Getting started on LCHF – Part 2: Fat adaptation


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.

92 Comments on “Getting started on LCHF – Part 2: Fat adaptation

  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. 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??

  5. 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. 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.

    • 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. 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.

  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

  15. 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.

    • 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?

      • 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.

    • 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?

      • 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.

      • 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.

    • 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.

      • 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

  16. 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????

  17. 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 🙂

  18. 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.

  19. 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

    • 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.

  20. 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 🙂

  21. 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!

  22. 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

      • 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.

  23. 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.


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

    • 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?

  24. Hi I just started LCHF .Can you please guide me how much protein, fat and carb I can eat per day. I am male 33 98KG. Also can I take low carb protein powder ?Thanks

  25. From web calculators I’m suppose to have about 95g protein and 158g fat. I’m struggling to eat this amount of food. I’m having a 2 egg omlette for bf, then 2x chicken drums, boiled egg and salad for lunch and dinner bacon, boiled egg and salad but am so full. I didn’t use to eat breakfast and so I’m struggling with this a bit. Do I need to eat all the food to lose weight? If I eat less will I still lose weight? Thanks Female, 37, 113kg (already lost 13kg using 5:2 diet, but feel so much better since I’ve cut out gluten and carbs)

  26. Weird question but can you eat sugar free chewing gum on this diet? I eat a lot of it. But then I read that it might have ‘sugar alcohol’ in it which is some kind of hidden carb. Is this correct?

    • Many do eat it – its not real food but the sugar alcohol doesn’t contribute too many carbs – xylitol is fairly safe as far as a food is concerned. My best advice is just eat real food, my second best advice advice is that if you have to then use the gum.

  27. Dear Prof. Grant,
    Good stuff. I tried myself to get into ketosis. I managed after couple of days. The highest value I read was 2.2 mmol/dl of ketones. However the Chirstmas times arrived and I “had” to give up on the regular fat intake low carb. Here they go my couple of questions. Hope you can give me some feedback.
    1. Can you (anybody) get in and out of ketosis (once adapted) easily? That means with no keto flu synthoms as well as fat burning machinery up and running in less than a couple of days.

    2. Would it be much of an issue going out to friends to have a higher carbs dinner (not liking saying “no” to home made prepared food from friends)? I am afraid of feeling guilty when I should not, just because I follow certain type of diet. And I can imagine people can get tired of hearing always the great reasons I might have just not to eat what they do.

    3. Does keto adaptation make a type 1 diabetic more resistant to low blood sugars (befor knock out)? I mean if the brain is using ketones as fuel, can the sugar levels be eventaully lower than with a higher carb diet?

    Thanks a lot in advance,



    • HI Luis

      You can get kept adapted fairly quickly is you have a history of lower carb lower sugar eating, typically less symptoms. Once adapted then you can easily move in and out of ketosis without issues. I suggest people don’t have to satay in ketosis if they aren’t inclined or they just eat more carbs.

      Type 1 diabetics are certainly less prone to low blood sugars because their control is higher, and even better they don’t suffer from severe typos because they can use ketones for fuel when glucose is low.

  28. Dear Prof. Grant Schofield,

    Today is my 5th week of low carb.

    I am male 27 years, diabetic type 1 for 15 years on insulin pump – and i workout 5x a week. HBCA1 before low carb is 6.2% – but when i read all the benefits of LCHF – i immediatly switched to LCHF.
    Before i ate around ~380 carbs per day

    Problem is that even though i am in full ketosis for 1 month – i am still

    – feeling very weak
    – confused / i forget stuff (this scares me)
    – tired
    – have tunell vision and mental fog.
    – irritability
    – i am not even considering working out – cause there is not energy even for normal daily activity.
    – lower back hurts me

    I have 70 kg.


    75% fats / 15% protein / 10% carbs

    200 fat / 90 protein / 50 carbs

    Am i doing something wrong – or body needs more time? I cant continue like this cause i need to work and workout

    I am also drinking 2 L of water per day + bone broth 2 cups + 3 gr of extra hymalain salt.

    Thank you

    • Look two important things:
      1. Keep salt intake quite high and se if that helps
      2. Insulin pumps and the setting – please see your endocrinologist who is low carb friendly about this. You may need to bring things down a bit and the success I have reported here is all with injected short and long acting insulin. So the actual amount of short acting you use must be considered and how that is interacting with your diet – the idea is tat you will need ay way less short acting and probably need to set the blood sugar level toolbar.

