20 Tips for Staying Low-Carb Healthy during the Holidays (and all year long!)

low carb tipsHo Ho Ho! Uh Oh…

The holiday season is upon us and we’re about to be bombarded by deliciously addictive sugary and starchy foods. Yum.

How can you say no to Grandma’s luscious, love-infused apple pie? Your uncle’s homemade egg nog? Your cousin’s world-famous candied yams that she made especially for you? And if your coworker leaves a beautiful tray of festive Italian Christmas cookies in the break room and nobody sees you eat one, does it really count?

So why not just give in for the season? You can just go back to healthy eating in January, right? That’s how I used to think. I believed I could make up for weeks of splurging by “being good” again. I thought that overeating sweets and starches only affected my weight, and that as long as I got back on track after the holidays and lost the 10 or 15 pounds I’d gained, then no harm done.

But I’ve come to understand that this is not true.

The Price of Indulgence (or the Science of Splurging)

Eating too much sugar can permanently damage your metabolism. The more often you indulge, the more insulin-resistant you can become. You can’t get your carbohydrate tolerance back; once it’s gone, it’s gone. The more sweets you eat over the course of your lifetime, the more likely it is that you’ll gradually lose your ability to process even healthier whole food sources of carbohydrates, like fruits and vegetables. While some people are more susceptible to this process than others, we are all at risk. [To learn what insulin resistance is, how you can tell if you have it, and what to do about it, please see my post How To Diagnose, Prevent, and Treat Insulin Resistance.]

More than 50% of Americans are already insulin-resistant, pre-diabetic, or diabetic.1)http://jama.jamanetwork.com/article.aspx?articleid=2434682 This means there’s more than a 50/50 chance that you, and most of the people you love, are in the same sugary boat. And it’s not just obesity or type 2 diabetes waiting for you down the road; insulin resistance is the single most powerful risk factor, by far, for the health problems we all fear the most, including cancer, heart attacks, and dementia (read my article in Psychology Today about how insulin resistance causes Alzheimer’s: “Preventing Alzheimer’s Disease Is Easier Than You Think“).

THAT’s why it’s worth trying to limit how many treats you eat this winter. Even if you don’t want or need to eat a low-carbohydrate diet, avoiding sugars and refined carbohydrates is the single most important thing any of us can do for our health, regardless of how old we are, how much we weigh, how much we exercise, or whether or not we already have any medical or psychiatric problems. And while it’s true that you can halt or even reverse many carbohydrate-induced diseases such as obesity, type 2 diabetes, and high cholesterol by eating a low-carbohydrate, high-fat (LCHF) diet, conditions like cancer or dementia are much tougher to reverse.

People with more severely damaged carbohydrate metabolism, or with more serious health problems like cancer or dementia, may even need to limit protein as well as carbohydrate, because excess protein can turn into sugar in the body. This is where ketogenic diets come in—a ketogenic diet is a low-carb, high-fat, adequate protein diet that forces the body to burn fat for energy. [To learn more about ketogenic diets, please see any of these posts].

Practice Makes…Less Imperfect

But I’ll be honest with you—it’s not easy to change from a regular diet to a low-carb diet. And it can be hard to stick to, especially during the holidays. I can’t promise you that I won’t succumb to temptation a few times this joyous season—we shall see! My goal will be to do my best, which is all any of us can do. It’s not about perfection, it’s about practicing making healthy choices as often as possible, and not judging yourself or anyone else about which sweet or savory treat may somehow find its way into one’s body. [Hey, how did that cookie get in there?]

Here’s a suggestion: decide now what your goal will be. Will your goal be to splurge only on Thanksgiving Day and Christmas Day? Or only at the Hanukkah party? Only on New Year’s Eve with your sweetie? Or are you planning to go the distance and stay true to your LCHF diet throughout the season? And if you do decide to take a holiday from your healthy diet, what will your definition of splurge be? You may want to set your heart on very specific indulgences that will really be worth it, as opposed to having a free-for-all. If you establish very clear goals you’re more likely to stick to them than if you try to wing it. Then, once you’ve decided on your goal, tell other people about it so they can support you.

So, in honor of bread-stuffed birds, gingerbread men, and figgy pudding, I thought I’d do something a little different in this post, and share some tips, tools and insights that I personally use to try to transition to and stay on a low-carb diet. Below you’ll find helpful lists of:

  • Products that are valuable to me in my daily low-carb/ketogenic practice
  • Tips and insights that make eating low-carb easier for me
  • Links to resources to inspire you, support you, and add variety to your diet

Some of the items listed below make great holiday gifts for low-carb friends and family members. A couple of years ago I had fun putting together a healthy low-carb gift basket for a friend who was just starting her LCHF journey.

And away we go!

But First…What Do I Eat?

