Author: Dr Jerry

A guide to Dairy and the Ketogenic Diet

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You might have noticed that there are mixed opinions from keto diet experts about dairy. Some feel it ok to include, others think that it is not.

Dairy has received both good and bad press over the years in regards to both weight loss and overall health.

Here is why it can be confusing to the eat dairy on a keto diet: milk, ice cream, and non-fat dairy products don’t belong in a keto diet. Yet butter, cheese, and other types of full-fat dairy can be a good fit.

Here are the basic types of dairy:

  • Milk
  • Cheese
  • Buttermilk
  • Butter
  • Curd
  • Cream
  • Ice Cream
  • Whey
  • Evaporated Milk
  • Condensed Milk
  • Sour Cream
  • Yogurt

In this article, we will take a closer look at dairy’s positive and adverse health effects. We will also look at some of the healthiest keto-friendly dairy choices you might want to include in your diet.
Understanding the components of dairy

To make it very simple: a dairy product is any food or beverage made from the milk of mammals.

Dairy from cow milk is by far the most common type consumed, there are also goat and sheep dairy products that are popular in some parts of the world.

When you break it down, there are four main components of dairy:

Lactose

Lactose is a disaccharide, or two-unit sugar, consisting of one molecule each of the simple sugars glucose and galactose.

The enzymes in your small intestine break down lactose into these simple sugars, which are then transported into your bloodstream.

Casein

Casein accounts for 80% of the total protein in dairy, including all nine essential amino acids. When milk is treated with the enzyme rennet to make cheese, the casein coagulates into curds, and the liquid portion containing whey is removed. Compared to whey and other proteins, casein can take longer to digest.

Whey

Whey protein makes up the remaining 20% of the protein in milk.

Most of the whey is removed during the process of making cheese. Like casein, whey contains all the essential amino acids, although it is digested much more rapidly.

Fatty Acids

There are hundreds of different fatty acids in milk, and the vast majority are saturated:

Saturated: 70% of total dairy fat, including 11% as short-chain fatty acids like butyrate and caproic acid

Monounsaturated: 25% of total dairy fat

Polyunsaturated: 5% of total dairy fat, including 2.5% naturally occurring trans fatty acids. Dairy trans fats are very different from the industrial trans fats found in margarine and other processed foods. Dairy trans fatty acids seem to have neutral or potentially even beneficial effects on health.

How much dairy is too much for ketosis?

While one cup of whole milk won’t harm you (or kick you out of ketosis), it is a bit higher in carbohydrate content than preferred for those on a low carb or ketogenic diet.

For this reason, milk can contribute to the hidden carbs that you may forget to factor into your keto macronutrient goals for the day.

Some examples of the types of dairy you can eat on keto are:

  • Greek yogurt
  • Heavy whipping cream
  • Spreadable cheeses including cottage cheese, cream cheese, sour cream, mascarpone, creme fraiche.
  • Soft Cheese including mozzarella, brie, blue, colby, monterey jack.
  • Hard Cheese including aged cheddar, parmesan, feta, swiss.

Of course, remember that there is a calorie component to cheeses and creams and that consuming a significant amount may reduce your weight loss.

As with most foods, enjoy a reasonable amount of dairy (in moderation), and you will enjoy the benefits of staying in ketosis.

Whether you’re looking to lose weight, manage a chronic medical condition, or simply want to overhaul your eating habits, changing your diet for the better is one of the best ways to improve your overall health.

Dr Jerry Hizon, MD strives to demystify the complex science of nutrition, giving his patients sound nutritional guidance designed to set them up for long-term dietary success, whatever their specific goals may be.

The Keto Diet and Intermittent Fasting

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The keto diet and intermittent fasting are two popular diets for losing fat, gaining lean muscle mass, and boosting your energy levels.

Many people wonder whether combining intermittent fasting with keto can help you experience even greater results.

The short answer is yes. Intermittent fasting on the keto diet is a simple ‘hack’ that can definitely accelerate the results and benefits.

What is Intermittent fasting?

