunger pangs have gone from every couple hours to virtually constant, no matter how much I eat, there's a constant dull hunger. My guess is this is the last desperate attempt by my body to get me to eat some carbs, but instead I just give it  more fat.

(Sidebar-- I've never had to diet to lose weight, and I've been guilty of judging others who fail at their diets. No more. I now know what's like to feel hungry ALL THE TIME. I can manage to get through a couple weeks of this, but if I was facing a life of constant hunger and food cravings, like a typical weight loss dieter, I couldn't stick to it either. I think after a month I'd fail, too. So to all those people I secretly judged, I'm sorry.)

I do have periods of really good mental clarity and creativity that I've noticed. I don't know if I can attribute that to ketosis, but I do feel like I'm having that "spark of inspiration" more often than normal.

In addition, I've gotten much better at doing chores. I'm a terrible housekeeper, always have been. But in the last couple weeks, I've managed to get myself to do daily cleaning and housekeeping, book keeping/finances, and other dull but necessary life stuff that I usually put off until the stress of not doing is too much to take. Caused by keto? I don't know, I don't have an MRI or whatever to measure brain function, but I'll take it whatever it is.

I also started practicing piano again. I started about a year and half ago, then fell off after a couple months. Now I'm back at it. I felt like I only had so much time and energy to devote to learning something new, so I choose writing instead of piano. Now I feel like I can devote plenty of time to both, but nothing else has really changed in my life, its an attitude shift I can't explain. Keto? Maybe, I don't know.

Overall, I'm noticing changes in my behavior and thinking, even how I interact with guests at work (I'm more tolerant, less easily frustrated, and more creative in conversation), that I believe are attributed to keto, but I can't quantify those changes. The changes I can quantify are blood glucose and ketones, which are where I'd expect them to be, and energy levels/strength versus caloric intake, which are not where they should be... yet?

My HRV scores are yoyoing, but I expect this. I'm in week 10 of a 12 week cycle, pushing for new personal records, so I expect my HRV to drop the morning after a workout. It is bouncing back up the next day, signalling a good recovery. Keto is supposed to aid in recovery, but so far, what I'm seeing is normal.

My body weight is down 4 pounds, and body fat is down 1%, which equates to about 2 pounds of lean mass lost, but this is also well within the normal deviation for me, and could easily be nothing. According to much of what I've read, about 50% of weight loss in the first two weeks is usually water, since hydration is an issue when adapting to ketosis (I have been peeing a lot!). I'd personally rather see the scale go up, while my body fat stays the same or drops, but maintaining for two weeks is nothing to worry about.

Week Three

On Monday, day 15, I woke up feeling great. The constant hunger pangs were gone, replaced by seemingly normal hunger around meal times. Meals made me feel full. My energy and focus throughout the day were good and constant. My workout didn't totally drain me, instead I felt good after.

I woke up around 7am (VERY early for me) feeling great, and when I finally went to bed around 1am it wasn't because I was exhaust, it was because it was time. I slept great.

I was also extremely productive that day. I've said before that my productivity has been rising, and it has. I studied new drink recipes I need to know for a new bar opening a couple weeks, I practiced piano, I tried three new recipes (including keto cookies for the holidays), I cleaned house, I still manged to watch several episodes of a TV show I'm binging, started a new book, went grocery shopping, did a little work on my motorcycle and worked out. And I never felt like I had "too much to do" for the day. 

I think its safe to say I've made it through the initial transition.

Thanksgiving!

The rest of the week has gone really well. I was a bit dumb in planning this whole journey right before the holidays, so half way in to week three was Thanksgiving. My plan was to spend it with my brother and his family who live an hour away, so I planned ahead.

I baked some keto-friendly almond shortbread cookies, I tried two different recipes, both were good. I also made a keto-friendly peanut butter mousse (basically peanut butter and heavy cream, because my brother loves anything peanut butter. Just being a good guest, I also made an asparagus dish I knew was keto friendly.

At dinner, I ate dark meat, a lot of it with gravy made from the turkey drippings (the gravy's only carb was corn starch, about a teaspoon for the whole batch, so not much per serving), and veggies. I skipped the sweet potatoes and stuffing and rolls, which were temping. I forewarned my family of my restrictions so no one was pushing those things on me.

I also had a couple glasses of whiskey and water, instead of beer or wine, and began the day with 500 cal coffee, and ended with 500 cal Chia (with 2 Tbsp each of butter, coconut oil and heavy cream blended in), to push my fat to protein ratios up.

I didn't measure my macros, I just tried to eat smart and get lots of fat. I'm pretty sure I way over did my protein, and was way over my calories for the day, but I expected both of those. Around 7pm I checked my blood work, ketones 0.3, glucose 79 (this is about 30 minutes after finishing the chai. So I crashed my ketones, but had kept my glucose down. I also felt sleepy, so I took a nap in front of the TV.

