Some tips for a ketogenic diet

I have written much about the ketogenic diet (KD), the state of ketosis, and its underlying science and clinical relevance. The ‘politics‘ of dietary advice too. However, I am aware that I have offered minimal practical advice. I have outsourced that to other sites, particularly for recipes and meal-plans. I have listed some at the end. Still, I have learned a few practical things along the way, which may be helpful to some. This post contains these odds-and-ends, and some personal thoughts.

Bread

I can’t do without bread” is a common and understandable first reaction, and a hurdle to starting a KD for some. Still, I think many people underestimate what they can do.

One of the things I decided, early on, was to give up on making low-carb versions of bread. The recipes I tried resulted in sad, disappointing and dysfunctional ‘bread’. Better to go without. However, a soft-boiled egg on toast benefits from something like toast (to mop up the yolk). I offer two solutions, neither of which attempts to be bread but, rather, to provide a practical substitute for bread.

This has been a useful way of thinking about the KD. Think alternatives, rather than low-carb versions of carb-foods. For example, ribbons of zucchini (on a mandolin if you have one), steamed, makes a nice alternative to ribbon pasta when combined with a meat sauce. Google ‘cauliflower rice’. Etc.

#1: Mushrooms: Hardly a recipe. Cook (e.g. bake) some large field mushrooms (stalks removed), whole. Mash some avocado with lime juice and Tabasco, gently warm. Poach some eggs (do it this way if you want to be fancy). Plate the mushrooms upside-down, top with the avocado, make an indent in the centre, rest an egg in that. Salt and pepper. Done.

You could sprinkle some mushroom powder over the eggs (dried porcini mushrooms, ground to a powder in a spice mill). Diced onion, tomato, fresh chillies could go into the avocado (taking it in a guacamole direction). Etc…

#2: Meatloaf: The aim is to make a dense meatloaf that will hold together when sliced. For this, we need a strong bind. The usual standbys – eggs (or flour) – are not useful (or allowed) for this. The best binder is table salt. I explain why in the ‘hamburger’ post. Here, we want to take it further, turning the mince into a sticky paste.

Use any fatty mince you like. I don’t usually recommend meat from sausages, because it is often filled-out with breadcrumbs, flours or other carbs. I am also suspicious of packs of minced meat in grocery stores (what parts of the animals did it come from? From how many animals? Is it sterile throughout?). Furthermore, it is almost always lean. I think a KD requires a butcher. I ask mine to mince 1kg of pork belly for me, which he cheerfully does on the spot.

Organ meats (liver, kidney etc) are remarkably nutrient-dense and adding them to the mix is a good way of including them in the diet. Normally, I use a 50:50 (or 60:40) ratio of mince to chicken livers (or beef kidney). Chicken livers contain all of the essential amino acids, all at high levels.

Weigh the mix, and add 2% by weight of salt (i.e. 20g of salt per kg). This is the critical step. The salt is the binding agent. No eggs.

Add other flavourings according to taste. A typical combination for me is a tablespoon of cayenne pepper, hot smoked paprika, garlic powder, onion powder and black pepper. I minimise anything non-protein that will break up the protein bonding and weaken the texture, e.g. diced brown onion (hence onion powder).

It all goes into the food processor and gets whizzed until it is noticeably sticky. If you can’t be bothered cleaning the food processor, it works fine in a bowl, squeezing and massaging the mixture through your fingers until it becomes drier and more sticky. It doesn’t take all that long.

Bake in a loaf tin, 175C, ~40m. Or, sous-vide at 60C for 2h (vacuum pack the mix then push it all to one end of the bag to approximate a cylinder shape). In this instance, I prefer the baked version – being a bit dried out and overcooked gives a firmer loaf better suited to its purpose.

Keep refrigerated. Slice as needed. Brown quickly in a hot pan. It works fine with Vegemite too. See also the flatbread recipe to follow.

Bacon

You can make your own this way.

Snacks

A KD is a satiating diet and, once adapted to fat-burning, snacks are rarely needed because the body mines its fat stores when energy is low. This is in contrast to high carbohydrate diets, in which body-fat is not burned because the body has adapted to burning glucose – once glucose levels are low, it is necessary to eat or snack again.

However, snacks may be needed during the first few weeks of a KD while the body fat-adapts. Try Googling ‘fat bombs’. These are high-fat snacks that should curb hunger quickly. Or, increase the fat content of meals. Put butter in your coffee.

