Nutritional Ketosis Week 2

Billiard Ball 2 licensedI’m happy with this experiment so far…

Other than an Easter blip, this was a pretty good week.

To read about week 1, click here.

Day 8 (Thursday Mar 28)

(day 2 of hormonal cycle)

  • Weight:  152.7 lbs
  • Body fat percentage (Tanita home scale):  35.5%
  • Morning glucose:  81
  • Morning blood ketones:  0.8
  • Morning urine ketones:  small
  • Morning blood pressure:  96/60
  • Morning heart rate:  66
  • Evening glucose:  84
  • Evening urine ketones:  small
  • Evening blood ketones:  1.1
  • Protein:  80 g
  • Fat:  76 g
  • Carbohydrate:  22 g
  • Calories:  1173
  • Exercise:  none

Foods:  Chicken, duck fat, swordfish, black tea, cucumber, artichoke hearts, dark chocolate (6 grams carb)

Evening notes:  I was VERY lightheaded this afternoon but felt better within 15 minutes of drinking Cyn’s potassium solution (1 tsp potassium chloride + 1 tsp salt dissolved in water).  Slept from 10:30 to 3:30.

Day 9 (Friday Mar 29)

Morning notes:  Feel ok.

  • Morning glucose:  87
  • Morning blood ketones:  0.6
  • Morning urine ketones:  small
  • Morning blood pressure:  94/65
  • Morning heart rate:  55
  • Evening glucose:  87
  • Evening urine ketones:  moderate
  • Evening blood ketones:  1.7
  • Protein:  83 g
  • Fat:  70 g
  • Carbohydrate:  18 g
  • Calories:  1086
  • Exercise:  Danced for over an hour

Foods:  Chicken, duck fat, lamb, artichoke dip (6 TBSP), chocolate (9 g carb), Emergen-C (6 g carb)

Evening notes:  I had an incredibly long and stressful day today but I felt fine all day.  Excellent energy for dancing in the evening.  Slept from 1:30 to 7:00

Day 10 (Sat Mar 30)

Morning notes:  I feel fine.

  • Morning glucose:  79
  • Morning blood ketones:  1.1
  • Morning urine ketones:  moderate
  • Morning blood pressure:  not measured
  • Morning heart rate:  not measured
  • Evening glucose:  77
  • Evening urine ketones:  moderate
  • Evening blood ketones:  2.3
  • Protein:  78 g
  • Fat:  90 g
  • Carbohydrate:  10 g
  • Calories:  1178
  • Exercise:  Bicycle ride for at least an hour

Foods:  Salmon, turkey, black tea, artichoke dip (4 TBSP), chocolate (6 g carb), olives (#32), half an avocado.

Evening notes:  Felt fine all day today.  Slept from midnight to 6:30.

Day 11 (Easter Sunday March 31)

Morning notes: Feel fine this morning.  I’m surprised that the olive and avocado didn’t bother me.

  • Morning glucose:  76
  • Morning blood ketones:  1.8
  • Morning urine ketones:  moderate
  • Morning blood pressure:  not measured
  • Morning heart rate:  not measured
  • Evening glucose:  87
  • Evening urine ketones:  high
  • Evening blood ketones:  2.2
  • Protein:  71 g
  • Fat:  152 g
  • Carbohydrate:  36 g
  • Calories:  1643
  • Exercise:  none

Foods:  Salmon, Beef (ribeye steak), artichoke dip (5 TBSP), coffee, heavy cream (10 TBSP), olives (32), chocolate (6 g carb)

Evening notes:  I wanted to save plenty of protein grams for Easter dinner (6pm) with my family, but that was hard.  I got hungry midday and ended up drinking coffee with cream and eating lots of olives so I wouldn’t get too hungry.  Slept from 11:00 to 9:00.