I woke up about 30 minutes later feeling pretty good. I checked my ketones again, 1.6, so I was back in. I was awake of productive the rest of the night (I even experimented wit making sphereified cocktails around 11pm). The next morning, ketones were still in range. I survived.

Sunday, day 21, I woke up feeling good, well rested, which is not always the case after a Saturday night behind the bar. Hunger pangs have continued to reduce, and the feeling of being full last longer after each meal. I'm definitely through the worst of adaptation now.

I've been really good about my meals, and having a lot of fun cooking new things that are keto friendly. I've felt good all week, waking up rested, and having consistent energy all day. I've found several good resources for keto-friendly food recipies that don't taste like "diet food" substitutes. Keto Connect and Carrie Brown (She has several cookbooks, including one very promising one all about keto ice cream I'm dying to try! I miss ice cream!) and Ketovangelist kitchen also has an associate pod cast. So there are lots of resources for cooking.

Thoughts and Observations

The first 10 days were tough, especially the Keto Flu. Getting genuinely ill didn't wasn't great either, but I think that's anomaly. My energy level suffered, my workouts suffered, and I was hungry most of the time, craving all my comfort foods. It was depressing and I was plagued with concerns that it wasn't working that whole first week.

Food prep is key. Keto is a new way of eating, so its not automatic to choose the right foods. Over time I know this will get easier as I learn, and as cravings fade away. I'm used to trying to force tons of protein to build muscle, now I have to be careful not to over do it. As I progress I'm sure I won't have to prep as much or plan ahead, there's just a learning period.

Learning about keto, and how the body processes excess protein has been an eye opener for me. As someone who has always been underweight, and worked hard to build muscle for nearly two decades, I was always of the belief that extra protein was good. Now I understand that excess protein is converted to sugars and spikes insulin, which can be bad for people who are insulin resistant. So not having to focus so much on proteins will be a shift for me.

I'm interested to see how keto effects my performance and ability to build strength. Its supposed to produce quicker recovery, which should improve muscle growth. In the past I've had problems gaining weight because I couldn't eat enough calories, with keto, that's much easier, just down a couple tablespoons of olive oil! 

My goal is to keep going for eight weeks total, and see how I'm feeling, and assess how its impacting my life. A Keto diet is "limiting" from the stand point of not eating a lot of things that the average population eats, so there could be a sense of missing out. On the other hand, I get to eat a lot of things they don't, like tons of fatty foods. And, if the reports are true, the desire for sugary foods will wane as I progress. 

Socially, I've made one important observation: When sharing food I made, like desserts, unless I want to have a long conversation about what a keto diet is and the health benefits, and argue that fat is healthy, just don't tell anyone the food is "keto friendly." People tend to look at anything that's a "diet food" as not tasty and don't want to try it. Most keto food isn't traditionally diet-food, they're full of fat and salt, which are two of the major flavor enhancers, so the food tastes great. If people don't know before trying it that something is "healthy" or diet related, they taste it with an open mind, and I avoid yet another long explanation.

Besides the social aspects of food, I also want to see how it affects my overall life. Will I have more energy? Will my workouts and recovery improve? Will I be able to build muscle? Will I get shredded? Will be more focused? Will my moods improve? If I'm feeling great, and energetic and happy, and writing a lot and being creative, and productive, those things will easily out weight any social-food related issues.

I've already had several people comment that I look really good. I've not lost any weight or fat (Remember, those aren't goals for me. A lot of people are very successful using keto to lose fat.), but people are still commenting that I look better and asking what I'm doing.

Guess I'm gonna find out!

Adventures in Ketosis - Part 1: Gearing Up

I'm always looking for natural ways to improve my health and sense of well being. Not long ago, I stumbled upon the concept of Ketogenic Adaptation, a.k.a. Ketosis or Keto. The science behind it is a bit complicated, but the short version is this: Adapting your body to prefer burning fats over carbohydrates -- not only for weight loss, but as a life style the has scores of scientifically proven benefits from diabetes control, improved cognition, reduced risk of heart disease, improved athletic endurance and performance,  even reduction of epileptic seizures, and many more.

I'm looking for the increased energy, cognition and performance aspects of it, along with reduced food cravings and, to be honest, getting my body fat below the 10% level out of pure vanity. The numerous other health benefits are a wonderful bonus. 

I won't go into all of the details, because frankly there are lots of resources (Check out The Art and Science of Low Carb Living for the single most comprehensive I've found.) It's similar to Paleo (but grounded in more science, from what I've seen) and Atkins (but less focused on short term weight loss), in that it requires a dramatic reduction in the amount of carbohydrates one eats. But the most important part is a dramatic increase in the amount of fat one eats, up to 80% of calories.