Still, even after long-term adaptation, there are times when I feel like something to snack on. Much of what can be found in the Deli section works – cheeses, yoghurt, charcuterie, olives, paté etc. Plus some nuts (maybe limit cashews and pistachios), or celery crudités. Dark chocolate (>70% cocoa).

A surprisingly nice combo is dark chocolate (I use 90% cocoa), chopped blanched almonds and diced crispy bacon. I use store-bought bacon for this because it is cut thinner than the bacon I make, and crisps up more thoroughly. Melt chocolate in a double boiler, mix in almonds and bacon, spread onto baking paper to set, then break up into chunks. It is best done in small batches and consumed in a day or so because the bacon will soften over time and change the texture from snappy to chewy. This goes as nicely with an evening red wine as it does with a morning black coffee.

An alternative to cheesy crackers is crispy cheese. Grate a cheese (or a combination of cheeses) of your choice into little circles, and cook until melted and crispy (on a non-stick pan, or baking paper in the oven). Cheese slices (but not Kraft-like slices) also work. A larger version, partly folded before it cools, can replace a taco. Or, make one in a non-stick omelette pan, covering the base of the pan, and add blended eggs just as it starts to brown (see my parmesan omelette post).

The cheese can be made thicker and more durable by adding in some almond flour. This gives a substitute for flatbread, a pizza base or anything similar. Basic recipe: 250g grated mozzarella cheese, 75g almond flour, 2 tbsp cream cheese, salt. Mix and cook in a double boiler (or the microwave, thanks R.B.) until it comes together. Remove and knead briefly, then roll to desired shape and thickness between baking paper while still warm. Remove top paper, transfer to baking sheet, prick all over with a fork, bake in a 220C oven until browned all over. The cream cheese is included because it contains vegetable gums that contribute to the texture (like xanthan, guar, carob-bean gums) and that probably help stop the cheese from splitting into fats and solids. So does cottage cheese, or just use some of the gums if you have them. More details on melting cheese. The image is poached eggs on toasted flatbread with hollandaise sauce.

Crepes

For this, you will need a small non-stick pan with a very flat base, positioned perfectly level. Add enough full-fat milk to cover the base thinly. There are no other ingredients. Heat the pan over moderate heat to evaporate the milk. Keep heating until the lactose and milk proteins react (Maillard reaction) and brown. Lift gently from the pan. Fill with berries and cream. Desserts can be problematic on a KD, although they rarely appeal to me personally. This is slightly sweet but within reasonable bounds. Delicate.

Chicken wings

Not a recipe, just a reminder – an excellent keto-snack or light meal. Straight under a griller at maximum power, until they start to burn. Mayonnaise on the side.

Mayonnaise

Most commercial mayonnaise will contain sugar, in some form or other. If you have a stick blender, it is easy (and satisfying) to make you own. Here’s how.

Bread crumbs

Deep frying is keto-friendly. However, batter and breading are not. I haven’t found an alternative to a batter, but if you grab a few packets of pork crackle from the supermarket and whizz the contents into a powder in the food processor, you have keto-friendly ’breadcrumbs’. Mix 50:50 with parmesan cheese to provide a binder. Add flavours of choice, although the parmesan might overwhelm them. I like to deep fry in tallow (rendered beef fat) or lard. I’ve given the method to make these in the rendering post.

You might need to experiment a bit with a binder if you don’t want the parmesan flavour (e.g. with seafood). I found a highly-unlikely solution in a 1939 cookbook. Coat the food in thick mayonnaise (home made of course) before covering with the crumbs. I expected the mayo to melt and slip off the meat, carrying the crumbs with it. I don’t even know why I tried it (I guess it’s a scientist-thing). So, I was surprised when it worked a treat. Here, with prawns.

When deep-frying, I cook the food sous-vide first (often the day before), and chill completely. This ensures that the food is always nicely cooked. Then, all the deep-fry step has to do is crisp the outside. Heat transfer will normally be enough to warm the food through. Many times, I don’t put a coating on at all. Most proteins benefit from a post-cook plunge in hot fat, if you can be bothered with the spluttering, mess, kitchen smells and cleanup that is.