If you’ve slept overnight and not eaten for 12 hours, then you’ve already experienced intermittent fasting! It simply means that you go for a specific period of time without eating. Some people choose 12 hours, 16 hours or even 24-48 hours. Whatever period of time you select is called your ‘fasting window.’ When you are outside the fasting window, you eat normally.

The key is to know when and for how long to fast. That way you aren’t tempted to snack during that time.

The difference with intermittent fasting is that usually when you eat throughout the day, you’re in a fed state. This makes your body keep digesting and absorbing nutrients from your meals.

Most people who have breakfast, lunch, and dinner will remain in this state during the day, and into the night. The only time their digestive system gets a break is when they’re sleeping.

When your body to enter the fasted state (usually after about 8-12 hours), it means that accelerated fat burning can now take place. Essentially fasting kicks your body into the same ketosis state as being on the keto diet does.

Keto is accelerated with Intermittent Fasting

Since the keto diet is designed to force the body into running on ketones from a very low-carb intake, you’re essentially fasting yourself of carbs. In a way, this mimics regular actual fasting that takes place with intermittent fasting.

When you restrict your body’s primary fuel source on the keto diet, adding fasting can kickstart your body into ketosis. Once you’re there, you just need to stay on the keto diet to stay in ketosis.

Also, when on the keto diet, you may find it easier to fast for extended periods of time, since your body becomes adapted to the fat burning and you are less hungry.

Here are other benefits that intermittent fasting with keto can give:

– Balancing blood sugar
– Improving nutrient absorption
– Detoxification
– Clearer mind, less brain fog
– Increased fat burn during exercise

On top of all this, intermittent fasting can help with unnecessary snacking and extra caloric intake throughout the day. And it’s as simple as setting a goal to not eat for as little as 8-12 hours. As you build your fasting window, you may find you can last 12-16 hours and then perhaps even 24 hours without too much worry.

If you are serious about kick-starting your keto journey, then intermittent fasting can give you that extra push you need. Once your there in the ketosis state, it’s much easier to stay on the keto path and achieve your goals.

Whether you’re looking to lose weight, manage a chronic medical condition, or simply want to overhaul your eating habits, changing your diet for the better is one of the best ways to improve your overall health.

Dr Jerry Hizon, MD strives to demystify the complex science of nutrition, giving his patients sound nutritional guidance designed to set them up for long-term dietary success, whatever their specific goals may be.

What kind of exercise is best for the keto diet?

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When starting to exercise on a keto diet, you may feel different than you have before. You may feel weaker, or not have the stamina that you had when eating a lot of carbs.

However, exercise, in general, will help you get into ketosis faster, so that is not a deterrent from embarking on exercise during this time frame. Instead, you should focus more on endurance and mobility.

Before the ketogenic adaptation phase is complete, your body is essentially weaning itself off the carbs as a food source. Carbs tend to be very good for exercise because they can make you feel like you have a lot of energy. But if you are wanting the full benefits of the keto diet, you must go through this phase.

The first few weeks, stick to light exercise

Before being keto-adapted, in the first 2-3 weeks of adopting the ketogenic diet, you should stick to low-intensity, aerobic exercise for a majority of the time so as to prevent sugar cravings and muscle catabolism during exercise.

Aerobic exercise, sometimes called cardio exercise, is anything that lasts over three minutes. It is ideal during this early phase. Lower intensity, steady-state cardio burns fat, making it very friendly for the keto dieter. You can also increase electrolyte and fluid intake by consuming water with a pinch of salt before working out.

Anaerobic exercise is characterized by shorter bursts of energy, such as from weight training or high-intensity interval training. Carbohydrates are the primary fuel for anaerobic exercise, so fat alone can’t provide enough energy for this type of workout.

Build up to high intensity over time

You should avoid doing high-intensity, anaerobic exercises until you’re are keto-adapted. because it can be counterproductive to adaptation and you will definitely have decreased performance during this time period.

Other exercises you can do during the early phases of the keto-adaptive phase are:

Flexibility exercises: these are helpful for stretching out your muscles, supporting joints, and improving muscle range of motion. Increasing your flexibility can also help to prevent injuries caused by shortening of the muscles over time. Yoga and simple after-workout stretches are good examples of flexibility exercises to try.

