Getting started on LCHF – Part 2: Fat adaptation

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In Part 1 of this four part series, we talked about how to kick start a LCHF lifestyle; what to eat and what not to eat. See “Getting started on LCHF – Part 1: Clean out day”.

In Part 2 we will look at how best to navigate the (sometimes difficult but hopefully brief) fat adaptation phase. Becoming fat adapted, or a fat burning machine as I call it, is necessary to see the full benefits of a low carb high fat whole food diet.

What is “fat adapted”?

When you have settled into a low carb high fat diet for a while, most people will describe a switch over in the way they access and use carbs and fat as fuel in their body.  We call this being “fat adapted” or, more technically correct, becoming “metabolically flexible”.

This is the ability to switch in and out of nutritional ketosis depending on whether carbohydrate is available or not. A metabolically flexible individual can be a carb burner OR a fat burner.  Many, including me, would describe this as the normal or default physiological state for humans. Mark Sisson wrote a nice post about this a while back.

I would say the major benefits are:

  • Burning less carbohydrate and more fat, both at rest and during moderate intensity exercise.  Less glycolysis means less oxidative stress, reactive oxygen species, and less glycated end products. That’s all good and means a better immune system and better health.  It also means that fat is more easily burned as the primary fuel source.
  • Missing meals and occasional opportunistic fasting is easy to do.  If you miss a meal for whatever reason, or they serve up inedible processed rubbish at a function you’re at, as a fat adapted individual you won’t miss a beat.
  • You will be burning fat as a primary fuel source because insulin is kept lower across the day. The appetite and weight regulation system, through the hypothalamus and leptin-insulin interaction, will work as it should.  It will now be easier to maintain a homeostatic weight.  You should feel more energetic because the vagal nerve isn’t down regulated to conserve energy, as it is when you are leptin resistant.
  • There is no longer the “glucose cliff” which most carb dependent people fall off each day. I think you know what I am talking about – it’s the  time in the day when the brain is saying “feed me or else”.  This just disappears and you end up with sustained energy from fat and good mental acuity the whole day.  For me this is massive and the major benefit of keto-adaptation.
  • You will probably sleep better.
  • There is an all round sense of calmness, at least for me, which isn’t there when I am going nuts on the carbs!

How to get fat adapted

Although the benefits of a LCHF lifestyle can often be seen in a matter of days, it is only once your body relearns how to use fat for fuel that you will start to experience effortless weight management, stable energy levels and for active individuals, the ability to perform and recover more efficiently and effectively.

First step is to start a Low Carb High Fat diet (see Part 1 of this series). Stick at it for 3-4 weeks and for many, that will be all it takes. BUT, there are several very important nuances which can either stop you from getting there, put you in a “feel like crap” metabolic grey zone, or have more serious issues. Here’s what to look out for and how to avoid them.

1. Quickly moving through the adaptation phase

It’s almost certain that you will get some (or all) of these symptoms if you have been on a moderate to high carb diet and you switch over to a low carb high fat whole food diet.

  • Dizziness
  • Light headedness
  • Brain fog
  • Lack of energy
  • Craving for sweet stuff because of sugar/carb addiction withdrawal

This is normal as your brain has been used to getting 100% of its fuel from glucose.  When there is no longer enough glucose to do this, the body will have to supply fuel from ketone bodies – notably beta-hydroxybutarate (BHB). For most people this isn’t a simple switch, as the machinery for doing so will require some biochemical re-orchestration. This basic physiology appears to be lost on most doctors and dieticians worldwide.  Yet it is probably the default energy system humans have run on for millennia.

My suggestion is to plan for this in advance.  If you have a job that requires actual thinking and attention then best start on a Thursday or Friday or while you’re on holiday. In my experience, it takes a couple of days to deplete the body’s glycogen reserves. Then you can have the ‘down’ couple of days over the weekend and hopefully most of the symptoms will be gone by the start of the next week.

It is critical during this phase that when you crave sweet things or carbs, you don’t succumb!

