The Keto Diet: Surviving The Worst Day

The keto diet is a low-carb, high-fat, and moderate-protein diet. It is known to be restrictive and can be challenging to maintain. The first few days of the keto diet are often the most difficult, with people reporting flu-like symptoms, including headaches, fatigue, muscle aches, nausea, brain fog, and irritability. This is known as the keto flu and is caused by the body's transition from burning glucose to burning fat for energy. During this time, it is recommended to stay hydrated, replace electrolytes, get enough rest, and ensure adequate consumption of fat and carbohydrates.

Flu-like symptoms

The so-called "keto flu" is a collection of symptoms that some people experience when they start a ketogenic diet. It is important to note that keto flu is not an actual flu, and you will not develop a fever. The symptoms are caused by the body adapting to a new diet that consists of very few carbohydrates. The symptoms can include:

• Headaches
• Fatigue
• Foggy brain
• Irritability
• Nausea
• Difficulty sleeping
• Constipation
• Diarrhea
• Muscle soreness
• Cravings

These symptoms typically appear within the first few days of starting the keto diet and can last from a few days to several weeks.

How to Ease Symptoms

If you are experiencing keto flu, there are several things you can do to ease the symptoms:

• Drink plenty of water: The keto diet can cause dehydration, so it is important to stay hydrated.
• Eat more often and include plenty of colourful vegetables: Eating a variety of foods will help ensure you are getting enough nutrients.
• Avoid strenuous exercise: Give your body some rest and focus on lighter activities such as walking or yoga.
• Replace electrolytes: Include potassium-rich, keto-friendly foods like green leafy vegetables and avocados in your diet.
• Get enough sleep: Lack of sleep can cause an increase in the stress hormone cortisol, which can negatively impact your mood and make symptoms worse.
• Cut down on caffeine: Caffeine can negatively impact sleep, so try to cut down or only consume it in the morning.
• Transition gradually: Instead of cutting out carbs all at once, try reducing your carb intake gradually while increasing the amount of fat and protein in your diet.

Digestive issues

Causes

The keto diet involves drastically reducing your carbohydrate intake and increasing your consumption of fats. This change can be a shock to the body, leading to digestive issues such as constipation and diarrhoea.

When you reduce your carb intake, your body's insulin levels decrease, causing it to excrete more water and sodium. This rapid loss of water and sodium can lead to dehydration, which is a common cause of constipation.

Additionally, the keto diet restricts many foods that are high in potassium, such as fruits, beans, and starchy vegetables. Potassium is essential for maintaining healthy digestive function, so a lack of potassium can contribute to constipation.

Diarrhoea, on the other hand, is often caused by the body excreting excess water during the initial stages of the keto diet. This is also a result of the decrease in insulin levels and the subsequent water loss.

Relief and Prevention

• Eat more low-carb vegetables: Low-carb vegetables such as leafy greens are rich in minerals and soluble fibre, which can help add bulk to your stool and promote regular bowel movements. They also help remineralise your body, preventing dehydration and maintaining healthy digestive function.
• Stay hydrated: Drink plenty of water and ensure you're consuming enough minerals to maintain a healthy balance in your digestive tract.
• Manage your stress: Stress can contribute to both diarrhoea and constipation. The keto diet can increase stress levels initially, so it's important to practise stress relief techniques such as meditation, yoga, and getting enough sleep.
• Gradually reduce carbs: If you're having trouble adjusting to the keto diet, try reducing your carbohydrate intake gradually instead of all at once. This can make the transition smoother and reduce digestive issues.
• Replace lost electrolytes: When following the keto diet, your insulin levels decrease, causing your body to release excess sodium. Additionally, the diet restricts potassium-rich foods. Replenish these lost electrolytes by salting your food to taste and including potassium-rich foods like leafy greens and avocados in your meals.
• Increase your fat intake: Eating enough fat can help reduce cravings for restricted foods and keep you feeling satisfied. This may help prevent digestive issues caused by carb withdrawal.

Fatigue

Salt Intake

Research suggests that adding salt to your diet can help alleviate keto-related side effects, including fatigue. Try salting your food generously or adding a teaspoon of salt to a glass of water in the morning. Alternatively, you can consume bone broth or bouillon, which are high in sodium.

Carbohydrate Intake

It is important to restrict your carbohydrate intake to less than 20 grams per day to ensure you enter ketosis. Eating more carbohydrates than your body can tolerate will result in a low-carb but non-ketogenic state, which can cause fatigue, hormonal fluctuations, and decreased athletic performance, especially in women.

Calorie Intake

Undereating on the keto diet can lead to fatigue as it reduces the body's production of energy hormones. It is important to ensure you are consuming enough calories, even if your goal is weight loss. Try increasing your calorie intake by a few hundred calories and see if that improves your energy levels.

Fat Intake

On the keto diet, fat is your primary source of energy. If you are not consuming enough healthy fats, you may feel exhausted. Make sure to include plenty of healthy fats in your diet, such as olive oil, avocado, nuts, and fatty fish like salmon.