Stability exercises: these include balance exercises and core training and will help improve your alignment, strength of muscles, and control of movement.

Will you lose muscle mass on keto?

Very often when considering the ketogenic diet, there is a concern about whether you will lose muscle mass. The keto diet is known for having great results for weight loss, however, there is a misconception that you may lose muscle as a part of the weight loss.

Really, it all comes down to what you eat.

Going keto means greatly reducing carbs, and since carbs are usually the body’s primary source of fuel, the diet requires using fat and protein as the main source of fuel.

If you still consume a good amount of healthy protein and fats when following the keto diet, your muscles will be fine.

The good news is that while there are some things to keep in mind, exercise is very possible and beneficial to the success of the ketogenic diet.

As you become keto-adapted, make sure to listen to your body, and go easy on heavy exercise for the first few weeks. Slowly, you will find that you can function just as well as before, perhaps even better on the keto diet when exercising.

Whether you’re looking to lose weight, manage a chronic medical condition, or simply want to overhaul your eating habits, changing your diet for the better is one of the best ways to improve your overall health.

Dr Jerry Hizon, MD strives to demystify the complex science of nutrition, giving his patients sound nutritional guidance designed to set them up for long-term dietary success, whatever their specific goals may be.

Constipation and Keto: Does it go away?

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One common side effect of a ketogenic diet is constipation. Constipation can be caused by many things namely: dehydration, lack of fiber, improper gut bacteria, etc.

Good news, constipation is temporary and there are many remedies you can do to reverse and prevent it, whilst still remaining on the keto diet. Below we have listed a few.

  1. Hydrate: Drink enough water & add salt to your water

As our bodies switch to replacing carbohydrates as a main fuel source to ketones, one loses electrolytes and fluids naturally. Loss of fluids can cause stool to dry out and lead to constipation.

Make sure you drink enough fluids each day and consider adding 1-2 tablespoons of salt twice a day to a glass of water to ensure you are getting enough electrolytes, as well.

  1. Eat enough fiber: Consume more low-carb & high fiber fruits and vegetables

Cutting out carbohydrates often means cutting out our main sources of fiber (i.e. grains). Fiber helps for healthy stool growth and evacuation (too much fiber can have the opposite effect).

Make sure you are getting enough fiber in your diet by adding low-carbohydrate fruits like avocados, tomatoes, cucumbers, and olives. Also eat plenty of low-carb, high-fiber leafy greens like kale, spinach, and lettuce.

  1. Consume MCT oil: Switch out your coconut oil for MCT oil

MCT (medium-chain triglycerides) oil has a natural laxative effect. Switch out your coconut oil for MCT oil to help with constipation.

Be careful to gradually incorporate MCT oil into your diet, because too much of MCT too quickly may cause stomach cramps, etc.

  1. Drink apple cider vinegar & herbal teas: Apple cider vinegar before each meal & tea after

Both apple cider vinegar and certain herbal teas have been known to aid in digestion.

Consider adding 1-2 teaspoons of apple cider vinegar to a glass of water before each meal. Drink herbal teas that have things like ginger, licorice, or dandelion after meals or as a replacement for coffee.

  1. Add proper probiotics & prebiotics to diet: Make sure your gut bacteria are healthy

Making a transition from carbs to lot of fats for fuel can have an effect on the many natural bacteria of your gut. The bacteria of your gut aid in digestion, which in turn aid in stool formation and evacuation.

To ensure you keep the proper ratios and health of these bacteria make sure that you are getting enough probiotics and prebiotics in your diet by incorporating things like whole-fat and low-carb yogurts and probiotic coconut yogurt like Coconut Cult yogurt.

  1. Consider supplementation: Milk of Magnesia & fiber supplements can be used

If the above changes to your diet do not work or are not feasible, try over-the-counter supplementation with things like Milk of Magnesia and/or fiber supplements.

All in all, as your body adapts to a ketogenic lifestyle and you implement a few of the above remedies, you should be able to enjoy a ketogenic lifestyle free of constipation. If constipation continues despite these remedies, see a doctor.