  • Eat enough salt. I think this is a real problem for people.  As the body adjusts, sodium tends to be dumped by the body to preserve the sodium-potassium balance in the body. You may also be eating way less processed food and thus less salt as well.  Low salt can result in hypotension (low blood pressure) and cramps, dizziness, lack of energy and so on.  I often have people add quite a lot of extra salt in the adaptation phase – up to 5 g a day extra.  That’s a lot.
  • If in doubt, eat more fat.  Don’t regard the adaptation phase as a weight loss phase.  You may end up losing weight, but the key is to make the metabolic switch.
  • MCTs may help.  Medium chain triglycerides, like Lauric acid (found in coconut oil), may help in alleviating symptoms. MCTs can be used by the brain directly as a fuel source.  So extra MCTs may help provide a second temporary fuel source to the brain as you adapt. We do need more evidence about this though which is why we have doctoral student Cliff Harvey, a long time keto-diet naturopath and nutrition guru, looking into exactly this.

2. Avoiding the grey zone – low carb limbo is a horrible place to be

  • Watch your carbs. Eating too many carbs will mean that you don’t quite deplete the brain of glucose enough for it to have to reset its fuel supply. This will most probably be the biggest stumbling block for most people. You can end up in a grey zone where you rarely have enough glucose to run the system, but you haven’t depleted it enough to stimulate ketone production and use. It hurts and it’s no fun and it’s unnecessary. Most people, depending on activity level, will initially need to go below about 50 g carbs a day.  That’s not much and carbs do hide everywhere, especially in processed food.
  • Watch your protein too! When you eat protein in excess of your daily needs – more than 0.8-1.2 g kg-1 body weight (about a deck of cards size of protein each of three meals) – then that extra protein will be converted to glucose (carbs) by the liver through gluconeogenesis. This is the hardest part by far in switching to this sort of eating plan.
  • Know what you’re eating. You have to have some way of learning how much carbs, protein and fat are in the various foods that you eat. The easiest way, thank goodness for technology, is a mobile app. In Australia and NZ the best is Easy Diet Diary – simply because it has the food database from both countries.  Don’t worry about the calories, but look at the grams of protein, carbs and fat you are eating each day.  I would have around 30-40 g of carbs, 120 g protein, and the rest, usually 180-200 g, would be fat (46 year old, 84 kg male with moderate activity level).

3. Measuring success

If you are successful, you will lose the carb and sugar cravings, develop a completely regulated appetite, and become a fat burning machine. That’s great, but are there ways of quantifying success beyond how you feel?  Yes, here’s how.

  • RQ – we use this in our lab – we use online gas analysis to understand the ratio of expired oxygen and carbon dioxide to work out the respiratory quotient (RQ).  RQ 0.7 = 100% fat burning. RQ 1.0 = 100% carb burning.
  • Keto sticks – these measure urine acetone. I don’t particularly like this method as it’s not reliable and doesn’t measure BHB.
  • Blood ketones – this is really easy and quite cheap. You can get a ketone metre and test strips from most pharmacies. You would normally want to see >0.5 mmol/l as evidence of nutritional ketosis.  This is my preferred method of monitoring, if you feel inclined.
  • Breath ketones – this technology has recently become available.  I don’t have one yet but as far as I can tell it measures breath acetate. I’ll try and suss this one out in due course.

Final words

Getting fat adapted is a great self experiment, at least to understand that you don’t have to run the brain on 100% carbs. There is another way, and it is what has defined you as a human for many many generations, so you may as well have that system operational.

I’m not saying you have to be, or it is even good to be, in a constant state of nutritional ketosis. Just that you can and should try and develop the metabolic flexibility to easily move in and out of that state. We don’t have all the answers about how that flexibility changes and the best ways to adapt.  That’s why we do research into this.

But try it and see how you go. Eat more fat and more salt, monitor carbs and protein carefully, and set aside some time to feel a bit low, and you will come out with a whole new appreciation for how your brain and body function optimally.

46 comments

  1. Interesting article, thank you. I don’t understand why the body would spill ketones.

  2. Thanks so much for your posts Grant, they’ve been really validating of my own experience of a LCHF diet, which I ended up at out of necessity – in a (so far successful) attempt to manage ankylosing spondilitis.