      • Insulin and blood sugars are not the problem … my bg is 5,5-6.7 since i started.

        I think i have found what was making problem. Yesterday i was so sad and tired from having chest pain, ( also worried ) i went to ER – heart and all is okay (i did this so i xan relax ) .

        Came home and ate instead of 70 fat for dinner .. i ate 110 fat. In 2h i was in ketosis. My breath became smelly, no apetite, dry mouth, thirst and i started feeling “the switch” …. i was in ketosis – but body was switching on and of ( i could feel this in my brain ). I had this when i started lchf for first week but than it all stopped on week 4, and i tough because i have ketones in urine there is no problem.

        It looks that even though i was consuming high fat, for my body it wasnt enough…so i was in grey zone for 2.5 weeks. And even funnier i always had ketones in urine. So funny how everyones body is diffrempnt.

        I hope this is it, still affraid of heart attack from fat :(.

        Thank you for reply.

  29. Dear Doctor,

    I have been having really hard time on this diet – i fixed everything – when i say everything i mean everything for last 2 months, but still i cant even stay on my feet and i am wanting to give up.

    But today it hit me – my doctor gave me 2 ampules of iron a day. In both of them there is 3 gr of saharazoes ( sugar ).

    Can this be keeping me in gray zone for 2 months ?

  30. Dear Prof. Grant Schofield,
    I have been living LCHF for about 5 weeks and loving it. I feel energetic, not bloated like before, I crave nothing, except protein.
    But two things:
    1. I am exactly the same weight as when I started, would you expect that I would have started losing some by now? (My BMI says I am ‘obese’) Do you think should I eat less protein, less fat or just smaller servings of everything?
    2. my breath smells so bad (most especially in the morning, but also afternoon), will this pass? is this normal?

  31. What would a race day strategy be for an optimal marathon for a fat adapted athlete? Is the train low race high concept worth doing and should you experiment with it first.? How about UCAN, is it ok to use?

  32. Hi, Prof. Grant!

    I’m glad I discover your blog! I’m a triathlete and I struggled with fatigue in the last 2 to 3 years. Last year I changed my training and I’m doing most of it aerobically, with few very intense sessions on some specific periods, and saw lots of improvements, but some health issues remain.

    I never had weight problems (in fact, I’m very lean), but willing to improve my overall health and my endurance, so I’ve been searching for athlete’s experiences with this diet. I’m already eating more fats and less carbs (no sugar, no wheat, mostly from fruits or root vegetables, and some glucose for longer sessions), but certainly more than 50 g/ day.

    For what I read, it’s needed to go for a period of higher restrictions of carbs (less than 50 g) in the beginning to get well adapted ad get all the benefits. I’m willing to try this, as I will not compete soon and have more time to adjust.

    How many time keeping this very low carb intake do you think it’s needed to adapt and not to enter the “grey zone”? And how long do you think aerobic sessions could last during these first adaptation (I’m assuming I won’t fuel and I’m already used to run up to 1 hr and to ride the bike up to 1hr15min only with water)? After the adaptation, you think one should count specific amount of carbs during the or better just try to fuel during long training and racing?

    I’ll keep reading your articles to find more answers! Thank you,


  33. Hi there, thanks for such great info. Im new to lchf and I’ve lost nearly 2 kg this week. I’m wonderin if it would be ok for my husband who has vasculitus, specifically microscopic polyangiitis?

    • Yes, but just work with your doctor on monitoring his medicament as he gets into the LCHF diet. The meds will probably need to change on LCHF especially blood pressure meds – he may need a lower dose. Please make sure your doc knows this.

  34. Been reading quite a lot on keto adaptation. What do you think of using blood glucose levels as an indicator for being keto adapted? Studies say blood glucose levels tend to be between 65 and 80 mg/dL on a ketogenic diet?!

  35. I wonder if you have an answer to my question:
    I am monitoring blood ketones and they are getting ‘lower’ rather than higher.
    2 days ago they were 0.6, day after 0.4 and this morning 0.3 yet I eat <10gr carbohydrate per day and the daily recommended amount of protein.
    I do use xylitol in my espresso coffee and bulletproof coffee so am wondering if this is 'keeping me in the grey zone'??
    I am trying to 'wean myself' off it just to see, so have halved it today and will work on getting shot of it.

    also another question: is it best to check blood ketones when you wake up in the morning or in the evening?

    thank you

    • Hi there, I’m not convinced that after the fat adaptation phase there is that much point monitoring blood ketones, breath or urine ketones. Probably the extent to which they are better utilised as fuel is unknown. If you are well adapted and eating well under 70 g carbs a day then you will have some sort of ketosis going on.