Unfortunately, I have a lot of food sensitivities (histamine, crucifers, nightshades, garlic, dairy, eggs, nuts, avocado, etc.). As a result I can’t take advantage of a lot of the common strategies most low-carb dieters use, so hopefully you will find some tips here that are new to you. I would also love to hear any tips you may have for me and for your fellow readers in the comments section.

I eat primarily a whole foods, pre-agricultural, low-allergen, high-fat/low-carb diet. I have experimented with ketogenic diets off and on for the past few years, and have been back on a ketogenic diet again for the past six months, because my carbohydrate metabolism is so damaged that this diet is the only one that keeps my blood sugar, weight, and appetite within a healthy range. I aim for about 60 grams of protein per day, 0 to 30 grams of carbohydrate per day, and as much fat as I want. I don’t count calories.

The foundation of my diet is fresh/frozen animals, the fattier the better—seafood, lamb, duck, chicken, pork, and liver. I eat naturally-raised meats whenever possible. We are proud members of Hettie Belle Farm, a wonderful local meat CSA in Warwick, MA that offers pastured pork, beef, lamb, poultry, liver, sausages and bacon. I supplement meat, poultry and fish with small amounts of the handful of plant foods that I can tolerate: low-carb squashes (zucchini/yellow squash, spaghetti squash, pumpkin), olives, mushrooms, cucumbers, lettuces, spinach, jicama, carrots, and small amounts of low-sugar fruits from time to time, such as berries and papaya. This is a very limited diet compared to most, but I have found some ways to make it more interesting and convenient.

If I can do it, with all those restrictions, I know you can do it! Most of you lucky devils can enjoy the richness and variety of eggs, cheese, coconut, heavy cream, macadamia nuts, and butter! What a wonderful world that would be! If you are struggling with the challenges that special diets can pose for holiday gatherings, read my Psychology Today post Dealing With Dietary Differences During the Holidays.

Now, finally, without further ado:

