Ketogenic AIP: Q&A

 

Sausgae, Avocado & TzatzikiI am experimenting with ketogenic versions of the Autoimmune Protocol (AIP) & I am starting to get a lot questions from people who are considering a ketogenic approach to healing. As many people have similar questions, I thought I would answer three common ones here:

Q:

Hello! I recently found your website and am really interested in starting the Wahl’s Paleo Plus. I’m unsure where to start or what to do?! I’ve been on a sugar cleanse for the past 2 months hoping that would heal some of the joint pain I’ve been experiencing & give me more energy, unfortunately I’m not seeing much improvement. I think maybe I’m consuming too much meat/protein. I’ve been paleo, dairy free, gluten free for a few years. Help!! Any insight or shove in the right direction would be very much appreciated!

A:

My first recommendation in starting the Wahls Protocol would be to read Dr Terry Wahls book. I would also recommend reading Keto-Clarity by Jimmy Moore for more information about ketosis.

The key with ketosis is getting keto-adapted. I’ve gone into ketosis twice in the last year & both times it took 40 days to get keto-adapted, though apparently some people get there in 2-3 weeks. Getting keto-adapted is different than getting into ketosis, which usually takes just a few days. Once you are in ketosis, hunger will be reduced so it is easier, but those first few days can be hard. You could go in with a fasting approach, in which you eat 2 high fat meals per day & experience the hunger before ketosis kicks in, or you could continue to eat according to your usual schedule & just shift your meals to align with the WahlsPaleo+ guidelines until you are in ketosis & then switch to 2 meals a day (fasting in between). It’s your experiment: you’re in charge!

Once you are in ketosis, but before you become keto-adapted, you will likely experience a decline in performance. This is the period when many people give up on ketosis altogether. As mentioned, it seems to take 40 days for me to get keto-adapted & as soon as I am, my energy levels pick back up & I’m able to do all the physical activity I love. When you are keto-adapted your body has fully switched from running on glucose to running on ketones. That’s the physiological shift. But going ketogenic (or making any other significant change) also requires psychological shifts. Stages of Change talks about some the psychological processes involved in making a major change like this.

Q:

Bacon, Avocado & OlivesMy naturopath told me she read a direct quite from Dr Terry Wahls about having a cheat meal once a week/ month. I really wish that’s true; however I have not seen any reference to this. Do you know anything about this?

A:

Cheat meals seem really, really important before you begin (I know!), but once you’re keto-adapted the concept becomes almost irrelevant. I now feel so satiated that I have no desire to cheat.

I have never seen Terry Wahls mention a cheat meal. What she does include in her ketogenic protocol (WahlsPaleo+) is higher carb vegetables (like root vegetables or winter squash) twice per week, but this is entirely dependent on a person’s ability to maintain ketosis. If you can maintain ketosis, she recommends including the nutrient density provided by these foods.

What Dr Wahls has done with her ketogenic protocol is create an out-of-the-box program that will work for most people. But we vary enormously in our tolerance for carbohydrates & protein when in a ketogenic state. Once keto-adapted, you can play around with higher-carb vegetables or increased protein to find your own tolerance levels. But some people (particularly post-menopausal women) may find they need to actually reduce the carbohydrate & protein levels to maintain ketosis. If you want to experiment to create your own personalized program, consider investing in a breath ketone analyzer to get accurate reading of your ketones.
Ultimately, biohacking is all about the experiments you set up for yourself to achieve the objectives you want to achieve, so whether or not to include cheat meals is entirely up to you. Keeping in mind, my husband Matthew has been on a strict dietary protocol for 10 months for his autoimmune conditions. He cheated once (with macadamia nuts & gluten free bread) in the early months and as that cheat set him back a full 2.5 months in his healing process, so he has been completely strict since. He’s not ketogenic, but on a low-FODMAP version of the Autoimmune Protocol.

Q:

asparagus & lemon pestoDo you do follow the intermittent fasting protocol (e.g. 12 – 16 hours between the evening and morning meal) and then only two meals a day?

A:

I do! My preferred pattern is to eat at about 10am & 5pm, with fasting in between. That’s what I do on weekends, but on weekdays I often eat both earlier & later in the day because my workday has to fit in between. If I’m really un-hungry before work, I sometimes bring my breakfast with me to eat mid-morning at my desk. When I eat enough fat, I’m not at all hungry between meals.
Some ketogenic people eat once in 24 hours. I’ve experimented with that, too, but I need to eat so much fat at my one meal that I actually feel a little too full for the first 6-8 hours. (Then pretty perfect for the next 8 hours & slowly more inclined to eat over the final 8 hours). After experimenting, I’ve found that I prefer to break my daily food up  into 2 meals with a longer overnight fast.

