Is the Keto Diet Right for You?

How to harness the power of this popular eating plan for long-term success.
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Q: So, I’m trying keto and mostly, I like it. But it seems kind of restrictive. Isn’t all that fat bad for my heart? Is this the best way to eat forever? 

—Taylor M., Indianapolis

A: One important benefit of keto eating is that it gets you off sugar. The average American is addicted to sugar, and most of us don’t even realize it. In fact, sugar may be as addictive as heroin; plus, it’s cheaper and socially condoned. America is the fattest country on the planet with the highest rates of diabetes. Luckily, many good people are willing to ignore the advertising and make sensible, health-promoting choices for themselves every day.

When your fuel comes from good- quality fat, as it does in the keto diet, that feeds your brain, which is made mostly of fat. That’s my favorite part about eating keto—I can sustain focused thinking for writing or listening to my patients. A sugar- or carb-based diet creates ups and downs of energy because sugar is a short-burning fuel. One molecule of glucose produces about 36 units of the basic fuel (ATP) made inside our cells. By contrast, one molecule of fat produces up to 146 units of ATP. That’s a huge difference! Fat is a long-burning fuel that will provide a steady stream of energy over 8–10 hours. Sugar and refined carbs give a burst of energy that lasts for 2 hours tops. I’m sure you have noticed that a high-carb meal will leave you feeling hungry sooner than a meal that has at least a few tablespoons of high-quality fat.

5 Tips to Succeed at Keto

Before addressing whether keto eating is “forever,” here are a few pointers for successfully experimenting with a high-fat, moderate-protein, low-carb approach to food and beverage choices. Your targets should be to get 70 percent of your calories from fat, 20 percent from protein, and 10 percent from low-starch carbs.

Because fat is much more caloric per quantity than protein, the volume on your plate between fat and protein would look about even, if you’re eating, as examples, pure coconut oil and pure-protein egg whites. Most foods are combinations of fat, protein, and carbs of course. But it’s not that hard to keep track of your intakes. You can get an app—try Cronometer or MyKeto—and also use a keto/glucometer. It’s worth it to get it right so you can appreciate what keto eating can do for your brain.

To fully implement a healthy keto eating plan, keep these five ideas in mind:

1. Invest in a combo ketone/glucose meter. 

Invest in a combo ketone/glucose meter. A glucose reading under 100 is a good sign. You’re in nutritional ketosis when the ketone reading is 0.5 mmol/L.

The ketone sticks don’t give enough specific information. The lancets are super tiny and hardly hurt at all. I prick my toes, which are less sensitive than the fingertips. When your glucose reliably reads under 100 every morning, that’s a good sign. You’re in nutritional ketosis when the ketone reading is 0.5 mmol/L.

Invest in a combo ketone/glucose meter. A glucose reading under 100 is a good sign. You’re in nutritional ketosis when the ketone reading is 0.5 mmol/L.

2. It is imperative to drink enough water and replace minerals. 

Unless you’re already an excellent hydrator, you’ll need to drink more water than you’re used to on a keto diet.

This means more water than you’re used to (unless you are an excellent hydrator already) and more complex salt on your food, or even a Sole for first thing in the morning (water infused with Himalayan sea salt).

Healthy Tip! 

Unless you’re already an excellent hydrator, you’ll need to drink more water than you’re used to on a keto diet.

3. Many people have trouble eating enough fat on a keto diet because we’ve been conditioned to think that fat is bad. 

But your brain is made of fat. All your hormones are direct derivatives of cholesterol, the most important, healing, nutritious fat in the body. You can’t live without it. Your liver makes exactly the amount of cholesterol that your body requires. So eat fat! It’s delicious, nutritious, filling, and won’t jerk your energy and mood around. It’s very pleasant to feel strong and stable for the entire day.

My favorite sources of good fats are wild salmon, small tinned fish, ripe avocados, coconut oil, and nuts. Keto food plans can certainly include good-quality red meat and organic dairy products. I personally am pesco-ovo-vegetarian, so I choose to not eat cow or pork products. Some people genuinely feel better eating small amounts of red meat.

4. Beware of too much protein, which will convert to glucose. 

You don’t need more than 40–50 grams of protein daily. A bodybuilder will need more but not the average exerciser.

5. Your microbiome will change when you’re on a keto diet. 

Help this process along by getting plenty of fiber in your diet (the main food for good bugs). Other ways to support healthy gut flora include bone broth (homemade is best, but there are some terrific commercial brands out there), glutamine, collagen, and my favorite: pickled veggies. Kombucha is a wonderful beverage for creating a happy gut.

Do You Have to Give Up Carbs Forever?

Once you’ve spent at least 6 weeks in nutritional ketosis, the benefits will be clear. But can you really give up birthday cake or nachos or toast forever? Just remind yourself that carbs are addictive, and the five seconds of pleasure pales in comparison to the obvious health benefits of avoiding them. That said, here’s an idea that works for many: I call it the 5-1-1 program. It’s similar to the 5+2 food plan, but a little different:

  • For 5 days of the week, eat keto, and make sure you are in ketosis by checking your morning glucose and ketones.
  • One day of the week, follow a 24-hour clear-liquid-only fast.
  • One day of the week, you can eat whatever you want. Hopefully, you will want to continue eating very healthy food—this is one of the most important choices you can make every day—but allow for some rice, or good-quality bread for 1–2 pieces of toast, or a baked yam.

Do you want to look good, feel good, and enjoy a long life in which you maintain a spry body and a high-functioning brain? Of course you do! Try keto or modified keto eating long term, and just say no to processed carbs. I promise you they quickly become unappetizing. Plan ahead, and make good food choices. This is the single best way to improve and maintain your health.

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