Guide to Trying Keto

The Problem

More than 80% of the US is considered metabolically unhealthy. Pre-diabetes has gone up . These issues arise due to insulin.

Every single cell in your body has insulin receptors, watching for insulin levels as a signal to engage in various actions."Insulin's most famous action is to control blood glucose," by allowing glucose to leave the blood and enter various cells (Bikman, 2024). As insulin works to help glucose enter cells, its signal is also received by many other systems within the body. Insulin is considered a fundamentally anabolic signal, focused on energy storage, as opposed to energy expenditure, such as fat oxidation. The presence of insulin prevents fat metabolism (Norton et al., 2022; Bikman, 2024). When your body begins burning fat for fuel, instead of carbohydrates, this is called ketosis, because the body processes fats, either ingested or from storage, into ketones.

In the past 100 generations we have radically altered our ability as a species to access carbohydrates and thereby elevated our insulin levels far higher and more frequently than ever before. This constant presence of insulin leads to an adaptive insensitivity, insulin resistance, causing greater amounts of insulin to be dispatched to handle the demands of the diet. This has put us into a hyper-novel situation, where the dynamics of our physiology are unprepared for our levels of insulin, and fall into many different novel disease states as a result:

"In fact, virtually every chronic disease is in some way either directly caused by insulin resistance, or exacerbated by insulin resistance, including the big killers, like heart disease, diabetes, certain forms of cancer, or the most common liver problem - fatty liver disease." (Bikman, 2024)
Keto Scale

keto-adaptationmetabolically flexible

Core Ideas

  • Do not forget to take enough salt.

    If you are ever less than high energy while in ketosis, you are almost certainly just salt deficient. Take a 1/2 teaspoon casually, by pouring onto your tongue and taking a large swish of water. The same applies to waking up hungry. Taking these salt bumps within the hour before sleep can also help mitigate the onset troubles some people experience during keto-adaptation, due, in part, to novel high and steady energy levels. If you react with immediate expulsion to that quantity, slow down.

    For reference, it's common to see recommendations proposing not to consume greater than 2,300mg of sodium per day. This is plainly half of what the data here would recommend. Ketogenic diets are known to increase salt loss, putting the optimal ketogenic ingestion towards the higher end.

    Salt Intake Mortality Curve
    Liu et al. (2024)
    Sodium (g)Sodium (mg)Salt (g)Salt (mg)Teaspoons1/2 Teaspoons
    22,00055,000~1~2
    44,0001010,000~2~4
    66,0001515,000~3~6
    88,0002020,000~4~8
    1010,0002525,000~5~10
    1212,0003030,000~6~12
    Teaspoon equivalents can vary around ±10%, with coarser salts resulting in lower sodium quantities due to less compaction.
  • Do not forget to drink enough water.

    One of the points of exercise is the hormetic stress of dehydration. Being unable to go without water is not a good sign of your health. That being said, whether you choose to dry fast in some regard knowledgeably and sensibly or not, your normal routine should include drinking a substantive quanity of water. You should probably add a nicer salt to it, around a teaspoon a liter. This may feel weird (softer) at first, until it doesn't anymore, and plain water becomes unsettling. I have at times used a 1:4 ratio of potassium chloride (purchasable under the banner of "salt substitutes", often they are about half sodium chloride) to sodium chloride 'salt', which conspicuously cancels out all salt taste. For instance, if you play with the ratio a bit, perhaps around 1/4 teaspoon potassium chloride to 1 teaspoon salt, you will find the added electrolytes rather untasteable. Without this, I have had good experience with water salted enough to be reminiscent of popcorn.

    It's to use sea salts for water, and keep the pink salts for food, so that the sight of your water does not lead people to ask questions, the answers to which they are unprepared to hear.

  • Maintain a mental model of insulin resistance when choosing how to eat

    If insulin is the primary blockage for ketogenesis, then hyperinsulinemia due to insulin resistance is our primary target when attempting to settle into burning ketones for fuel. This means keeping insulin levels as low as possible, as often as possible, as long as possible.

    Extending the length of time from your last meal one day, to your first meal the next day is important for this reason. The more time you spend with low insulin, the quicker you will adjust, adapt, and feel more comfortable without carbs. For this reason, you want to keep in mind a restricted feeding window, delaying time to breakfast until, say 11am-1pm, and ending your meals for the day earlier, like 4pm-6pm. Keeping to this strictly will provide a serious boost to the speed of adaptation.

    Eating, while insulin resistant, even a low-carbohydrate meal, will cause an aberrantly large insulin response. That is, if you are quite insulin insensitive, a meal of the same size will take you longer to normalize insulin from, than someone more insulin sensitive. This can even mean that a diet can be ketogenic for someone highly experienced on the diet, with excellent insulin sensitivity, but essentially not ketogenic for someone insulin resistant.