– Dr Jerrry Hizon

Vegetarian Options for the Ketogenic Diet

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Are you a vegetarian and want to start the ketogenic diet?

Good news, a vegetarian keto diet is both reasonable and possible. Here are a few things to consider when doing so.

Since vegetarians naturally eat more vegetables and grains as a replacement of meats and animal flesh, they must be careful to not to go beyond the typical 35 grams limit of carbohydrates per day on a keto diet.

To assist you here is a guide to carbohydrate options as a keto-vegetarian:

What to Avoid:

  • Grains (pasta, bread, tortillas, rice, cereals, etc.)
  • Legumes (beans, etc.)
  • Sugars (honey, soda, table sugar, syrups, etc.)
  • Fruits (especially juices; eat more whole fruits and limit the number of whole fruits)
  • High-starch root vegetables (potatoes)

What to Eat:

  • Swiss chard
  • Kale
  • Spinach
  • Broccoli
  • Cauliflower
  • Asparagus
  • Cucumber
  • Summer or winter squash
  • Mushrooms
  • Eggplant
  • Garlic
  • Onion
  • Tomato
  • Green beans
  • Bell peppers
  • Cabbage
  • Zucchini

It is also important for vegetarians on keto to ensure that they are getting enough proteins and fats in their diet. An easy way is to incorporate the following oils, fats, and proteins in their daily diets.

It can be noted that eggs and high-fat dairy are a GREAT source of both fats and protein for a vegetarian. To be eco and animal-friendly with these items, you can consider sourcing from local farms. Make sure to research brands at your local supermarkets that pasture-raise their animals (not just marketing terms of “cage-free”).

Fats and Oils options as a keto-vegetarian:

  • Avocado (whole and in oil form)
  • Olive oil
  • Coconut oil
  • MCT oil
  • Olives
  • Coconut cream
  • Full-fat cheeses
  • Grass-fed butter

Protein options as a keto-vegetarian:

  • Eggs
  • Full-fat dairy
  • Tempeh (fermented and organic tofu)
  • Tofu
  • Seitan (grain-based so higher in gluten)
  • Miso
  • Nuts and seeds (best= macadamia nuts, walnuts, coconut, almonds, pecans, brazil nuts, pine nuts, chia seed, flax seeds, etc.)

In addition to the above, here is a list of possible substitutes that vegetarians (and vegans) may want to consider using when going keto. Be careful to check the carbohydrate content of these substitutes, as they often have added sugars or more carbs than their “meat” replacements.

Vegetarian alternatives or substitutes on a keto diet:

  • Replace heavy cream with coconut cream
  • Replace yogurt and sour cream with nut-based yogurt
  • Replace butter with coconut oil or vegan butter
  • Replace animal cheeses with nut-based or vegan cheeses
  • Replace table sugar and honey with stevia or erythritol

All in all, there are many options when going keto as a vegetarian. Make sure to stick to the proper macro ratios of a ketogenic diet. You can do this by using a keto macro calculator to help you keep track of and obtain the proper macro ratios.

– Courtney Assuma

How to measure your Keto Diet success

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When you start the Keto diet how do you know when you have achieved nutritional ketosis? How do you know if the diet is successful? Have you actually reached ketosis?

There are three different types of ketones we can measure in the body to see if we are in ketosis: acetone, acetoacetate, and Beta-Hydroxybutyrate (BHB).

Measuring Acetone

Acetone is the least invasive ketone to measure, as it is found in the breath. Since acetone is not the ketone used for energy by the body this is not a direct measure of ketosis. The presence and level of acetone positively correlates with BHB and can be used as a less precise measure of ketosis. When measuring ketones with breath, the Ketonix will light up with a color corresponding to the amount of ketones present. Usually yellow to red is the goal.

Measuring acetone can be done by using a Ketonix breathalyzer. The device can be used multiple times without anything more to purchase. While a little pricey, about $189-$239, the one-time investment is the only investment.