Day 12 (Monday Apr 1)

Morning notes:  Mild headache, mild low backache (these are typical dairy side effects for me), and creasey skin (olives).  I had been hoping that if I stuck to olives cured in salt instead of vinegar that they might not bother me, but it’s not so…

  • Morning glucose:  80
  • Morning blood ketones:  1.4
  • Morning urine ketones:  high
  • Morning blood pressure:  108/61
  • Morning heart rate:  67
  • Evening glucose:  81
  • Evening urine ketones:  high
  • Evening blood ketones:  3.2
  • Protein:  81 g
  • Fat:  90 g
  • Carbohydrate:  37 g
  • Calories:  1377
  • Exercise:  Jogged for 2.25 miles

Foods:  Chicken liver, chicken, beef (ribeye), duck fat, black tea, artichoke dip (2.5 TBSP), grilled artichoke hearts in olive oil (#4), Iceberg lettuce, chocolate (15 g carbs), olives.

Evening notes:  Good productivity and energy first part of day, then ran out of steam after jogging and had a harder time concentrating. Turned out ketones were very high in the evening–too high for my comfort level, anyway!  So I ate some more food before bed.  Slept from 11:00 to 4:00.

Day 13 (Tuesday Apr 2)

Morning notes:  Very creasey, eyes a bit dry, tired.

  • Morning glucose:  86
  • Morning blood ketones:  1.9
  • Morning urine ketones:  high
  • Morning blood pressure:  not measured
  • Morning heart rate:  not measured
  • Evening glucose:  76
  • Evening urine ketones:  high
  • Evening blood ketones:  2.6
  • Protein:  85 g
  • Fat:  121 g
  • Carbohydrate:  19 g
  • Calories:  1621
  • Exercise:  none

Foods:  Chicken, turkey, duck fat, black tea, grilled artichoke hearts in olive oil (#4), artichoke bottoms (#5), chocolate (6 g carb)

Evening notes:  Felt fine as day went on. Long clinical day was easily manageable. Slept from 10:00 to 6:00.

Day 14 (Wednesday Apr 3)

Morning notes:  Tired.

  • Morning glucose:  84
  • Morning blood ketones:  1.7
  • Morning urine ketones:  moderate
  • Morning blood pressure:  92/63
  • Morning heart rate:  63
  • Evening glucose:  73
  • Evening urine ketones:  high
  • Evening blood ketones:  1.6
  • Protein:  94 g
  • Fat:  76 g
  • Carbohydrate:  15 g
  • Calories:  1218
  • Exercise:  none

Foods:  Chicken, duck fat, tuna sashimi, salmon sashimi, artichoke dip (12 TBSP), black tea, chocolate (9 g carb)

Evening notes:  Excellent productivity during my 12-hour long clinical day but got hungry late afternoon and had not only run out of protein grams, but had also run out of duck fat.  Eating my chicken for lunch without any added fat was not satisfying.  So instead I ate quite a bit of artichoke dip (3/4 cup), which made me very tired. I went to bed early and slept from 9:00 to 2:30 (ugh).  The artichoke dip contains olive oil, garlic, onion, and vinegar–all things which bother me if I eat more than a little bit of them. I should know better–as my sister is fond of saying, I am “allergic to flavor.”

End of Week Totals:

Weight at end of Week #2:  152.8

Change in weight over past week:  up 0.1 lbs

Change in weight since day zero:  down 3.4 lbs

Body fat percentage at end of Week #2:  35.5%

Change in body fat over past week:  none

Change in body fat since day zero:  down 1%

Waist measurement at end of week #2:  94 cm

Change in waist measurement since day zero:  down 3 cm

Reflections on Week 2:

Overall I’ve been happy with the diet this week.  My appetite, mood, and function have been pretty good all week, and it’s nice to be able to exercise when I have time.  It’s been an especially busy week due to Easter weekend travels and an unusually high number of patient care hours (Spring tends to be a very busy time in Psychiatry), but it was very easy to maintain the diet despite these factors.

Ketones rose despite no change in daily protein or carb intake.  Unclear if this was an effect of exercise, time, or both.  I do not feel well when ketones are above 3.0.  My goal is to keep them between 0.5 and 3.0; ideally between 1.5 and 3.0, but I’m not prioritizing ketone levels yet–right now I’m just practicing keeping my protein intake at about 80 grams per day and my carbs below 30 grams per day.

