The Top 10 Ketosis Mistakes and How to Prevent Them

What mistakes are you making when it comes to your health? I know I’ve been making plenty. That’s why I’m tracking my data in this recent ketosis experiment that I’m doing. What about you?

Most people think that the ketogenic diet is just “low-carb” which leads them to make many mistakes that prevent them from not reaping all of the benefits of ketosis that they could. What benefits? How about an improved immune system, increased longevity, lower inflammation, effortless weight loss, decreased hunger, reduced risk for disease and more.

Read on to know the top 10 ways that people make mistakes with ketosis and how you can prevent them.

1: Not tracking protein intake

By far the biggest problem with a ketogenic diet is not tracking how much protein you are eating. The far majority of people are simply eating too little protein… not too much protein. 

Protein can turn into carbs by a metabolic process called gluconeogenesis, meaning “making new carbs.” This then spikes insulin, and reduces ketone levels. HOWEVER in your actual body, this is a really rare process that I only see with myself and patients of mine if we are guzzling tons of liquid protein shakes (like whey). Even though you are eating super low carb, this could make your body switch back and forth between energy systems, which will lead to high levels of fatigue or “low carb flu.”

The easiest way to avoid this mistake is by tracking your ketone levels to see how you respond to different amounts and different types of meat. Everyone is different, so the only way you can tell is by tracking. I “listened to my body” before and it didn’t work. I wasn’t in ketosis when I thought I was. I also thought ketosis kind of sucked. It didn’t, I was just wrong. The only way you know is by tracking.

But wait, are you going to lose all that muscle mass if you limit protein? No. Not me at least. I’ve been chronically overeating protein for years now. Five weeks into my experiment I’ve dropped from about 200 grams of protein per day to about 120 grams of protein per day with an increase in three pounds lean mass. You need much less protein than you think. Get it from real food sources and you’ll be fine. 

This also means don’t follow a lot of calculators on the web that say you should eat 40g of protein on a ketogenic diet. This is far too low for any human being to function on a long-term diet. Set your protein first (min of 70g for most people) then carbs at 20-50g, then add your fat back in.

Tips:

  • Track your protein and make sure to keep grams are appropriate.
  • Eat protein in solid food form unless it comes from collagen
  • Eat higher fat proteins (fatty beef instead of lean chicken breast)

2: Not tracking carbs

The first rule of ketosis is that you do not eat carbohydrates. The second rule of ketosis is that you do not eat carbohydrates. However, there are carbs in everything and you can’t avoid them entirely. The amount of carbohydrates you can have that will allow you to stay into ketosis will vary per individual.

A single avocado can have enough carbs to kick some people out of ketosis. The key word here is “some” people.

Many factors are at play here to see how much carbohydrate you can tolerate before they kick you out of ketosis. Your metabolic history, lifestyle, types of carbs and more will all affect how you will be able to process and utilize carbs.

How do you track the amount of “hidden” carbs in foods though? The easiest way is to use an application like MyFitnessPal and just punch in every single thing that you are eating. It can be annoying but a couple weeks of work can lead to years of benefits. Do the work.

Just like with protein, the easiest way to check this out is to test your ketone levels. As an easier option here, you can check glucose levels as well to see how much your blood sugar increases after a meal. This should not be more than 15-20 points. The lower blood sugar spike, the better.

A general rule of thumb to those who are new to ketosis is to start at about 5% of carbohydrates for total calories. Once you are in a state of ketosis you can start to ramp these up if you’d like to see how much your body can tolerate. Just remember to keep testing.

Tips:

  • Use an app like MyFitnessPal and track for at least a few weeks, keeping % of carbohydrates under 5% of total calories
  • Track with blood glucose meter and ketone meter
  • Adjust as needed

3: You’re not eating enough fat

When you reduce carbs and protein, it is sometimes hard mentally to eat enough fat. We’ve been told all of our lives that eating fat will lead to heart disease and many other health problems, which is simply not true. 

If you decrease two main sources of food (carbs and protein) you need to drastically increase another source (fat).

The easiest way to make sure you’re getting enough is again by using an app like MyFitnessPal (no affiliation, seriously), setting calories to where you need, and making sure you are getting 80-85% of those calories from fat. Track, don’t slack.

Not eating enough fat will make you super hungry and can lead to problems like undereating (see below).

This will probably be difficult in the beginning! But if you track early and get a hang of it, then you’ll be able to eyeball easily as you go along.

Tips:

  • Use an app like MyFitnessPal to track how much fat you should be eating in a day
  • Aim for 80-85% of total calories from fat initially and adjust later

4: Not eating high enough quality fats

Just because you are in ketosis doesn’t mean you should be sacrificing quality. A huge mistake with most ketogenic diets is the lack of inclusion of high-quality fats. Yes, you can get into ketosis by eating a very low carb diet that’s very high in poor quality foods. No, that type of ketosis is not healthy. Garbage in, garbage out.

Fats are the backbone for making new cells and brain tissue, neurotransmitters, hormones and most bodily functions. This means we should be focused on getting as high of quality fats as possible. Do you want all of those things to be high-quality, or low-quality?

And because the diet you are eating is 80-85% fat, the quality of fats you eat matter even more.

Think of whole, non-processed food choices. This means grass-fed meats, wild fish, cold pressed oils, avocado, nuts, etc. Not frankenfood fats that come in super bright packages like low quality processed cheese and other dairy products, bacon and other low-quality fluorescent non-food items.

Tips:

  • The quality of fat matters even more when you are on a ketogenic diet
  • Make sure your fat is coming from a variety of whole food sources with as much omega 3 fats as possible

5: Not eating enough calories

One of the things that happen when people start eating more fat and less carbs and protein and not used to it is to spontaneously reduce calories. While this can be effective in the short term if one wants to reduce body fat, this can be detrimental to hormonal processes in the long term.

