Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet (28 page)

Ketones are normally only made in quantity during a prolonged fast, as probably occurred a lot during evolution and even now possibly during illness or dieting to lose weight. Ketones are somewhat elevated even after a normal overnight fast.

– Dr. Charles Mobbs

I know I’ve probably already lost at least half of you just by bringing up fasting (the other “f” word), but stick with me here because it could be another instrumental piece to the proverbial puzzle in maximizing the benefits you get from ketosis. Periods of fasting cause the body to react as if it is starving, increasing the production of ketones.

But just mention the word
fasting
to someone on the street and the reaction you’ll get will probably fall somewhere between complete scorn to sheer terror at the idea of going without food for more than a few hours. Believe me, I understand, because I had the same reaction in 2006 when I first heard about intermittent fasting (IF) from a low-carb author, blogger, and physician named Dr. Michael Eades, author of the bestselling book
Protein Power
.

Dr. Eades wrote a blog post about IF that captured a lot of attention, generating the most comments that he had ever received on a blog post. The traditional method of fasting calls for alternating days of fasting and eating (eat Monday, fast Tuesday, eat Wednesday, fast Thursday, and so on). The IF plan that Dr. Eades was attempting, however, was a bit more practical. Here’s what his sample IF eating schedule looked like:

• Day 1 – Eat anytime until 6:00 p.m. and then stop eating
  
• Day 2 – Don’t eat until 6:00 p.m.
  
• Day 3 – Eat anytime until 6:00 p.m. and then stop eating
  
• Day 4 – Don’t eat until 6:00 p.m.
  

And so on. Of course, you aren’t constantly eating on the days you stop eating at 6:00 p.m.; you simply eat as you normally would, when you are hungry. And for the sake of his experiment with IF, Dr. Eades even said to feel free to eat whatever you want. However, he does advocate a low-carb diet and recommends sticking with low-carb foods while on IF to maximize its impact, especially for the purposes of weight loss.

Dr. Eades said it was very easy for him to skip breakfast and lunch. And if you think about what happens on the weekends, when your day is probably not quite as regimented as it may be on a hectic work or school day, you likely end up eating fewer meals almost naturally—even spontaneously. Still, I was extremely skeptical of the whole idea of fasting, even on an intermittent basis. Why would you put yourself through the torture of going without food, bringing on ravenous hunger, and fool yourself into believing you’ll enjoy it? Who in their right mind would ever do that?

That was then; this is now. The concept of fasting as part of a healthy lifestyle has become popular in recent years among people following a Paleo lifestyle (which hearkens back to the nutritional habits of our hunter-gatherer ancestors), many of whom are attempting to get into ketosis. Intermittent fasting can be a powerful strategy for optimizing weight and health, but it is still highly controversial and misunderstood by many people. Who should be fasting and who should not? How long should you fast to get the most benefits out of it? Can you produce adequate ketone levels without fasting? These are just a few of the questions we’ll be answering in this chapter.

First, yes, it’s possible to have beneficial levels of ketones without fasting, but it can be difficult for some. If you’re eating the right amounts of carbs to your tolerance level, protein to your individual threshold, and fat to satiety and
still
aren’t producing enough ketones, it could be that you’re eating too much food, and perhaps too often, as we shared in chapter 10. Fasting will tend to bump up your ketone production.

The single largest problem for ketone production is excess calorie consumption. On the other hand, the ketogenic diet is therapeutic for a broad range of diseases when consumed in carefully measured and restricted amounts.

– Dr. Thomas Seyfried

When I started on my one-year nutritional ketosis experiment, I had no intention at all of fasting. But I quickly discovered that it just started happening spontaneously and naturally, especially when my blood ketone levels exceeded 1.0 millimolar. I remember early on, within the first few weeks of my experiment, my wife asked me when I last ate. After looking at the clock and then going back through my food logs, I realized it had been about twenty-eight hours. I had totally forgotten to eat. If you know me well, then you’ll realize just how phenomenal this was! I was so satisfied by the ketones my body was producing that I couldn’t remember that I needed to eat something. Those days of being “hangry” were long gone, and I was now experiencing the power of ketosis in action.

I realize this all probably seems a bit odd to those who still think they need three square meals a day, as we all grew up believing. But it’s time to start looking outside the box of conventional wisdom and realize that fasting is probably a lot more normal than you think. If you’re consuming a meal of whole foods that is low-carb, moderate-protein, and high-fat, with plenty of calories, then why would your body need to be fed again in just a few short hours? It wouldn’t. As long as you didn’t overdo it on the carbohydrates or protein and ate plenty of fat, you should be able to go twelve to twenty-four hours before your next meal rather easily.