20 Low-Carb Tips for the Holidays

  1. packages of Miracle NoodlesMIRACLE NOODLES. I first discovered these zero-carb “yam” noodles (shirataki) at an Asian market near my home and would eat them as a low-carb side dish on occasion. Then, my local food co-op started carrying Miracle Noodles, and my life was forever changed. These no-carb noodles come in a variety of shapes and flavors like fettuccini, rice, ziti, and spinach! These have become a staple in my diet because they’re a wonderful vehicle for bacon fat or other leftover fat and make for a delicious and satisfying side dish or lunch. My go-to recipe is a bag of (well-rinsed) noodles, ¼ cup of pumpkin puree, some sage, fennel, and porcini salt (see below), all cooked in as much bacon fat or other drippings as they’ll absorb. Sometimes I add mushrooms or zucchini, too. Strictly speaking, Miracle Noodles are not whole foods, but you have to choose your battles. Unlike other low-carb pasta substitutes, they are grain-free, soy/legume-free (except miso variety), and egg-free. They’re made from glucomannan, a soluble fiber extracted from the root of the konjac plant, which is native to Asia. I find them so helpful that I decided to enroll in their affiliate program, which offers my readers a 10% discount by using coupon code: AFF10MN. Smaller quantities are available via this Amazon link.
  2. BACON/SAUSAGE ON THE GO. Bacon is a great breakfast food for me because it’s relatively low in protein and very high in fat. Unfortunately, it takes a while to cook and can be messy. Breakfast while staying at others’ homes can be challenging because most people don’t eat fatty meat for breakfast, and most hosts don’t take kindly to you commandeering their kitchen to cook large quantities of splattering strips of bacon. So my partner had the brilliant idea of pre-cooking uncured bacon at home, and packing it in a cooler for trips. Voila! Our car became an instant bacon-mobile. Then I just re-heat it quickly or enjoy it as a cold snack at my destination. We do the same thing with fresh or frozen fatty sausages. My favorite are sweet Italian pork sausages from our wonderful local butcher (Sutter Meats in Northampton MA), or for a super-convenient alternative when you’re pressed for time, try Applegate frozen Chicken & Sage Breakfast Sausages. I actually prefer pastured pork belly (the cut of pork that bacon is made from), or better yet, lamb belly, to bacon, but these don’t travel as well.
  3. GOURMET SALT. Last year while visiting Portsmouth, New Hampshire for a Sound of Music Sing-a-Long (I’d never seen so many nuns or Gretls in my whole life), we discovered a small shop called the Salt Cellar and my life was forever changed. I can’t tolerate most marinades, rubs, or spices, so gourmet salts opened a whole new world of flavor to me. The Salt Cellar carries dozens of varieties of smoked, flavored, and natural salts. We have become regular mail-order customers, buy in bulk, and if any of our friends hasn’t received salt for Christmas yet, they’re about to. My favorites are espresso (a revelation on pork), porcini, applewood smoked (amazing on grilled beef), merlot (great with duck), chardonnay smoked (delicious on chicken), lemon or lime (for fish and summer squash), and vanilla bean (just for fun)!vinegars and salts
  4. GOURMET VINEGARS. Just as gourmet salt opened a new world for me, so has gourmet vinegar. On a cold and rainy summer day, a friend we were visiting on the coast of Maine introduced us to a wonderful shop in Rockland called Fiore Artisan Olive Oils and Vinegars, where they let you taste all of their products before buying. High quality infused vinegars can be intensely, deliciously sweet, and they do contain a little sugar, but a little bit goes a long way. Just a teaspoon or two drizzled over meat or vegetables can add a burst of flavor for only a few grams of carbohydrate. The absolute best, in my opinion, is their 18-year aged balsamic vinegar, but other favorites include black currant, espresso, and cinnamon pear. I do have histamine intolerance and therefore can’t have much vinegar, so be careful if you have issues with aged foods.
  5. bacon grease keeperBACON GREASE KEEPER. The other half of eating low-carb is eating high-fat! The great thing about bacon is that not only do you get to enjoy it in all of its glory when you eat it, but you can then collect and save all of the bacon fat for later cooking. A bacon grease keeper is essentially a ceramic crock with a sieve on top that sifts out the leftover charred bits of bacon. I keep my bacon fat in the fridge because I find it easier to use when it’s solid, and it keeps longer, but some people prefer to leave it on the counter. If you eat a lot of bacon, this is a must-have! You can also take it out and pass it around if it’s time for those party guests who have overstayed their welcome to head home.
  6. MYFITNESSPAL. There are people out there who can wing it, but I’m not one of them. It’s too easy for me to go astray if I’m not keeping track of everything I eat and holding myself accountable. This is the best app I could find on the market, and the free version does everything I need it to do. I use it to track protein and carb intake, the foods I’m eating (in case I have a food reaction I can look back to see what the culprit may have been), morning blood sugar, morning blood ketones, weight, and body fat percentage. The app lets you store common combinations of foods as meals so you don’t have to enter each individual item every time. It also lets you store custom recipes, and share meals with friends. You can adjust the settings on the website to customize what you want to track. The few limitations of this app are that it insists on tracking fat, calories and fiber (things I don’t care about at all), and you have to set your macro-nutrient goals as percentages of calorie intake rather than maximum grams per day. Since my goals are to eat a maximum of 60 grams of protein and 30 grams of carbohydrate per day, I had to set my daily caloric intake at 2400, although I end up eating much less than that on most days. It’s probably easier to customize goals with the paid version of the app, but it’s pricey. If you know of an app that I or other readers may like better, I’d love to hear about it!
  7. vegetable spiralizerSPIRALIZER. We love our vegetable spiralizer! My sister gave it to us for Christmas last year and it was one of our favorite gifts. Eating a low-carb diet means giving up pasta, but with this nifty gizmo we can turn plain old zucchini, carrots and cucumbers into beautiful extra-long curly strips of various shapes that are great when you need to see a little special something on your plate. I enjoy thinking of it as a medieval vegetable torture device:) It comes with different attachments so you can make thick, wide, or thin strips. We use the Paderno World Cuisine 3-blade model, which is affordable, sturdy, and easy to use (we’ve heard mixed reviews about the hand-held models).
  8. SodaStreamSODASTREAM What’s left to drink after eliminating soda, juice and other sugar-sweetened beverages? Pretty much just water, and unsweetened tea and coffee. A SodaStream allows you to carbonate your own water to make seltzer at home. I love seltzer and used to buy multiple bottles a week, lug them home, and then have to cart the empties to the local transfer station. SodaStream comes with reusable bottles, saving you all of that hassle, and we never run out of seltzer anymore. You can flavor your water with fresh lemon or lime juice or a splash of fruit juice if you like (skip the flavor packets that come with your new SodaStream, because they contain sugar or artificial sweeteners). My mom has a manual SodaStream that has worked perfectly for her for years. We purchased an automatic SodaStream model a couple of years ago that frequently exploded and flooded the countertop, so we traded it in for a KitchenAid Sparkling Beverage Maker. If you choose the original SodaStream brand I’d just recommend avoiding the automatic models.
  9. SLOW COOKER. A slow cooker is a must-have for busy whole-food low-carbers, especially in the colder months. But if you’re eating a ketogenic diet and need to count protein grams, once you’ve got meat, vegetables and broth all mixed together in a brothy stew, how do you accurately measure how much protein and carbohydrate is in your serving? This is what we do: cut the meat into single serving portions before you put it into the slow cooker. That way you don’t have to fight the broth. More appropriate if you are trying to control protein quantity, but may be applicable to carbs too. Advantage of slow cooker: fast and easy prep; multiple servings of meals.
