Five Steps to Jumpstart the Ketogenic Diet

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In this post we will take a look at how Heads Up Health can help you successfully navigate the challenges of initiating and maintaining a ketogenic diet. In particular, we will introduce tools that can help you adjust your food intake to meet the requirements of the ketogenic diet, measure and fine tune your progress along the way and share data with your health practitioner if you need extra assistance.

If you want to skip ahead and start logging some data now, use the button below to create your account. Or read on for our “Five Steps to Jumpstart the Ketogenic Diet.

Step 1 – Master Your Macronutrients (Protein, Fat & Carbs)

The hardest part about going keto, especially for beginners, is learning how to adjust your food intake to meet the requirements of a ketogenic diet. The ketogenic diet is a high fat/moderate protein/low-carb diet. If you’ve never counted calories or read food labels before, learning how to correctly adjust your diet can be tricky at first. Fortunately, there are some tools to help and we will cover them in this section.

As a general rule of thumb, your daily caloric intake on keto will consist of approximately 75% fat, 20% protein and 5% carbs. If you are new to keto and coming off the Standard American Diet (or other “low-fat” diets), simply shifting your food intake toward these general percentages will begin to produce some noticeable results. Give it a try for a few weeks and see how your body responds.

Macronutrient ratios for ketogenic diet

Macronutrient ratios for ketogenic diet

Example: When I first started keto for general weight loss, I focused only on percentages and set a goal of 80% fat/15% protein/5% carbs. It took a few weeks of trial and error to learn which foods I could to eat in order to reach my goals, but it got easier with practice. Over the course of about six months my weight dropped from 197 pounds to 184 pounds and my body fat dropped from 24% to 20%. Overall I was very pleased with these initial results.

Once you get comfortable with the general high-fat/modest protein/low-carb diet, you can further optimize your results by measuring your macronutrients in grams. This allows you to further refine your caloric intake based on your age, sex, body-type and activity level. You can also tailor your caloric intake based on your own unique metabolic characteristics and your specific health objectives on keto (weight loss, cancer treatment, diabetes management, muscle growth etc.)

  • Example: After my first six-months on keto using basic percentages, I decided to start tracking macronutrients in grams so I could shift focus from losing weight to building muscle. I used the Ketogains calculator and shifted to a daily goal of 1,600 calories consisting of 124 grams of fat, 100 grams of protein and 20 grams of carbs.

Your best friend for learning how to track your macronutrients on keto is the myFitnessPal app. This is a free app that makes it easy to track your daily macronutrient breakdown. Here are the recommended steps to use myFitnessPal to fine-tune your macronutrient consumption:

1a. Download myFitnessPal on your smartphone or computer

1b. Change the app settings such that your daily macronutrient goals are appropriate for a ketogenic diet. A good place to start for beginners is with a goal of 75% fat:20% protein:5% carbs. The image below shows how to change your goal settings on the iOS version of myFitnessPal. Whether you are using percentages or grams, you can tweak your daily macronutrient goals on this screen:

Changing MyFitnessPal goal settings on the iOS app

Changing MyFitnessPal goal settings on the iOS app

1c. Log everything you eat throughout the course of the day in MFP. For packaged foods that have a barcode, use the app’s barcode scanner to import the macronutrient data into your personal profile

1d. Regularly check your progress throughout the day to ensure you are adhering to your macronutrient goals and adjust food intake accordingly. The image below shows how you can check your progress through the app to see how close you are to your target ratios:

MyFitnessPal macronutrient ratios

Check your progress in the MFP app

1e. Lastly, sync your MFP account to your Heads Up profile so you can track your nutrition data along with everything else we will be covering in the rest of this post. For example, in the graph below I am comparing my daily fat intake (measured by myFitnessPal) with my daily blood sugar readings (entered manually).

Correlating fat intake with fasting blood glucose

Correlating fat intake with fasting blood glucose

This takes some work up front but it’s a very educational exercise. After a couple weeks, you’ll have the hang of it. You will likely reach the point where eating to your target macronutrients is pretty intuitive. Additionally, as you become more advanced with the ketogenic diet, you may find yourself revisiting your macros and tweaking them to suit your specific body and your specific health goals.

