Mental block re. getting into ketosis

Tswa · Sep 30, 2018

Hi guys,
I'm T1, have been for 8 years. I've been experimenting with low carb/keto meals and like the effects on my blood sugar, but I'm experiencing a bit of a mental block. Just for reference I'm looking to lose ~10kg.
I've always been taught ketones are bad so the idea of having high ketones is freaking me out a bit, even if it's nutritional ketosis.
I'm also struggling with the ratios in the keto diet. Having 60-70% fat is freaking me out, I keep worrying that I'll do it and it'll make my sugar better but make me fatter
Also does anyone have any tips to get the right fat ratio without doing fat bombs? Cos that is what is really getting me. The idea of putting butter in my coffee etc, I can't get past that. Of a day I'd have low carb muesli and yogurt for breakfast, leftover dinner for lunch, and some sort of meat (chicken or steak usually) with mushrooms and veges for dinner. I don't think this is high enough in fat to get the keto benefits.
Any tips!?

Indy51 · Oct 1, 2018

Sorry I can't help with the Type 1 side of things, however, a couple of things re diet.

It's absolutely not correct that you need to be in ketosis to lose weight. Before you get worried about being in ketosis, why not try reducing carbs to between 50-100g carbs per day and see if that helps with weight loss. You'll have less to fear on the ketone front by staying around or above 50g.

It's also not necessary to eat fat bombs, drink buttered coffee, etc. The main thing is to stop buying all the "low fat" labelled products that usually contain large amounts of sugar. If you eat dairy, concentrate more on the full fat versions of plain Greek yoghurt, cream, cheese, milk, butter, etc. It's unnecessary to add extra fat to the diet - just don't fear the natural fats that come with protein.

Good luck with it

Safi · Oct 1, 2018

@Indy51 has given some good advice so i'll just tag in @Mel dCP who is type 1 & as I understand it doing keto - she might have some relevant tips for you

Oldvatr · Oct 1, 2018

Safi said:
@Indy51 has given some good advice so i'll just tag in @Mel dCP who is type 1 & as I understand it doing keto - she might have some relevant tips for you

I too agree with what is being said here. (I am also T2D) but yes, LCHF is counter intuitive and the opposite of the standard diet advice normally taught in Daphne and Desmond training. I personally use the PIOPPI diet which is an LC version of the Mediterranean Diet, as it is similar to LCHF without going keto. As an insulin user, you should be able to cope with higher carb levels than me as a T2 so keto is probably less important for you. As Indy51 says, many here lose weight without keto but then again many do not, but it is worth experimenting.

The high fat intake advised for LCHF is only needed if you are exercising to any significant degree, since it is there to stop the body scavenging glucose from muscles, and yes, provides the alternative energy to protect them. It is not needed as much if you stay just above keto levels ( i,e, approx 50 to 100g carbs a day level) Most if us here find that our cholesterol levels actually improve when doing LCHF types of diet if we use the right fats.

LooperCat · Oct 1, 2018

Morning, thanks for the tag @Safi

I’ve been doing keto since January, and it’s got my HbA1c down from 89 at Christmas to 40 last month.

It’s not the fat that gets you into ketosis, it’s the lack of carbs. When your body doesn’t have enough glucose to power it, it switches to burning fat - well, it breaks down fat into ketones, and that’s what gets burned for fuel. The tiny amount of glucose that is required for a couple of functions in the eyes and brain is made by the liver from protein in a process called gluconeogenesis.

You don’t need to eat tons of fat on keto - especially if you want to lose weight. Your body will use the fat you eat for fuel before it started to use the stuff you already have stored, so there’s no need to eat tons of it. The keto idea is that carbs are a limit, protein is a goal & fat is a lever. So you limit your carbs and don’t do over your target, you aim to hit your protein amaount, and you use fat to keep you from being hungry.

It’s better to look at your macros in grams rather than % - there’s some good calculators on keto sites like ruled.me - as an example, my daily macro targets are 30g carbs, 90g protein and 90g fat. Some people like to keep their carbs under 20g a day, but I’m in ketosis with my 30g.

As for ketosis, it’s a different thing to ketoacidosis - but we’ve had it hammered into us as T1s for so long that ketones are to be avoided at all costs, and it’s hard not to panic when we see them.

