#1 Understand what keto means
What is keto? Keto is not a food, keto is not a brand name, keto is not a license to eat whatever is called “keto.” Keto is a metabolic state. “Keto” comes from the term “ketosis,” which really means fat burning. The most important thing, I think, to start keto right is to understand that there’s no such thing as “keto food.” Ketosis is a metabolic state of fat burning and that’s what you’re trying to achieve.
#2 Keep the carbs super low
The main thing about a keto diet is not consuming a certain type of food or oil or avoiding a certain thing. The key thing is to keep the carbs very low. If the dietary carbohydrate is very low, your body is able to burn its own fat and then ketones are generated from your own body fat. A natural ketogenic diet really is one that focuses on eating things that are low in carbohydrates and are nutritionally sound.
#3 Count total carbs, not net carbs
The reason for this is that the net carbs can be absorbed and can affect the metabolism, even though when you use the net carb calculation it’s assumed that they don’t affect the metabolism. I’ve always used total carbs in my clinic because it’s more precise; you’re not assuming that the fiber isn’t absorbed or assuming that the sugar alcohol isn’t going to impact the metabolism. Count total carbs. Most people will want to be under 20 to 30 grams of total carbs for the day. Not per meal, but for the day.
#4 Eat what you enjoy
Choose the foods that you like. We have it all on one sheet of paper for you to choose from. Meat, poultry, fish and shellfish, and eggs are excellent sources of nutrition and they’re super low in carbs. You can eat what you like from among these foods. Everyone has a different type of food they like. I learned recently there’s a certain brand of moist and fatty brisket from a local place with collard greens. I could live on that! You might not like that and that’s okay. Just choose the proteins that you like.
#5 Protein comes first
Protein comes first on a keto diet, not fat. So many people have been taught that keto means adding oils, adding fats, and over-consuming fats, or that you need to drink ketones to get ketones. No. Remember, keto is a metabolic state achieved by keeping the carbs super low. Your body burns fat and generates the ketones internally. Protein comes first. Prioritize protein.
#6 Clean out the pantry of non-keto foods
Clean out the refrigerator; get rid of the carbs. If you’re just starting, give yourself a break. If you’re quitting smoking and there’s a cigarette around, you’re going to find that cigarette and smoke it. It’s very similar with carbs – if you’re quitting carbs and you have a tendency, almost an addiction, to the carbs, give yourself a break by not having the carbs around. As you get started we recommend that you get rid of all the carbs on one day to give yourself a chance to make that break. It’s a little easier to do it all in one fell swoop.
#7 Avoid keto junk foods
If a product says “Great for keto diet,” today, in 2023, that generally means that it’s not good for a keto diet! If it says “keto ice cream,” “keto pork rinds,” make sure you look at the total carbs, not net carbs. Some products might be okay depending on your carb threshold, but don’t automatically think that they’re okay because they have the term “keto” on them. Remember, there’s no “keto food.” Ketosis is a metabolic state achieved by keeping the carbs very low.
#8 Don’t measure ketones
I know that seems strange, right? Actually, by keeping the carbs really low you’re going to be in ketosis, so I don’t recommend that you measure urine or blood or breath ketones. All of those are available, but it complicates things. People come to me saying, “I got tired of measuring with the finger prick or breath or urine.” You don’t have to measure ketones; just keep the carbs super low. Don’t use an app – it overly complicates things and that is a recipe for not having a long-term relationship with a dietary pattern. If it’s difficult and complicated you’re just not going to keep it up. The main thing is finding foods you love among the low-carb keto allowed foods and choosing things that you can live with for a while. That’s what makes it sustainable.
#9 Follow the right teachers
Follow the teaching of someone who uses the keto diet for the same purpose you want to use it. All too often I see people come in trying to follow an influencer who was in the gym and pounding the oils and never had to lose weight, but they’re (the patient) trying to lose weight. The influencer is using the keto diet for a different purpose than what the follower is trying to use it for. If you’re trying to lose weight, reverse type 2 diabetes (which is the work that I do in my clinic), you want to follow an influencer or a teaching that actually is one that’s using a keto diet for this purpose. If I asked you to have lots and lots of fat and oils and drinks and unlimited amounts of cheese and mayonnaise, then you would be hard-pressed to burn your body fat because you’re getting so much fat in the food. Beware of how and why the influencer is teaching. That’s a common mistake; I see there are a lot of versions of keto today, so you want to use one that’s designed for the purpose you’re looking to use it for.
#10 Fast food can be keto
Fast food restaurants are fine. Don’t stress, just avoid the carbs or keep the carbs super low. I’ve had people who could only eat at fast food restaurants for whatever reason – locality, cost, preference. It’s okay. Just avoid carbs or keep the carbs super low. You’ll get into a nutritional ketosis metabolic state by keeping the carbs low, wherever you get your food.