  10. BLOOD GLUCOSE METER. Testing my blood sugar every morning gives me the daily reality check I need to keep myself honest. If I eat too much protein or carbohydrate, I may not see the scale go up and I may feel fine the next day, but that blood glucose meter will let me know that my metabolism is unhappy, and reminds me of why it’s important to continue with my low-carb eating plan. Blood sugar testing can be so much more meaningful than tracking weight, because blood sugar values are all about the metabolic and health benefits of low-carb eating, not about how you feel about your body shape or size, or what the number on the scale may mean to you or anyone else. Blood sugar values are purely objective and carry no stigma or shame. The cost of the meters themselves is usually not the issue, it’s the blood test strips that run into money, so compare strip prices when shopping. The meters I own are the OneTouch UltraMini, which measures blood sugar only, and the Precision Xtra Blood Glucose and Ketone Monitor, which can measure blood sugar and blood ketones (separate strips required). Ketone strips are expensive, but thanks to Dara Smith’s recommendation in the comments section below, I now order strips from an Australian distributor for about $1.50/strip.
  11. FIND YOUR SWEET SPOT. I wish I could tell you exactly how many carbs you can eat per day to make an LCHF diet work for you, but everyone’s carbohydrate threshold is different. Most people do well if they stay below 25 grams of carbohydrate per day, but some people can get away with up to 60. If you find that you’re still craving carbohydrates, then you’re probably still eating too many carbs for your metabolism. Take heart! Although it sounds counter-intuitive, the less carbohydrate you eat, the less carbohydrate you’ll want to eat. Carbohydrates cause cravings. Reduce the carbs to the point of your personal threshold, and the cravings go away. Then you will find that you are eating only when you’re hungry, not because you just feel like eating. If you have lowered your carbohydrate as much as you possibly can and you’re still struggling with cravings, see #18 below.
  12. EAT MORE FAT. Bacon fat and duck fat and lard, oh my! These are my personal favorites for cooking. Other healthy fat options you may find helpful are olive oil, coconut oil, palm fruit oil, and avocado oil. Avoid seed and vegetable oils as they are almost always highly unnatural, industrially refined oils, and they are very high in omega-6 fatty acids, which promote inflammation. Carbohydrates make you hungrier, whereas healthy fats are satisfying and delicious and don’t raise your appetite. For people who are new to low-carb eating and are used to avoiding fat, this can be a big adjustment. Practice embracing fat as your friend!
  13. MAKE A WEEKLY MEAL PLAN. It doesn’t have to be detailed, but since you will be eating primarily perishable foods, you’ll need to remember to take things out of the freezer in advance or plan your shopping trips so you don’t run out of good food. If you run out of food and get hungry at an inconvenient time, you’re more likely to go off the rails.low-carb tips sample menu plan
  14. BRING YOUR OWN FOOD AND/OR EAT BEFORE YOU GO. It can be particularly difficult to stay on your diet when you are at a party surrounded by deliciously sugary foods. Arriving with a full or partially full belly can help you resist temptations, and if you bring scrumptious food that you can enjoy, you can take part in the social aspect of eating without having to eat foods you are trying to avoid.
  15. DON’T GO IT ALONE. It is SO much easier to stick with a key lifestyle change if you have a support network. An LCHF diet, unfortunately, is still a rather unconventional diet, so you may face a lot of skepticism or even face pressure to give it up. If you have at least one other person on your side who is also eating an LCHF diet, you can share your challenges, your recipes, and your successes, making your journey a lot easier and a lot more fun. There are also many on-line forums that can be helpful for people looking for additional support and community (see resource list below). Having supportive people in your life is especially important if you’re the only one in your household who lives the low-carb lifestyle and your cupboards are filled with tempting sweet and starchy foods.
  16. BE A RESPECTFUL ROLE MODEL. Remember Grandma’s love-infused apple pie? If your goal is to say no, be polite and complimentary, and explain that you love her pie and wish you could have some, but that you have to turn it down for health reasons. A helpful sentence is: “My doctor told me I have to be careful with carbohydrates.” If you practice setting a healthy example, other people in your family may be inspired to change their diet in the future, especially when they see the obvious changes in your health. It doesn’t usually work to get preachy or tell other people how they should eat. Just focus on yourself and if others are curious and want to know more about how you got healthy, they’ll ask you.
  17. YOU’RE HUMAN, NOT PERFECT. This is perhaps the most important tip. Don’t beat yourself up if you go astray. Sugar is addictive. You spent much of your life enjoying sugary foods and you love them. You’re trying not to eat them, yet you are constantly bombarded with advertisements, social messages, and convenient carbohydrate-rich foods and drinks everywhere you go. It’s only natural that you’re going to be tempted. Don’t be too hard on yourself. Do the best you can as often as you can. The key, though, is to get back up on the horse and return to your low-carb daily practice as soon as possible. You have made a commitment to your health. Don’t let the occasional human moment derail you. With practice, it gets easier and easier to resist unhealthy foods, partly because you’ll find it takes a few days of sheer willpower to get back on that horse, and you’ll get tired of the struggle. It’s a lot easier to stay on the horse than to keep climbing back up there. For a really funny commentary about trying to adapt to a low-carb diet, I highly recommend Dr. Michael Eades’ post: Tips and Tricks for Starting or Re-starting Low-Carb.
  18. NOT LOSING WEIGHT? If you’re eating low-carb partly to lose weight, and you’ve gotten your carb grams as low as you possibly can, what else can you do to fix your broken scale? Some people can’t lose weight if they are including certain mischievous items in their menu. The most common weight loss blockers are: dairy (raises insulin levels), low-carb sweeteners (raise insulin levels and trigger sweet cravings), caffeine (destabilizes blood sugar, insulin, and stress hormone levels), and too much protein (turns into sugar). If you’re not already exercising, add some strength training to your plan. Resistance training lowers blood sugar and improves insulin sensitivity.
  19. constipated pufferfishCONSTIPATION ON LCHF? Contrary to popular belief, constipation is not caused by a lack of carbohydrate, but by the presence of specific foods that are difficult to digest. LCHF and ketogenic dieters often experience constipation because they are suddenly eating higher quantities of potential intestinal stoppers such as nuts and dairy products. For a more complete list of foods that can stop you up, along with explanations, please see my post Constipation and Ketogenic Diets.
  20. DON’T FEEL WELL ON LCHF? GOT THE “LOW-CARB FLU”? If you feel worse on a low-carb diet, especially if you’ve given yourself enough time to adapt to it (approximately 3 days to 3 weeks, depending on the person), you may be sensitive to a food you either never used to eat before or are now eating a lot more of than you used to. When I first went ketogenic in 2013, I felt awful. It turned out I had a sensitivity to histamine and other biogenic amines. These sneaky little devils are found in things like fermented, aged and preserved foods. I cut them out and felt great! My suggestion is to keep a food diary that records foods and symptoms to try to isolate your culprits. Common low-carb food sensitivity culprits include nuts, coconut, dairy, artificial sweeteners, and histamines/biogenic amines.

