Keto 101
Keto 101: Ratio, Ratio, Where for Art Thou, Ratio?
The first step in utilizing a ketogenic diet is to calculate your ideal ketogenic ratio, that is, your ideal ratio of total fat (in grams) to total carbs plus protein (in grams) that keeps you in nutritional ketosis. For Keto 101, there are two main things that require management with ketogenic eating, macronutrient ratios and thresholds. To put it more simply, in what combination do you need to eat fat, carbs, and protein, and what are your individual limits of each?
To get started, if you can figure out your ratio you will then pretty easily be able to figure out your thresholds. As far as your ratio goes, here are some very over-simplified guidelines. Different people have different ratios (for weight loss), but generally-speaking, here are some generic example scenarios:
- 20-Somethings: 1:1 (people with low resistence to weight loss)
- 30-40-Somethings: 2:1 (this is basically the old-school Atkins diet)
- Harder Cases: 3:1 (people who have medium metabolic issue, e.g. insulin-resistance or type-2 diabetes)
- People with Difficult Metabolic Issues: 4:1 (this is typically the epilepsy or other medical-needs diet, this is VERY hard)
What I believe will work for most people is a 2:1 ratio. You may be able to get away with a 1:1 ratio, or you may require a 3:1 (or even 4:1) ratio (especially if you are doing ketogenic for medical reasons).
OK, What Do Those Ratios Mean?
To calculate ratios you take total fat relative to the total carbs plus total protein for every meal. Also, ratios are calculated by weight, not by calories. That is, weight (typcially in grams) of fat as compared to weight for protein + carbs.
With reagrd to carbs, notice I did not say net carbs. There are almost as many schools of thought about strictness of ratios as they are people airing them. My opinion is that every gram counts, no matter what it is. Fiber, artificial sweeteners, I count all of it. There is lots of argument about this but this is what works for me so it’s my $.02.
Just as important as calculating ratios is at what interval you calculate ratios. Ratios are calculated for every meal. Do not calculate ratios once per day, you will make troubleshooting almost impossible and you are not reflecting an accurate macronutrient load. Calculate your ratios every meal, ideally before you eat. That way, if you need to add a tablespoon of oil to your eggs, you can do it when you cook, instead of doing a shot of oil at the end, yuck.
How Do I Calculate Ratios?
Here’s how you calculate ratios on individual foods (and where learning Keto 101 comes in really handy). Look at the food label and add total carbs (do not subtract fiber) to protein. Multiple this by two and that is the total fat you will need to have that food be a 2:1 (similarly, multiply by three to figure out how much fat is needed to make it 3:1). Here’s an example:
For this food, we have total carbs and protein of 9g. At a 2:1, we need the fat to be 18g (9 x 2 = 18). For 3:1, we would need the fat to be 27g. We have total fat in the food of 15g. To make this food a 2:1 we need to add 3g of fat (18 – 15 = 3). BTW, the food above is almost 2:1 by itself, which is pretty rare. Most of the time you will be adding more fat, usually in the form of some sort of oil or cream to most foods. Again, you want to calculate ratios per meal. Knowing what ratio each food item is is handy, but it is the meal you are looking to balance.
Before you eat, calculate the total macronutrient load of your entire meal (macronutrients just means fats, carbs, and protein). Food tracking apps (e.g. for smartphones) are invaluable here. Sitting down with a pad of paper for 20 minutes before you eat is no fun. Apps like “Lose It!” and “My Fitness Pal” have very complete micronutrient information for most store-bought foods (just scan the barcode, determine your serving, and poof, all the data you need).
For any given meal, take the total fat you are about to eat and compare it with the total carbs (including fiber) plus the total protein. For example, let’s say for lunch you are going to have 80 grams of fat, 6 grams of total carbs, and 15 grams of protein. That would be 80 to 6+15, or 80 to 21. If we divide 80 by 21 we get 3.81. As such, that is a ratio of 3.81:1. Almost a 4:1. Nice.
Now, here is where food tracking apps come in super-handy. In Lose It!, for example, total calories are shown for fat, carbs, and protein (and you can look at macronutrient calorie summaries per meal). Even though calories aren’t that helpful for this, they can be used to get total weights. Every gram of fat has 9 calories, just like every gram of carb has 4 calories and every gram of protein has 4 calories. Knowing this, on a 3:1 ratio for example, I know that my total carbs and protein needs to be 13% of my calories.
