The Keto Diet for Chronic Pain Relief

"Keto" is certainly a buzzword these days, and for good reason. Not only is safe and rapid weight loss a reality on the ketogenic diet, there are many other medical benefits like lowered blood sugar levels, improved cholesterol and lipid panels and increased insulin sensitivity.

The incredibly long list also includes mood stabilization, increased energy and mental function, and has shown to be beneficial to those suffering from Alzheimer's disease, early dementia, diabetes, mental health disorder and even some cancers.

Chronic pain is not exempt from the list. The research so far has shown this to be a three-fold combination of ketogenic benefits which aid in neurological and other inflammatory pains.

First though, let's go over the basics of the ketogenic diet, so you can then understand how it can help with pain relief.

The Keto Diet

In a nutshell, the ketogenic diet, is a carbohydrate-restricted way of eating. Instead of using sugar to provide the energy necessary for the body and brain, the body naturally switches over and uses ketones. Ketones are produced when carbs aren't present. The alternative, cleaner fuel!

On the ketogenic diet, followers are recommended to limit carbs, get adequate protein and high fat on a 5%-25%-70% caloric ratio respectively. The numbers may differ slightly for certain individuals however, the ratio clearly demonstrates the vast majority of calories are ingested from fats. It sounds drastic and certainly unrealistic at first.

However, it should be noted fat has more than twice the calories of carbohydrates or proteins gram for gram. There are 9 calories per gram of fat versus only 4 calories per gram of carbs and proteins.
Many foods you may be eating currently may not be included in a keto diet, and many of these foods may be causing you inflammation and pain.

What to Eat?

The simplest way to summarize keto-approved foods is to label it as clean eating. There are many keto-approved foods that are both delicious and satiating. Here are the basics:

Good fats. Avocado, coconut oil, grass-fed butter, full fat dairy and eggs are great for reaching that 70% daily intake of fats.

Above-ground vegetables. The best choices with the least amount of carbs are dark, leafy greens (spinach, kale, chard, collards, etc.), broccoli and cauliflower. Green beans and squash are also great options. Spiralizers have taken zucchini to a whole new level for the keto-ers!

Nuts are a good source of both fat and protein but should be eaten in moderation. Likewise, fruits should be limited to berries as most other fruits are loaded with sugar.

Lean meats with the least amount of processing are optimal. Shellfish is another great option, however watch out for the fat content!

What NOT to Eat?

This list is much shorter and tends to scare people away at first.

Here's the no-no list:

Basically, keep things simple. Stay away from processed foods, sugary/starchy fruits and vegetables, artificial sweeteners, grains, legumes and refined oils/fats. Foods pre-agriculture is a good starting point.

Again, many of these foods cause inflammation and therefore pain.

The Trifecta of Keto on Chronic Pain

Essentially there are three components in the ketogenic way of eating which help with chronic pain relief. Some argue most pain issues are originated by inflammation. And it turns out, sugar is inflammatory.

Research, and common sense, indicates a diet high in carbohydrates could certainly be the source of at least some chronic pain. Goodbye ibuprofen and hello ketogenic diet!

" Less Weight, Less Pain
One of the benefits of the ketogenic diet, and probably the main reason most venture out and try it, is weight loss. And with weight loss comes less pressure on painful joints and stiff bones. It makes perfect sense.

" Adenosine
The human body is smarter than most realize. Adenosine is the body's naturally produced anti-inflammatory analgesic. Studies have shown those who maintain a state of ketosis also have higher levels of adenosine.

" Sugar-Free
Ingested sugar, which as above is highly inflammatory, sets off the insulin alarms to help get the sugar to the cells that need energy. What happens when there is leftover sugar roaming around? Most of it is turned into fat.

Double trouble: Sugar is inflammatory and increases fat stores. The ketogenic diet is devoid of inflammatory sugars and artificial sweeteners. Remove the sugar, remove the pain?

Maybe "remove the pain" is reaching a bit, but the science is there. Those with IBS, fibromyalgia, arthritis, carpal tunnel syndrome, neuropathy, and any number of other problems where inflammation is at the core could benefit from a great deal of relief.

Additionally, better mental focus, increased strength and stamina, and improved overall health are all part of the reward plan of the ketogenic diet.