Helpful Resources

  • Dr. Michael Eades and Dr. Mary Dan Eades have been studying, prescribing, and writing about low-carbohydrate diets for more than 20 years, and are generous treasure troves of information: https://proteinpower.com/
  • Dr. Andreas Eenfeldt is a Swedish physician whose wonderful website is dedicated to low-carb high-fat diet education and inspiration: http://www.dietdoctor.com/lchf
  • Professor Tim Noakes is a South African elite athlete, professor of exercise science, and diet revolutionary who turned to a low-carbohydrate eating plan called the Banting Diet to manage his own type 2 diabetes: http://realmealrevolution.com/
  • Jimmy Moore is the low-carb community’s most valuable educator, communicator, and ambassador—podcasting, tweeting, periscoping and blogging passionately about the science and experience of low-carb living. He has interviewed virtually all of the experts in the field and is a tireless advocate for public health. His site is packed with more information than you could ever want! http://livinlavidalowcarb.com/blog/
  • Dr. Jeffry Gerber is a family physician based in the Denver area who hosts a very informative and accessible website about the how and why of low-carbohydrate diets and health: http://denversdietdoctor.com/dr-jeffs-blog/
  • Dr. Ann Childers is a psychiatrist and weight management specialist based in Oregon whose website includes blogposts, videos, and podcasts about LCHF diets and mental health: http://lifebalancenw.com/
  • Dr. Sarah Hallberg is a weight loss specialist affiliated with Indiana University who has an interactive website dedicated to teaching people with type 2 diabetes and other metabolic problems how to improve their health using low-carbohydrate diets: http://fitteru.us/
  • Ellen Davis is a clinical nutritionist who hosts a welcoming and comprehensive website devoted to ketogenic diets. It is packed with great information, meal planning advice, and tips: http://www.ketogenic-diet-resource.com
  • Libby Jenkinson is a pharmacist-turned-low-carb educator based in New Zealand. She hosts a beautiful website full of tips, recipes, and information for people of all ages who want to understand and apply LCHF principles to their lives: http://www.ditchthecarbs.com/
  • Carrie Brown is a chef and writer with a vibrant and eclectic website that includes wonderful recipes for a variety of special diets, including low-carb diets: http://marmaladeandmileposts.com/archives/category/food/recipes-other-lifestyles/low-carb
  • Laura Dolson is a health and food writer who hosts a wonderfully practical site about low-carb eating that includes lots of great recipe ideas along with posts about how low-carb diets affect your health: http://lowcarbdiets.about.com/

I hope that you or someone you love will find these tips and tools useful. Remember, don’t focus on what you’re giving up on an LCHF diet—focus on what you’re getting! Deliciously satisfying fatty foods, freedom from carbohydrate cravings and yo-yo dieting, and the peace of mind that comes with knowing that how you’re eating now actually optimizes your whole health, not just your weight or your appetite.

Happy Healthy Holidays, everyone!

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References   [ + ]

  • Annlee

    Rather than MyFitnessPal, I prefer CRON-O-Meter. https://cronometer.com/ It has some of the same “features” – but I am comfortable using it to spot check my carb and protein intake. As with you, the rest is “meh.”