OK, I know that probably sounds super-complicated, but it isn’t. Since this is Keto 101, Here, let me show you (this is a sample day from my Lose It! summary screen):
When I plan my meals, I watch this percentage and make sure it is 13% or less. For 4:1, this would need to be 10% or less, and for 2:1, the percentage would need to be 18% or less. When you find a meal that is the ideal ratio for you, look at what this combined percentage is and just aim for that from then on.
How Do These Ratios Affect/Influence Weight Loss?
The goal of a ketogenic diet is to induce and maintain nutritional ketosis. By being in nutritional ketosis, you force your body to use ketone bodies (bi-products of the metabolism of fats) as its primary fuel, rather than glucose (sugar). The transition from running on glucose (or, being a “sugar burner”) to running on ketones (or, being “fat-adapted”) can be a little bumpy. This can be softened a bit, but it does take some extra management.
It is important to note that this isn’t an either/or. Everyone burns both ketones and glucose. No matter how deep in ketosis you are, the brain still requires a little glucose, as do “fast-twitch” muscles (e.g. what power or high-intensity athletes use). What nutritional ketosis does is flip the switch in your body to use ketones as its primary fuel. Flipping this switch actually makes a lot of people feel a lot better, like ketones have always been their body’s preferred fuel. For some people, though, glucose is the preferred fuel (sometimes women are this way, high-intensity athletes are often this way).
By switching over the ketones as your body’s primary fuel, for some people, two things happen. First, insulin is cut down to almost zero, which can undo the issues of insulin-resistant muscles causing excess glucose to be stored as excess body fat. Second, by being fat-adapted, stored body fat is more-easily mobilized, allowing the body to release it as weight loss. In a very over-simplified way, keto-adaptation, as well as consistently being in nutritional ketosis, allows the body to more efficiently and accurately utilize and release body fat, generally causing a net release of body fat over time.
How Do I Know If I Am In Ketosis Or Not?
The easiest way to find your ideal ratio is to find the ratio of eating that consistently keeps you in nutritional ketosis. That is, looking at what ratio and quantity of fat, carbs, and protein keep your body in ketosis, keep your body primarily burning fat. The easiest way to tell if you are in ketosis is to test yourself. Urine strips are inexpensive and easy to use (don’t hold them in your stream, just get them wet and wait 30 seconds). There are new breath meters on the market, but my feeling about these devices is that they are very “gen 1”, meaning they will not only get cheaper in the coming few short years but also get much, much better.
The gold standard for ketone testing is blood ketone testing, meaning using a blood testing meter and special ketone testing strips. There are a couple of issues with this, though. First, you have to actually get blood out of your body to test, meaning you will be poking a small hole in your finger each and every test. This may be a big deal for some people. Secondly, the testing strips are extremely expensive, sometimes over $3 each. Meaning that if you are using these strips, some of which some will be duds, testing just became an expensive pastime.
My advice is to start with the urine strips, at least in the beginning. Urine strips stop working for some people, but that usually takes a while being totally fat-adapted for that to happen. Testing is most needed in the beginning anyway, so urine strips are probably a perfect solution for most people. Someday we will probably just take a selfie with our iphones and it will tell us every health data point we care about, but in the meantime, urine strips are probably just dandy.
After a while, most people can sense ketosis fairly accurately. The difference in how someone feels on ketosis is not subtle, and there are other ques too. For instance, I can taste ketosis, especially when I transition into it. It is an odd, sweet taste in my mouth, almost like a tiny drop of liquid sweetener or cantaloupe juice. It is even more obvious when I transition out of ketosis, so much so that I rarely test myself anymore (after all, if weight is moving in the right direction, and positive direction towards goals is being achieved, there is no reason to test).
So, Once I Find a Ratio that Allows Me to Lose Weight I’m Done?
Not necessarily, it is still important to calculate your macronutrient threshold. Especially for older people, or those who find it difficult for their body to lose weight, it is important to know just how much of each macronutrient category they can have and still lose weight.
Hold on, I know I said this was a no-hunger diet and this sounds like calorie control. Let me explain. Although I only know this directly from personal experience, as well indirectly from anecdotal-only evidence from others, there is a maximum amount of protein and carbs I can eat and still lose weight. As such, in addition to knowing my meal ratio is 3:1, I also know that in any given day I need to stay under 60 grams of protein and 30 grams of carbs (I really hit the zone at 50 grams of protein and 20 grams of carbs).
