Our program at Duke University was one of two programs that were starting to look at the safety of a low-carb diet. Starting in 1998, Dr. Jeff Volek (who was at the University of Connecticut, now at Ohio State University), was also looking at the diet. He’s not an MD and doesn’t use it in the clinic, but he was studying it in a very circumscribed, careful manner in his own practice that he had at the University of Connecticut. Because I didn’t know much about nutrition, I learned a lot about it very quickly as we were faced with two people who lost all this weight at the Veterans Affairs medical center. Dr. Will Yancy and I started to embark on a clinical research program to see if a low-carb diet could be safe. We knew it could work; we saw several people have great success. You could just go on the internet or read books with testimonials, but we didn’t know if it was safe. Now, after 20 years, I can tell you it’s safe. You have to do it right, and you have to learn a little bit, but it’s safe if you learn how.
In the first study we did, we put 50 people on a low-carb keto diet known as the Atkins induction level of carb restriction. There were no medium-chain triglycerides (MCTs) being used back then in 1998. There was no coconut oil in the coffee and no macro calculators. I didn’t even ask people to write down what they were eating, because as you know if you’ve started this way of eating, in the beginning, the hunger goes away after a day or two and you lose one to two pounds per week, pretty much effortlessly, because you just eat less. As we were designing the study, I started a low-carb diet myself to learn how to implement this, and how to teach other people how to do it. I visited doctors who’ve used it for years to learn as best I could from those who had already done it for a long time. One of the things I had to learn on my own was how to get people chocolate. You can tell people to follow something, but if you’re not allowing people certain things, they’re not going to follow the program for very long. I learned very quickly that if people were going to stick with this for the long term, then I had to find a way to let them have chocolate! This was before any keto chocolate bars were readily available.
A swig of a chocolate protein shake
If the program is going to be successful over a long period of time for most people, you’re going to have to give them some treats here and there. I learned very quickly that you could get these protein shakes that are very low in carbs – you could even get them way back then, 20 years ago – and if you taught people to just have a swig – just a sip of the shake – they could get the chocolate flavor and they would be satisfied. If you really feel the need for chocolate, as most people do, get one of these protein shakes. I don’t care what brand it is. Find one that you like and that is low in carbs. If you calculate how many grams are in a swig or a mouthful of a chocolate protein shake, it comes out to be about half a gram. Of course, it depends on how big your swig is, but my point is, don’t drink the whole shake. You don’t need the shake to get protein. These protein shakes are not designed to be meal replacements; you want to get your nutrition from real food just as much as possible. I recommend a swig of a shake mostly just to take the edge off a chocolate craving.
Just a square of chocolate
Another way to get chocolate is to have only one square. This could be keto chocolate, which is sugar-free, or it could be just the regular chocolate off the shelf. You have to limit the amount and calculate the total grams in a square of chocolate. There are some ingenious things that have happened – you can get an individually wrapped square or rectangle shape of chocolate and you feel like you’re getting the whole bar when you’re actually having the conditioned cues of opening the wrapper and eating the whole thing. (Because the “whole thing” is very small.) I’ve had a lot of people be successful with just a square or two every day, not even just every now and then, but every day. Just keep the carbs really low and make sure you’re having only a very small amount of the chocolate. If you find yourself eating the whole bar of chocolate and you can’t stop it at one square, then you can’t use this trick. There’s a little trial and error learning about how you respond to different foods. Chocolate is not forbidden on a keto diet. You can get chocolate and it doesn’t have to be expensive. It could be the simple chocolate off the shelf at the grocery store; you just have to limit the amount.
Small restaurant splurges
Every now and then I’ll go to a fancy restaurant and get some chocolate mousse. The portion size of chocolate mousse at a fancy French restaurant is very small. Sometimes I will share the serving of chocolate mousse with the person I’m dining with instead of having the whole thing. It’s very satisfying. There are other ways to get chocolate. Be creative within your means, or splurge a little every now and then. Just always watch the total grams of carbs. Some products are not very low and they can get you in trouble. Also, it’s important to consider the “trigger food” concept. If you can’t have just a little bit yet, then don’t go there yet – but hang on. It’s not forever. You can incorporate a bit more carbs when you’ve reached your goal.
Check out the full video here.