    • Thanks for the tip, Annlee!

    • boppy76

      I second the recommendation for cron-o-meter. The free app works well on the web or on your mobile device and has all the features I need to track food intake and macronutrient amounts. Better yet, it offers one of the features that is missing from myfitnesspal – you can choose to track either net carbs or total carbs. I find it very easy to use.

  • Brita

    Thanks for the informative post Dr Ede. I realize I have almost all the same problems as you….
    Working in the field of research and nutrition (i actually did my PhD on milk) and finding out later that i cann´t tolerate dairy (not only lactose) is a hard one to swallow. I feel so stupid and betrayed for some reason. My system is totally broken; for me to even enjoy 50g of protein, I need to exercise before my meal…. I also need to exercise or do an enema before I can go to the toilet. I cannt tolerate carbs food(with gluten or not), eggs and many veges, and dust, cats, dogs are a big problem for me. Plus I am in constant need of iron, vit.C and other minerals (I have the sickle cell trait). I try not to consume more than 10g fibres a day, and I have a huge relief from bloating. But at this point in time, my stomach hurts each time I eat anything, so I know something is so wrong and needs to be fixed. Did you noticed any of these issues before? I am almost certain I have a digestive problem. Any idea of which supplements can help me incoorperative this low carb lifestyle? and what would you recommend for trace minerals and vitamins? I ´ve heard liquid Magnesium helps with constipation. is it safe, and which is best?

    • Stephen

      Brita, magnesium is useful and important, but it comes in different forms. I’m not aware of any safety concerns if taken sensibly. Magnesium Citrate has a laxative effect. Natural Calm is one product that I’m aware of on Amazon, but I should say I haven’t used it. If people want to take magnesium without the laxative effect there’s magnesium malate.
      If you don’t want to take magnesium, I’ve found that a tiny amount of syrup of figs each day (the brand name in the UK is Califig) is useful. Once things are normalised, a third of a teaspoon each day is enough to keep things that way for me.

    • Hello, Brita

      It is difficult to troubleshoot these symptoms without knowing exactly what you’re eating. If you haven’t yet tried a week or two of eating only meat/poultry/seafood and accompanying animal fats, that may be worth a try to see if you can identify your culprits. If you haven’t see my post about digestive troublemakers, you may find it helpful: http://www.diagnosisdiet.com/common-constipation-culprits/

      • Brita

        Stephen and Dr. Ede, your replies are so helpful.I have to try further to see how I can fix my system.

  • Phil

    Great post Georgia, this is super helpful! I seem to be like you with sensitivities: nuts, coconut, dairy, eggs, nightsgades, crucifers, spices all make me feel bad. I have histamine intolerance too. I just wish it were easier to find very fresh meat in the uk on a regular basis.

    • Hi Phil

      One thing I say in my histamine intolerance post is that frozen meats can often be much better choices than “fresh” because fresh meat travels to the store and sits on display for however long, so if you have access to good quality frozen meats, you may want to give those a try.

  • Stephen

    Thank you for all the good advice. I’m relieved that I can eat dairy.
    As for sugar, I’ve found that the less I eat the less I want. In social situations when offered a sugary ‘treat’ I simply say a polite no thank you or, if pressed, say that I need to avoid sugar. It’s true, but I accept that people might infer that I’m diabetic. So be it. I’m prepared to explain if need be but try to avoid being a food bore, unless asked.
    One curiosity: since eating a low carb diet I’ve felt much better, both physically and mentally, but I do have a persistent slightly runny nose. No big deal or inconvenience.

    • Hi Stephen

      Great strategies for dealing with social pressure to eat sweets, thanks! And as for the runny nose, while there are many possibilities, it may be due to either histamine intolerance or dairy, both of which are known for causing that symptom. But as you say, if it doesn’t bother you and you feel well otherwise, then you may simply want to leave it be:)

  • Dara Smith

    Ketosistools.com sells ketone test strips for $1.50. They are located in Australia,

  • John

    Dr. Ede, Thank you. Very helpful regarding the dangers of splurging. It happened to me and was off track for several weeks. It was hard to restart my low carb. I found that I had obsessions and compulsions for simple carbs. Very intense. In an earlier post you talked about carbs minus fiber for net carbs. In this post you indicated you don’t concern yourself with fiber. I have been trying to maintain 30 grams net carbs per day. Should I just be counting the carbs and forget about net carbs? I’m not clear on that. Also, I found it impossible to eat all he calories suggested for my height/weight (2500). I use Sparkpeople to track and my calorie intake. It is usually between 900 and 1300 max. I often just don’t feel hungry. Is that ok, or what should I be eating more of ?. Thank you.