Learning how to properly calculate and track macronutrients is essential on keto so it’s worth the time investing in this skill. If you have questions, there are tons of online ketogenic communities (check out the Ketovangelist group on FaceBook) that can help you dial things in and answer your questions.

Step 2 – Balance Your Blood Sugar

In addition to MyFitnessPal, your glucometer will become another very important tool in your keto toolkit.

Track your blood glucose with Heads Up Health

Tracking your blood glucose

There are a few important areas to pay attention to when it comes to tracking your blood sugar on keto:

  • Fasting blood sugar: Your “fasting” blood sugar is taken after consuming no food or drink (except water) for a period of 8 hours. Typically this measurement is taken first thing in the morning upon waking. Your fasting blood sugar will drop significantly on keto as you reduce your carbohydrate intake. This is also one of the first telltale signs that your body is on the way toward a state of ketosis.
    • Example: When I am not following a low-carb/high-fat ketogenic diet (i.e. eating whatever I want), my fasting blood sugar typically ranges between 95-100 mg/dL (5.3-5.6 mmol/L). When I am following a keto diet, my fasting blood sugar is typically between 80-85 mg/dL (4.4-4.7 mmol/L). I’ve gotten to know my body well enough that after about three consecutive days of fasting readings between 80-85 mg/dL, I expect to be in ketosis and will measure my ketone levels to confirm (more on that later).
Fasting_Glucose_Heads_Up_Health

Fasting glucose decreasing as you reach ketosis

  •  Post-prandial blood sugar: “Post-prandial” simply means a blood sugar reading taken after you eat a meal. Our goal on keto is to keep blood sugar low, thereby minimizing our insulin response. If you aren’t sure how your body will respond to a certain meal, test your blood sugar one-hour, two-hours and three-hours after eating. Try to limit post-prandial blood sugar to below 140 mg/dL (7.8 mmol/L) and ideally below 120 mg/dL (6.7 mmol/L). Healthy fats consumed in food have virtually no impact on blood sugar, which is part of the reason why a low-carb/high-fat diet is excellent at keeping you feeling full AND minimizing blood sugar response.
    • Also notice how high your readings go after a particular meal and how long it takes for your readings to return to normal.

For more information on tracking blood sugar with Heads Up Health, check out our blog post and the video below:

Step 3 – Beat Down Body Composition

Weighing oneself every few days is another important monitor. The state of ketosis causes a diuretic effect resulting in weight loss due to loss of body fluid, which may be 5-10% of total body weight in the first few weeks of going keto. This is why it is imperative to hydrate with fluids and keep an eye on the scale, especially during the early stages of keto.

Withings_Body_Composition_ketogenic_diet

Track body composition while on the ketogenic diet

Once your body’s mineral and fluid levels have had a chance to adapt to the new diet, your body will start melting away unwanted fat. By keeping blood sugar low through a low-carb/high-fat diet and minimizing insulin response, we shift the body’s metabolism to burning fat instead of storing fat. Even better is the fact that unlike a traditional calorie-restricted diet, you won’t be sacrificing muscle mass as you lose weight.

It is important to track BOTH weight AND body fat on ketogenic. If the weight number isn’t moving down but the body fat number is, you are on the right track. You are building and maintaining muscle mass while the fat mass is going down! You will likely notice your clothing starts to fit much better, even though your total scale weight may not be moving as fast as you’d like.

Heads Up can automatically connect to wireless scales from FitBit, Withings and more. Or you can enter the data manually from any scale you want.

Track your body composition on ketogenic diet

Track your body composition on ketogenic diet

There are limitations with scales as a measure of body composition, but the data can still be a helpful guide. For more advanced body composition testing, consider periodic DEXA scans, which are considered the gold standard. For example, I personally use a Tanita body fat scale at home for daily readings and I supplement this with bi-annual DEXA scans.

Step 4 – Time to Test the Ketones

So now you’ve dialed in your macronutrients with MyFitnessPal, you’ve seen your fasting blood sugar readings come down as you’ve restricted carbohydrates in your diet and you are seeing your weight start to come down on the scale. Next step is to test ketone levels to ensure your body is entering into ketosis.