    So, when it's 4pm and you're considering whether to tack on a final bit of food, be aware that doing so earlier is better. In general, you should try to aggregate all the carbohydrates you do end up consuming towards the center of the window, and ensure that foods you eat first, and especially foods you eat last, are the most low carb. So, if you choose to include almonds and chicharrones in your approach, knowing that almonds are a trap, and it's near the afternoon, opt for chicharrones instead of almonds in order to protect the intensity of the overnight fast, and keep your day's insulin minimized into a shorter period. You only have to make this correct decision in the face of an annoying transition into fasting a few times before it pays back in dividends with radically easing the transition thereafter. A succeeding ketogenic approach will in due time induce an extreme reduction in obsession with food, make eating much more voluntary, and make the hours after a meal gracefully transition back into fasting.

    Most importantly, this means that what you can get away with early on is far less than what you will be able to get away with later. It is for this reason, among a few other, I recommend being unnecessarily strict for the first few months. Cashews may very well be too high in carbs for you, while insulin resistant, overweight, inflamed, and low energy, but it is quite possible after reversing these effects that they could a become perfectly nice part of your ketogenic routine.

    The diet I use while transitioning certainly looks more strict that how I eat when maintaining a low weight. You will genuinely find differences in how satiating zero-carb meals feel, comparing when you first start to when you've lost 40 pounds.

  • Do not get fancy reading labels.

    The usual presentation is to limit yourself to 20g of carbohydrate a day, calculated by subtracting fiber from the quantity of carbs in a food. Screw that. You will use that to gaslight yourself endlessly, fail the diet, and blame it for your lack of benefits, and I know you'll do that, because I've caught myself doing even after doing multiple previous seasons of ketogenic diet successfully! It's nonsense: Do not even buy or bring home anything with more than 5g Total Carb per serving - ever (early on). Don't use fiber as an escape. Certainly do not mix up the sugar with the carbohydrates. The only exception to this is, cautiously, sugar alcohols. I have had an okay time with sugar alcohols in stevia sweeteners with a coffee, but the quantity in ketogenic ice creams make them an "advanced technique" (and frequent pitfall). Don't even get me started on keto-meals that imitate carbohydrate foods.

    With a home filled with nothing but foods with less than a gram of carbs, you're in an excellent position. Then, you can eat careless, as you're hungry, whatever is available. You can even engage in pathetic grazing behaviors, and so long as you respect a narrow feeding window, be on your way. You'll have no need to do potentially self-deceptive calculations with your hand on a yogurt. When in doubt: Make yourself some God damn bacon, and get a grip :)

    Do not rest anything on your willpower that you can rest on prior planning.

    Do not screw yourself with blurring the lines. When you are still trying to lose weight initially, rather than eating ketogenically long term at maintenance, you should only eat foods with radically low carbs: pure meats, cheeses, eggs; gladly putting back item after item in the store, and clinging fast to the core reliables: bacon, steak, skin-on chicken, fish, eggs, a bulletproof coffee. Notice I did not include almonds.

    This will seem restrictive, until that time at which you have redeveloped insulin sensitivity, and re-adapted to fat burning, at which point I genuinely swear to you—it is not the same. It no longer is restrictive, it's perfectly filling, and no real interest exists whatsoever to 'mix it up' dietarily (yes it can become behaviorally monotonous, if you're not particularly occupied with anything).

    Nothing tastes as good as healthy feels. That will sound like a vapid platitude, until healthy hits you. Then you'll scoff the idea of needing to eat anything beyond the short list.

  • Eat if — and only if — you are hungry.

    Hunger, initially, can be indicative of mere carbohydrate withdrawals. After this, however, once you've attained a fairly steady beat with staying in ketosis, exhibiting anywhere from about a pound of weight loss per week, to a half pound a day, it's important to remember that your intention during weight loss is the usage of stored body fat for sustenance. So long as you're eating a reasonable meat-based meal per day, you have essentially no reason to be eating more meals, if you do not even feel hungry. This lack of hunger, hours away from meals, is a sign of your insulin insensitivity dropping, and your body becoming adept again at transitioning from meal provided energy, gracefully back into internally derived energy.

    During these periods, I have had good effects from eating, say, 8 strips of bacon, 4 eggs, and a few sardines, for the whole day, ensuring to keep this within a relatively condensed window, leaving some 18 hours where I consumed salted water and sugar free sodas.

    That being said, eat freely as much as you want, until you are satisfied! When you are eating, do not count calories. (Conceiving of the metabolism in terms of calorie counting is one of the greater nodules of sophistry in our time: it requires no knowledge of anything to believe, in both senses of that phrase.) Eat as much as you care to, with regards only to carbohydrate content.