    • Hi John

      Thanks for asking about fiber–I realize now that what I wrote is confusing! When I said I didn’t care about fiber, I meant that I don’t care whether or not I eat any fiber and don’t care how much fiber I eat. However, I do (still) care about net carbs. I wish the app would track net carbs, but instead it tracks total carbohydrate and fiber, and then I have to subtract fiber from total every day to get my total net carbs for the day. It’s not a big deal, just one extra step. Maybe the paid version of the app would track net carbs, I don’t know.

      As for trying to eat enough calories, calories don’t matter unless you are hungry, underweight, or losing weight too fast. If none of those things are true for you–and you feel good eating the calories you’re eating, no worries. As long as you are getting enough protein for your size and activity level and staying in your healthy range for net carbs (30 max is great for most!), you should be fine.

      • John

        Thank you Doctor. I forgot to ask you, what do you recommend as a calculation to determine amount of protein needed. I have seen so many different ones over the years. Recommended amounts for my height and weight have been as low as 25 gm and as high as 120 gm. I am safely down 20 lbs since I began following your posts. I don’t want to sabotage my progress. I really appreciate you taking the time to answer questions.

        • Hi John

          Great question–when I was first experimenting with keto, I came across a wide range of recommendations, too:

          I am 5′ 5″ and my lean body weight is 45 kg

          Dr. Seyfried recommends I eat between 62 and 92 grams of protein per day.

          Dr.s Phinney and Volek recommend I eat between 75 and 156 grams of protein per day.

          Dr. Rosedale recommends I eat 77 grams of protein per day based on my body measurements, but 47 grams of protein per day based on my lean body weight.

          What I discovered, through much trial and error, is this:

          If I’m exercising, I can eat about 70 grams of protein per day. If I don’t exercise, I can eat about 50 grams per day. If I eat more than this, my blood sugar goes up, my appetite goes up, my weight goes up, and my ketones go away.

          If you are safely losing weight and aren’t hungry, tired, or feeling emotionally or physically unwell, you’re probably doing great! But I think it makes sense to base protein intake on lean body weight and activity level. I can eat just a little more than 1 gram of protein per kg lean body mass if not exercising, and about 1.5 grams/kg if I am exercising. Since we are each metabolically different, I can’t say if that rule would work for everyone, though.

          Hope this helps more than it confuses the issue!

          • John

            Hi Doctor, it does help, I know I will have to refine for my height and weight but it gives me some parameters. Wish you the best for the Holiday Season and thanks again for taking the time to answer.

          • Hazel

            Thanks, doc, for that excellent comment. Very illuminating. And helpful.

          • John

            Hi Doctor. Have been trying to learn more about Keto. Finding it pretty intimidating. Seems like there are so many physiological nuances I am wondering if this needs to be done under a doctors supervision. Issues such as ketosis vs ketoacidosis, elevated blood sugars during exercise when in ketosis etc. Seems like one could easily damage one’s health by going it alone. Any advice? Thank you

  • billslo

    I might have missed it, but have you discussed salicylates?

    • Dear billslo,

      Unfortunately not yet, but it is a topic I would love to cover in 2016! Natural toxins in plant foods are my favorite things to think about, so I look forward to sharing what I learn as soon as possible. In the meantime, if you haven’t already discovered http://salicylatesensitivity.com/ , it has good information and a large, active forum for people with salicylate sensitivity.

  • TheDiva

    Thanks for sharing! I stumbled upon your site googling a weird question (something about heavy cream but I can’t remember exactly at present). I love all of the insight you provide and that you aren’t afraid to challenge conventional beliefs. I also love that you readily admit when you don’t know something for sure – so refreshing! I was overweight (what some would call skinny fat since I was tall and hid it better than shorter people) most of my life and ate terribly – refined grains and lots of margarine, juice and soda all day. Ughh I’m surprised I didn’t have more health issues but I was somewhat active. Once I started on a journey for better health I have traversed most dietary plains from vegan to paleo. Primal has made the most sense to me (and I love Mark Sisson). I am currently trying to eat what is considered ketogenic (higher fat consumption) without being super strict. So far I have been able to control my weight and/or lose it without gaining it all back like I used to whenever I fell off the wagon. I did have a question about root starches/flours namely tapioca and potato. Do they create the same issues that refined grains do? Since most of them are sorta pure starch anyway I wondered if eating them in flour form was comparable to grain flours. I really wish I remembered my heavy cream inquiry 🙁 Anywho. If you could please let me know your thoughts on the tuber flour vs grain flour I would appreciate it. Thanks for all that you put out there and keep up the great work!

    • Dear Diva

      Fabulous questions! Thanks for your kind words and yes, there is SO much to know, nobody could possibly know it all. I love learning new things about food and the body and brain every day by reading articles, talking with colleagues, listening to patients, and reading smart comments from my readers!

      As for non-grain flours, when it comes to blood sugar and insulin regulation, they are no better than grain-based flours.