  3. “Blood ketones – this is really easy and quite cheap. ” Where do you buy them cheaply? As fas as I now they’re a couple dollars per strip (order of magnitude cheaper than glucose blood strips).

    Also, this “grey zone” you mention – is it just when becoming ‘fat adapted’ for the first time or does this zone persist during the usual cycling in & out of ketosis?

  4. trekkiemaiden · · Reply

    Hi, you don’t buy blood ketones – you buy a glucose meter, as used by diabetics, and buy special ketone sticks to use with it. They are not the same as the glucose sticks the meters normally come with, they are more pricey still, but try Ebay, it’s the cheapest place to source them I’ve found so far!! This then will measure the ketones in your blood. Hope that helps.

    Grey Zone?? Personally not experienced it, I go in and out regularly but obviously eat the right balance. Everyone is different, so self experiment. Good luck.

    Sorry can’t answer the previous q, as to why we spill ketones, – guess it’s the excess/unused ones!?? Prof??

    1. Acetone is the one that spills overinto urine and breath – BHB does not that is why we prefer the blood testing.

  5. Bill UK · · Reply

    It took me sometime to fully adjust to LCHF, although now I have so much more mental and physical energy. It’s also the stigma of eating saturated fat. The conditioning from the medical establishment and the media, products etc is so strong.

    I have found that I need to eat a lot of it (saturated fat) to feel “normal”. What is also interesting is that my menu has changed in a positive way, foods which i had previously thought of as ‘no go’ have returned and opened up all sorts of culinary options.

    Its been a long and sometimes difficult process but I am glad I have been through it.

  6. Catherine Crofts · · Reply

    About spilling ketones, the body produces three different ketones, especially during the adaptation phase: acetone, acetoacetate and beta-hydroxy buterate (BHB). Only BHB is used as fuel (and is the one that is measured on the blood strips) the other two are simply excreted, mainly via breath and urine. We know that as you become fully fat adapted (about 4 weeks) then the amount of urinary ketones (acetone and acetoacetate) drops off, so only blood BHB levels are useful for long-term monitoring. It may be because as the body burns fat more efficiently, more BHB is produced and less of the other two.

    The “grey zone” is should only occur while getting fat burning efficient and as long as you keep fat burning efficient (i.e. by keeping carbs low enough), it should only be a once-off occurrence. I personally had a horrible two days when I went from a 100% carb burner (as measured by RQ) to being in nutritional ketosis. Now, I know I cycle in and out of ketosis and don’t have any issues with brain fogginess. I think the key is to really move through that state quickly and being determined about it.

    Having said that….if someone takes medications, especially ones for blood pressure or diabetes, please don’t drastically reduce carbs without dietetic and/or medical supervision!

  7. Thanks for this really practical and helpful advice. The best news (for me, having been on yo-yo diets for the last 30 years) is that I can be confident that I can just miss meals and it’s not going to be a big deal. My blood ketosis reads 0.5 for the first time today, so hopefully I’m on my way!

  8. haha, yes trekkiemaiden, I know one doesn’t “buy” blood ketones, but measures them. Actually, it’ll soon be possible to be ketone esters/salts (see Dr. D’agostino’s research for updates).

    just to clarify — “Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals”:

    B-hydroxybutyrate itself does not provide energy unless it is first converted to acetoacetate via ?-hydroxybutyrate dehydrogenase. In a sense, plasma B-hydroxybutyrate can be thought of as a ketone reserve; when plasma acetoacetate concentrations begin to decrease, more of it is produced from B-hydroxybutyrate.

  9. What do you think about transitioning to LCHF while doing regular high-intensity exercise? I eat whole food only and relatively low carb high fat but have been hesistant to go ketogenic because of training.

    1. I think it depends on your goals – and the duration of training. If the training is long and hard then you need glucose – its just not possible to do an hour plus very hard session without glucose coming it. However there is a cost in metabolic damage and a benefit in fitness and other stuff – so its a balance. I’d drop down to some short HIT if you want to try some ketosis for a few weeks and just self experiment as to whether you get any extra benefit from it. Given you are already eating well and I assume in good shape and feeling good, then stay with what works?