Measuring Acetoacetate

Found in the urine during the first few weeks of the Keto diet, measuring acetoacetate is relatively easy to do. This method is probably the least effective because it is dependent on the user’s ability to correctly identify which color the stick actually is and the overflow of ketones not the actual level of ketones in the body is what is measured here. When measuring ketones from a urine stick match the color of the stick to the color on the label, usually the darker purple, the higher the levels of ketones.

Acetoacetate can be measured using ketone urine strips like Ketostix, which are inexpensive around $10 for 50-120 strips. Measuring ketones through the urine is only feasible for 2-4 weeks at the beginning of the Keto diet, after that the body is Keto-adapted this is no longer an effective way to measure ketones.

Measuring Beta-Hydroxybutyrate (BHB)

Found in the blood, BHB is the most precise measurement of ketosis and is measured the same way as glucose. This method is the most invasive as pricking the finger is needed to obtain the blood to be tested. When measuring the BHB, the ideal range for weight loss is about 1.5-3 mmol/L and for a therapeutic diet (think cancer support) it is from 3-6 mmol/L.

A blood meter and strips are needed to perform this measurement, and these can be pricey, the strips alone run from $5-10 and the meters are around $40-60.

Are There Other Ways to Measure?

Yes, once you have been on the Keto diet awhile, there are signs you can look for that will indicate you are in ketosis. These include:

  • Reduced hunger, you can go longer than 2 hours without eating
  • Mental clarity will be increased
  • Stable energy throughout the day, no afternoon crashes
  • Reduced cravings

While these are not a way to measure your ketone level, once you have established your Keto diet and tested your levels, you can begin to know how your body feels when in ketosis and when you have slipped back into using glucose. If you cannot tell a difference, then testing with one of these methods will be necessary.

As always, before beginning a new diet or lifestyle change, please consult your doctor, especially if you are on medication.

– Erin Kirkpatrick

What are the Benefits of the Keto Diet?

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When considering a ketogenic diet, many people wonder if the change is worth it? Obviously any diet is usually started because of the health and weight loss benefits. However, there are many benefits to low-carb, high-fat ketogenic diets.

Below I have listed a few of the benefits that sway many people to choose a keto diet.

Increased weight loss

Eating a high-fat diet, low-carb diet facilitates weight loss by diminishing hunger, reducing overeating or eating too many “empty” calories. Feeling satiated longer also helps facilitate fasting, which can further assist in weight loss.

In addition, a high-fat, low-carb diet can decrease total body fat as it decreases insulin levels, leading to less fat storage, and it causes the body to “burn” its’ fat stores for fuel decreasing fat stores overall.
Reduced risk of Type II diabetes

When we eat carbohydrates, they are broken down into simple sugars. They are then released into the bloodstream, leading to increased blood sugar levels. As blood sugar levels increase, insulin is released. Insulin is a hormone that tells our bodies to store as much energy in the form of glycogen and fats as possible.

By eating a low-carb keto diet, one can normalize blood sugar levels, control the release of insulin, and reverse the effects of insulin resistance (characteristic of type II diabetes). In this manner, keto can be used to treat or possibly reverse type II diabetes, sometimes even replacing or supplementing medication.

Improvement of neurological disease

A high-fat, low-carb keto diet has a neuroprotective effect by correcting abnormalities in cellular energy usage common in most neurological disorders.

In this way, a keto diet can improve memory function, minimizing diseases like Alzheimer’s and Parkinson’s.

It has also been shown to help epilepsy by reducing seizures and lead to mood stabilization when dealing with diseases like autism and even schizophrenia.

Reduced risk of heart disease

A low-carb, high-fat diet can reduce the risk of heart disease by reducing triglycerides, increasing “good cholesterol” and decreasing “bad cholesterol,” lowering blood pressure, and reducing abdominal fat.
Increased triglycerides levels in blood and increased fat in the abdominal cavity lead to increased risk for heart disease. A keto diet decreases the amount of triglyceride in blood and lowers the amount of fat in the abdominal cavity, reducing the risk of heart disease.