The ketogenic diet is a great option for most people with unlimited benefits, but unfortunately isn't for everyone. There are certain circumstances where one should not entertain the ketogenic lifestyle.

As always, discuss drastic dietary changes with medical professionals just to be on the safe side.

Cholesterol and the Ketogenic Diet

Much of what most people thought to have understood about cholesterol, both the "good" and the "bad" ones, is outdated and completely misunderstood. Until now doctors and medical professionals warned patients about eating high-fat foods for fear of increasing cholesterol levels which then would undoubtedly lead to heart disease and other metabolic issues like diabetes.

Likewise, some folks are uber-hesitant to begin a ketogenic diet based on the all you can eat bacon and cheese buffet which goes against everything the medical professionals have been preaching all these years.

Both Are Wrong

It's true. And once the bigger picture, the true picture, is clear... it will all make sense. Only humans and animals produce cholesterol which means humans get the 25% mentioned above through animal proteins. Plants are naturally cholesterol-free.

The Cholesterol Myths and Truths

First, we need to get a better understanding of the whole cholesterol fiasco and why the previous myths have been debunked.

" Cholesterol isn't harmful. In fact, the human body produces 75% of the necessary cholesterol supply and the other 25% is ingested.

" Cholesterol doesn't just float around willy-nilly in the bloodstream causing plaques and heart disease.

" A "cholesterol panel" is actually a lipid panel. Cholesterol isn't even an interest; it's the vehicle in which cholesterol travels that wreaks havoc on the cardiovascular system.

When a lipid panel is drawn the good old doctors are looking for the numbers and sizes of the cholesterol carriers (lipoproteins), not the cholesterol itself. HDL (good), LDL (bad) and VLDL (ugly) are the vehicles, like a car per se, for cholesterol.

These particles move the cholesterol around the parts of body where it's needed.

" The HDL, high-density lipoprotein, is deemed the "good" one because it's responsible for returning any leftover LDL cholesterol vehicles back to the liver to be recycled or sent down the poop chute. HDL has anti-inflammatory properties and assists the immune system.

" The LDL, low-density lipoprotein, is not so good. These guys are slow and tend to get stuck in the arteries which starts plaque buildup. The LDL value calculates how many and the size of these lipoprotein vehicles are in the blood. An overabundance of smaller LDL vehicles can cause problems. The best scenario is there is a lower number and they are bigger in size.

" Then there is the VLDL, very-low-density lipoprotein, which doesn't even carry cholesterol and instead carts around triglycerides. Triglycerides are the byproduct of leftover and unused sugars (carbohydrates) that need a place to hide. They are smaller than LDL cholesterol carriers, thus the risk for heart disease is much greater with these guys.

In summary, cholesterol gets a free ride and a bad rap. Lipoproteins are just trying to do a good job, for the most part, and it appears that eating foods high in carbohydrates and sugars is the real culprit.

How Does Keto Help Cholesterol Levels?

Research has shown improved lipid panels in both men and women in several studies. A low-fat diet versus a ketogenic diet has also been examined and studied specifically for lipoprotein improvements. Studies have been conducted for as few as 24 weeks to more than a year.

The common factors in research thus far:

" Triglycerides decreased due to the ketogenic diet limitations on carbohydrates and refined sugars.
" Increased LDL carrier size.
" Increased the number of HDL carries to deal with the LDL.
" Decreased body mass index and weight.
" Better blood glucose readings.

Pretty awesome news for those struggling with an out of whack lipid panel. And weight loss. And glucose issues.

The #1 Ketogenic Diet Myth

A menu consisting of bacon and cheese isn't going to cut it on the ketogenic diet. That's simply not true and a terrible meal plan. The ketogenic diet is based on getting the correct number of macronutrients (protein, fats and carbohydrates) to maximize results and maintain a state of ketosis.

It's all about balance. Adequate protein, higher percentage of calories in fat than anything else and limit carbohydrates to 20-50 grams. Individual numbers vary based on goals and other factors. There are a number of macronutrient apps and calculators online. So, go ahead and eat the bacon and savor that cheese. They aren't forbidden; they just have to fit the ratio.

Need another reason the bacon and cheese diet is absurd? Humans need to balance electrolytes. Sodium, potassium and magnesium are imperative for health and wellness. Some of this can come from animal proteins, but the best sources are above-ground veggies. Plus, vegetables are a great source of vitamins and antioxidants.

