Top 5 Nutritional Ketosis Mistakes—And How to Fix Them

Having trouble getting your ketones up, dealing with side effects, figuring out your protein intake, and/or finding the right fats?

Nutritional ketosis is a powerful metabolic state in which your body primarily burns fat and ketones rather than glucose for fuel, which occurs when dietary carbohydrate intake is reduced (not eliminated) to below your personal threshold of carbohydrate tolerance. Once ketosis is achieved and maintained, the metabolic benefits are bountiful: safe and effective weight loss, reduced hunger and cravings, decreased inflammation, lower and more stable blood sugar (thus, reversal of Type 2 diabetes), and beyond.

The length of time it takes a person to adapt to nutritional ketosis varies as each person has a unique biochemistry and varying degrees of metabolic damage needing repair. If weeks or even months have passed and you are still struggling, you may be falling prey to one of these common mistakes that can interfere with nutritional ketosis.

The following is condensed from the Virta post Top 5 Nutritional Ketosis Mistakes—And How to Fix Them

Anna Barnwell, MPH, MSW, April 25, 2018

Be sure to watch the embedded videos.

Mistake #1: Too much protein, not enough fat

A well-formulated ketogenic diet is moderate, NOT HIGH, in protein. Protein has a moderate insulin-stimulating effect, and it can interfere with ketone production by the liver when consumed in excess.Most healthy individuals require between 1.5 and 1.75 grams of protein per kg of ‘reference body weight’ to maintain lean body mass and function during a ketogenic diet. Intakes above 2.0 g/kg reference weight show no additional benefit. Here’s where you can find your protein needs on a ketogenic diet.

How much protein? Dr. Phinney helps you figure that out in this Post.

Calories from FAT should make up the majority of your dietary intake in order to feel adequately satisfied. Adding fats like olive oil, butter, cream, coconut, or canola oils to meals without being accompanied by extra protein is critical to achieve both satiety and nutritional ketosis.

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Mistake #2: Choosing the wrong kinds of fat

When it comes to consuming dietary fat, it’s not only about quantity, but quality, too.

Fat is essential and two of its primary functions in humans are: 1) as a fuel source, particularly when “keto-adapted,” and 2) to build and maintain vital membranes for all the cells in the body.

On a ketogenic diet, monounsaturated and saturated fats should provide the majority of your dietary fat intake to supply the body with energy, as the body prefers to use these types of fats for fuel.

Monounsaturated fats are found in oils such as olive, avocado, and canola, as well as in some animal fats such as lard. Saturated fats are naturally concentrated in most animal fats such as dairy fat, beef (suet), and lamb, as well as “tropical oils” (e.g., coconut and palm oil). Dietary saturated fats are readily burned off to be used for fuel (i.e., they won’t accumulate in your blood) when a person is keto-adapted.

Polyunsaturated fats are not well-tolerated in large amounts. Therefore, vegetable oils should be limited and avoided. Common sources include soybean, corn, sunflower, safflower, cottonseed, and peanut oils.

The two sub-classes of polyunsaturated fats, omega-6 and omega-3, are essential to consume in small amounts for the purposes of membrane health, as our bodies cannot naturally make them. To consume the recommended amount of omega-3 fatty acid, eat 3 servings of cold-water ocean fish per week or take at least 1 gram of fish oil daily (or flaxseed oil if you are vegetarian or vegan). Consuming excess omega-6 fats, however, will lead to stomach and intestinal upset and possibly increase inflammation.

(Lydia buys fish from Vital Choice which are Certified Purity,the wild fish and shellfish are free of hazardous levels of contaminants; see in the revealing mercury chart here

Finally, avoid artificial trans fats all together, such as commercial shortening and margarine, as they are strongly linked to coronary artery disease.

The “right” Fats & Oils chart.

