If there was a diet that normalized your appetite to a point where you’re rarely hungry, burned fat, brought you stunning mental clarity, and fatigue-beating energy for days, would you try it?
This may sound too good to be true. Just another hyped-up diet. And that would be true. The ketogenic diet is not a cure-all. It’s not the best diet for everyone. But for those whose genetics prefer to run on fat (instead of sugar), the ketogenic diet can be one of the best solutions to naturally overcoming chronic fatigue.
If you’re familiar with my work, you’ll know that my slant is towards a whole-food or paleo-style diet. With that said, I don’t recommend buying into the dogma of any particular nutrition plan. You are a unique snowflake. Your nutrition plan should be too.
Paleo, Mediterranian, ketogenic, Atkins, high-carb, low-carb, or any other diet you’ve heard of is a general template. And generalities don’t work for most of us. I’ve written at length about personalized nutrition in this post. While this post is about the ketogenic diet, don’t get stuck in the dogma behind it. Make it your own.
Read on and I’ll show you how.
What does ketogenic even mean?
In the most general terms, a ketogenic diet is one that is high in fats and low in carbohydrates. Ketosis is the state in which one burns ketones (ketone bodies). Like sugar, ketones are a source of energy for the body. Ketones are produced in the liver as a by-product of digesting fat.
Most modern-day humans never get anywhere close to a ketogenic state. The average North American gets 40-60% of her calories from carbohydrates. The average ketogenic dieter gets 10-20% of her calories from carbohydrates. It is this restriction of carbohydrates that pushes the body to stop running on sugar (carbohydrates) and start running on fat (ketones).
Humans are unique in that they are duel-fuel burners. Meaning that you can run on either sugar or ketones. This flexibility in your metabolism is likely what kept your ancestors alive during periods of near-starvation.
Who benefits from a ketogenic diet?
No, not everyone will feel great on a ketogenic diet. It depends on where your ancestors came from. Should your ancestors be of Inuit descent, you’ll probably feel amazing on a ketogenic diet. The food traditional Inuit cultures had available to them included high levels of animal fats/proteins, very low levels of vegetables, and almost no fruits. Conversely, the Kitavan tribe from New Guinea get nearly 70% of their daily calories from carbohydrates. Should you have Kitavan descendants, it’s unlikely you’ll thrive on a ketogenic diet.
How do most people with European heritage fare on a ketogenic diet?
For European paleolithic ancestors, obtaining food was a daily challenge. As there were no means of storing or preserving food, each day presented a new challenge to obtain adequate calories for survival. Some seasons (late summer and fall) offered an abundance of food (but only for a few short weeks). Others, like winter, offered great challenges in obtaining enough daily calories.
In these periods of near starvation, the body would be deprived of carbohydrates. It is at these moments your ancestors likely entered a ketogenic state. This allowed them to utilize any excess body fat as fuel. Ketosis would be the difference between finding food the next day or dying.
Many cultures did no subsist solely on carbohydrates or fats. They ate whatever they could find. Which meant carbs in the warm months and fats in the cold months. These are the genes that have been past on to you. Genes that are (likely) adept at burning both carbohydrates and fats as fuel.
So, why not try burning fat? It may be just what you need to overcome fatigue.
How can a ketogenic diet help fatigue?
A ketogenic diet can help overcome fatigue by balancing cortisol. You may know cortisol as the stress hormone.
Did you know that blood sugar irregularities may be what’s causing your fatigue?
Strained relationships, finances, etc. are certainly stressful. But more often than not, chronic fatigue is caused by chronic stress. And chronic stress often comes about through hidden causes. I go into more detail on all the hidden causes of stress in this post. One of the more common hidden stresses is blood sugar imbalance.
In the standard American/Canadian diet, blood sugar fluctuates wildly. Have you ever been hangry? This is often a response to a drop in blood sugar levels, or, hypoglycemia. When much of the food you eat comes via refined carbohydrates, your blood sugar peaks shortly after eating (the food is digested into sugars) and then troughs an hour later (the sugars are used by your metabolism). This phenomenon is called rebound hypoglycemia.
Crashing blood sugar is a big stress to your body. Remember, low blood sugar levels can be fatal. In response to the stress, your brain instructs the adrenal glands to secrete cortisol. Cortisol helps to rebalance blood sugar by converting lean muscle into sugar (glucose). This occurs until we replenish glucose stores with another high-carb meal or snack. Everytime your blood sugar drops, your body responds by excreting cortisol.
If you have a muffin and a double-double coffee for breakfast, your blood sugar will crash within an hour (that’s why you’re hungry shortly after finishing). For lunch, you have a peanut butter and jam sandwich. Again, blood sugar drops off within the hour. A couple granola bars will spike your blood sugar before dinner (only to then send it crashing back down shortly afterward).