Some other ketosis-related posts

Ketogenic Breakfast

 

19 Comments

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19 responses to “Ketogenic AIP: Q&A

  1. Chris Dahl

    Reblogged this on pure paleo 30 and commented:
    Petra is a smart writer whose food views coincide with my own. However, she’s much better at writing regularly. So I thought you’d enjoy a “re-blog”

  2. Melanie

    I’m on AIP and low-FODMAP diet. Can I realistically try going ketogenic? As in, will I have enough vegetable options to keep a diet balanced in minerals and vitamins? I have an autoimmune disease, so the AIP and low-FODMAPS diet is crucial right now.

    • It is feasible to do a ketogenic low-FODMAP diet, but I cannot say whether it would be advisible. As you may know, Dr Wahls has built her ketogenic protocol around a much higher quantity of vegetables than has traditionally been the norm for keto-adherents. It’s the medium-chain triglyceride oils (such as coconut oil) that enables ketosis in the presence of higher carbohydrate levels on the Wahls Paleo Plus, & its the higher carbohydrate levels that enables the nutrient density. You could still go with the higher-carbohydrate levels (more vegetables) on a low-FODMAP ketogenic AIP, but you’d have a much more limited range to choose from.

      • Melanie

        Because of my diet, I’m already limiting my vegetables to leafy greens (no lettuce since I don’t digest them so well), carrots, turnip, sauerkraut and some bok choi. I haven’t done much research on ketogenic diet breakdown yet (fat vs protein vs carbs), but can you recommend a good website that might help me rearrange portions if I wanted to pursue this? I’ve looked at this website and it seems to give a good amount of information:
        http://www.ketogenic-diet-resource.com/low-carb-food-list.html

        Thanks!

      • Because we all have different tolerances for carbohydrates & protein when it comes to maintaining ketosis, rearranging portions really has to be a personal experiment. I haven’t found a website that I could recommend that addresses this thoroughly, but would suggest Dr Terry Wahls book as a starting place. She recommends 6-12oz of protein a day (the lower range for women) and 6-9 cups of vegetables. Not sure if you tolerate berries, but she also recommends up to 1 cup of berries a day. Lots of coconut oil. Not sure if you’ve seen this post I wrote about it: https://petra8paleo.com/2014/04/18/what-can-you-eat-on-the-wahls-paleo-plus/ For myself, I build my meals around fat & infill protein & carbohydrates as/if needed. This seems really normal to me now but was definitely weird at the beginning!

      • Melanie

        Nothing feels weird to me now! I eat pork patties and sauerkraut every morning, but I’m really getting tired of that. Since I can’t have any seed spices, garlic or onions, I have to make everything myself (can’t buy sausages from the local farmers). I can’t tolerate avocado or coconut milk/butter either, so it’s very limiting as you mentioned in your reply.

  3. I’m living the ketogenic way vicariously through you, Petra. And, with much interest.

  4. MIchelle

    As a follower of your blog for a while now, as well as someone who can not seem to get enough of the discussion and fascination with the Ketogenic diet for my autoimmune health concerns, I was wondering if you would be willing to do a blog post on your own experiments with exact ounces and grams of protein and carbohydrates. I know it will be different for everyone, but you have had success with this and I was wondering if you would share your exact ounces and grams? To help me see more visual realistic numbers. Dr. D’Agostino states, “It is nearly impossible for most people to maintain even moderate levels of ketosis if protein is greater then 2 grams per kilogram of body weight.” He uses high levels of coconut and MCT oil like Dr. Wahls to leverage increased protein and carbs, so that number seemed low. For someone like me who is trying to think all this through before starting the Ketogenic diet and weighs 54 kilograms, that would be only 108 grams or 3.8 ounces of protein each day. I have read Terry Wahls recommendations as well and was planning on more like the 6oz a day. All my thinking froze when I began seeing my meals with only 3.8 ounces of protein split between two. That seems so little!? Also, I do not know if you have come across all the lectures on: http://www.ihmc.us/ocala_lecture_series.php I have loved the lectures from Dr. Peter Attia, Dr. D’Agostino, Jeff Volek, Dr. Alessio Fasano, Dr. Mary Newport, Dr. William Davis, Dr. Larry Smarr, and will soon be available for viewing, Dr. Colin Champ. The lectures make the Ketogenic diet so intriguing that you wonder why more are not trying it. I find myself watching them over and over again why I am getting ready and reviewing the facts. I think you will really enjoy the lectures, if you have not already watched them. It would be helpful for me as I try and really visualize this if you would be willing to share exact numbers of protein and carbs and help me understand the exact number of Ketones that you are producing, based on those numbers. Your blog has been most helpful for me to visualize this, but more exactness would be of great help. Thank you, thank you!