There’s a massive difference between the relatively small amounts of ketones we get with a keto diet and the amount you get in DKA - which only happens in the absence of insulin. It’s perfectly safe, but overcoming the panic when we get them isn’t easy. I typically have 0.7-2.5 on my blood meter, I try to keep it below 3 on the advice of my diabetes specialist dietitian. My team are perfectly happy with my following this way of eating, and prescribe me blood ketone strips so I can keep a close eye on my levels.

I’d really recommend this book, it’s written by a doctor who is himself T1: Ketogenic Diet for Type 1 Diabetes

Sorry my post is a bit disjointed, had a heavy weekend...

Tswa · Oct 3, 2018

Oldvatr said:
I too agree with what is being said here. (I am also T2D) but yes, LCHF is counter intuitive and the opposite of the standard diet advice normally taught in Daphne and Desmond training. I personally use the PIOPPI diet which is an LC version of the Mediterranean Diet, as it is similar to LCHF without going keto. As an insulin user, you should be able to cope with higher carb levels than me as a T2 so keto is probably less important for you. As Indy51 says, many here lose weight without keto but then again many do not, but it is worth experimenting.

The high fat intake advised for LCHF is only needed if you are exercising to any significant degree, since it is there to stop the body scavenging glucose from muscles, and yes, provides the alternative energy to protect them. It is not needed as much if you stay just above keto levels ( i,e, approx 50 to 100g carbs a day level) Most if us here find that our cholesterol levels actually improve when doing LCHF types of diet if we use the right fats.

So I am exercising, quite a bit, so any advice on what I should do pre-workout?

Tswa · Oct 4, 2018

T

Mel dCP said:
Morning, thanks for the tag @Safi

I’ve been doing keto since January, and it’s got my HbA1c down from 89 at Christmas to 40 last month.

It’s not the fat that gets you into ketosis, it’s the lack of carbs. When your body doesn’t have enough glucose to power it, it switches to burning fat - well, it breaks down fat into ketones, and that’s what gets burned for fuel. The tiny amount of glucose that is required for a couple of functions in the eyes and brain is made by the liver from protein in a process called gluconeogenesis.

You don’t need to eat tons of fat on keto - especially if you want to lose weight. Your body will use the fat you eat for fuel before it started to use the stuff you already have stored, so there’s no need to eat tons of it. The keto idea is that carbs are a limit, protein is a goal & fat is a lever. So you limit your carbs and don’t do over your target, you aim to hit your protein amaount, and you use fat to keep you from being hungry.

It’s better to look at your macros in grams rather than % - there’s some good calculators on keto sites like ruled.me - as an example, my daily macro targets are 30g carbs, 90g protein and 90g fat. Some people like to keep their carbs under 20g a day, but I’m in ketosis with my 30g.

As for ketosis, it’s a different thing to ketoacidosis - but we’ve had it hammered into us as T1s for so long that ketones are to be avoided at all costs, and it’s hard not to panic when we see them.

View attachment 28748

There’s a massive difference between the relatively small amounts of ketones we get with a keto diet and the amount you get in DKA - which only happens in the absence of insulin. It’s perfectly safe, but overcoming the panic when we get them isn’t easy. I typically have 0.7-2.5 on my blood meter, I try to keep it below 3 on the advice of my diabetes specialist dietitian. My team are perfectly happy with my following this way of eating, and prescribe me blood ketone strips so I can keep a close eye on my levels.

View attachment 28747

I’d really recommend this book, it’s written by a doctor who is himself T1: Ketogenic Diet for Type 1 Diabetes

Sorry my post is a bit disjointed, had a heavy weekend...

This is amazingly helpful, thank you! Do you have any tips on how to deal with a heavy weekend?

Resurgam · Oct 4, 2018

Whilst I've been eating the natural fat which comes with the foods I eat I have lost three stones, and without trying. I have also seen my cholesterol falling - all contrary to the 'fat is bad' mantra.

Tswa · Oct 4, 2018

Resurgam said:
Whilst I've been eating the natural fat which comes with the foods I eat I have lost three stones, and without trying. I have also seen my cholesterol falling - all contrary to the 'fat is bad' mantra.

That's amazing, go you! I just had a colleague at work tell me I'm slimmer now than when I started a month ago, so that's positive!

Oldvatr · Oct 4, 2018

Tswa said:
So I am exercising, quite a bit, so any advice on what I should do pre-workout?

I believe Tim Noakes is a well known advocate of keto diet who gives presentations on the subject. He is (or was) a T2D but is also an athlete / trainer / coach based in South Africa. I do not have any suitable links, but he will show up on Goole, and there are many here who follow his advice. I personally do not exercise due to previous CVE, so cannot give any personal advice coz it ain't in my experience.....