    Eating too lean can be a problem, so generally opt for fattier cuts, and rejoice in pouring olive oil on everything, and needlessly dipping in melted butter. Too much protein as a problem for ketosis is still in debate. I think the truth will end up being that within the context of a real whole-food meat, you cannot overeat in any way. Over-controlled lab conditions examining whey protein isolate?—Results may vary. As long as you have ample fat intake, large amounts (far higher than you think) of protein remains what it has always been: an exceeding good.

    In summary, eat as much protein and fat as you want, and bump the fat a bit more than you think.

  • Opt for coconut, butter, lard, and MCT oil

    Medium-chain triglycerides (medium length fats, as opposed to long molecule fats) are processed more directly into ketone bodies, so readily, in fact, that you can experience increases in ketone bodies from coconut oil despite continued consumption of carbohydrates. That is, MCT's bypass some of the usual blockages to ketogenesis. This makes them extremely helpful on a ketogenic diet, especially early on, for the encouragement of the body to generate sufficient quantities of ketones, even before you've adapted much to the diet. Coconut oil contains these in useful quantities, and you can get specific MCT oils for a truly detectable effect.

    For cooking in high heats, stick with fats that can handle it like coconut and avocado oil. Remember, if fats are the main part of your diet, you had better pick good ones. The best is any fat that comes from an animal that used to stand and graze. Grass-fed beef tallow, lard, butter etc. Most fats on birds are harder to find in high quality. Fats are used as prison cells on animals for locking away "toxins," so its especially important that the fats be from high quality animals. This is not really available with birds, so, excess fatty parts of chicken are not something you're obligated to keep in your meal.

    All foods on this planet have a positive and a negative story to tell. There are problems with modern meat. These problems don't matter. There are also obscure problems with olive oil. These problems also don't really matter, in the grand picture. Olive oil is, in practice, good, healthy, and excellent to include in your diet, ketogenic or otherwise, just like saturated fats, lard, tallow, and butter.

    The negative story with seed and plant based oils, however, holds some serious weight to it. The reasons for this involve the toolkit that these organisms have evolved to deter their being eaten. A coconut is technically a seed, but is fine, because you couldn't eat a coconut if you tried, as it's encased in very strong wood. As a result, it has never had any need to adapt deterrents/deterrence inside the oil. Obviously, similar things can be said about a pig. Plants, however, have been at war with all herbivores for forever — they know they're being eaten, and they can't walk away.

    Plants have adapted means of spreading their seeds via their expectation that animals will eat them. In these cases, you can expect that what you're eating isn't poisoning you (although it may be hijacking your senses to induce you to eat more). This is why apples are neat, but their seeds have cyanide (designed in a quantity to kill much smaller bugs than you). Plants may be happy with you eating fruit flesh, but are engaged almost entirely in attempting to get nothing and nobody to digest their seeds, whether by poisoning the seed, or ensuring its nutritional value negated until sprouted. They are also, plainly, chemically unstable fats, leading to near instant rancidity and subsequent metabolic disasters upon their ingestion. Long story short: never consume safflower, rapeseed, sunflower, or really any plant based oil that we have only managed to generate in the last 100 years. The jury is still out partially on sesame, as it may dodge a small part of this problem.

  • The Bulletproof Coffee

    This is a seriously useful foundational routine. Consuming large amounts of fat isn't terribly easy, but the consumption of fats is one of our signals to the body that it needs to get out of carbohydrate metabolism, and get to burning fats.A great way to introduce a helpful basis of fat for the day is with a bulletproof coffee, a blended drink that may seem odd at first but will become, as your mind builds associations between fat and the vigor of ketones, the most cherished drink you've ever had.

    The recipe is simple: excellent butter, MCT oil (or coconut oil good as well), vanilla in some form, and potentially further sweetener, in some low-glycemic form.

    I have enjoyed a recipe using:

    • About a teaspoon of a stevia based sweetener. Sweetness varies between products so consult the label. (Avoid anything with dextrose, but you'll probably be lucky to find any without sugar alcohols which are... fine.)
    • Varying between 1 to 2 tablespoons of Kerrygold butter, a high-quality Irish butter than genuinely brings notes of chocolate when put in this context (don't ask me how, I have no idea).
    • Some arbitrary splash of MCT oil, or about a tablespoon of coconut oil
    • Arbitrary dash of sugar-free vanilla syrup
    • Blend it all up together with 8 oz of dark, medium, or light roast coffee for like 15+ seconds.

    Play with the recipe yourself. I recommend staying with vanilla as the flavor, as it plays off the coconut/MCT and butter strangely well; although I've wandered into all sorts of other flavors just fine. The butter provides a latte like color, and some complex body to the flavor, while the MCT oil is reminiscent of coconutty and adds a velvetyiess.

