Context in The Ketogenic Diet

Frequently, we receive questions to the website, Facebook, Reddit, etc that all seem to center around the same set of questions:

• Should I add more/less/the same amount of ________ to my diet?
• What should macros look like?
• How much rest should I take between sets?
• Should I add another hour to my sleep schedule?
• What should I wear tomorrow?

OK, so we probably don’t get the last question all that often – but the point still remains. We are often asked questions that may seem to be completely unrelated, but the answers to them are all related. We frequently find ourselves responding with a two-word first sentence: “It depends.”

“It depends” is one of those expressions which can be viewed as dismissive and colloquial – akin to the Southern American saying, “Well bless your heart.” The reality, however is that the answer to any of those questions (yes, even the one about fashion) is dependent upon the context in-which it is asked. In order to provide any guidance or recommendation, we find ourselves following up the first sentence with a series of questions:

• What are your current stats? (age, sex, height, weight, body fat %, medical conditions)
• What are your current macros?
• What is your current level and volume of training?
• How long have you been ketogenic?
• What variation of a ketogenic diet do you utilize?

Demographic Questions

Those questions are asked with a specific intention – understanding more about you and how we can best help you to find a solution/resolution/direction. But the question remains – why? Why do we need to know so much about your current circumstances in order to provide guidance…after all, isn’t getting into ketosis just like falling off a horse? Well…it depends.

Addressing these topics in order, why do we need to know enough information about you to create an eharmony.com profile of you? Because all of that information matters…it paints a picture of the individual. Are you obese? Are you lean? Are you pre-/post-menopausal? Insulin resistant/PCOS/T2 diabetic? What is the amount of lean mass as compared to fat mass that you are toting around? All of these factors play into recommendations in some fashion or the other. Some directly, some as useful information in understanding and identifying macronutrient requirements (which, as if by some miracle of editing wizardry, we will cover next).

Current Macronutrient Consumption

Macros are an interesting topic. So often we see recommendations, even those from reputable health and fitness experts, represented in percentage. 70% fat, 25% protein, 5% carbohydrate…that’s the magic formula to be ketogenic. While we recognize the wisdom of those people, context is king once again. If an individual were consuming 10,000 kcal per day, that would make their daily carbohydrate consumption 167g. That is hardly ketogenic. Likewise, it would make their protein consumption 625g daily. Neither are a recipe for a well-formulated ketogenic diet. On the other hand, an individual who is trying to “cut hard” and is eating 800 calories per day using magic ratios would consume only 50g of protein daily; an amount insufficient to sustain lean mass.

It is important, then, to ask ourselves – what is the most important macronutrient? For reasons that I can address in a future blog, I find myself of the opinion that the answer to that question is protein. Insufficient protein can lead to immune issues, signaling and other hormonal issues, muscle catabolism, decreased TDEE, etc. So as the anchor of ANY discussion on macros which should take place in helping provide assistance to those who are interested must be, “how much protein are you eating?” Again, this is contextually dependent. Are you naturally relatively muscular? Are you later in life? Are you currently training? What does your training consist of? All of these factor into an individualized answer. What we can say, however, is that most of the evidence seems to indicate that a safe range for any individual who is eating a well-formulated ketogenic diet falls in the realm of 0.8-1.2g of protein per pound of lean body mass. Why lean body mass? Because white adipose tissue (fat) is significantly less metabolically active than is lean tissue.
Ketogains strongly recommends against the use of ratios based solely on our experience that they work well for those whose current weight is a standard deviation either side of the mean as it pertains to normal weight, normal height, and normal lean mass. They don’t work for the statistical outliers who are cutting or bulking. Translation: morbidly obese will overeat fat and morbidly underweight will overeat protein if ratios are used to determine macronutrient breakdown.

So again, the use of macronutrient ratios works fine for those coaching individuals who have their diet down to a science…but in the real world of Joe Six Pack and Susie Spin Class ratios fall apart somewhat. Ratios should be applied within *gasp* proper context!

How Long and How Much Do You Train?

Next, we tackle training. Why do we ask? Three reasons:

1. The damage of muscle tissue which occurs during strenuous exercise tends to cause protein requirements per day to increase marginally.
2. Folks routinely over-estimate their caloric burn from exercise, either because of a heart rate monitor or because they read a chart that said jogging burns X calories per day.
3. We want to understand your base level of fitness – are you still experiencing “newb gains,” or have you been at this for five or ten years?

As with anything, your training will be reflected in your macros to some degree…while we don’t recommend eating back calories (if one is on a cut), for those who are bulking or eating at maintenance, the reality is that adjustments to macronutrients as well as Calories consumed per day need to be adjusted. Of secondary consideration (and somewhat out of order as I will discuss ketogenic diet variations below) are that we see people frequently with significant weight to lose or having just begun a ketogenic diet who are attempting to engage in what we would consider advanced protocols – a targeted ketogenic diet (TKD), a cyclic ketogenic diet (CKD), or some variant of either.

How long have you been ketogenic?

Frequently we are met with the question – what does it mean to be ketoadapted? It’s usually asked by someone who has tried to “do this ketogenic diet thing” a few times, but scrubbed out on day 3 or day 4, having declared that it was detrimental to athletic performance or general well-being. The challenge is that becoming ketogenic is not challenging. Don’t eat carbs, don’t overeat protein, eat sufficient fat…move heavy things. Wait 2-3 days. Magic. The longer-term aspects of ketogenic dieting, however, is that given sufficient time, the body upregulates hormonal, cellular, and other aspects of your body’s metabolism to cause you to be sufficiently well-adapted to the use of ketone bodies and free fatty acid to fuel its metabolic demand. That upregulation is called ketoadaptation. It does require several weeks of consistent ketosis to achieve, and significant deviations from ketosis (i.e. 2-3 days of cheating) will largely undo that upregulation.

What Do You Mean by Ketogenic Diet?

As I touched on briefly above, there are generally three accepted “versions” of a ketogenic diet. Loosely, they can be defined as:

• Standard Ketogenic Diet (SKD): A diet which is consistently low enough in carbohydrate to induce ketosis without the use of either timed consumption of carbohydrate around training, or pre-planned carbohydrate cycling.
• Targeted Ketogenic Diet (TKD): A diet which mirrors SKD closely, but has a small amount of highly-digestible carbohydrate consumed pre- or intra-workout.
• Cyclic Ketogenic Diet (CKD): An approach to a ketogenic diet where SKD is implemented, but with scheduled breaks in low-carb eating. During those breaks, carbohydrates of a specific type, amount, and nature are consumed.

None of these, however, are “cheat days.” They aren’t “carb loads” which equivocate to eating as much Ben and Jerry’s as one can get ahold of.

Our reason for asking often comes down to reading/listening/engaging with individuals who are not reaching their goals but who are using a lazy form of CKD to justify “cheat days.” TKD and CKD are prescriptive in nature – meaning that they have specific purposes, specific amounts, specific timing, and specific outcomes. If any of those confuse you, chances are you don’t need them and should default back to SKD.

In Conclusion

So, to bring this full-circle – why do we ask? Because we care. We care enough to recognize that you are more than a formula, that your outcome requires nuance and context. No simple formula can sufficiently capture who you are metabolically. No trite information or dismissive answer with a pat on the head is going to put you on the road to success. We care enough to provide contextually appropriate answers, insight, thoughts, and guidance. And we wouldn’t have it any other way.