    • Hi Michelle, I’m not skillful enough to give exact grams of my foodstuffs. I wish I were! My understanding is that we all have different tolerances for carbohydrates & protein, so formulas are only useful as starting places. I aim for about 8 ounces of meat a day & know that I can maintain ketosis if I sometimes have more. Right now I’m eating super low-carb as an experiment, but I know I can maintain ketosis at higher levels of carbohydrates, too. I’ll tell you what I just had for my evening meal, in case that helps: a lamb shank (slow-cooked with bacon) (about 5 ounces of protein); a bunch of watercress cooked in the lamb/bacon juices (which were mostly fat), 2 avocados & a piece of berry fudge. If you want to be able to measure your ketones accurately, you might consider getting one of these: https://www.ketonix.com/ I’m just waiting for mine to come in the mail!

      • Petra, this was helpful! I (Michelle) actually have one of those ketonix and I like it. I have picked up moderate levels on the device. Maybe I can leave a picture on your facebook page. I would like to see exact numbers, so that is why I now have the blood monitor, but have not wanted to waste the testing strips until I get into a system. It sounds like you are able to eat very comfortably and maintain ketosis. Your estimates made me feel more confident in going a head and having more rather then less. I can always scale down, right. Thank you!

  5. I am finding that the Ketonix seems to give you high reading when it actually is not that high. I am still eating too high of carbs (over 90 grams), I feel. And my protein is still pretty high, as I have been slowly easing into this diet. I used the Ketonix tonight and the reading was red, which would indicates high levels of ketones. Then I broke out my new ketone blood monitor and the actual number was 0.6, which is in the optimal range, but really quite low. The goal is to be between 0.5 and 3. Maybe a mixture of the Ketonix a couple times a week and testing blood a couple times a week may be a good combination. I know it was not until Jimmy Moore was able to get into optimal ranges when the benefits soared. It seems it would be a shame hanging out at 0.6 and picking up a red on the reading thinking high levels were in use only to find out with a little more adjusting one could have had greater benefits. I hope to see the price of the ketone strips come down in the future. Thank you for allowing me to share my experience with Ketonix vs. a blood ketone monitor. And again thank you for sharing your meal portions. This conversation has been helpful.

    • Thanks for sharing this information, Anna. Just thinking as I write, but I’m wondering if the Ketonix Sport model https://www.ketonix.com/index.php/product/sport would be better calibrated with the blood monitor? Jimmy Moore advises checking ketones regularly & I certainly am not going to contradict that advice, but I don’t check them at all currently & it’s pretty clear I’m deeply in ketosis. But I’m not trying to determine my upper threshold for carbs & protein just now. Accurate data would be very important for that experiment.

  6. It is helpful to hear that you just know and it becomes pretty clear when you are deeply in ketosis. Maybe after I make it through the initial adaptation process, I will experience that as well. Then the need to test becomes less important. Honestly, it was Dr. Wahls and my trust in her judgement to feel interest in the ketosis diet, but really it has been reading your blog that has given me the bravery to go a head and give it a try. Also, I have tried many fat bomb recipes on-line, but none of them leave you feeling well. Your fat bombs on the other hand, do leave me feeling well. I have bison liver in the freezer waiting to give your way a try, so your blog has been more helpful then any book or lecture I have read. It has given me a visual of this option and I appreciate that you go about the diet as nutritionally dense as possible. I have not been impressed with the way others choose to pull off the diet. Thank you for your ideas, work, and time.

  7. Pingback: Biohacking is Research | petra8paleo

  8. Sue

    Hi Petra,

    Thank you very much for your post and blog. I just would like to mention that I have experience an almost full recover from my thyroid autoimmune disease symptoms on a AIP-Ketogenic diet, plus intermittent fasting. Joint pain, inflammation, migraines, skin issues, hair loss, dry eyes, dry skin, brain fog, fatigue, and gastrointestinal issues have almost dissipated. I tried for 2 years the AIP protocol and I experienced no more than 70% recovery plus several flares (probably due to an extreme carbohydrate sensitivity). Now, after experiencing with keto diet and intermittent fasting, in addition to AIP diet, I feel on my 100%, with any flare at all, and lots of energy.

    I believe my experience is similar to yours and I’m looking forward to your AIP-Keto recipes to generate an improved and delicious healing diet to deal with autoimmunity!

    Thanks again for your blog and sharing with us your amazing recipes and ideas!

    Sue

    • I’m so happy for you, Sue! I have found that a ketogenic diet doesn’t work for me in the long term. but we are all unique. I am so pleased that you have experienced such a profound reversal of your symptoms.

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