Cholesterol isn't such a bad guy after all. The ketogenic diet can absolutely assist in correcting a lipid panel, along with many other benefits. Oh, and a slab of bacon a day with a block of cheese certainly doesn't fulfill the ketogenic dietary needs, but both are in fact keto-friendly foods.

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Ketogenic Diet and Mental Health

Nearly everyone has at least heard of the ketogenic diet by now and its weight loss properties. The word "diet" alone should give that much away, and the fact that almost everyone knows someone who is praising the ketogenic way of eating.

Making its way into mainstream media, the origin for the ketogenic diet was actually to serve pediatric epilepsy patients refractory to medications.

Mental health issues have steadily been on the rise. Depression and anxiety are more prevalent now than ever. More and more cases of bipolar disorder and schizoaffective disorder are being treated as well.

While many limit the mental health field to psychiatry, there are also neurological components to many mental health disorders. The brain is a very powerful tool and it needs food to carry out its many functions.

Fun Fact: The human brain only amounts to 2% of total body weight yet uses approximately 20% of the energy supply.

What is the Connection?

The honest answer is nobody really knows for sure. There have been studies of course, but researchers are vastly under-funded and the data isn't completely reliable.

Either the ketones and state of ketosis was not verified, there is no control group, people dropped out of the study, or mental health care providers are relaying a few success stories on their own clients but lack an official study.

The studies needed to prove any correlation in the ketogenic diet and reduced or eliminated mental health issues would take years and tons of money. And people. People who can stick to the ketogenic diet.

From the information that has been gathered to date leads researchers to believe the fuel type could be responsible for the decreased mental health problems in those following the ketogenic diet.

It helped in seizures, that's proven. Both mental health issues and seizures have neurological factors. Logical thinking would lead us to believe the same could be true.

Ketogenic Diet vs American Standard Diet

In case no one has explained it yet, the ketogenic diet restricts carbohydrates (20-50 g daily) and uses a higher fat content with adequate protein strategy. Limiting carbs forces the body to switch from being a glucose-burning machine to a fat-burning machine.

This is called the ketogenic state. It takes less than 48 hours to get into a ketogenic state and somewhere around a month to be fully adapted.
The American Standard Diet (ASD) doesn't limit carbs and it's not unheard-of to consume 200 carbs in a single day.

In any Italian restaurant it's entirely possible to eat that amount of carbs in a single meal; Bruschetta appetizer, spaghetti and meatballs for the main dish and of course the tiny loaves of bread to nosh on while waiting to be served.
The Brain: Glucose Fuel or Fat Fuel?

This is where science should be giving the answers, but as noted above, researchers are basically winging it on what is known to date. There are several changes when fat-burning takes over and glucose is no longer the main fuel source: the presence of ketones, lower blood sugar and less insulin production.

Is it one of these or the combination that creates a happy brain? And it might be years before anyone really has a definitive, scientifically based answer.

The general consensus is the brain may prefer ketone fuel due to it's anti-inflammatory properties regarding neurotransmitters. Think of it this way... a plate of pizza rolls or a plate of cream cheese spread on slices of ham and wrapped around dill pickles?

Which snack is going to leave someone feeling bloated, groggy, braindead and feel like a nap is in the future? And which snack is going to actually provide clean fuel until the next mealtime?

Double Whammy

Not only can the ketogenic diet be beneficial for weight loss, the studies are showing promising results for mental health issues as well! When one loses weight, it feels good on the inside and outside. Fueling the body with the right ratio of macronutrients (proteins, fats and carbohydrates) is like using premium gas for vehicles.

As the inside is working much more efficiently and weight loss begins, body image is also much more positive. The ketogenic diet could be an alternative to those who are unable to afford psychiatric medications or who just want to try a more holistic approach.

Maybe medications haven't been as successful as expected. The reasons to try it are endless and the reasons not to is a much, much shorter list.

As with any big dietary changes, it should be discussed with medical professionals prior to starting. The ketogenic diet is appropriate for most people, but there are certain individuals who should not attempt this way of eating.

