For those who are considering a ketogenic diet, there are a few important matters you should take note of before you make the dive.

A good starting point is to ask yourself if you are truly determined as we’ve seen and heard of instances where overly zealous people hopped on a ketogenic diet expecting dramatic weight loss but later gave up on it when they felt sick or didn’t immediately see the intended results. In most cases, it was because they did not approach and follow the diet in a proper and systematic manner.

Therefore, we want to encourage those looking to adopt the diet to approach it the right (and safe) way. Once again, we had the pleasure to invite Dr. David G. Harper, co-author of BioDiet: The Scientifically Proven, Ketogenic Way to Lose Weight and Improve Your Health, to tell us about what one needs to know and do before starting a ketogenic diet.

(Those of you reading about the ketogenic diet for the first time, it is essentially a high-fat, low-carb diet. We did a piece with Dr. David G. Harper dispelling common myths regarding the diet here.)

D: Dr. David G. Harper

For people who have decided to embark on a ketogenic diet, are there any important precautions they need to be aware of or steps they need to take before starting the diet?

D: The first step that anyone should take would be to consult with their family physician. Some people may have extremely rare genetic and metabolic disorders that prevent them from metabolizing ketones or fats properly. Those on prescriptions are strongly advised to seek consultations as certain medications may increase the risk of ketoacidosis (when the body starts breaking down fat at a rate that is much too fast). The same applies to people with obesity who may have comorbidities like hypertension or diabetes.

People should also be willing to commit to the diet since cycling on and off it can be hard on the body. One should keep at it for about 12 weeks in order to fully adapt metabolically and see if it’s having the appropriate response in terms of changes in health, weight loss and so on. It’s also a good idea to prepare your home environment to ensure you have ketogenic-friendly foods and remove any temptations from your kitchen/pantry that would disrupt the diet.

(Those wanting to learn more, this topic is covered in Chapters 5 and 6 of BioDiet in which Dr. David G. Harper outlines his Five-Step Program.)

Do you need to prime your body before starting a ketogenic diet? If yes, what would that involve and how long would that usually take?

D: It’s important to point out that people should always ease into a ketogenic diet. The problem is a lot of people get information online which may be misleading, believing they should immediately and greatly restrict their carbohydrate intake from the onset. This often leads to ‘keto flu’ where they experience symptoms including headaches, dizziness, lethargy and digestive issues.

What you would want to do instead is to take steps to alleviate those potential problems. One would be to stay well-hydrated. The other would be to take MCT oil, a supplement made from a type of fat called medium-chain triglycerides, to allow your body to adjust to the presence of higher levels of ketones before you restrict carbohydrate intake. I recommend starting with one teaspoon of MCT oil per day and then up the serving to two tablespoons after two weeks or so. It’s also a good idea to avoid consuming sugar-sweetened food and drinks like cookies and pop, and alcohol.

If you are a pregnant woman, can you go on a keto diet? Are there any risks they need to be mindful of?

D: Again, I’d defer to the individual’s physician to determine that. Metabolically speaking, it’s not a good time for a pregnant woman to start a ketogenic diet (unless they’re trying to maintain one if they’re already keto-adapted). The reason is that your fatty tissue stores many environmental toxins to keep them out of your system and you don’t want to be circulating those through your body when you’re carrying a baby as those stored toxins could be absorbed into the fetus.

Is there anything that one should buy before going on a ketogenic diet?

D: Reading a book (other than a cookbook) written by somebody with authority on ketogenic diets would certainly help them become more well-informed about what you should do beforehand. Aside from my own book BioDiet, there’s a number of other books out there that you can buy to educate yourself before embarking on the diet.

As mentioned previously, MCT oil would be a good thing to have. Because people are restricting a lot of the foods they’d normally eat that may be providing some vitamins and minerals, I’d also recommend taking multivitamins for the first month or so. If you want, you could also invest in some Ketostix. These are small, thin plastic strips, once dipped in urine or passed through a stream of urine, tell you the level of ketones present in your urine – an important indicator whether your body has adapted to ketosis. Ketostix can usually be found over-the-counter in pharmacies.

There are different variations of ketogenic diets out there. How does one know which version of the ketogenic diet they should undertake?

D: Unless it’s being prescribed by a physician, then the ketogenic diet that people should be adopting is what’s clinically termed as a well-formulated ketogenic diet. It’s specifically designed to be a balanced diet and by that I mean it provides all of the calories, vitamins, minerals, fibre and everything else your body needs. BioDiet is based on a well-formulated ketogenic diet. Of course, there are other types of ketogenic diets like the therapeutic ketogenic diet but they are adopted more for short-term interventions for specific conditions like brain tumours, epilepsy or so on.

Should one stop intaking alcohol before going on a ketogenic diet?

D: Typically, they should refrain from consuming alcohol in the first month or so as they begin to ease into a ketogenic diet. It does interfere with some of the liver processes that are undergoing a transition to a different type of metabolism and also impairs their judgment which may lead to reduced willpower to stay with the diet.

What is the glycemic index and why is it important for people to know about this term before going on a ketogenic diet?

D: If a person is adopting a well-formulated ketogenic diet, then they don’t really need to be concerned with the glycemic index as it only applies to carbohydrates and ketogenic diets are generally very low in carbohydrates. That being said, it’s useful to understand what the glycemic index is. It’s essentially a scale that ranks carbohydrate-rich foods or drinks by how much they raise blood glucose levels after consumption. Foods like bread, pasta, sugar-sweetened products and rice have a high glycemic index while most vegetables would usually have a low glycemic index. Thus, people on the ketogenic diet should definitely avoid high glycemic index foods. You can check out a comprehensive glycemic index for some common foods here or in Appendix D of BioDiet.

We’d like to thank Dr. David G. Harper for taking the time to provide us with valuable insights in regards to how to prepare yourself before adopting the ketogenic diet. His book, BioDiet, covers everything you need to know about a well-formulated ketogenic diet and comprehensively outlines how one can safely and successfully adopt the diet. BioDiet is available in softcover at your local bookstore or online at Amazon, Indigo and Barnes and Noble. It’s also available as an eBook and Audiobook.

ABOUT DR. DAVID G. HARPER

As an educator, researcher and health consultant, Dr. David G. Harper, has studied the impact of diet on human health for many years. The culmination of that extensive work is the BioDiet, a well-formulated ketogenic plan that works with the body’s natural processes to improve health and reverse decades of damage caused by our collective carbohydrate addiction.Dr. Harper and Dale Drewery adopted the BioDiet in 2012 and the weight loss and health improvements they experienced led him to counsel hundreds of people on the Biodiet with similarly consistent and impressive results.

Dr. Harper is an associate professor of kinesiology at the University of the Fraser Valley and a visiting scientist at the BC Cancer Research Center, Terry Fox Laboratory. He holds a PhD from the University of British Columbia and completed a post-doctoral fellowship in comparative physiology at the University of Cambridge. He is on the scientific advisory board of the Canadian Clinicians for Therapeutic Nutrition and is a member of the Institute for Personalized Therapeutic Nutrition.