You have done all the research and been convinced that it makes good sense to be consuming a diet which is low in carbohydrates and high in fat (LCHF) but also described as ketogenic. Then you have to decide how to put it into practice. It can all be quite a minefield because different people have different ideas about what exactly is meant by a ketogenic diet and how it can be implemented. In this blog I will make some suggestions based on my own experience and that of friends who are travelling on the same road.

I will begin with some basic principles:

  • There is no “one fits all” strategy because everyone is different so what works for one does not necessarily work for others
  • It follows therefore that you have to determine what is the most effective approach  for you
  • Make a start by doing an evaluation of your current diet and identify the changes you think would be needed
  • Do not be over ambitious. I recommend an evolutionary approach rather than a revolutionary one.
  • It is important to understand that the object is to make permanent changes to your regular pattern of food consumption
  • Introduce one change at a time. If you find that you simply cannot adjust then forget about it. Meal times should be enjoyable occasions not something to endured. However do not give up easily because the taste buds can adapt so give each you attempt a fair chance to be successful
  • Continue to introduce changes to suit yourself. Regard it as journey with many different turns and twists
  • The best way to judge if progress is being achieved is how you feel in yourself. If things are going well you should certainly feel more lively and energetic. You will probably lose weight. In my own case I lost about 5kg even though my BMI at the start was about 24. If you have an opportunity for blood analyses to be done, then the glycosylated haemoglobin (HBAc1) is probably the best one. The gives a good indication of the average blood glucose over the past 3 months.
  • Some advocate targets such as a specific amount of carbohydrates per day. This just does not appeal to me. You will definitely know yourself if there are improvements in your physical and mental health. So hopefully you reach a point where you are satisfied that significant progress has been achieved. But you can still keep trying out new ideas.

Now let us consider some practicalities. The top priority has to focus on eliminating as much sugar as possible from the diet. Sugar is “empty calories” which means it is just a source of energy and does not contain any other nutrients such as fats. proteins, minerals or vitamins. By contrast, there is a large body of evidence which demonstrates that excessive intake of sugar contributes to the development of a range of chronic diseases including Type 2 diabetes (T2D), heart disease and various cancers. The use of sugar in beverages and baking is obvious but the big problem is the widespread use of sugar in processed foods. It is not easy to identify because so many different terms can be used. The ingredients on chocolate biscuits include sugar, glucose syrup, invert sugar syrup, fructose, molasses all of which are forms of sugar. When sugar is digested, glucose and fructose are released. Fructose is likely to particularly damaging because it can only be utilised in the liver and so if present in excess will result in the condition of fatty liver. Sugars can interact with proteins thereby preventing them functioning properly. Because fructose has much greater affinity for the proteins than glucose this means sugar and High Fructose Corn Syrup (HFCS) are likely to be more dangerous than other foods which do not contain it. This is also a reason to limit the consumption of fruit juices because of the high content of fruit sugar which is fructose. It is absolutely vital to avoid all the “low fat” versions of all foods. Invariably the good fats have been removed and replaced with sugar and sweeteners. Although these are promoted as “Healthy” the reality is that they are anything but!

The next step is to consider the other sources of carbohydrates which are primarily those containing grain products such as bread as well as potatoes, pasta and rice. These contain starch which breaks down to glucose. Try to limit those which are refined, as for example white bread. This is because the glucose is released quickly resulting in rapid increase in the level of the blood so that insulin has to produced. It is the excess insulin that does so much of the damage leading to various types of ill-health. On the other hand, those foods which have not been refined release the glucose slowly. Porridge made from whole grain oats should not be a matter of concern.

According to the official dietary guidelines in most countries, the advice is to reduce the fat especially the saturated fat (SFA) and to replace it with complex carbohydrates. As many diabetics have found to their cost, this strategy is likely to result in raised blood glucose levels (1).

It is of course necessary to replace the carbohydrates with other foods. The main emphasis should be trying to increase the amount of vegetables. Onions, mushrooms, broccoli, cabbage, cauliflower, tomatoes are all very good sources of a range of nutrients.  Green leafy vegetables and salads are all good news. Although avocadoes have a high fat content, the fats are all good. It is important to recognise that the most of the SFAs from animal or vegetable sources are really valuable nutrients. Eggs, meat and dairy products are absolutely fine, especially the full fat versions but be careful with meat products unless you know exactly what ingredients are present. Where fats/oils are needed for preparation or cooking then choose butter or coconut oil. Olive oil should be used but preferably not for high temperature cooking. Fish and fish oils are predominantly omega-3s but vegetable oils and those polyunsaturates which “lower cholesterol” are mainly omega-6s. As the omega-6:omega-3 ratio in typical diets is far too high then cut out the omega-6s but boost the omega-3s.

Berries, nuts and seeds offer great potential because they contain lots of valuable nutrients and can be used for breakfast and salads as well as being key ingredients for baking.

I have only been able to provide an introduction here and hope to return to this topic in the near future. Further ideas and insight can be found in these references (2,3).