There are two main things to do before starting the ketogenic diet: check in with your doctor and begin reducing carbohydrate intake.
As we’ve just discussed, the ketogenic diet is not appropriate for everyone. It’s important to talk to your doctor before starting to address any underlying health issues that could be aggravated by a major dietary shift. In addition, your doctor can take baseline blood pressure, cholesterol, and serum triglyceride measurements.
For unknown reasons, some people just don’t react well to the ketogenic diet and end up with dangerously high levels of fat in their blood. In some cases, this is due to poor fat and carbohydrate choices; in other cases, it may be for individual genetic reasons.
Taking baseline measurements and checking in again after the first few weeks can help ensure that you aren’t endangering your health.
The other things to do before beginning is start cutting down on the amount of carbohydrates you eat. A good target is to cut down by about 50g of carbs per week, an amount equivalent to a can of soda or two slices of bread. If you norfmally eat 325g of carbohydrates every day, aim for 275g per day over the next week, then 225g for a week, then 175g, etc., until you reach the 100 to 75g range. This gives your body time to start adapting before you begin eating just 30–50g of carbs each day.
The ketogenic diet can result in a variety of side effects, including increased thirst, fatigue, dizziness, fruity-smelling breath, hunger, trouble sleeping, nausea, constipation, and diarrhea. Most of these will dissipate after the first few weeks. If they don’t, or are severe, discontinue the diet and seek medical advice. If you experience serious symptoms like throwing up, trouble breathing, or fainting, seek medical attention right away. There are several things you can do to help ease mild side effects.
As we discussed above, start reducing your carbohydrate intake before beginning the diet, so your body has time to adjust. It’s also important to drink lots of water, as being in ketosis can increase water excretion. If you become dehydrated, consider rehydrating with an electrolyte-enriched formula to resupply potassium, magnesium, and other ions. Including exogenous ketones and MCT oil can be extremely helpful by supplying ready-to-use ketones and supporting fast ketogenesis to ensure that your body has a steady new energy supply after the reduction of carbohydrate intake.
Finally, you must eat lots of leafy green and other non-starchy vegetables. Repeat: eat lots of vegetables! Whole grains and legumes are great sources of fiber in a normal diet, but obviously can’t provide much for the ketogenic diet. This means that in order to avoid constipation and maintain good digestive health, you need to eat lots of vegetables to reach the recommended fiber intake of 25–35 grams per day. Nuts, seeds, and occasional servings of berries are also good fiber sources.