What You Should Know Before Starting a Keto Diet

A ketogenic diet means that most of your calories are coming from fat, you are eating a moderate amount of protein, and keeping carbs low – around 50 grams net carbs. In my opinion, when done correctly this type of diet is best for controlling and preventing chronic disease – most notably diabetes and obesity – and can make you feel awesome!

Note: I advocate for a little more protein and a little more carbs than the traditional hardcore ketogenic diet (i.e. carbs under 20 grams) and I am a proponent of a cyclical ketogenic diet which means carb refeeding 1-2 days per week – more on this below and in a future post.

Here are some things to know before starting a ketogenic diet:


1. You need to increase your salt intake

When you are in ketosis your body will rapidly be shedding electrolytes, most notably sodium, from your kidneys. Unless you have a medical condition by which you are forbidden to eat salt, add sea salt or Pink Himalayan Salt to your meals, and opt for bouillon balls and/or bone broth as other ways to get salt into your body.


2. You need to increase your fluid intake

Water follows sodium, so as your kidneys are shedding off more sodium you are going to lose more water as well. Carbohydrates also hold onto water, so eating less carbs means less water stored in your body, and that you need to increase your water intake. Shoot for 2-3 liters of fluid per day at least.


3. Don’t eat too much protein

It’s hard to eat too much protein, but it is still good to know that yes, you can have too much. Too much protein can cause your body to convert the excess amino acids to sugar, and sugar triggers the release of insulin (fat storage hormone) which can lead to fat gain.

A rough estimate of how much protein you should be getting is 0.7-1.0 grams per pound of body weight. More protein is needed for an individual who exercises hard daily, because more amino acids will be needed to repair the muscle that has been broken down.


4. Expect the keto “flu”

As your body switches from sugar burning to fat burning for fuel this can cause what is known as the “keto flu.” It means you may feel lethargic, foggy, and run-down. Do not worry – this will not last long but does happen when switching to this type of diet.


5. Stick to healthy fats

Ketosis does require most of your calories to come from fat, that being said, you want to stick to the good non-processed, grass-fed, natural fats. These include eggs, fatty fish, coconut oil, olive oil, full-fat dairy, avocado, and nuts. Things to definitely avoid include processed meats and processed cheeses.


6. Consider increasing carbs one or two days a week

I am a huge fan of a cyclical ketogenic diet which means you are increasing your carbs 1-2 days per week, or having a “carb-refeed.” Individuals working out hard everyday or few days a week will burn through their glycogen stores faster, and may need to increase their carbs twice a week or more. The hormone leptin which helps to regulate appetite, can also become low on a ketogenic diet and is boosted up when you eat carbs.

Women are especially susceptible to leptin changes and should definitely be re-feeding carbs 1-2 days a week at least. Probably the only group of individuals who may not see a benefit from increasing carbs once a week are men who do zero exercise – which hopefully fits the description of no one reading this because exercise is great for your body and mind!


7. You might develop dry eyes

This happens when you are eating very low carbs for a long time because tear production requires some glucose. This symptom actually happened to me long before I understood a keto diet could cause this, and can be very irritating and even lead to more severe eye problems. When your eyes are getting very dry this may mean you need to up your carbs a little more daily, and increase the number of days you do a carb-refeed.



About the author: Sarah-Kate Rems is an Ivy-league trained Board-Certified Family Nurse Practitioner with an expertise in preventative healthcare. She considers nutrition and exercise to be the basis of well-being and is a strong advocate for daily physical activity and maintaining a healthy diet. Sarah-Kate is also a co-founder of The Mindful Tech Lab

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