Diversion: Why was a modernist cook reading a 1939 book? It’s called “The Gentleman’s Companion”. Volume I is the ‘Exotic Cookery Book’ and V. II the ‘Exotic Drinking Book’. The gentleman author is Charles H Baker (1895-1987). He, and other companions, travelled the world in the 1930s, often on luxury yachts, to eat and drink at locations exotic for their times. No expense seems to have been spared (or work done for that matter, although he was writing for some food magazines). The books are a combination of travelogue, recipes and eating experiences, make interesting reading, are a window on the times (for a certain ‘class’ of gentleman) and sometimes uncover lost ideas. There are two ways to get the sort of money needed for that lifestyle – marry it or inherit it. He did both, by marrying an heiress to a mining fortune. There is something to be said for marrying wisely.

Low-carb processed food

It is advisable to avoid processed products advertising themselves as ‘low-carb’ or ‘low-sugar’, or at least to scrutinise them closely. There are many sugars that are not called sugar and that don’t need to be added to the carbohydrate (or sugar) count on nutritional labels, plus there are multiple names that sugar can legitimately go under for disguise. Take a closer look at the Ingredients List instead. Further, some manufacturers make the nutritional numbers up.

Besides, these sorts of processed foods are not what the KD is about. Eat real food instead.

Sugar

This is another common can’t-do-without. However, irrespective of whether one is on a KD or not, I think sugar is something that we should eat rarely, perhaps on the occasional celebration. It is not only the glucose that is problematic, but also the fructose (table sugar is half-and-half). Also, it can behave like an addictive substance for some. Sugar-related mood highs are followed by lows that drive repeat sugar consumption, giving short-term relief but deeper lows over time. The same phenomenon can apply to food high in starchy carbohydrates (glucose) – they’re called ‘comfort foods’ for a good reason. As Gary Taubes puts it – asking how much sugar is safe to eat is akin to asking how many cigarettes are safe to smoke. In the end, it’s a personal decision.

Some reasons for a KD

There are many reasons that someone might embark on a KD. It might be weight loss or management. Or, in the case of type 2 diabetes, glycemic control. Perhaps the possibility of reducing chronic inflammation, ameliorating free-radical damage, reversing a fatty liver, improving the metabolic profile or protecting the cardiovascular system are aims. A big aim might be neuroprotection.

The brain of a person who follows a high-carbohydrate diet will only have access to glucose for energy under normal conditions. Neurons don’t burn fatty acids or amino acids for their energy, and most of these cannot cross the blood-brain barrier (BBB) anyway. Those that do (our ‘essential’ fatty acids and amino acids) have more important roles than fuel. The brain is the most energy-intensive organ in our body by far, and it seems a risky business to make it glucose-dependent for life. This may be particularly important if glucose metabolism becomes compromised over time. Ketones are an alternative fuel for the brain. Plus, they seem to have protective properties. More in my brain post.

Other practicalities

Breakfast is usually very low carbohydrate, or none at all in the case of bacon and eggs. It is usually preceded by a run. The idea is to exercise at the start of the day without providing glucose, in the hope of kick-starting ketone production. I do not know if this is achieved (muscles might just mine their glycogen stores, for example). However, my ketone levels typically rise a couple of hours after exercise.
Lunch is where I get my main carbs and fibre, but it is still low-carb, includes fat and usually protein. If breakfast was sufficiently fatty, lunch might not occur until 6 or so hours after breakfast, with nothing of significance eaten in between.
I don’t eat an evening meal as such. Sometimes cold meat, cheese or something like that a few hours before retiring.
If I feel like a snack at any time, it’s likely to be nuts. I probably eat too many though.

More likely than not, lunch and evening are going to be accompanied by a red or two. Dry wines (red or white) are low-carb (thank goodness).

I don’t count calories or weigh grams of carbohydrate. I measure ketones (with a finger prick device) to confirm ketosis. I try and eat as much animal fat or olive oil (extra virgin) as practical – never refined polyunsaturated ‘vegetable’ oils like sunflower or canola. There’s a post on why.

I find the diet enjoyable and sustainable, and can’t imagine going back to carb-based eating. Ironically, I would have to give up too much that I now like to do that.


Print This Post Print This Post

External links:

www.dietdoctor.com

realmealrevolution.com

ruled.me

There are many other sources of recipes and meal-plans. These site are just ones I have visited regularly and cooked from.