How to Exercise on the Ketogenic Diet

For many, one of the biggest perks in following the ketogenic diet is that exercise is not a requirement for weight loss. Many people have successfully gotten to their goal weight without so much as adding an evening stroll around the block to the daily routine.

However, there are also those who are interested in exercise, or already established in an exercise routine, and have concerns about macronutrients (protein, fat and carbohydrates).


It's important to first establish a goal for exercising. Getting healthier? Adding activity to a sedentary lifestyle? Increase endurance and stamina? Weight loss? Muscle gain? Muscle tone?

There is an endless supply of reasons for exercising, from heart health to intense bodybuilding. The goal, however, determines a great deal when adjusting macronutrients is necessary for maximum effects.

Adding an exercise routine to virtually any diet where there is a calorie deficit will enhance weight loss results and improve overall health. Likewise, adding exercise to a diet with a calorie surplus will enhance muscle gain and improve performance.

However, when exercise is added to the ketogenic diet, stored fat is used for energy at an increased rate and oftentimes the results are noticeable in just a short period of time.

Types of Exercise

This is where there seems to be a bit of confusion regarding exercising while already enjoying the many benefits of the ketogenic diet. The biggest question is predominantly regarding carbohydrates and should one carb-up pre and post workout. The answer is Yes and No. It depends on the type of physical activity.

" Aerobic Exercise / "Cardio" - Exercises which are longer in duration and low intensity usually do not require adjustments to macronutrients. These are fat-burning activities, and if the goal is weight loss, incredibly beneficial. Walking is probably the most popular type of cardio.

Workout routines where the body is in movement for three minutes or longer without breaks is considered cardio as well, like kickboxing, Zumba, etc. Even dancing is cardio!

" Flexibility & Stability Exercise - This group includes core and balance routines, yoga, Pilates, stretching and range of motion exercises aimed at muscle tone while still being low impact. Wall squats while doing any number of tricep/bicep curls with 5 lb weights is a good example.

This works the core, legs and arms simultaneously. These are also fat-burning activities, and again, upping carbs isn't usually necessary but also isn't out of the question.

" Strength & High Intensity Exercise - In this category are the folks who do CrossFit, high-intensity interval training (HIIT), weightlifters, bodybuilders and other athletes. These types of exercises are carb-burners and yes, increasing carbohydrate intake is the way to go here.

Adjusting Macros

Undereating and overeating are undeniably common while exercising and living a ketogenic lifestyle. People sometimes don't eat enough or are eating too much of the wrong foods for the type of exercise regimen, thus weight loss stalls or weight gain ensues.

Here is the key:

" Aerobic Exercise / "Cardio" - Don't change a thing. If after exercise sluggishness or lethargy is noticed, eat a healthy snack featuring good fats and a little protein. Something like cream cheese spread on a piece of ham and rolled on a dill pickle (ham and pickle rollups) should do the trick nicely.

" Flexibility & Stability Exercise - It's okay to increase protein here, and even carbs if necessary, but not by much and make certain they are good choices. And only on exercise days. Adequate protein is essential to retain muscle mass and still lose fat. Perhaps increasing by 10-15 grams on exercise days for protein.

As far as carbs, only take in enough to provide a small energy burst without kicking the body out of ketosis. A few almonds or berries are good for carb-ups. Quality jerky, avocado or boiled eggs are easy ways to add in some extra protein and good fats.

" Strength & High Intensity Exercise - Definitely get in additional carbs. This is not an excuse to jump into the drive-thru and get a super-sized order of French fries. Fast-acting, clean carbs are always the best option, like fruit. A general rule is 15-30 additional carbs pre and post workout are a good starting point. Further adjustments might be necessary.

Pay Attention

Ultimately paying attention to one's body is going to be the biggest key to success. Everyone is different; what works best for one might not work that way for another. Listen to the body. Feed it what's necessary.

Sometimes there's a period of adjustments until the right combination of macros is discovered. Make good choices and enjoy the results!


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Why Weight Loss Stalls On The Ketogenic Diet

The ketogenic diet is making headlines everywhere in recent times. It's been around for nearly a century and had its debut as a medical diet in 1924 for epilepsy and other metabolic dysregulations. It was all but extinct until the 1990s when it made a comeback and has been hitting mainstream media since. Why? Because it works!