AloeSvea · Oct 19, 2018

Tswa said:
That's amazing, go you! I just had a colleague at work tell me I'm slimmer now than when I started a month ago, so that's positive!

@Tswa - is that you in the avatar-pic on your posts? If it is my maternal feelings are on alert! I can't help but notice your clavicle bones are showing, if that is you. So if that is you, and you are so slender that your clavicle bone is showing (what I notice in my own adult daughter when I start to worry if her weight is getting a bit low/she's not getting enough nutrients to be healthy), I wonder why you are wanting to lose 10kg?

Please forgive me if I am way out of line, and just ignore me if the pic is more an 'idealised' you/a pic of a model, and not actually you, well - ignore me if that is the case for sure. (Although I would say your 'target' is not a healthy strong weight. But I am all for muscles not bones!) (my daughter gets this too .)

Tswa · Oct 19, 2018

AloeSvea said:
@Tswa - is that you in the avatar-pic on your posts? If it is my maternal feelings are on alert! I can't help but notice your clavicle bones are showing, if that is you. So if that is you, and you are so slender that your clavicle bone is showing (what I notice in my own adult daughter when I start to worry if her weight is getting a bit low/she's not getting enough nutrients to be healthy), I wonder why you are wanting to lose 10kg?

Please forgive me if I am way out of line, and just ignore me if the pic is more an 'idealised' you/a pic of a model, and not actually you, well - ignore me if that is the case for sure. (Although I would say your 'target' is not a healthy strong weight. But I am all for muscles not bones!) (my daughter gets this too .)

Oh aha yes that is me, but I've always had a sticky outy clavicle, it's just my bones. Current BMI is 27 so definitely overweight. Please don't worry! Thanks for your concern.

HSSS · Oct 19, 2018

AloeSvea said:
@Tswa - is that you in the avatar-pic on your posts? If it is my maternal feelings are on alert! I can't help but notice your clavicle bones are showing, if that is you. So if that is you, and you are so slender that your clavicle bone is showing (what I notice in my own adult daughter when I start to worry if her weight is getting a bit low/she's not getting enough nutrients to be healthy), I wonder why you are wanting to lose 10kg?

Please forgive me if I am way out of line, and just ignore me if the pic is more an 'idealised' you/a pic of a model, and not actually you, well - ignore me if that is the case for sure. (Although I would say your 'target' is not a healthy strong weight. But I am all for muscles not bones!) (my daughter gets this too .)

My clavicles stuck out when I was bmi of 30 and most definitely overweight. I think it’s just how some people’s bones are. Ribs, hips bones etc might be another matter but not clavicles.

mike@work · Oct 19, 2018

Tswa said:
T

This is amazingly helpful, thank you! Do you have any tips on how to deal with a heavy weekend?

I'm sure she does, but if i don't remember all too wrongly, that belongs to the advanced course. The advanced course is so difficult, that you will surely get a heavy headache from it...

And yes, I suggest that you test the many advice given here - I think you will be pleased with the end results...

AloeSvea · Oct 21, 2018

Tswa said:
Oh aha yes that is me, but I've always had a sticky outy clavicle, it's just my bones. Current BMI is 27 so definitely overweight. Please don't worry! Thanks for your concern.

Well, @Tswa, no wonder you use your own pic! I would too if I photographed as well as you do . (Which reminds me - I must get a full-grown aloe plant pic for the southern hemisphere summer, to represent me...)

I hear you on the bones/bmi front. (My daughter always reassures me too .)

Type 1 is not my forte of course - if you were type 2 it would be unusual for you to be bottom-heavy in the fat storage pathway department (which is the healthier fat storage pathway for women, and probably for men too but more unfortunate for them, as it would be heavier on the estrogen then?). As type 1 your fat storage pathway is irrelevant to your health I take it? And your weight concerns are to do with general health considerations? Like CVD prevention and so on... If you are indeed bottom heavy, that bodes well for you, general-cardiovascular-health wise. (I am assuming you are bottom-heavy due to your being very slender on the top! At least the torso and neck region, as in @HSSS? .) (Me? I tend to top heavy with a very short fat neck when fat! Does not look so good in photos! Especially the few chins...) (Yes, LCHF and keto keep me one-chinned I am happy to say. And my short neck just a short neck without being a fat one. Please note - I am just talking about my own body! Not casting aspersions on anyone else's!)

Mental block re. getting into ketosis

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