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Learn more about health fats at

Mistake #3: Not enough salt

Current US dietary guidelines recommend 2300 mg of sodium per day. However, recent research published in mainstream journals like the New England Journal of Medicine highlights that consuming 2300 mg or less of sodium daily actually increases mortality in the general healthy adult population; in fact, for optimal health, most of us need anywhere between 4000-5000 mg of sodium per day – and that’s for people consuming standard diets containing appreciable amounts of carbohydrate.

On a ketogenic diet, consuming adequate sodium becomes all the more critical, as the rate of sodium excretion by the kidneys into the urine increases quite significantly while in nutritional ketosis.This means that most people on a ketogenic diet need to consume closer to 5000 mg (i.e., 5 grams) of sodium (which equals 12 grams or 2.5 teaspoons of salt) per day in order to maintain an adequate balance.

Starting in just the first few days of adapting to nutritional ketosis, neglecting to consume 5 grams of sodium can put your circulatory system into disarray and trigger the notorious “keto flu” symptoms: headaches, dizziness, lightheadedness, fatigue and constipation.And here’s an important point:this daily need for 5 grams of sodium continues as long as one remains in nutritional ketosis; it’s not just a temporary need during keto-adaptation.

Fortunately, you can keep these symptoms at bay and improve your overall well-being and function by simply salting your food moderately and consuming 2 servings of broth or bouillon daily. For most people, this results in about 3 grams of sodium from regular food plus 2 grams from broth, totalling 5 grams per day.  Keep in mind that salt and sodium are not the same meaning, 1 teaspoon of salt is the equivalent of 5 grams of salt but contains only 2.3 grams of sodium (the rest is chloride). 

Note: please consult a medical professional if you have high blood pressure or fluid retention due to congestive heart failure or kidney problems to determine the right dietary sodium intake for you.

Mistake #4: Stagnant “macro ratios”

There are three major macronutrients (or “macros”) that supply humans with energy (calories) from foods: carbohydrate, fat, and protein. On a well-formulated ketogenic diet, your daily energy needs should be satisfied by approximately 5-10% carbs, 70-80% fat, and 15-20% protein.

When you initially begin a ketogenic diet and are losing weight, 70-80% of energy will come from burning your own body fat stores from adipose tissue – NOT entirely from dietary sources. As you approach “weight maintenance” the fat needed to supply your daily energy will have to come from your food because you no longer have as much excess fat to lose! The chart below shows food macronutrient intakes plus body fat contributions as one progresses from through the stages of weight loss to eventual weight stability. It is for a 5’6” women going from 180 to 140 lbs.

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You will continue consuming approximately the same, moderate amount of protein in addition to non-starchy vegetables.

You will need to eat more of the “right” types of fats as you approach and then achieve weight maintenance. Please watch the video.

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Dr. Phinney explains macros in his video: What should my macros be on a Ketogenic diet?

To track grams of carbs, proteins and fat Lydia uses the free version of Carb Manager

Learn more at

Mistake #5: “Needing” to fast

Fasting is being promoted as potent tool for rapid weight loss, enhancing ketone levels and increasing life span. But, much of the research supporting these benefits has been done in mice. Well-done human research on the long-term safety and efficacy of fasting raises important concerns, particularly if one chooses to fast longer than one day. Fasting for more than 2 days can lead to lean tissue loss and even a permanent reduction in reduction resting metabolism (Fothergill, 2016 is cited in the Virta post), among other significant health concerns.

Going in and out of the fasting state while on diabetes or high blood pressure medications can lead to dangerous swings in blood glucose or blood pressure, and this is risky if done without close, expert medical supervision.

In contrast, achieving and maintaining a stable state of nutritional ketosis with real food while avoiding majorly wide swings in your daily caloric intake and medication needs will be safer, more sustainable, and more enjoyable.

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May you Live Long Healthy.

Yours truly,

Lydia Polstra





Disclaimer: The content of this email or Post is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations is at the choice and risk of the reader.

Author: 2healthyhabits

My goal in life is to experience the exuberance of true good health by returning my body to the healthy state it was meant to have.

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