The basic principles to keep in mind when doing this type of diet are:

• Keep net carbs (total carbs minus fiber) below 50g per day
• Keep protein between .7g and 1g per pound of lean body mass per day (too high can throw you out of Keto, to low can cost you lean mass)
• The remainder of your calories (60-80%) are from healthy fat sources, mainly saturated and monounsaturated. 
• Stay away from polyunsaturated fats, too many tend to make people feel ill.
• Increase sodium intake, because you'll be excreting more than on a high-carb diet. 

The goal is to restrict your carbs enough to force your body to convert fats into chemicals call ketones, and to use those as an energy source. However, it can take two to three weeks for this adaptation to take place, and afterwards, increasing your carbs too much can cause your body to switch back over to the preferring carbs.

There is an important distinction a lot of discussions about Keto seem to miss or gloss over: being "in ketosis" is different from being "keto adapted." Ketones are specific chemicals your body produces from fat. When you're body produces enough to put your blood serum levels of ketones between 0.5mM and 8.0mM, you are considered to be "in ketosis." This does NOT mean that your muscles, organs and brain are actually choosing to use these available ketones as fuel. In other words, just because there are ketones available, does not mean your body uses them.

There are now a number of performance supplements available that will very quickly increase your blood ketone levels, but if you're body doesn't choose to burn them (because it is carb adapted), they won't do you much good. Being Keto-Adapted is when you're body recognizes ketones as a primary and preferred source of energy. That takes a couple weeks to reach, and must be maintained through diet. 

Once keto-adapted, I expect the performance benefits of keto supplements are probably very good, but they're pretty new in the market, and I'm not a competitive athlete, so I'll leave them alone for now. Besides, the science already shows the endurance increases of a keto lifestyle are pretty remarkable, I'm not sure the unknown risks of supplements are even worth it.

There's tons of info available about the sciences, the body chemistry, recipes, etc. But little about what to expect while going through adaptation, the initial two to three weeks. What I've seen says many people experience a initial period of lethargy and mental fog, some so bad its called "Keto flu," and that after about two weeks, you suddenly feel fantastic. But not much else about the day to day, hour to hour things you'll experience.

I know when I begin making a lifestyle change, I become hyper aware of my physical and mental state, and constantly wonder "is this normal?" Since I couldn't find anything detailed about what to expect, I decided to document my experience for others considering this change. 

My documentation will be as detailed as I can make it, but I am not a scientific or medial expert, so follow at your own risk. And please, consult your doctor and read the research on Ketosis and Low Carbohydrate Diet before trying this yourself. 

Keto is about using diet to make some pretty radical physiological changes. Fortunately, I love tracking numbers, so I have a solid base line of my own data for months, and even years, across a variety of bio-markers which I will continue to monitor as I go into Ketosis. Here's the various types of data have been and will continue to monitor through the next few weeks.

Heart Rate Variability (HRV): This measures the variation in time between heart beats and is a measure of the your bodies ability to recover from stress, both physical and mental. It is taken every morning upon waking. I've been tracking mine consistently for a couple years as a way to know if my body is ready for another hard workout, and it's very effective in telling me when I need to take a break. I use a Polar Heart Rate monitor chest strap and Elite HRV app. 

Body Composition: Body weight and body fat are important to know together. I have tracked both for years, and recently began using use a Skulpt Chisel, which is accurate to within 2% of a DEXA scan. I have data going back to July 2017 from the Skulpt, so I can monitor any changes in my lean body mass and body competition. I typically weigh myself first thing every Monday morning, take 8 body measurements with a tape measure, and do a full Skulpt scan (16 readings) for body fat and muscle quality. 

Blood Markers: Blood glucose and Ketones are the things I want to know, they should be inversely affected, as Ketones rise, glucose should decline. I use a Keto-Mojo, which monitors both with different test strips in exactly the same way a diabetic would measure their glucose, by pricking my finger and getting a little blood. Prior to beginning the diet, I measured both ketones and glucose for a couple weeks to get a baseline.

Ketones can be measured three ways, with urine test strips, with a breathalyzer and in the blood. Urine stripes only tell you what you're excreting, and are effected by hydration, so they're not very accurate. Breathalyzers measure acetone in your saliva, which again is an excretion, so not as accurate, and the device is expensive.

Keto blood test measure ketones in your blood, which are the ketones you're body can access to energy, so its the most accurate. Until recently, the blood test strips were expensive, about $5 each. Keto-Mojo now offers them for $1 to $2, depending on if you get into their "Founder's Club." 

Macro Nutrients: To make sure I'm doing the diet correctly, I'm recording everything I eat with the Cronometer app on my phone. It can measure net carbs, which makes it much easier, and includes alcohol as a fourth macro, which I do drink, so that's handy. I don't expect to track my food so meticulously after I'm fully adapted, but it'll help to learn what I can and can't eat and how much.

Those are all the things I'll be tracking, along with keeping a journal of my experiences. In my next post, I'll give you details about how it all went!