To take this a step further, just like calculating ratios, figuring out macronutrient thresholds are done per meal as well. For me, I find that consuming more than 40 grams of protein at any meal is problematic (this makes me avoid chicken and turkey). I feel sleepy and sluggish, just like I had an insulin dump. Staying under 40 grams of protein (with no carbs) seems to avoid this.
An important thing to keep in mind is that ketogenic eating is not necessarily a low carb diet. It is a low carb AND low protein diet. Carbs are not the villain and protein is not the hero. To do ketogenic effectively, both must be kept low and you must stay within your thresholds for each. There is no hard/fast rule for figuring out thresholds, everyone has to figure this out over time. You may be able to trade carbs and protein freely, or you may need to keep one low and the other may not affect you.
To figure out your thresholds, notice over the first few weeks which days you consistently lose weight. See if you can spot a pattern. Get a hunch, try it and see if you can reproduce the results. Ketogenic eating is about turning these dials, fat, carbs, and protein. Everyone has an ideal setting of each and needs to use trial and error to find them.
What Can I Expect in the Beginning?
Keto-adaptation takes time and can be a little uncomfortable. People often call the symptoms the “keto flu”, and it does often feel like you are sick. Lethargy, killer headaches, and nausea are common. This can be made A LOT better by adding extra salt to your diet. Some people take a cup of warm chicken broth twice a day. Personally, I don’t want the added carbs/protein so I just add 1/4 to 1/2 teaspoon of good sea salt to about 8 oz. of water. If you do this, be careful. If you are sensitive to salt water, you may very well soon have an unpleasant bathroom experience.
Keto-adaptation can take a couple of weeks (even up to six) or a couple of days. Everyone is different. If you are feeling sluggish and your head is exploding, extra salt can help quite a bit. This phase will pass and when it does, you should feel a lot better.
Early on, tracking meals and doing ratios is a major pain in the ass. Going out to eat is extremely hard and I think most people often just eat the same meals over and over in the beginning. That is basically what I do now, especially for lunch. I have 3-4 known-good meals that I just make over and over again. I also only have coffee (with only ice in it) for breakfast since I like to run fasted in the late mornings.
In the beginning it is important to set realistic goals. Ketogenic eating can cause rapid weight-loss, especially in the beginning. Early on, a lot of that weight is water as your kidneys dump it and salt (hence the need for more salt in your diet). But even after the weight loss from the release of excess stored water, weight-loss can be pretty fast. When this happens, know that it is only how things are now. You will stall, you may go backwards for a time. There are tools for fixing this, but just know that ketogenic eating is a dynamic process. Things do dial-in over time, but it takes a while for you to learn good habits, and to get a sense of how to effectively manage ketosis. It also just takes your body a while to adapt and chill out. Many of us have been in semi-starvation, or are dealing with bigger inflammation or food sensitivity issues, so our bodies may need some help to be able to relax and do what actually is very natural. It takes patience, care, and the determination to solve problems, as well as the general desire to take very good care of yourself.
As far as weight-loss goals go, try not to set any strict short-term goals in the beginning. Don’t look at the scale the first week and see a five pound loss and immediately calculate how soon you will reach your goal based on losing five pounds a week. I think it is great to have an overall goal to aim for, say losing 50 lbs. But to say I need to even lose 3 lbs. a week is just setting up a future disappointment. Can you lose 3 lbs a week on keto? Probably. But, that does not mean you won’t have to solve problems, or that your weight loss will be that consistent. We are not robots and our bodies do not follow a perfectly-predictable pattern. With ketogenic, what we are doing is creating an environment where the realization of our goals is the natural outcome. The specific timing of goal attainment, though, is not really up to us, and it is different for every body. Eating strategies are a long-term project and require flexibility, attention, gentleness, and determination.
Another thing to keep in mind is that keto has strict rules. Once you figure out your ratios you must follow them at every meal. Just doing keto once in a while does not work. To keto-adapt and have the benefits of a ketogenic diet, the best tool you have is your consistency. A lower ratio consistently followed will give you better results of a higher ratio only sporadically followed. You do quite a bit of harm by not following your plan to the T. That does not mean you cannot cycle out of ketogenic, I talk about that in the next section, but it does have to be intentional. Ketogenic eating has rules and these rules must be followed all the time. In the smallest possible nutshell, that’s Keto 101.
In the next section, Keto 201, I discuss how to fine-tune keto, how to solve common problems, and generally how to live on and with keto over a longer-term.