Blood Sugar has been in excellent control–rock solid stable every single day.

Weight Loss:  I lost no weight this week.  This could be because I’m still adapting to ketosis, or because of dairy intake on Easter, or because of little bits of sugar each day, or because of hormonal effects, or because of exercise (?muscle?).  Time will tell. I can say that my clothes fit better today than they did just a few days ago.

Energy hasn’t been stellar, but it’s been adequate.  There have been windows of time when I’ve had excellent energy (dancing on Friday night, for example), but also times when I’ve felt more tired than I’d like.  These energy fluctuations appear to be unrelated to ketone and blood sugar levels.  They may have to do with food sensitivity reactions, or they may be part and parcel of the initial adaptation process, which can take several weeks or more.  Time will tell. I’ll be seeing my new primary care physician today to discuss the possibility that thyroid and/or adrenal issues may be playing a role here as well.

Sleep continues to be irregular, but in my experience this is mostly to do with food reactions.

Blood Pressure is on the low side, at least first thing in the morning, using my home BP cuff.  However, I do not feel lightheaded in the morning, and it was 118/60 mid-day today at the doctor’s office.  I took Cyn’s advice and have been taking a lot more potassium this week–1/2 to 1 tsp of potassium chloride (750 to 1500 mg) per day.

Goals for Week 3:

I would like to try to clean up my diet this week without eating more protein, and aim towards my happy all-meat plan.  I suspect that food sensitivity reactions may be interfering with my sleep and energy, and I’m hoping I can remove plant foods without getting hungry.  If I get hungry, I’ll eat some veggies and try again to clean things up after I’ve (hopefully) fully adapted to burning ketones for energy.  Oh, and biggest lesson learned for the coming week:  never run out of duck fat:)  

I should have some new lab tests available for posting next week, including a repeat homocysteine level, complete thryoid panel, a VAP cholesterol profile, vitamin D, and a few others.  Real Woman Anne has just given me her pre- and post- ketogenic diet lab tests, so those will be included in next week’s report as well.  To see my lab tests from February, click HERE.

Your thoughts are welcome!

Coming this weekend to the Food and Health Blog:

THE HISTORY OF ALL-MEAT DIETS AROUND THE WORLD

To be notified of blog posts as they become available, please click here↓

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  • jalam1001

    Hi Dr Ede

    Thanks for sharing your experience with Ketogenic diets and bio-metric data. It is very informative.

    I was wondering why you have not included your basal temperature data along all other bio markers?

    It is easy to get and have relationship with thyroid function.

    http://doctormurray.com/health-conditions/hypothyroidism/

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Dr. Murray

      Thanks for this suggestion–absolutely, I will start tracking and reporting temperature today!

  • Esteban

    It appears to me that you are starving yourself with such a low caloric intake. Are you staying satiated with this diet or mostly hungry? The reason I say that is because if your body reads “starvation” then your leptin levels will come down and start a chain reaction to other hormonal changes/imbalances in order to keep you alive which, from what I’ve read, means store fat whenever possible with whatever is available. By the way, I enjoy your website! Thanks!

    • http://diagnosisdiet.com/ Dr. Ede

      Hello, Esteban

      I have really not been hungry on this diet this week, generally speaking, but on those few occasions when I was hungry I simply ate more food. I have no interest in being hungry, so I just eat more. You see on Wednesday I ate extra protein, for example. I have felt MUCH less hungry on this diet than I did on a standard weight loss diet (1200 cals per day including carbs). My understanding of starvation is that it differs from ketosis–starvation means no food, which means no protein. If you eat adequate protein, your body should be able to turn to fat for energy–that’s what it’s there for. It can take a few weeks for the body to be able to efficiently burn fat for fuel, so I’m not past that window yet, but that’s my understanding. I’m glad you are enjoying the site, thank you!

  • sheik

    My BP was 96/68 one da last week and my cardiologists told me yesterday that is too low.

