Keto Clinic Insights: Your Guide to Successful Ketogenic Living – Adapt Your Life® Academy



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Keto Clinic Insights: Your Guide to Successful Ketogenic Living

There are so many different ways of doing this. Through the years, there will be people who come to me; they’ve read “The New Atkins for a New You,” which is a book I’m an author of, and it has a certain food list and a variety of things to have. Then they think that’s the only way to do it. If you start presenting menus and here’s what you do for the week, it can be limiting for people. Now, not everyone. For those of you who just need direction and understand food and how to prepare things, there’s very little to say other than, “Eat things you like from the list of foods!”

Make the list your own

The first thing is, you don’t have to eat everything on the list. I’m sure I said that in the class, but it goes by fast, and I did have someone come in who had a spreadsheet with every little item on the list checked off – “I had this, I had that.” No, that’s not the point. The point is to get into the keto metabolism. Remember, there are no “keto foods.” It’s a metabolic process, and you want to keep the foods low in carbs. You also want to eat foods that you like, and that’s one of the keys to the diet being sustainable.

Is it important to have variety?

In terms of variety, you might be surprised that you’re happy with very little variety, and that’s fine as long as the nutrition is good. A big mindset paradigm shift is, you don’t have to eat colorful things on the plate. You don’t have to have a certain amount of this, that, and the other thing every day. There’s more flexibility than that. At first, we do ask you to have vegetables and leafy greens, for example, but they are limited because they have carbs in them. But you don’t have to have them every day. It’s funny; someone will come back to me and say, “I haven’t been strict.” I said, “On the days you haven’t been strict, what have you been doing?” They might say, “I haven’t had my vegetables every day.” That’s a minor issue, because as long as you’re getting good nutrition – meaning the meats, eggs, poultry, fish, and shellfish – you’re going to get all the nutrition you need there. So it’s okay if you relax those rules. It’s not a rule, but there’s an upper limit on greens and vegetables. Some days if you just can’t get it together to have a vegetable, it’s okay.

Variety comes in different ways. It’s thinking that you need the green, yellow, the rainbow of colors. I want you to throw that out the window. That’s an old way of doing things that doesn’t focus on the nutrition of it. I’m not sure how that got started. Probably to have you eat more vegetables, but we want to limit vegetables on a keto diet. At first, limiting the variety might be an advantage for you if you’re just getting started and you’re not sure what to have. In an interview with Michael Crichton, one of the producers and authors that many of us know from our time, he was asked why he ate the same thing every day. He’s a rich person and could have anything. He said, “It takes away three decisions I have to make.” He likes the same thing for breakfast, lunch, and dinner every day. As long as that’s good nutrition, that’s fine. Some people are happy to have bacon and eggs every day. You might not have lunch if you’re not hungry; you may just have dinner and mix up the variety a little bit, but you’re happy, and that’s just fine. Don’t feel like you have to rotate through all the different foods. The variety can be as simple as you want it to be as long as it’s good nutrition.

The other thing about variety early on: some people feel like they need to have something new every day. These are the two extremes. Either you eat the same thing every day or some people feel they need to have something new every day and that’s a little more of a challenge. Again, our style is to teach you how to do keto, and then you can figure out what kind of car you want to get in. If it’s fancy, you go to the farmer’s market and get grass-fed beef. That’s fine. Or if you are eating fast food, that’s fine as long as you keep the carbs low. If you’re trying to find something new every day, try to think through if that’s not a holdover from the other way of eating where you think you have to eat by the clock. There’s a lot of habit eating. The faster you can unlearn that, the better this is going to work because it is possible to eat too many low-carb foods and not lose weight. Sam Feltham, a young man in the UK, experimented on himself where he ate many, many calories, about 5,000 a day, which is more than anyone would need. He gained weight on a keto diet, but he didn’t gain as much as he gained on the other diets. You can eat too much of the foods that are “unlimited” if you’re not getting the natural limitation in hunger that keto gives to just about everyone. (Here’s a study Sam Feltham did based on comparing 5,000 calories of 3 different diets: keto/low-carb, low-fat, and very-low-fat vegan.)

If you need variety, there are lots of different websites and cookbooks. (I like Linda’s Low Carb Recipes.) Part of the issue, however, is to match the teaching of these books with your style of learning. A lot of people today can’t just take a recipe and say, “That’s how it would look.”

Keto-friendly food substitutes

If someone early on is doing great but they don’t quite feel satisfied, I screen for two domains: Do you miss sweet things and/or do you miss the old or other types of foods, the savory (starchy) foods? If it’s missing sweet things, I have a certain category of sugar-free items (such as low-carb, high-protein chocolate shakes or sugar-free jello) because most of my patients want something fast and simple, but you can do things that are more complicated on the savory side.

I ask, “Do you miss rice?” and then talk about cauliflower rice. If they haven’t had cauliflower rice before, I tell them that you can find it in the grocery store in the frozen section, so you don’t even have to use a food processor to make your own cauliflower rice, although you can do that, too. Mashed cauliflower is a mashed potato substitute. Cauliflower is also a macaroni and cheese substitute. These are things that I would just routinely go through.

