Ketogenic Diet Guide

Overview

A high-fat, very low-carbohydrate diet that shifts your body into ketosis for metabolic benefits.

Ketosis is a metabolic state where the body burns fat for energy instead of carbohydrates, producing a special energy source called ketones from fat as an alternative to carbohydrates. It only occurs when there are almost no carbohydrates in the body.

Keto has been all the craze for the last 10 years, and I’m sure you’ve probably heard of it or even tried it. However, what we find is that people who think they tried keto properly most likely were not doing it in the correct way. That is to say that it is not a high protein diet, and you really need to be eating most of your calories from fat.

Many times it’s also claimed that keto is a fasting-mimicking diet. However, we want to add the point that if you’re doing keto properly, you should actually have a high energy availability. That’s why keto can be phenomenal for people that suffer from bipolar, depressive, or ADHD issues. If it truly works for you, there is a moment when your brain just turns on and the world almost appears in vibrant color.

Ideally, if you have the right genetic and microbiome markers from the data that we’ve gathered, a ketogenic diet should allow you to naturally run in an energy deficit where your body is making up the deficit by using your body fat stores. Without going into the technical details of ketosis, it could actually be possible that you would eat the same amount of calories on a ketogenic diet and lose weight from where you were before.

When fully in the swing of a ketogenic diet, you should be repeatedly hitting your satiety markers. If you find that you’re getting hungrier or agitated, or you have a lot of food noise, you need to feed that back to Patchwork, it doesn’t mean that a ketogenic approach is wrong for you, but it might mean that some of the foods are triggering issues.

Key Principles

The key principles are the absolute majority of the food that you eat needs to be a fat source. Ketones themselves are exceptionally protein-sparing because they spare the body from needing to use protein to produce carbohydrates. So you don’t need to be concerned too much with the amount of protein that you’re eating. Critically, in modern industrial keto, it’s become accepted that “net carbs” are all that matters, but we haven’t seen this play out and you should ignore this idea.

  • Very low carbohydrate intake (Max 20g per day)

    At first glance, this seems extreme, but once you get into the flow of it, it’s really straightforwards. It does mean that what is on your plate will be radically different while you’re doing this compared to probably what you’re eating before.

  • High healthy fat intake (70-80% of calories)

    Keto is a high fat diet, and in another place we can talk about what that means for cholesterol in your body overall, but fundamentally, don’t be afraid to eat fat.

  • Moderate protein intake (max 0.7g per lb of lean mass)

    Patchwork has written about this elsewhere, but there is an obsession over protein going on at the moment. Ketones themselves are incredibly muscle-sparing, lean proteins actually do trigger an insulin response in most people and thus will knock you out of ketosis, and where most people go wrong when doing a ketogenic diet is eating too much protein.

  • Strict elimination of most carbs

    The hardest part for most people is the strict elimination of carbohydrates. Fundamentally, to do this diet anything with starch or sugar needs to be fully removed from your plate. You want to be limiting carbohydrates to a maximum of 20 grams per day. And if you’re eating lots of vegetables, you’ll easily hit that.

  • Healthy fats (avocados, olive oil, coconut oil)

    Critically, by calling out healthy fats, we want to draw attention to the fact that there are unhealthy fats. You don’t want any industrial fats. So no seed oils, no hydrogenated oils (Crisco) and no lard.

  • Fatty fish

    Fatty fish like salmon, especially Atlantic salmon, are absolutely welcome. If you want to eat fish regularly, try and limit your intake of large fish like salmon to only twice a week, and then make up the rest with small bottom-feeder fish like mackerel or sardines. This will limit your heavy metal exposure.

  • Meat and poultry

    Beef, lamb, chicken, turkey - have at it. When it comes to chicken and turkey, it probably still makes sense to try and shoot for breast and to skip eating the skin, and then make up the fats in other places.

  • Eggs

    We love eggs on a keto diet. There is a 50/50 protein to fat ratio by grams which means that it’s about a 3:1 ratio of fat to protein calories. If you’re going to make eggs a staple of your diet, make sure you’re getting the highest quality eggs possible. Pasture A’s is the gold standard. Costco and Sam’s Club will make your life a lot easier here.

  • Low-carb vegetables

    This is funny to call out, but most people don’t realize that many of the vegetables they eat are full of carbohydrates. As we’re limiting carbohydrates, we want to focus on the low-carb veggies. Those are typically the leafy green and cruciferous veggies, like broccoli or spinach. There’s some developing science around raw veggies, so if you’re going to make vegetables a large part of your meal, make sure that they are thoroughly cleaned and cooked.