Furthermore, a low-carb, high-fat diet leads to increased HDL (“good cholesterol”) and a decrease in LDL (“bad cholesterol”). LDL, the “bad” cholesterol, carries cholesterol from the liver to the rest of the body. Whereas, HDL, the “good cholesterol,” is a lipoprotein that carries cholesterol away from the body and to the liver where it can be reused or excreted.

In addition to the above, a low-carb, high fat keto diet is also known to decrease blood pressure, reducing the stress on the heart and the risk for heart disease.

Cancer treatment and prevention

Cancer cells, unlike normal cells, can only metabolize glucose for energy. Thus, switching to a high-fat and low-carb diet can essentially “starve” cancer cells of glucose, whilst still feeding normal cells which can metabolize fats as energy.

Consistent energy levels

A low-carb, high fat keto diet can help to stabilize energy levels throughout the day as one can avoid the “bonking” or crashes from carbohydrate intake (rapid blood sugar increase and decrease).
The high fats can keep one satiated and full of energy longer, reducing any cravings or caffeine needs/ crashes as well.

Increased performance for endurance athletes (endurance performance)
A low-carb, high fat keto diet has been implicated with increased output and increased performance for a longer duration for endurance athletes.

Increased longevity

A keto diet can decrease the risk of cardiovascular disease and myocardial infarction and protect against strokes, in turn decreasing associated mortality.

Anti-aging

As mentioned above, a low-carb keto diet can lower insulin. Lowering insulin reduces oxidative stress on the body. Reduced oxidative stress increases lifespan and slows degradation, having an “anti-aging” effect.

Decreased pain and lower inflammation

A low-carb keto diet also decreases inflammation. Decreased inflammation, leads to decreased pain.

These are some of the benefits that you can expect from the keto diet, if you stay committed to it. Of course, there can be challenges, but the results are worth it.

If you are interested in getting started with a keto diet, we can help you stay on track, with our Nudge Coaching program, and guidance from Dr Jerry Hizon. Contact us to see how much better you can feel!

– Courtney Assumma

The Challenges of Going Keto

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As one begins to embark on the Ketogenic diet many challenges arise; ranging from social to medical to the fear-inducing Keto-flu to fighting carbohydrate or sweet cravings to the “what on Earth am I going to eat?!” question.

Friends and family may be shocked when you decide to eat a high fat diet after believing that fat is the enemy campaign for the last 40 years, options at the coffee shop are slim to none, and people look at you like you are in a cult as you describe your fat-burning breakthrough.

While all these challenges may seem funny, they feel very real to those of us that have “Gone Keto.”

Let’s go through and see how we can get through some of these challenges.

Medically research has shown the Keto diet has shown great promise in slowing and in some cases stopping the progression of many chronic diseases such as Type 2 Diabetes, Alzheimer’s, arthritic conditions, high cholesterol/low HDL cholesterol, cardiovascular disease, and obesity. Unfortunately, we cannot say the same for a high carbohydrate diet.

The Keto-Flu is a short period during which the body is adapting over to using ketones for fuel instead of carbohydrates. One way to reduce the symptoms of the Keto-Flu is to begin the Keto diet slowly with a slow carb diet by gradually getting rid of carbs over a few weeks.

Increasing salt intake will also help as it is critical to keep a healthy electrolyte balance; pink Himalayan sea salt has a nice blend of minerals and works well for this. Increasing water intake to about 2-3 liters per day is very important as well because as we decrease the number of carbs we eat the body will flush out excess water.

Social life can get a little tricky on Keto. Most people socialize around food and will not support a person who isn’t eating the typical American fare. This is when Keto support groups and Keto meet-ups can be helpful. There are many options for support groups that only meet online and there are some groups that meet in person on a regular basis.

Sharing recipes and pushing through a plateau is always easier with friends that have been through the same struggles. Carrying your own oil packets can also be helpful when eating out as you can add a healthy fat to most meals and still get it to be Keto-friendly.

And the question… What am I going to eat?!