When insulin isn't running rampant through the system to combat glucose spikes, stored fatty acids are released into the bloodstream and filtered by liver thus creating ketones. By restricting carbohydrates, the body adapts to a new fuel source as glucose is no longer in abundance and instead opts for ketones.

Following a ketogenic diet isn't simply about foods and getting in the appropriate macronutrients. And this is precisely why people complain of weight loss stalling out and reaching a plateau.

Not in a State of Ketosis

The entire foundation of the ketogenic way of eating is based on maintaining a state of ketosis. Cheating and indulging "just this time" could potentially throw the body out of ketosis. Our bodies prefer glucose for fuel; it's the first choice.

If cheat meals or cheat days are allowed, the body stop using ketones for fuel and switches back over to glucose. And even if the ketogenic diet is back in full-force immediately after a sweet treat or deep-fried fat-fest, it still takes 24-48 hours for ketone production to begin again. It's just not worth it.

The most effective way to check for ketosis is using a blood meter. It's an expensive route, but it works. There are also urine strips, however these are highly inaccurate and lead to many false negatives. It only measures the ketones remaining in the urine, not the ketones already used for fuel.

There is also a breath analyzer on the market, however it is also not very reliable. The easiest and least expensive alternative is paying attention to symptoms: Clear mental status, less of an appetite, greater energy and strong-smelling urine.

Eating Too Much or Not Enough

Calories matter. Macros matter more. And keeping track of all intake matters most. The macro ratio normally looks something like this: 5% of daily calories from carbs, 10-20% from protein and 75-80% from fat. Carbs and protein each have 4 calories per gram, while fat grams are more than double at 9 calories.

There are a number of free apps for logging daily intake. Those who wish to reap the many rewards of a keto diet should be diligent in keeping track of their macros and minerals, as well as water intake.

Rule of thumb for macros: Carbs are a hard limit, protein is a target and fat should be balanced. If you go over a bit on protein, adjust carbs and/or fat accordingly so your caloric intake goal is achieved.

Hidden Carbs

These tricky suckers are everywhere and are often the main culprit for weight loss stalls! Read food labels and research the ingredients if unsure about something listed. Almost everything labeled "sugar-free" still has a substitute sweetener.

Keto approved sweeteners: Stevia, pure liquid sucralose, and erythritol. Steer clear of anything else.

Low-fat dairy is riddled with hidden carbs. The amount of carbs increases when the amount of fat is lowered. Yogurt, if not fermented, can be a carb-catastrophe. Shredded cheese has potato or corn starch added to keep it from clumping. The less processed, the better to avoid a sneak attack weight loss stall.

And finally, make sure to log seasonings and spices when creating a meal. Onion powder has approximately 5g of carbs per tablespoon, and garlic powder even more with 6g! It would be awful to have a simple flavoring drop-kick the body right out of ketosis!

Time and Quantity of Meals

While the body is in ketosis, we need to give it time to actually use the fuel we are supplying with each meal. Keep meals at least four hours apart and have no more than three meals a day.

If the schedule for meals is normally twice a day, it's okay to maintain that schedule as long as the macros are met. Snacking might also be an issue is weight loss has stalled out.


Assuming cardio workouts are going to get the weight off faster is false. If cardio is already part of the daily routine prior to keto, go ahead and continue. Adding weight-lifting or HIIT (high-intensity interval training) to the routine will be of more benefit than adding more cardio for avoiding muscle loss. Although, exercise is not necessary to lose weight on the ketogenic diet.

Fat Bombs & BPC

There are several resources advocating fat bombs and "Bullet Proof Coffee" claiming fat burns fat or it takes the toxins out of coffee. Completely false. Fat does not burn fat, and frankly, the human body doesn't know the difference in table fat versus stored fat.

If you ingest it, it's going to get burned prior to the body going to its own resources, like stored fat, and thus ketone production slows. Have a balanced, keto-approved breakfast instead. Try a couple of eggs cooked in butter and half of an avocado with black coffee.

The ketogenic diet isn't rocket science, but there is a healthy amount of information to be absorbed. Don't let it get over-whelming. Once the routine starts and logging foods becomes habit, it gets much easier. Every human body is different and what works for one might not work well for another. Take the time to make adjustments and log any changes. Just don't give up!

Getting to Goal - Lasting Weight Loss
A Step-by-Step Guide to Lasting Weight Loss.