Remember, this happens very naturally and shouldn’t be associated with any hunger or discomfort at all. Try it and see what happens. You may be tempted to cut back on the amount of food you consume when you eat more fat in your diet, but don’t. A meal should be pretty substantial, especially if it ends up being your only meal of the day. Maybe that breakfast of two eggs and two slices of bacon should become four eggs cooked in butter and topped with cheddar cheese and sour cream, three slices of bacon, and an avocado. The former meal will likely have you looking for more food in a few hours, whereas the latter meal might take your mind off of food for the rest of the day. What freedom you can experience by making IF a part of your life!

Each patient [in Dr. Atkins’ clinic] was told to include a protein serving with each meal and snack. It was not necessary to trim the fat from meat or remove skin from poultry. We encouraged the liberal use of butter with vegetables and healthy oils like olive oil on salads. Sour cream and heavy cream were also allowed.

– Jackie Eberstein

Think of IF as a means for measuring your “keto fitness level.” Once you become fully keto-adapted and begin spontaneously fasting for twelve to twenty-four hours at a time with ample hydration, there is a sense of freedom from no longer having to look for something to eat every three hours. Using ketones as fuel enables you to be mentally sharp and have total hunger control without consciously using your willpower to resist temptation to eat. Spontaneous intermittent fasting with no adverse side effects is a very clear indicator of optimal metabolic health.

In the context of commencing a high-fat diet, it indicates the metabolism is burning fatty acids and ketones and that is what is essential for optimal health.

– Dr. Ron Rosedale

But what do you do if you start to get hungry while intermittent fasting? The answer is pretty simple:
eat something!
When you feel hunger, your body is signaling that you need more food. But do keep in mind that not every gurgle and noise that comes from your digestive system is hunger.

DOCTOR’S NOTE FROM DR. ERIC WESTMAN: To drive home the point that you do not have to eat three meals a day, I created a sign for the wall of my clinic room that says “Eat When Hungry, Drink When Thirsty!” I want my patients to think of it as an ancient proverb! Many of my patients have told me that it helps remind them that they aren’t “skipping meals” when they only eat once or twice a day.

I’ve seen Dr. Westman’s “Eat When Hungry, Drink When Thirsty!” sign posted prominently on the wall of every single patient room in his Duke Lifestyle Medicine Clinic in Durham, North Carolina. It sounds so simple, doesn’t it? But what makes it incredibly profound is the fact that very few people these days are actually listening for their bodies to tell them when they are genuinely hungry or thirsty. The fact is that eating carbohydrates makes you hungry. This is an important concept to figure out if you’re going to attempt to engage in fasting.

When I weighed over 400 pounds, I was hungry virtually all the time. And it didn’t seem to matter how much food I put in my mouth; I just kept eating and eating and eating. Getting my hunger under control and recognizing what true hunger was supposed to feel like was a huge part of my success. Of course, hunger is a subjective feeling that’s different in each person, so I can’t tell you exactly what true hunger will feel like for you. But I can tell you what hunger is
not.

DOCTOR’S NOTE FROM DR. ERIC WESTMAN: For most people, hunger and cravings for carbohydrates will go away after one to three days of significantly reducing them in your diet. But as time goes on, other reasons for eating may become problems that interfere with your progress toward ketosis.

Sometimes what feels like hunger may actually stem from a nutrient deficiency. I once received an email from a blog reader who was new to ketosis. Despite eating a low-carb, high-fat diet, she was having trouble getting her hunger under control, as well as experiencing constant brain fog and the excruciating headaches that can accompany the switch to running on ketone bodies. I suggested that she boost her daily salt intake by adding extra salt to her food and drinking, for example, a bouillon cube mixed with some warm water. Within just a few days, she was seeing great results, as she wrote back to me:

Hey Jimmy,

Thanks so much for responding to my email! I took your advice and added the bouillon to my diet. Since then, my headaches have vanished and I can now tell when I’m truly hungry. I measured my blood ketones and blood glucose for the first time. I hit 1.2 millimolar in my blood ketones and my blood sugar was 93. Yesterday I ate bacon, spaghetti squash, and ground beef with marinara sauce along with some grass-fed butter, coconut oil, and 85% dark chocolate and felt completely satisfied. I should have been doing this a long time ago!

Simply by increasing the amount of salt in her diet, she was able to feel completely satisfied by the foods she was already eating. Her excitement about discovering what hunger and real satiation are supposed to feel like is something I wish I could bottle up and let you experience for yourself. Far too many people who attempt to go on a diet to lose weight think being hungry is a virtuous, even desirable, thing. Can I tell you how insane that is? If you are feeling hungry, your body screaming at you to feed it.