Nowadays, in the clinic, I talk about chaffles (cheese waffles) on the first visit. They have become so popular and so easy to do. In my area, there are a lot of people who come back and say, “I miss my bread,” so I proactively plant the seed of chaffles as a substitute. I now send people a PDF file with 200 chaffle recipes. I found it online and the person who put it together said that they would love it if it was sent around. The problem with that PDF file is that it does include almond flour with some of the chaffles, and if you’re just starting out with keto and you find you have to be really strict to get this to work for you, I don’t want you using almond flour at first. Remember, it’s not on the “allowed” food list at first – nut butter and nut flour. When you’re looking at the chaffle recipes, realize that you can’t use the almond flour ones yet.

I used to give a class to my patients who were just beginning on keto and I would watch people’s responses in the class. There were always one or two people out of ten who would have a very dramatic response – “My fruit! What will I do?!“My bread … how will I survive?” I reassure them and say, “No, it’s fine.” What’s remarkable, unbelievable, is that in just a day or two, those cravings go away. If they do linger – and I guess my point was that there are a lot of people who come back to my office who somehow have bread getting back into their diet – it’s the carb creep. Some people know exactly how many carbs are in the bread, but it’s enough carbs to stop the program from working. These are the kinds of substitutions for variety that I’ll talk about.

If someone is unsatisfied, I’ll have some people come to me and say, “I don’t know what to have.” I ask if they’ve looked at the list again and most of them haven’t, so I remind them to do that rather than just give them the missing thing. An insight in a low-carb clinic was that if someone doesn’t feel satisfied it’s because they’re a sugar addict, and they miss sugar. It’s sugar that is calling out to say, “Find me and eat me again!” I’m knowledgeable about that, but I want to give substitutions as much as possible to make this easy as you transition.

Be aware of teachings in cookbooks

You can use simple or more complicated cookbooks. I am trying to begin teaching the basics: you have to find the type of cooking you want. Maybe you want all of these different options. Maybe you want fancy ingredients that you can only find on the internet. Most importantly, when you’re looking at cookbooks and looking for variety, as we mentioned in the class over and over and over, be very careful about using total carbs, not net carbs. Still, some of these keto cookbooks are going to be using net carbs, and you’re assuming about the subtraction of the fiber and the sugar alcohols. I don’t want you to have to assume. Eventually, you might increase the total carbs, but I think it’s a better foundation to learn how to do total carbs, and you just increase the amount when you can, if you can, and if you want to, and not use net carbs to get into that trap of prepared foods and foods that aren’t truly low in carbs. It’s more difficult to get good results from keto when using those kinds of products. Early on, one of our main themes is to keep it simple. Don’t worry about having a rainbow of color on the plate. Make sure you’re sticking to the list, and don’t worry too much about the variety. If you want to, changing sauces or dressings up is a simple way to give you some variety and change the flavors.

Food rotation

In the clinic, what I noticed is people tend to rotate through a different food. I’ll hear, “I’m tired of eggs.” I will suggest that they try eggs in different forms or just stop eating them for a while. What happens over time is that you start wanting eggs again, and there’s a natural cycle of eating a certain type of food and then withdrawing from it, saying, “I can’t have it anymore; I don’t want it anymore.” I think that’s a natural cycle that happens to many people. One of the downsides of thinking you need to have variety – and I’ve seen this happen – is that you think that’s the only way to do keto. You don’t have the basic understanding that there’s no “keto food.” It’s really a metabolic state, and occasionally if you go off or come on quickly or have a very small amount, that’s going to be okay within the certain parameters we have. I’ve seen people feel overwhelmed because they don’t have time to prepare all of those fancy foods, and they don’t have time to meal prep. If you’re cooking for a family or you’re working and don’t have a lot of time, you might meal prep on the weekends, think ahead, prepare, and have things ready. The less complicated you make the whole process, the more likely you are to keep it going over time.

We want to support you

This is a place to support you. It took me 10 years to give up jelly beans on Easter. I grew up with jelly beans and Halloween and all this, and I had compressed it to that one day out of the year with the family with small kids and then I would just not have them or leave them around the house. A good strategy for holidays like Halloween is to have the treat on the day of the holiday, not throughout the following week or month.

Occasionally I do eat carbs. I’m not a Puritan keto guy. I don’t think anyone should be a zealot or puritanical, meaning holy and bringing the shame, guilt, and arrogance of being perfect. You have to know that I’ve been doing this for 20 years. 99.9% of the time I don’t eat carbs, so that allows me, for example, to now and then have a croissant. I don’t like to have hundreds of carbs. I couldn’t do that now after everything I know about how bad carbs are for you. That would be like smoking a pack of cigarettes. I couldn’t do that. It’s just good for you to know that down the road, if your metabolism allows it, yeah, sure, you can have carbs again, unless the research says that here are the benefits you are going to have by being in ketosis all day every day. Even with myself, I’m not going to be a hundred percent strict about it. I think we get a lot of benefits from lowering the insulin level, and if you do that 29 out of 30 days a month, you’re going to be better off than you were by not doing keto at all. For me at this stage, occasionally I’ll have a carby meal. It’s not very often, and I enjoy it. Early on that kind of approach can derail you. It can be very difficult, and that’s why at first, we’re very strict about the rules and follow them just as closely as you can until you get the time and the familiarity with it over a period of time.

To summarize, food variety is less important than good nutrition, and the variety can be the same food every day if it’s good nutrition. There are a lot of different ways to do this. It’s very flexible. There are a lot of style differences. A lot of the challenges that you might have are different styles in the same household. You have to just be aware and tolerant of different styles of approaching food variety. Watch the full video here.

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