  10. Great article Grant. I really enjoyed the talks at the LCHF day in Auckland a few weeks ago – disseminating this sensible, disease-healing lifestyle is the big challenge! Sadly, I feel that the biggest obstacle is the medical community which made the wide selection of medical personnel presenting even sweeter! I just wanted to let your readers know about a fantastic app – Keto Diet. Easy meal planning, fabulous recipes and solid advice.

  11. Genhunt · · Reply

    Kia ora, I’m keen for some advice please. I have been on the LCHF lifestyle for only 8 weeks. I’m a fish eating vegetarian, 46 years, Maori/NZ European, lightly active, only have 1 kidney (donor) and have lost 5 kgs since starting LCHF, with a goal of losing another 10kgs. I have not been hungry once since starting! Type 2 Diabetes runs rampant through my family. I recently used a keto calculator which indicated my daily intake should be 57g protein, 25g carbs and 130g fat. But I’m hungry :( Can you please advise where I’m going wrong? Also with only having 1 kidney, albeit healthy, I’m concerned I’m putting extra pressure on it with this kind of eating. Would really appreciate your help. Thanks.

    1. I’m not sure of your weight so not sure about protein – but think you may be a little low on protein. I’m 84 kg and moderate activity level and eat about 120 g/day protein as a guide.

      1. Genhunt · ·

        I was 78kg, now 72kg, female, do you think more than 57g protein/day is ok with the 1 kidney?

      2. I think 70-80 g a day would be fine

  12. Hi I’m interested in the LCHF lifestyle however I have a small problem where there are allergies in the family and I think we would all have to try the LCHF lifestyle for it to work. My son is 8 and is highly allergic to Nuts and Eggs and my partner is allergic to seafood, peppers, coconut it can be very limited in our family diet. How can I live this LCHF when my son heavily relies on carbs as he theres so much he can’t eat he loves pasta, mashed potatoes he can’t eat nuts or drink almond or coconut milk or anything with egg in it mayo, meringue or even baking. So if we take away pasta or carbs what could I feed him. There are so many foods that we can not eat as a family. Even cooking eggs or fish can irritate both of them so we just exclude from our diet or myself and my daughter go out for our fix. Do you have any suggestions

  13. Hi Grant
    Thanks for such a good article. That makes it a bit more clear with the diet but at the same time I have more questions after reading it.
    I am on your diet for 4 weeks now. Not sure what am I doing wrong. I didn’t loose any weight but I am also not gaining any (which is probably a good sign).
    You say in one of the articles that with that diet I should feel energized. And I did for the first week or so. Second week I was feeling very weak. Come back from the gym in the morning and the only thing I wanted to do is to fall asleep again. Now its a bit better but still not enough energy to go through the day. Coffee does not help much. In this article you say that its normal for the first few days as its adaption phase. But I have all other way around.
    You also say that we need to add extra salt in adaption phase. And what about after the adaption phase? Should I limit the salt or is it still fine? In other worlds how much mg of salt should I consume? And how do I find out that my adoption period is ended considering my weakness?
    Also you said to limit protein. But what about mussel repair? Is 0.8-1.2 of protein for 1 kg of body weight is enough and what be a good snack after the workout? It also leads to my next question about completely irregular eating. Is that normal? As sometimes I have my breakfast at 8 am (not because I am hungry but because I need to go to gym at that time therefore need some fuel) If I don’t go to gym than I am not hungry till about 11 am and therefore I have my lunch and dinner later. So regular meals are not important? Just worried as in a traditional diet its recommended regular eating to boost metabolism.
    In addition you say not to worry about calories intake. But what about standard formula cal in – cal out? How it works if as a result I consume more cal than I burn? Which is probably easy to do when eating fat
    Also a bit confused with the carbs as well. Surprisingly for me,I don’t have any cravings for carbs, I mean that starchy carbs. But the carbs is everywhere. Do you mean to limit the one in vegetables as well? I use Easy Diet Diary that you recommended and according to that diary the main amount of carbs from my diet comes from dairy products (such as milk in coffee, yogurt, fruits that I try to limit)
    Should I probably do RQ test to find out if I am fat burner or carbs burner? Do you do it in your lab?
    Lastly wanted to ask if that’s ok to eat lentils and quinoa? Also what about Rice bran oil?
    Sorry for such a long post, but I am really confused after I used to read all about healthy eating, carbs and calories and now trying to understand what I am doing wrong been on completely different diet and researching on it every single day
    I would really appreciate your help. Thanks