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Sheik

      This could be my home cuff or the fact that I test BP first thing in the morning before I’ve done anything. I just checked it here at work (10 am) using a different cuff and it was 121/82.

  • Rick Stewart

    Can’t wait for the “All Meat Diet” Blog!

    • http://diagnosisdiet.com/ Dr. Ede

      Thanks for the enthusiasm, Rick–it’s coming up soon!

  • Ellen Davis

    Dr. Ede, I have just discovered your blog, and I wanted to say thank you for sharing your experiences. I write about all this on my website http://www.ketogenic-diet-resource.com, and although I am working on a Masters degree in nutrition, I’m not a physician, so I’m thrilled when an MD chimes in on this subject. It just strengthens the message, so again, thank you!

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Ellen
      And I’m thrilled to hear that you are entering the field of nutrition and are interested in “unconventional” diets. I’ll take a look at your site, thanks for the link!

  • Monica

    The following link contains a list of various beverages, foods, etc and how each affects the various blood types. I do remember you saying that certain foods for Type A did not agree with you.

    http://www.dadamo.com/typebase4/typeindexer.htm

    D’Adamo has a “pyramid” of diets, each one growing increasingly customized with the zenith being the SWAMI software which requires a plethora of measurements and medical information in order to produce exactly what foods are beneficial, neutral, or avoids. The BTD is the most generalized, the genotype less so and SWAMI as I said most customized. Unfortunately, what he produced in that trio has been maligned due to the inevitable ‘differences’ for one person on each level. SWAMI is $70 but it was the best $70 I’ve ever spent.

    To summarize and point out the obvious, the more specific the diet, the more effective it is.

    I’m Very tempted to send it to you. (SWAMI). Would you use it? :)

    take very good care

    Monica

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Monica
      I appreciate the ideas, but any food that is not meat simply does not agree with me, so I would not be able to try another plan. I am very unusual in this respect, so I’m not saying that the plans you have read about may not be helpful to the average person with my blood type, but I’m not the average person…

  • Laura James

    It should be interesting if you can get into keeping track of your temperature and pulse rate upon waking and before bed as well as after meals. Then when you get your thyroid panel back you will have some additional information to draw patterns from.

    It’s becoming clear to me that temperature and pulse are some strong indicators of how fast my metabolism is working. I’ve found that for good sleep, stable weight/weight loss, and general comfort I need to be warm and not have a super low pulse rate. Btw I am about your age height and weight and have always struggled with my weight. I usually have a honeymoon period with the various diet experiments I’ve tried, but nothing worked until I focused on my temps and pulse.

    I hope your moderate ketosis diet brings you relief from food sensitivities, but for weight loss and sleep it seems to require enough calories to get good thyroid function. Not sure if this diet can help with that if yours is less than optimally working.

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Laura
      Thanks for this feedback. Just to clarify, I’m definitely not using the KD to relieve me from food sensitivities–I’m just experimenting with it for weight loss and optimal function. Since I have not yet been on it long enough to be fully adapted, I am reserving judgment about its effects until after I’ve been on it for at least 4 weeks, if I am able to stay on it comfortably for that long. I would be curious to hear more about how you optimized your vital signs and what diet you ultimately found helpful in your particular case. According to Dr. Rosedale, lower blood pressure, heart rate and basal body temperatures are good for health and longevity. It makes sense to me that lower metabolic rates would slow weight loss of course, so we have to distinguish between optimal health and optimal weight loss. I’m more interested in health than weight loss, ultimately, but am hoping that once I’ve adapted to the KD I will be able to achieve both? I have known people who have lost weight using Weight Watchers who have said that they knew they were losing weight when they felt cold in the evening. I have not been cold on this diet so far–no colder than usual. ( I have been sensitive to cold all my life.)

  • bjjcaveman

    Keep up the awesome work! Great to see that you’re feeling better on this way of eating.

    • http://diagnosisdiet.com/ Dr. Ede

      Thanks bjjc!