As one transitions from high carb to slow carb to keto increasing fat is easy because it is done in steps. Cutting out grains, sugar, and potatoes the first week is a great way to reduce carbs. Adding coconut oil or grass-fed butter to coffee is a nice way to increase fat intake. Pouring olive oil on everything you eat will increase the fat intake. Eating one avocado per day will add over 20g of fat while only adding about 10g of carbs. Taking the next steps of eliminating underground vegetables, keeping protein to about 20% of your caloric intake and fueling up on fats can come later when you have gotten comfortable with the slow carb lifestyle.

Fighting the carb and sweets craving can be a challenge if there are no healthy options around. A great thing to have on hand at all times is dark chocolate (either 70% cacao or stevia sweetened); a square or two can usually cut through any sweet craving. Also, dropping one in your coffee along with a spoon of coconut oil is like eating a Mounds bar. Another option to have stored in your freezer or fridge is sweet or savory Keto-bombs/fat-bombs. These are like truffles made with healthy fat and a small amount of flavoring (you choose) that can be popped in your mouth whenever you feel a craving come on.

As with any new diet or exercise program, it is always recommended to consult your medical doctor especially if you are on any medications.

Listen to your body and go slowly.

– Erin Kirkpatrick

What to know about a Ketogenic Diet during Pregnancy

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There is a lot of agreeance among the health and nutrition fields that point to a ketogenic diet as an aid to fertility. While ketosis can be helpful in helping one get pregnant, the question is: is it safe to maintain a keto diet while pregnant?

Ketosis vs. Ketoacidosis

There is a bit of controversy whether the answer to this question is yes or no, and most doctors are still trying to “get with the curve” and understand/ grasp what a ketogenic diet is. Such doctors in the latter half of the controversy, are hesitant to recommend or even steer patients away from “low-carb” dieting while pregnant based on their concerns not on ketosis, but something called ketoacidosis.

Ketoacidosis is a state in which the body has an extremely high number of ketones and blood sugar levels. The result is a dangerous acid-base (pH) imbalance. Such a state is unhealthy for any individual, pregnant or not.
Ketosis, on the other hand, is a metabolic state in which the body uses fats (ketones) as fuel versus carbohydrates. In ketosis blood sugar is normal, there is a healthy pH (acid-base) balance, and ketone levels are relatively low. This is considered a “healthy” state of the body.

Maintaining a healthy keto diet leads to a state of ketosis, not ketoacidosis. Ketosis can be healthy for both mom and child when it comes to pregnancy.

Natural Pregnancy and Ketosis Connection

Keto and pregnancy are naturally connected. Nausea and curved appetite during pregnancy cause many women to go in and out of ketosis naturally. In addition, pregnant women naturally become insulin resistant to provide the developing child with proper nutrients, making them more sensitive to carbohydrate intake. Thus, maintaining a ketogenic diet during pregnancy may help aid these natural processes.

In addition, ketosis can be a healthy and natural adaptation for the baby. Keto-adapted babies have an easier time converting ketones to acetyl-coA and myelin. Such conversions aid in brain and neural development of the child.

Eat Whole Foods and Listen to Your Body

While a keto diet, and ketosis, can be good for both the mother and child throughout pregnancy, there are a few fundamental concepts to consider.

Do not focus on weight loss. Many who start the keto diet do so for the weight loss benefits. This should not be the goal of pregnant women on keto. It is important that both the mother and child get the proper nutrients and calories and weight gain is a natural and healthy component of pregnancy.

Do not be strict keto. It is not uncommon to go in and out of ketosis just based on fluctuations in appetite and nausea throughout pregnancy. Listen to your body and the baby and do not fret or put your body through additional stress to try and maintain a constant state of ketosis. If your craving a piece of whole grain sourdough toast, feed the baby what it wants.

Whole food, nutrient-dense, and calorie sufficient should be the focus. This may be redundant, but when pregnant, making sure the baby and mother get proper nutrients and caloric intake is the primary concern when it comes to diet. The best way to achieve these things is to eat whole foods like vegetables, fruits, nuts, legumes, and grass-fed meats. One should avoid processed and packaged foods.

Breast Feeding and Ketosis

It is recommended that one breastfeeds, on or off keto. Breast milk is better than formula. Breast milk is high in natural fats, whereas most formulas are high in carbohydrates and sugar. If one has the ability, breast milk is a better option to make sure the baby is getting proper nutrients and not getting addicted to a high carbohydrates and sugar diet at a young age.