  14. Also how many g of carbs and fat should I consume per day? I am 33 Years old, female, 60kg, moderate activity. Thanks

    1. I am most interested in protein carbs, fat to make the hunger up

  15. Melissa · · Reply

    Hi Prof Grant, I adopted the LCHF lifestyle a couple of months ago. Sadly, not losing weight yet. I’m told to eat a maximum of 65 grams of protein, 162 grams of fat, and about 50 grams of carbohydrate daily to achieve my goal weight of between 65 to 70 kg. I’m 52 years old and weigh about 85 kg, and 163 cm tall. I’ve read that I would need to balance my pH also in order to lose weight. This I’ve been doing by taking a lemon/apple cider vinegar drink at least 3 times a day. I also have laryngopharyngeal reflux. An ENT specialist put me on medication for this a few years ago. I took the tablets for about 6 months but they didn’t make any difference. Do you think this condition can be fixed by following an LCHF lifestyle or do you think it may be that the damage needs correcting with fundoplication. I would love to have my voice back the way it used to be. Any insight you have on this would be much appreciated.

    1. Hi Melissa, happy to help, what are the amounts of fat carbs and protein you are eating each day in grams? Can use easy diet diary or my fitness pal to calculate?

      1. I’m sticking as close as possible to 65 grams of protein a day, though some days it is more. I have no problem consuming at least 162 grams of fat a day and I’m not going over 50 grams of carbohydrate daily and often it’s a lot less than that.

    2. Ok I’m not that convinced by the Ph idea, but I’d consider eliminating both dairy and grains for a while and see if anything changes? Or have you already tried this?

      1. I haven’t eaten any grain for months. I have been eating dairy in the form of butter and cream and a bit of full cream milk in tea. I don’t drink coffee.

      2. Since 16 April, which is the last time I sent you a message, I have put on a few kilos in weight but I’m rigidly sticking to LCHF. I do pilates 3 times a week and my body shape looks slimmer but now I can’t get into my jeans! I don’t know what I’m doing wrong. When you suggested that I stop all dairy, do you mean just full cream milk or cream and cheese as well? I presume butter is still okay too.

      3. YEs that was my suggestion – just a few weeks dropping all dairy and see how you respond?

  16. Love to help, what are the grams of fat carbs and protein your diary is telling you? That’s the clue really?

    1. Thanks Grant. Its all depends. Like today we had lunch and dinner at the restaurant. Tried to choose healthy option with green salad and cream souse. no carbs. As a result my daily protein was 73g, fat 68, sat fat 42, carbs 45, sugars 36 (most of it from trim latte and cream based sauce. Sodium was 1468 mg (so probably too low for adaption phase?) But all these results after reading that article. Before that protein was between 60 to 104 g, carbs 60- 120 (no starchy carbs) and fat 60. Does it tell anything? Do I do something wrong? All the carbs and protein comes from healthy food.

      1. Ok, simple for a start eat more fat, way more. Protein ok, less carbs prefer less than 50g carbs, 120 g fat or more, similar protein. The extra fat is important otherwise you’ll be hungry or eat more carbs

  17. Prof. Grant Schofield · April 16, 2014 – 8:09 pm · Reply→
    I am most interested in protein carbs, fat to make the hunger up

    That was worry me. I can eat more protein and less fat and be full. Or eat ball of salad with avocado and be full. Thats why I probably need an idea of the proportion of protein to fat and to carbs. not sure if I am right though????

  18. Hi there, I am just looking into getting started on LCHF. Reading mixed ideas about protein and fat levels. Seems to be consensus about carbs being under 50g though.

    I am a 33 year old female looking to lose weight. 170cm tall and currently 97kg.

    Are you able to advise optimum protein/fat/carb levels?