      Definitely better than my first experiment–I’m (very) cautiously (slightly) optimistic…

  • http://www.facebook.com/profile.php?id=701725905 Dan Ordoins

    I enjoy reading your blog.

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Dan
      Thank you so much for reading and for letting me know! It helps a lot to keep me motivated:)

  • Tyler

    Can’t wait to see your lab test results! And so glad to see you are feeling better this time around on your revised approach!

    • http://diagnosisdiet.com/ Dr. Ede

      Thanks Tyler!

  • Elyse

    Can you please elaborate on creasy skin? This is the first I’ve heard it included as as a symptom or side effect, but have noticed that this comes and goes in my mother depending on her health.

    Btw, I heard you speak mid-2010 at the Hallowell Center. I was quite confused by your conclusions/recommendations but it did send me down a path that led to a dramatic improvement in my family’s health. Thank you!

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Elyse
      I’m so glad to hear that you’ve found ways to improve your family’s health through diet, despite my confusing you! As for creasy skin–I mean that when I eat the wrong foods I wake up the next morning with creases in my skin where the pillowcase or sheet or blanket wrinkles have left their marks and it takes a while for them to go away. I view it as a sign that I’ve retained some fluid. A similar thing can happen at the end of the day if I’m wearing socks–you can see indentations where the sock line was. This does not happen when I’m eating things that don’t bother me.

      • Tyler

        Could this be a collagen problem? Have you ever thought of drinking bone stocks?

        • http://diagnosisdiet.com/ Dr. Ede

          Hi Tyler

          If you’re referring to the fluid retention issue, I doubt it is collagen, because it only occurs when I eat the wrong foods. I have not added bone stock to my menu for a couple of reasons–one is that I wouldn’t have any way of knowing how many grams of protein are in it, and the other is that I tend to do best with minimally processed, fresh foods. However, once I am solidly adapted to a ketogenic diet (assuming that happens), I may feel I can take more liberties with the exactness of the protein gram counting, or at least experiment with broth to see how it goes.

          • Tyler

            I certainly wasn’t recommending store-bought bone stock ;) . I make my own and it’s infinitely more tasty. And it’s all from fresh, local farm ingredients. I understand that you wouldn’t know the macronutrients in it. And I guess I missed the part about it being only when you eat certain foods.

            To relate why I suggested it, my initial thought was that your skin isn’t elastic enough, and as a result is having trouble return to its natural shape. Homemade bone stocks will have the entire extracellular matrix of biomolecules which your body will incorporate into its own extracellular matrices, which I’m sure you know already, given that you’re a doctor and I am not!

            Anyway, press on!

          • http://diagnosisdiet.com/ Dr. Ede

            Hi Tyler
            I truly appreciate your insights and suggestions–simply being a doctor does not make me any smarter about food and health than anybody else, and I learn from everyone:)

          • Tyler

            I’m actually going to begin my journey to become a doctor this fall at the University of Louisville School of Medicine. Any small pieces of advice to an aspiring doctor??

          • http://diagnosisdiet.com/ Dr. Ede

            Congratulations on your acceptance to med school, Tyler! It will be wonderful to have you on board as one of a (slowly) growing number of nutritionally-savvy physicians! As for advice: if you don’t yet know what field of medicine you want to enter, take your time and try to enjoy and learn from every rotation, keeping your mind open so that you can let your specialty choose you. Otherwise, the best advice I can give is to listen to your patients, and believe them. You will learn just as much, if not more, from your patients as you will from your physician mentors. Take the best care of yourself as you can by getting enough sleep, exercise, and healthy food whenever possible. And don’t worry too much about grades unless you hope to enter an extremely competitive specialty–I focused a lot on grades when I was a student and did well, but it really had no impact on my future. Once you are a physician you will have plenty of options regardless of whether you got the highest grade in any class. Good luck!