Additionally, coconut oil, a common component of the keto diet, can assist in lactation and allows breast milk to contain lauric acid that helps support a babies’ healthy metabolism.

Clinical Guidance

It is highly suggested that you start the diet before getting pregnant. Switching from burning primarily carbohydrates as fuel to fats as fuel can be a stressful transition on your body. Avoid extra stress on the baby and mom by navigating this transition before conception.

Also, it is best to have some clinical guidance while maintaining a ketogenic diet during pregnancy. A doctor can make sure that both the mother and the baby are getting enough nutrients and calories and monitor healthy levels for both mom and child. Because some health professionals are still trying to “catch-up” to the ketogenic diet, it may be helpful to explain your dietary choice as one in which you are avoiding sugar and focusing on healthy vegetables, fruits, and proteins versus telling them you are on a keto diet. Or better yet, seek a health professional that does understand the keto diet.

Take-Away Message

It is safe and arguably healthier for both mom and child to maintain a ketogenic diet during pregnancy. It is vital that the mother listens to her body, gets enough calories, and focuses on whole food consumption during this process. It is recommended that a mother seek clinical guidance to help navigate and monitor.

– Dr Jerry Hizon

Alcohol and the Keto Diet

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A lot of people ask: Can you drink alcohol on the keto diet? Or do you have to abstain completely?

The simple answer, yes, you can drink certain types of alcohol in moderation with the keto diet and still reach your goals.

Below we will break down each type of alcohol and make recommendations for each category then we will list a few helpful points with regards to alcohol and keto.

Beer:

Carb count: 13 grams net carbs per glass
Avoid: most beers, as most are high in carbs
Okay: lighter, American beers are the best option as they are lower in carbs
(i.e. Bud Select, Miller 64, Michelob Ultra, etc.)

Wine:

Carb count: 1-2 grams net carbs per glass
Avoid: sweetened or flavored champagne, dessert wines, or sweeter wines (i.e., Moscato)
Okay: unsweetened/ unflavored champagne and dry red or white wine

Liquor:

Carb count: 0 g net carbs per shot
Avoid: liqueurs, sweetened or impure spirits
Okay: pure spirits like whiskey, brandy, cognac, vodka, and tequila

Mixers:

Avoid: sodas, simple syrups, juice, and most bitters (as they come with added sweetener)
Okay: sparkling water, citrus (lime, lemon, orange), and olives

5 Helpful Tips for alcohol and the ketogenic diet:

  1. Most people find that they have a reduced tolerance for alcohol on keto. That means they tend to get “drunk” a lot faster. Thus, be careful to only drink 1 to 2 glasses and don’t drive.
  2. Hangovers can be worse on keto. Since the keto diet causes one to urinate a bit more, especially in the beginning, alcohol consumption can add to a dehydrated hangover effect. Be sure to drink one glass of water per 1 shot (or glass) of alcohol consumed.
  3. Alcohol may slow weight loss. The liver will metabolize alcohol before other forms of energy (even ketones). Thus, alcohol consumption may hinder a weight loss process. Be careful to drink only in moderation and take into consideration cutting all alcohol consumption out if you are not able to obtain your weight loss goals with moderate consumption.
  4. Be careful when ordering mixed drinks from bars or restaurants. Although pure spirits may have 0 carbs, the added sodas and sweeteners to mixed drinks and cocktails are loaded with carbs. Stick to soda water, lime, and ice with any pure spirit.
  5. One may turn carb cravings into alcohol cravings. Alcohol, like carbs, can be a quick sugar source to the brain. Be careful not to replace one addiction with another. Drink only in moderation.

In summary, you do not have to cut out all alcohol consumption on keto. Stick to very light beers, dry wines, and champagnes, or pure spirits. Drink in moderation, only 1 to 2 glasses in a sitting. Avoid sugary mixers and add-ins.

Take care to hydrate and be mindful of tolerance and hindrance to weight loss. With all that said, we hope that you found this helpful.

– Dr Jerry Hizon