The Keto Diet for Weight Loss

By now almost everyone has heard about or even tried the ketogenic diet for one reason or another. This low-carb way of eating is getting all the glory for many pounds shed as of late, even though it's been around for quite some time. Originally thought of as only a way of eating for children with epilepsy it has grown in the last decade or so into quite a phenomenon.

In the simplest of terms the keto diet is a low-carb style of eating causing the body to shift into a state of ketosis. By limiting carbs, the body has to look for another efficient fuel source. The objective in the keto diet is to switch from using glucose as fuel and move over to ketones thus making it an ideal diet for Type 2 diabetics.

Ketones are produced in the liver by the breakdown of fat cells. Essentially, the body is burning fat for fuel in ketosis. The human body is very brilliant and when given the right tools, can run like a well-oiled machine!

How to Obtain the State of Ketosis

The metabolic state of ketosis is achieved by maintaining a daily carbohydrate intake under 25g. It's actually very simple. It only takes 24-48 hours of low-carb eating to shift the body naturally into ketosis.

Every nutrition store has a variety of ketone-enriched supplements to push the body into ketosis faster, but for the average person using ketosis as a weight loss plan, it's not really necessary and quite frankly, a waste of money.

There are also keto-strips to dip in urine, similar to what the nurse uses when running a urinalysis, but these have thus far been highly inaccurate and are again, unnecessary. The body gives signals when it's first in ketosis.

Here are a few:

  • Strong smelling urine
  • Bad breath (acetone)
  • Short-term fatigue and/or flu symptoms
  • Appetite suppression
  • Weight loss!

By allowing the body to enter ketosis naturally, without enhancements, one knows exactly what's going in and coming out. Speaking of which, sometimes what's coming out (at first) isn't very regular.

Keep in mind, more of what's being ingested is being utilized by the body now so there's less to evacuate. If the frequency gets concerning, please contact a primary care provider for advice.

The Bad Foods

It's not a long list, like many probably fear. In fact, the guidelines are simple.

Steer clear of these food groups:

  • Sugar
  • Starchy foods
  • Grains
  • Trans Fats
  • Fruit
  • Low-fat products

The biggest key to being successful with the keto diet is in taking on a more natural approach to eating. The more "real" the food, the better for you. A good habit to form is reading ingredient labels. Many items labeled "Diet" or "Low-fat" or "Heart Healthy" are riddled with sugars and carbs.

The Good Foods

This is the best part of the ketogenic diet! Below is a list of categories and a brief explanation of each:

    • Protein. The best of the best is organic, pasture raised and grass-fed.
    • Veggies. Lean on leafy greens and veggies grown above ground. Underground veggies are typically high in carbs. Fresh or frozen, it doesn't matter.
    • Dairy. Full-fat dairy items.
    • Fats & Oils. Always opt for a natural fat source. When necessary for cooking choose coconut, butter or olive oil.
    • Nuts and Seeds. Fatty nuts like macadamias and almonds are great in moderation.
    • Beverages. Water. If flavoring is needed use real fruit juices or flavorings using Stevia as the sweetener.

The Macronutrient Ratio

Calculating the individual macronutrient ratio is based on current weight, health history and weight loss goals for that person. Macronutrients are carbohydrates, proteins and fats. Since the carb count is less than 25 grams daily, it should equal to no more than 5% of daily macronutrient intake.

There are a number of calculators available online to assist in calculating macros. Seeking the advice of a professional, like a certified nutritionist, is optimal but not an option for some.

An individual macro ratio might be 5% calories from carbs, 55% calories from fats and 40% calories from protein. Depending on the caloric needs and weight loss goals, the actual grams of each macro will fluctuate. That is, except the carbs. It will always be under 25 grams daily and some even go as low as 20 grams.

The Reality of Keto

Yes, cutting back drastically on carbs for a hard-cord bread and pasta eater is going to be a challenge. The good news is for most people, the carb cravings fade away within the first couple of weeks.

And of course, the weight loss will be a driving force in continuing with the new way of eating. And that's exactly what the keto diet is: a new way of eating.

This isn't for yo-yo dieters or those just wanting to lose a couple pounds by next week. The keto diet is a lifestyle change. And is definitely a change for the better!