    Many thanks :-)
    Dena

    1. Hi there around 50g carbs a day, protein about 1.1.5 g per kg body weight a day, rest eat fat until full!

  19. Yrene · · Reply

    Great stuff.

  20. Hi there
    Is it true that having fat with sugar/carbs is worse than having the sugar/carbs on its own? e.g. the occasional treat of a sweet pudding – is that made worse by having cream on it? I heard that in the presence of sugar/carbs the fat you eat is not good for you, as it is stored not burnt.
    Thanks.

    1. Hi fat high sugar diet is what we cal the standard American diet and that ends very badly/////

  21. Anita Asherson · · Reply

    Hi I am om LCHF diet for a few weeks now am Female 60 yrs old. Haven’t really lost much weight. I thought this would be a simple diet as it’s based on our ancestors going back far and up to past generation diet where their diets which was high fat, full dairy etc also ate starch, potatoes, rice, bread and they were healthy they never had to do all this carb counting, controlled protein potion sizing etc to count calories seems easy compared to the obsessive way one must look at carb counting also protein and even fat. When I wasn’t losing weight and go hold of Sally Ann Creed was advices to look at my fat consumption which surprised me as the story was always told fat doesn’t make you fat and when I asked how can it not if eaten in excess to what the body needs was told this again. Then was given advice to look at fat consumtion as might be too many calories. Was eating meant to be so obsessive and all consuming ?
    Also read that lots of women are having problems losing weight like men. Read somewhere cant remember where that we metabolize fat differently from each other as men do to women so maybe us women who are battling might have to reduce our fat consumption, I notice they do this on Atkins. Please advice
    Many thanks
    Anita

    1. YEs of course it is still possible to over eat fat an dput weight on Its just harder to do this if you are eaten to fullness as the feedback system works better than when overwhelmed with insulin.

  22. Hi Grant, great article, and its answered a few questions for me that I wasn’t able to get from other keto resources. I’m into my 6th week of eating low carb, and the weight loss has been fairly slow. Only lost 5kg so far. I’m watching my carbs and proteins, ensuring I have enough fats and drinking loads of water. So not too sure what I’m doing wrong. Going to keep at it though, if anything, I feel so much better :)

  23. From the states, here. Thank you for a clear description on the keto process and how to induce it. I’m book-marking this page!

  24. Hi Grant,
    I am in my 4th week of LCHF. I eat below 50g of carbs per day, about 100g of fat and about 120g of protein. I’m a female and weight 65 kg, I’m a runner and have 5 sessions per week. Is 120g too much protein for a runner? Also, I haven’t lost any weight. Initally I lost about 1 kg and it seems to me that I have more belly fat than I used to. This week I had sever pain in my calfs and my running sessions are a lot harder than they just to be. I feel like I have no energy to run. Also, how do I increase my fat intake besides eating cocnut oil with a spoon.
    My goal is loosing 5kg and to prevent myself to gain more weight. I also experience some hormonal disbalance so I am wonder if this lifestyle will help me to reach hormonal balace.Thanks for you answer

    1. MY advice to try the following – first get your salt up as much as you can, second you are likely eating too much protein – can you try around 90 g/day?

      1. I could try that. But is it possible to increase abdominal fat with LCHF? I have a problem with water retention so increasing my salt intake is not an option.

  25. Hi I started eating LCHF last July – I was pretty strict with the carbs to begin with, got into keto and turned into a weight loss machine. I often had some carbs on the weekend but still lost weight. I lost around 14 kgs in 7 months – I might add I was doing way more exercise (just bush walking or regular walking) than I used to as a bonus so may have had a lot to do with the easy loss.
    Anyway I fell off the wagon end January and about 7-8kg of those I lost I have found again. So I’ve been trying to get back on the wagon, but I don’t seem to be able to get back into the fat burning machine stage again. Like I said, the only difference previously is exercise so I guess that’s what is wrong, but I keep reading that exercise isn’t necessary for this diet.

    Help?

    Oh and I ‘ve never weighed protein or fat grams, just carbs.

    1. I m guessing the extra carbs or protein were getting used up by the exercise. Neo probably you were a bit over on either carbs or most likely protein. The extra glucose demand from the exercise may have taken care of that?

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