When you eat fat, you are more full, which makes it easy to eat less calories, but that doesn’t mean you should. When I first started eating a true ketogenic diet, it was difficult for me to get more than about 1600 calories. I’m a lean 175lb male who works out and need about 2600 kcals a day. You see the problem here. 

When your body has much less calories as an input, it goes into starvation and hoarding mode. It thinks the trend will continue and so it hoards precious resources (stored body fat, substrates to make hormones and neurotransmitters) and doesn’t want to thrive.

Most of the metabolic and thyroid problems people claim are caused by a ketogenic diet are actually just a low-calorie problem. This especially applies to women.

At least at first, start the ketogenic diet trying to get a maintenance level of calories and adjusting your metabolic processes before you start lowering overall calorie intake. When you do, do so to normal hunger levels and don’t go too low. Track, don’t slack.

Tips:

  • Don’t try to lower calorie levels at first
  • Track to make sure your levels of food intake are high enough and consistent
  • Eat to hunger levels

6: Not eating fermented foods

An easy way to boost your gut and immune system is by getting a heaping serving of fermented foods. Many people skip on this class of superfoods because they are so focused on fat, but fermented foods play a very large part in digestion and overall health.

Try to include at least 2-3 servings of fermented foods a day from different sources. This can be a few tablespoons of sauerkraut or kimchi, a little bit of kefir or full-fat yogurt, or raw pickles.

Tips:

  • Try to include a bite of fermented foods with 2-3 meals a day

7: Not getting enough micronutrients

When you start eating way more fat and less carbs, you end up getting less plant diversity, which leads to less micronutrients. This is one of the biggest mistakes of the ketogenic diet.

Because fat is so filling and some vegetables contain carbs that can kick you out of ketosis, it can be difficult to stay in this balancing act of veggies or no veggies.

A trick to get more variety or to get a lot of nutrition in at once is steam up a big pot of veggies or greens then add fat to reduce the impact the fiber has on your blood sugar levels. The fat keeps you in ketosis and helps with nutrient absorption, and cooking or steaming the greens greatly reduces the bulk of food.

Another great way to get micronutrients is to eat more than muscle meats of an animal, especially organ meats. Organ meats like liver and heart are some of the most nutrient-dense foods on the planet and go a long way in shoring up nutritional deficiencies from not eating enough plant diversity.

Tips:

  • Get a variety of plants
  • Steam greens and add fat to get more nutrition
  • Eat organ meats for a nutritional powerhouse

8: Not testing blood levels

There are three primary ways to test ketone levels: through your urine, breath, or blood. 

Urine tests are good to detect initial boosts in ketone levels, but once your body starts becoming efficient at using ketones, you don’t excrete as many through the urine, so it looks like your levels are decreasing when they are actually increasing.

Breath tests are unreliable, slow and can be as good as guessing when it comes to ketone levels. Skip until you correlate with blood strips.

Blood tests are the gold standard to tell exactly the levels of ketones in your blood that your body is using and the only way you can really see if something modifies your ketone levels. Because you get a specific reading (in mmol) you can gauge before and after meals, workouts or anything else you want to test. The only downside is that the strips to test are a little expensive.

Testing a couple times a day is usually good enough to see trends if what you’re doing is working appropriately.

I wrote up all of the information that you’d possibly need about testing your ketone levels if you care.

Tips:

  • You can use urine meter at the beginning, but switch to a blood meter
  • Test at least in the AM and PM to see overall trend lines

9: Not eating enough fiber

Gut health is another important, and often neglected, facet of health that gets ignored when people switch to a ketogenic diet.

If you think about probiotics as introducing new good bacteria for your gut, think about fiber as the food for all of the existing (good) bacteria in your gut. You actually have more bacterial cells in and on your body than you do human cells, so you better treat them right!

A way to get more fiber in that is the same as getting a lot steamed greens at once. This will vastly reduce the bulk of many vegetables. You can also make “creamed” version of vegetables by simply blending up a bag of steamed cabbage, kale, or spinach with half a can of coconut oil or some butter and cream.

Another way is to make a huge fat smoothie but add a ton of vegetables. If you add coconut milk, cream, nuts, eggs, and avocado to a smoothie with a ton of spinach, kale, and cabbage, you’ll actually stay in ketosis pretty easily. And it will taste like a milkshake. Bonus!

Tips:

  • Steam veggies to reduce bulk and increase fiber amount
  • Make “creamed” veggies as sides
  • Make fat smoothies with tons of added veggies

10: Not tracking glucose with ketones

High levels of ketones are not enough. You should also be looking at your blood sugar to see if you’re still insulin resistant and if your body is still trying to use blood sugar as a source of energy.

Since you’re already poking your finger and getting blood, you might as well get a glucose meter as well, which is a really good marker of your overall metabolic state.

This will also help you see how much meals are affecting your blood sugar and give you a good sense of what you should be eating and what you should be avoiding.

To get a good sense of really how deep into ketosis you are, use a thing called the Glucose Ketone Index. Click those blue words to see how to measure it yourself.

What is the GKI? The most therapeutic range of ketosis comes when blood sugar is at the lowest and blood ketones are at the highest. Simply put, you don’t get all of the benefits of ketosis when both your blood sugar and blood ketones are elevated at the same time. You must test!

Tips:

  • Buy a blood glucose meter
  • Test in the AM and PM and before and after meals
  • Try to get blood sugar down and ketones up
    mistakes on a ketogenic diet

Those are some of the main reasons why people can’t stick to a ketogenic diet or why they become unsuccessful. Have you found reasons that don’t jive well with you? Leave them in the comments below!