Meal Schedule

Eating regularly is one of the best ways to maintain energy levels, especially when starting a keto diet. Aim for at least three meals a day, spread evenly throughout the day. If you are still feeling fatigued, you can add a few low-carb, high-fat snacks. Intermittent fasting may not be suitable for everyone, especially when starting a keto diet.

Exercise

A sedentary lifestyle can contribute to fatigue. Try to incorporate some form of exercise into your routine, such as daily walks or a combination of weight training and cardio. However, if you are feeling extremely tired, it is important to listen to your body and not push yourself too hard.

Cravings

The keto diet is a very low-carb, high-fat, and moderate-protein diet. It is associated with some unpleasant side effects, which some people experience when their body adapts to the new diet. These symptoms are often referred to as the "keto flu" or "carb flu".

The drastic reduction in carbohydrates can come as a shock to the body, causing withdrawal-like symptoms similar to those experienced when weaning off an addictive substance like caffeine. Transitioning to a very low-carb diet can cause you to crave foods that are restricted on the keto diet, such as cookies, bread, pasta, and bagels.

How to reduce cravings

• Eat enough fat: Eating enough fat, the primary fuel source on the keto diet, will help reduce cravings and keep you feeling satisfied. Research shows that low-carb diets help reduce cravings for sweets and high-carb foods.
• Gradually cut down on carbs: If you are having a difficult time adapting to the keto diet, try eliminating carbohydrates gradually, rather than all at once. Slowly cutting back on carbs while increasing fat and protein in your diet may help make the transition smoother and decrease keto-flu symptoms.
• Drink plenty of water: A keto diet can cause you to rapidly shed water stores, increasing the risk of dehydration. Staying hydrated can help with symptoms like fatigue and muscle cramping.
• Replace electrolytes: When following a ketogenic diet, levels of insulin decrease, which causes the kidneys to release excess sodium from the body. The keto diet also restricts many foods that are high in potassium, including fruits, beans, and starchy vegetables. Getting adequate amounts of these important nutrients is an excellent way to power through the adaptation period of the diet. Salting food to taste and including potassium-rich, keto-friendly foods like green leafy vegetables and avocados are good ways to ensure you are maintaining a healthy balance of electrolytes.
• Get enough sleep: Fatigue and irritability are common complaints of people who are adapting to a ketogenic diet. Lack of sleep causes levels of the stress hormone cortisol to rise in the body, which can negatively impact mood and make keto-flu symptoms worse. If you are having a difficult time falling or staying asleep, try reducing your caffeine intake, cutting out ambient light in the bedroom, taking a bath, or getting up early and waking up at the same time every day to normalize your sleep patterns.

Lack of sleep

Starting a keto diet can impact your sleep, both positively and negatively. In the short term, you may experience insomnia and interrupted sleep. However, in the long term, the keto diet can lead to deeper sleep and reduced overall sleep requirements.

Causes of Short-Term Sleep Problems on Keto

When you start a keto diet, your body goes through a metabolic shift from burning sugar (carbohydrates) to burning fat. This transition period is often called the keto flu, and it can include symptoms like fatigue, low energy, irritability, headaches, and insomnia.

• Carb withdrawal: Your body is used to relying on carbohydrates as its main source of energy, so when you suddenly reduce carb intake, it can affect your sleep.
• Electrolyte imbalances: Restricting carbs on keto leads to lower insulin levels, which can result in deficiencies of electrolytes like sodium, potassium, and magnesium. These electrolytes are important for normal brain functions, including sleep.
• Increased urination: The keto diet is a diuretic, which means you may need to urinate more frequently, interrupting your sleep.

How Keto Can Improve Sleep in the Long Term

While the keto diet may cause initial sleep disturbances, it can ultimately lead to deeper sleep and improved sleep quality. Here's how:

• Stabilized blood sugar: Keto helps get you off the blood sugar roller coaster, which means less midnight hunger and more stable energy levels.
• Increased deep sleep: A 2008 study found that a keto diet increased deep sleep in non-obese men. During deep sleep, your body heals, forms new memories, and clears out proteins linked to Alzheimer's.
• Weight loss: Keto has been shown to promote weight loss, especially in obese and diabetic populations. Losing weight can lead to improved sleep quality.
• Reduced sleep apnea: Obesity increases the risk of sleep apnea, so by helping with weight loss, keto may indirectly improve sleep apnea symptoms.

Tips for Improving Sleep on Keto

If you're struggling with sleep while on a keto diet, here are some quick tips to help you get a better night's rest:

• Give it time: Allow your body two to four weeks to adapt to the keto diet and break your carb addiction.
• Reduce blue light exposure: Minimize blue light from electronic devices before bed to promote optimal melatonin levels.
• Increase salt intake: This helps prevent low sodium levels and optimizes your antidiuretic hormone (ADH), which helps you sleep through the night without frequent urination.
• Consider electrolyte supplements: Potassium and magnesium supplements can help correct electrolyte imbalances and improve sleep quality.
• Practice relaxation techniques: Wind down before bed with a relaxing routine, such as reading a book or listening to soft music.
• Avoid caffeine close to bedtime: Cut back on coffee and avoid consuming caffeine within 6 hours of bedtime to improve sleep quality.

Frequently asked questions