  • Someone, Somewhere

    Hi Dr. Ede,

    A quick suggestion and a quick question:

    Suggestion: What part of the chicken do you normally eat? I’ve experimented quite a bit with chicken, and have gotten to the point that the only part of the chicken I now cook for myself is the wing. The wing seems to have the highest ratio of fat to protein of any part of the chicken, which makes sense, since it also has the highest surface-area-to-volume ratio. When I eat any other part of the chicken—leg, breast, or thigh—I find myself feeling like I’ve eaten too much protein and not enough fat. When I just eat the wings, however, I usually feel no need for additional fat. (Side note: I recently had grilled chicken skins at a Japanese restaurant; they were delicious. I’ve tried in vain to find chicken skins at my local markets. I intend to keep searching, perhaps finding a chicken processing plant, as one butcher suggested; perhaps the processing plants have some leftover skins from all of the skinless pieces they prepare for fat-phobic Americans.)

    Question: What are your thoughts about mercury in seafood and its impact on human health (especially your speciality, psychiatric health)? I’ve been meaning to ask you this for awhile, and now I have an excuse, since you mentioned you ate both tuna sashimi and swordfish this week, which are considered to be two of the most mercury-laden foods on Earth. From what I’ve read, mainstream medicine seems to say that we should limit mercury exposure (while it also seems to be increasingly recognizing that the benefits of omega-3 fatty acids outweigh the risks of mercury exposure, at least to some extent). Meanwhile, alternative medicine says that we should get our mercury levels checked and our mercury chelated, if necessary. I’ve read a bit about this subject. The original studies that implicate mercury in neurocognitive impairment strikes me as quite shoddy, while the science behind chelation also seems questionable. On the other hand, mercury is a known toxin and has been shown to cause serious problems in high doses. If you wouldn’t mind sharing, what are your views on this complex, controversial subject?

    • http://diagnosisdiet.com/ Dr. Ede

      Hi SS
      Since I’m limiting protein, I don’t worry about overeating protein. I have felt fine lately eating all kinds of chicken, but I always eat the skin and I always add duck fat. The one time last week that I had to eat plain white meat chicken without any duck fat, I didn’t feel bad, I just felt hungry. As for mercury, I have not researched that topic at all. Since my diet is already so restrictive, I feel I have to choose my battles:) For whatever it’s worth, I don’t feel I’m experiencing any cognitive problems. Grilled chicken skins sound DELICIOUS.

      • Someone, Somewhere

        Hi Dr. Ede,

        I’m glad you’ve found a way of working with chickens that works for you :)

        I know your list of topics to get to is extremely looong, but if and when you do choose to fight the mercury battle, I’d be interested to read your thoughts :)

  • http://www.facebook.com/angelina5566 Evangelina Aguilar

    that is an interesting (not healthy ketongenic diet.. ) in my humble opinion.. but to each its own. have you read the book Elaine Cantin Ketogenic Diet (for Diabetes I, Cancer and other ailments?).. just the food you ate seems so unhealthy… I did and do here and there the ketogenic diet Elaine used to cured her cancer, and while Idid it once with fish, I do it now vegan.. but your choices are just not healthy at all.. in my eyes and humble opinion. there are healthier choices (specially if you are not vegetarian or vegan) .. but not sure what you are really trying to achieve with it.. I would encourage you to get Elaine’s book which many many people with all types of chronic disease are using.. of course if you use it “to loose weight , (temporarely) ” and not to heal then may be your diet is what people ought to do.. just a thought. (just seems interesting.. yet another diet)..

    • http://diagnosisdiet.com/ Dr. Ede

      Hello Evangelina
      My goal is primarily to be as healthy as possible. It would be nice to lose a little weight, but that is not my primary goal. I don’t know if you have read articles on my site about vegetarian and vegan diets, or about meat, or about vegetables, but if you do, you may find some interesting information. I am not able to tolerate most plant foods, so a vegan diet is not an option for me. I used to eat a mostly plant diet until i got sick; changing to a mostly-meat diet is what restored my own health. I understand that my opinion about food is very different than most. What is it about my diet that you think is unhealthy?

  • Abdo Waked

    Very informative topic and discussion, thanks for you efforts. I was wondering if anyone has tried the drug called Histame and what are its side effects and I could find any side effects on the web except it is expensive.