  • Nuts and seeds

    Nuts and seeds have a great protein-to-fat ratio and can be added to keep things interesting. But do not go eating tablespoons of peanut butter. Nuts are high in polyunsaturated fats, and so we don’t want to make them a keystone piece of the diet.

  • Full-fat dairy

    The best bit of going keto might even be this: that you can now eat full-fat dairy. That means butter, using half and half in your coffee, or even getting 90% of your food from eating whipping cream.

Foods to Avoid

  • Grains
  • Sugar
  • Most fruits (a handful of berries gets a pass)
  • Starchy vegetables
  • Legumes
  • Seed Oils

  • Keto “Snacks”

    A quick note about keto “snacks”. The food industry loves to make money. As the words “keto” and the ketogenic diet gained popularity, the food industry started making processed foods that would fit the bill to be described as keto. Some of them even have labeling that says “certified keto” on them. They make keto cookies, cereals, snack bars, chocolate etc. If it’s indulgent in real life, there’s usually a keto version of it. Stay away from this stuff. Fundamentally, when there’s a processed food, it will use the least expensive, lowest quality ingredients. It increases heavy metal exposure and it’s usually packed full of seed oils. Anecdotally, we would say 80% of the time we find that people aren’t working with a ketogenic diet; it’s because of the keto snacks that are eating.

Tips for Success

  • Track your macros carefully: Carbs, Fats, and Proteins

  • Keep it simple stupid (KISS)

    Time and time again, we see people mess up keto because from day one, they’re trying to create the most complex meals out of a keto cookbook. The best tip for success we have on this is to start radically simple. Have one protein source and one large fat source and have one simple vegetable fiber source. As you get into the flow and you’re feeling the full benefits of ketosis, you can add complexity into the mix.

  • Increase salt intake

    When you go on a ketogenic diet, what you are effectively trying to do is keep your insulin radically low. Insulin, the primary fat storage hormone, also helps your body regulate its salt balance. So by having insulin low, your body will be dumping salt on a regular basis. You need to increase your salt intake to make up for it. The Keto flu described below is primarily driven by people being low on salt.

  • Stay hydrated

    In the process of your body dumping salt, you’ll also be peeing more, so you want to make sure you stay hydrated.

  • Ignore the water weight

    Your liver and your muscles are carrying a lot of additional weight in the form of glycogen, which is bound up in water. When people go on a ketogenic diet, they usually see immediate radical weight loss that then slows and demotivates them. The majority of this weight loss is your body using up and removing all of its glycogen that is stored. In the first two weeks, any radical weight loss - don’t get too excited, don’t get demotivated. Stick with the process.

  • Prepare for keto flu

    The Keto Flu phenomenon affects many people differently based on the diets that they’ve had before, whether they’ve eaten a low-carbohydrate or ketogenic diet before as well, and whether they are genetically predisposed to being keto-resistant. We’re hoping by having prescribed this diet to you, we don’t think that you are genetically predisposed to being keto resistant. The keto flu is just that - a natural process of your body adjusting. It can give you flu-like symptoms of headaches and exhaustion. Being mentally and physically prepared for it is a great way to know that it’s coming and not be concerned. Also make sure that you are having enough salt and that you have a decent fat sauce to hand to deal with it. We love coconut and MCT oil also Butter in your coffee or tea can be great.

  • Consider supplementing electrolytes

    Adding to the salt intake mentioned, many people choose to supplement with magnesium, potassium, and sodium electrolytes through different forms and that can usually help you if your body is really letting go of a lot of salt. Magnesium is often one people miss, so feel free to use a magnesium supplement. Lite salt with it’s 50% sodium and 50% potassium is a great way to get some of the potassium you might be missing.

  • Be cautious on the sweeteners

    Artificial sweeteners are not sugar, and so in theory, they should be keto. But what we’ve actually discovered is that most people have an individual response to different sweeteners. Additionally, sweeteners usually have added sugar hidden in the recipe to make sure that it doesn’t clump up in a packet. Our general advice is just be very cautious. For some people, artificial sweeteners can destroy their microbiome and prevent them from maintaining a ketogenic state.

    If you absolutely must have sweetness in your tea, coffee, or with your food, the best solution we found is a “rare sugar” called allulose. Again, use caution - allulose is being added to a whole bunch of processed foods. We don’t think you should be eating keto snacks with allulose; just get the pure powdered form and use that.