      As for your excellent dairy question? I wish I could tell you. I haven’t been able to locate any definitive information about whether the naturally-occurring hormones in dairy foods are equally present in all forms of dairy products or if they are higher in some forms than others. I suspect the hormones are present in cream, but I’m really not sure. Just another thing I don’t know:) If anyone else out there happens to know of a good source of that information, I’d love to hear about it! There’s some more information about these hormones in general in my dairy post if you haven’t seen it already:


  • Nancyscial

    “If I can do it, with all those restrictions, I know you can do it! Most of you lucky devils can enjoy the richness and variety of eggs, cheese, coconut, heavy cream, macadamia nuts, butter, avocado, shrimp and scallops! What a wonderful world that would be!”

    Could you explain what would happen if you ate scallops or avocado?

    I just had blood work done and my LDL is 157. HDL 58 blood is 86. I was put on a “water” pill for swelling and high blood pressure. So I begin the journey of what my body needs for my best health.
    Thank you from a fellow MA resident !

    • Hi Nancy

      Hello from western Mass! I had two bad reactions to scallops several years ago but tested negative for shellfish allergy, so I’m assuming the scallops triggered a biogenic amine reaction: http://www.diagnosisdiet.com/histamine-intolerance/ . I can tolerate small amounts of avocado on occasion, but too much avocado also seems to trigger biogenic amine reactions for me (itching, swelling, etc).

      Glucose and HDL look good. If your triglycerides are also nice and low, then your metabolism is probably in pretty good shape, but it would be ideal if you could also have a fasting insulin test done: http://www.diagnosisdiet.com/how-to-diagnose-prevent-and-treat-insulin-resistance/ to see where you are on the insulin resistance spectrum, since that is a common cause of high blood pressure. If you haven’t tried a low-carbohydrate diet, it can be very helpful in reducing fluid retention and lowering blood pressure in many people. Carbohydrates tell the body to hold on to extra water. Swelling and blood pressure issues can also be related to biogenic amine intolerances, so that may be worth exploring as well.

      Best of luck and let us know if you have more questions along the way!

    • Nancyscial

      Thank you for the reply!
      I have been reading a lot about carbs,histamine, cholesterol, night shades, ect.
      Very interesting!
      I will check out your suggestions too!
      My triglycerides are 140, could be better ! I do drink wine with dinner, might have to stop for a short while to see if it is bothering me. Only started that 3 yrs ago tho. I have had psoriasis for about 15 yrs now but has stayed the same all this time.
      Is there genetic testing to figure this out? Would love to know. My children and I were diagnosed with EDS. A Few hrs back but there is no genetic testing for that either!
      Eastern Mass!

      • Hi Nancy

        Yes, the fact that triglycerides are high and that you have psoriasis means that your diet could use some tweaking. However, I’m confident that both of these issues can be resolved by dietary changes if you’re persistent and willing to do food experiments. In addition to looking at alcohol, take a look at your total carbohydrate intake per day (lowering it usually takes care of high triglycerides within a matter of weeks) and psoriasis is usually a food sensitivity, so take a look at the most common food triggers: dairy, grains, legumes, nuts, eggs, nightshades. You could either remove them one at a time (takes forever) or you could start with an all-meat (fresh/frozen) diet and add back one food group at a time. With the exception of beef and seafood, to which some people have a sensitivity, animal foods are the least likely foods to cause health problems of any kind. Good luck, Eastern Mass!

        • Nancyscial

          Thank you !
          I have stopped wine,potatoes, and nuts for about two weeks so far.
          The only other things are fish, shellfish, and rice. I eat a lot of seafood, I hope it’s not that, I love seafood ! I,m thinking maybe grain? I have oatmeal and eggs in the morning. Also a vodka drink on weekends !
          I did buy some miracle noodles to try. I thought I would start to notice something by now but maybe too early.

          • Hi Nancy

            Rice and oatmeal are very high in carbohydrate (and grains in general are not healthy foods for humans: http://www.diagnosisdiet.com/food/grains-beans-nuts-and-seeds/. However, everyone’s tolerance for carbohydrate varies, so you’ll have to see how you do! Skin conditions caused by food sensitivities can take several months to clear, whereas triglyceride levels typically respond to carbohydrate reduction within just a few weeks. Ideally you’d re-evaluate everything in about 3 months to see how your experiment is going. I hope it’s not seafood too!

  • Tracey

    Thank you for all of your wonderful information. I have the same food intolerance issues as you and really feel best on a mostly fat and meat diet with little veggies. Reading your website provides verification that it is not in my head and ok at the same time.

  • GlenysP

    This is probably one of the best articles I’ve read wrt tips for staying low carb. I’ve been a low carb advocate for about 8 years, my problem is that I don’t always practise it 🙁 I get so sick of the struggle of getting back up on that horse that instead of getting up and staying on it, I stay off it… until I get so sick of myself and how I look and feel, exactly like I’m feeling now. I am going to save this page as a favourite so I can come back to it easily and I am also going to check out some of those links above to see if they can keep me on that horse. Thank you for a wonderful site, I have only just found it but I am trying to read as much as I can.