  • Vinegar blunts insulin response

    This has been found with 'acetic acid' in apple cider vinegar, which is just the compound which makes all vinegars vinegars. So, try rice vinegar or balsamic or malt vinegar. Learn how to use it in cooking, and do so.

    Switchel was a popular summer drink in the American colonies, potentially originating from the Caribbean, made of water, spiked with ginger and vinegar. There are recipes which attempt to sweeten it, but if you just dump some salt in it and get the ratios right, it's sort of like an acidic lemonade. The vinegar and salt (and, hell, probably the ginger in some ways too) provide detectable energy, and drinking this while keto during 100° shifts out in the sun helped me not only not pass out like multiple other coworkers, but easily maintain energy.

    If you do end up consciously deciding to have a carbohydrate rich meal, it makes some sense to pair this with a shot of vinegar. Pretty much everyone uses apple cider vinegar for this, due to its slightly more varied flavors.

    Whether breaking ketosis or not, including pickled foods as frequently as possible will be useful. Many pickled foods are quite low carb, such as classic pickles, olives, and okra. It is worth noting, although many classic pickles contain literal-actual high fructose corn syrup, I suspect the quantity of it in relation to the vinegar makes it actually still quite ketogenic, in terms of encouraging, maintaining, or facilitating low levels of insulin across time. When you add to this that they are an excellent way to bump your salt (especially if you add more salt to the jar), and at very least seem to subjectively curb cravings, they are an excellent tool.

  • Targeted, well-formulated fasts are highly useful

    Your overnight fast is an eternal part of your life. You might note that this is inherently a dry fast. Whatever you can do to nurture this fast in length, and intensity, will be to your benefit when becoming more fat-adapted and reducing excess weight.

The extent of insulin sensitivity needing to be regained in order to see a condition remit is generally unknown, and at very least varies somewhat between conditions. Many, many symptoms can disappear within days, and weeks. Severe and debilitating mental illnesses usually report around 3+ months. Interestingly, that 3 month length is not so much accompanied by so gradual a change, but rather a comparatively stark transition that distance into the diet.

References

Bikman, B. (2024). Why We Get Sick: The Role of Metabolism in Health. Presented for Florida Institute for Human and Machine Cognition. https://www.youtube.com/watch?v=tGMrgcUeGeM
Bikman, B. (2024). Myths & Misconceptions of Insulin Resistance. Presented for CoSci, Las Vegas. https://www.youtube.com/watch?v=kT6c7QwTH7o
Drüeke, T. B. (2016). Salt and health: time to revisit the recommendations. Kidney International, 89(2), 259-260. https://doi.org/10.1016/j.kint.2015.12.009
Goodpaster, B. H., & Sparks, L. M. (2017). Metabolic Flexibility in Health and Disease. Cell Metabolism, 25(5), 1027-1036. https://doi.org/10.1016%2Fj.cmet.2017.04.015
Kelly, D. M., & Jones, T. H. (2015). Testosterone and obesity. Obesity Reviews, 16(7), 581-606. https://doi.org/10.1111/obr.12282
Laffel, L. (2000). Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. Diabetes Metabolism Research and Reviews, 15(6), 412-426. https://doi.org/10.1002/(SICI)1520-7560(199911/12)15:6%3C412::AID-DMRR72%3E3.0.CO;2-8
Lebovitz, H. E. (2001). Insulin resistance: definition and consequences. Experimental and Clinical Endocrinology & Diabetes. https://doi.org/10.1055/s-2001-18576
Liu, D., Tian, Y., Wang, R., Zhang, T., Shen S., Zeng, P., & Zou, T. (2024). Sodium, potassium intake, and all-cause mortality: confusion and new findings. BMC Public Health, 24(180), . https://doi.org/10.1186/s12889-023-17582-8
Masood, W., Annamaraju, P., Suheb, M. Z. K., & Uppaluri, K. R. (2023). Ketogenic diet. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK499830/
Norton, L., Shannon, C., Gastaldelli, A., & DeFronzo, R. A. (2022). Insulin: The master regulator of glucose metabolism. Metabolism, 129(12), 155142. https://doi.org/10.1016/j.metabol.2022.155142
Poff, A. M., Koutnik, A. P., & Egan, B. (2020). Nutritional Ketosis with Ketogenic Diets or Exogenous Ketones: Features, Convergence, and Divergence. Current Sports Medicine Reports, 19(7), 251-259. https://doi.org/10.1249/jsr.0000000000000732
Sherrier, M., & Hongshuai, L. (2019). The impact of keto-adaptation on exercise performance and the role of metabolic-regulating cytokines. The American Journal of Clinical Nutrition, 110(3), 562-573. https://doi.org/10.1093/ajcn/nqz145
Talley, J. T., & Mohiuddin, S. S. (2020). Biochemistry, fatty acid oxidation. StatPearls. https://europepmc.org/article/NBK/nbk556002