If this cycle continues day-after-day, cortisol levels will become chronically elevated. You’ll feel chronically stressed. Should nothing change, in a last-ditch effort of self-preservation, your brain will signal to dramatically lower cortisol production. Burnout ensues. You’ll feel exhausted. Chronic fatigue sets in. Your brain feels foggy. You’re nauseated. You have no appetite. And you can’t seem to tolerate stress at all anymore.
The ketogenic diet stops your blood sugar from the yo-yo effect. Stabilizing blood sugar stabilizes cortisol. If cortisol is balanced, your likelihood of developing fatigue is low. This is how the ketogenic diet can help to regulate energy levels.
Blood sugar aside, those with chronic fatigue have been shown to have elevated levels of chronic inflammation. (3, 4) Chronic levels of inflammation have also been shown to negatively affect cortisol levels. I dig into the research behind cortisol levels and chronic inflammation in this post. Adhering to a whole-food ketogenic diet has been shown to lower inflammatory markers like c-reactive protein. (5) This will also help to normalize cortisol levels.
How to go keto if you have chronic fatigue
Here’s what I don’t recommend doing:
- Follow your friend’s guidance.
- Purchase a stack of “keto” supplements.
- Start a ketogenic diet tomorrow.
Following the above three steps is how most people go about starting a ketogenic diet. It’s also a surefire way to feel even more fatigued. For the majority readers, you’ll be asking your body to transition from a lifetime of carbohydrate dependence. This will not happen overnight. A lifetime of carbohydrate dependency creates a need for regular carb-feedings. A slow, gradual progression is the best way to reduce your need for carbohydrate dependence. It will also help prevent you from feeling even more fatigued.
Before starting a ketogenic diet, I recommend readers start with a paleo diet. You can learn more about how to start a paleo diet here. A paleo diet will decrease your carbohydrate intake by about 50%. Moving from a paleo diet to a keto diet will likely drop your carbohydrate intake by another 50%. To avoid the drastic drop in carbohydrate intake, I recommend using the paleo diet as a stepping stone towards to ketogenic diet.
Once you’re comfortable with a paleo diet, only then should you progress to a ketogenic diet. For most people, I recommend staying strict on the paleo diet for 30 days before progressing to the ketogenic diet.
If you’re suffering from high levels of fatigue, the last thing you need is dietary stress. The progression towards ketosis should be slow and steady. Don’t feel you need to be on a strict paleo diet overnight either. For the majority of our patients, we slowly transition them to a paleo diet over six weeks. Below are the same steps we recommend to our patients in the clinic:
- Get as many family members or friends to join you as possible
- If you’re accountable to others, you’re more likely to stick to the plan.
- Identify all sources of gluten that are currently in your house and in your diet.
- For more information on where gluten hides, see this post.
- Remove all things gluten from your household.
- This will avoid temptation.
- Stick to a gluten-free diet until it feels effortless.
- this could take 30 days or 30 months. There’s no rush.
Now that you’re gluten-free, the next step is to transition towards a full-on paleo diet. This involves removing all grains, dairy, alcohol, and refined sugars. Below are your next steps:
- Remove all grains from your diet
- Do this only after you’re comfortable with a gluten-free diet.
- At this point, you’re essentially following a paleo diet.
- Remove beans and legumes from your diet.
- Remove dairy from your diet.
- Remove alcohol from your diet.
- Remove all sources of refined sugars.
- Natural sweeteners like maple syrup and honey are ok.
Voila! You are now following a paleo diet. Next step, ketosis!
Phase III is your first foray into ketosis. To do this, you’ll need to change the amount and types of fruits/vegetables you consume while simultaneously increasing your fat intake. This switch can feel incredibly foreign in the beginning.
All of this new information can be confusing. To ensure you are getting enough calories, your fat intake is high enough, and your carbohydrates are low enough I strongly recommend you use some sort of food tracking app. My preference is cronometer.
Start by tracking the food you are eating on your paleo diet. Pay close attention to the grams of carbohydrates you are eating each day. It’s likely somewhere between 50-100 grams/day. Below, I outline the step-by-step plan for entering into ketosis:
- Enter your height, weight, age, and gender into the app.
- Cronomter will then tell your basal metabolic rate. This is the number of calories you will burn when at rest.
- Try to attain this number of calories each day.
- Set your cronometer app to the ketogenic diet settings (this is a good place to start).
- This will limit your carbohydrate intake to 20g/day
- Follow a 2-week ketogenic meal plan.
- This makes grocery shopping a breeze.
- Click here for a stellar 2-week plan.
- Enter everything you eat/drink into the app
- Pay close attention to the amount of fat, protein, and carbohydrates you are eating.
- The app will let you know if you’re going too high/low in any one category.
- In 2-3 days you will have depleted your body’s sugar stores and you’ll be in ketosis!
- It will take a few weeks for you to become fat adapted. While your body adjusts, it’s entirely normal to feel “off”.
Ok, there it is! Your step-by-step action plan to beat fatigue by entering ketosis.
Now I want to hear from you!
How did your transition to the keto diet go?
Post your keto questions below. I promise to answer them!
Also published on Medium.