There is a big difference between just eating a low-carb/high-fat ketogenic diet and actually being in a state of ketosis. This is an important distinction to understand, especially for beginners.

There are two methods you can choose from for testing ketones:

4a. Blood ketones: This is considered the most accurate method. Just like testing blood sugar, it’s a drop of blood onto a finger stick to get a reading. Nutritional ketosis is considered to be in the range of 0.5 – 3.0 mmol/L.

 

Precision_xtra_blood_ketones

Track blood ketones with the Precision xtra ketone meter

4b. Breath ketones: This method is more affordable as it does not require expensive test strips. Devices like the Ketonix breath ketone meter provide a reusable and accurate method for testing.

Breath ketones - ketonix

Ketonix breath ketone tester

Some people may find they can effortlessly enter ketosis within a few days of following a low-carb/high-fat ketogenic diet. For others, it may take weeks of trial and error. A lot depends on your own unique level of metabolic health. Testing ketone levels can be a very helpful piece of biofeedback as your learn to master the ketogenic diet.

track_ketones_heads_up_health

Enter ketone readings into Heads Up Health

Regardless of which method you choose, be sure to log your readings in Heads Up.

track_ketones_dashboard_heads_up_health

Track ketones on your Heads Up dashboard

Once you have a good handle on what it feels like to be in ketosis and which variables affect your level of ketosis (sleep, stress, exercise etc.), you may find yourself needing to test ketones less frequently. Conversely, if you are using the keto diet for cancer treatment, diabetes management, obesity management or fasting protocols, you may still need to test regularly.

For more information on how to track ketones with Heads Up Health, check out this video:

Step 5 – Don’t forget the bloodwork

The last piece to keep an eye on is your blood chemistry. We highly recommend periodic lab work (ideally every six months) to make sure everything on the inside is trending in the right direction.

There are a few specific sets of lab values to keep an eye on. We break them down here with some high-level guidance on what you should expect to see. Work with a health care practitioner for further guidance on running lab tests and interpreting results.

  • Lipid panel (cholesterol, HDL, LDL, triglycerides and particle size): In general your lipid panel numbers should improve on keto. While total cholesterol and LDL cholesterol may increase, this should be more than offset by the increase in HDL (good cholesterol) and the drop in triglycerides as you reduce refined carbohydrates. LDL particle size should also improve as your make the switch to a diet higher in healthy fats that are rich in omega 3’s.
  • Inflammation (hs-crp, homocysteine): These and other markers of inflammation should start to come down as processed foods, refined sugars and other inflammatory foods make their way out of your diet.
  • Blood sugar (glucose, insulin): Fat consumed in food has virtually no impact on blood sugar and insulin levels. As such, metabolic markers like glucose and insulin should start to trend down as you make the switch to a low-carb/high-fat diet.
  • Full thyroid panel: If you feel you are doing everything right but still not able to lose weight on keto, you may want to consider a full thyroid panel. This panel will check your body’s hormonal and metabolic systems to ensure they are in working order. This panel can also be helpful for those who have been on keto for a long period of time. Some long-time keto dieters report symptoms such as hair loss, cold hands and other symptoms which may suggest nutrient deficiency or thyroid-related issues.

The Heads Up Health software is connected to over 2,000 medical facilities across the United States and can automatically sync your lab test results. For facilities we don’t support, it only takes a few minutes to enter this data manually. See this video for instructions on both methods.

Tracking lab tests in Heads Up Health

Tracking lab tests in Heads Up Health

If you want to run your own labs, our resident Functional Medicine Advisor, Dr. Justin Marchegiani, has put together a comprehensive panel for only $349.

Ketogenic Diet Summary

More and more people are turning to the ketogenic diet for the wonderful benefits that come from a body burning fat for fuel as opposed to sugar. The benefits don’t always come easy though and ketogenic diets take some work.

Heads Up was built specifically for this purpose. We give you the tools to track all your data and kick maximum keto butt! You can get started for free using the button below. If you have any questions at all, we are here to help. Shoot us an e-mail and we will get back to you in a jiffy.

 

About the Author


Dave Korsunsky is a technologist and health tracking enthusiast. He is also the founder and CEO of Heads Up Health.

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