  36. Can you drink a Atkins shake a dat 15g protein 1g sugar 150 cal 1g net carbs Would this be pretty OK.

  37. Pingback: Adieu les carbs et bienvenue le FAT! | CRAZY PASSIONS

  38. Hi I’ve been on lchf for 6 weeks with 72, height 1.71 age 44 usually eating under 15g net carb, 40-50g protein and under 70g fats. I’m never hungry but feel drained and now have stomach bloating and water retention for the last 3 days. I drink between 1.5-2 litres of water per day, no dairy, no nuts About 4-5 cups black coffee and x 2 cups black ginger tea. Walk about 5km x3 per week.Not losing weight or cms Gall bladder was removed 23 years ago and really battle with constipation Any suggestions would be really appreciated.

  39. Hi
    I wonder if I can increase my carb intake withtout gaining weight after becoming keto adapted?

  40. I adopted this diet recently, after speaking to an acquaintance who had adopted this diet a few months ago. He was diabetic, and was carrying alot of waight in his midsection. He has already lost 50 pounds in just the few months, and his diabetes is all but gone. I’m only a few days in, and already, I’m feeling like a new person. My energy is through the roof, and my moods are totally stable. Also, I feel great after I eat, not sluggish like is used to after loading up on a carb heavy meal. Is it weird that I already feel so much better?

  41. Hi Grant,
    I’ve been wheat and grain free for a while and mostly dairy free, only have a bit every now and then but I think I’m over eating calories. I’m fairly petite at 46kg but I have gained belly fat and is now making me feel self conscious! As I’m quite petite, only 5’1, I think I need to watch my food intake as I can over eat in calories with protein and fat. Can you suggest how much fat, carbs and protein I need to aim for? 1300 calories doesn’t go far when eating fat! Thanks

  42. Hi there, I have been following the LCHF lifestyle for more than a month now. For the first three weeks, I felt awesome. I lowered my carbs to between 110-150g per day. I lost 3kg, and I’m lighter than I’ve been as an adult. (I am a pretty fit individual, run regularly (a half marathon in August) and was already pretty healthy at 67kg, 170cm). I don’t want to lose too much more weight now!

    But then something happened. For the last two weeks I’ve been battling what I Suspect is reflux, and also feeling dizzy and “not quite 100%”.
    Is it possible to have a delayed switch? I.e. Could this be a really long fat adaptation phase? I am adding salt to everything as well as occasionally licking salt off my hand (lol).

    I’m no longer tracking my macros but my best guess would be under 100g carbs per day and about 130-140g fat.

    Is it possible to eat too much fat?

  43. Prof. Grant, I am trying to adopt a low carb high fat diet but am having some problems. I usually wind up with dry skin and extremely chapped lips after a couple days, also muscle soreness and shortness of breath and cold extremities; eating more carbs (even the bad ones…) seems to help. So that has me thinking that perhaps I am eating too much protein and not enough fat on this diet; I love eggs and the yolks but fatty meat it is difficult for me to eat. I have never been a heavy meat eater. Do you have any tips on how to make the fat part of meat more palatable or tasty? I find it has a really chewy texture, which I dislike.

    I also am thinking that perhaps another reason for my dry skin/lips could be a fatty acid imbalance. I do not have access to grass fed so my extra fat would have to come from butter, chicken skin, and whatever fat is on red meat.

  44. Hi Grant, is there any advice that can be given ito incorporating Hammer Nutrition into a LCHF eating plan.

    I have successfully been using hammer products for the past 6 years and hope to continue doing so going forward. During the off season I have been experimenting with the LCHF eating plan to lose weight… I Have already lost 8 kgs and have some way to go.

    The training has really been gym work and light swimming, biking and running. My recovery has been good and have had no “hunger” issues as with a normal high carb diet. In the past two to three weeks I have started to increase intensity and duration but my recovery is slow and the legs are becoming heavy. While the literature says it will get better as one becomes more fat adapted, I am concerned that I may get myself in to an over trained state even before the season starts.

    I would like to stay in a fat adapted state for a few more months ( have an Long distance triathlon race in June 2016) to lose the additional weight. My question is should I introduce Hammer back into my diet at this stage what would be the maximum number of carbs ( perpetuem and recoverite) that could be consumed that will keep me in in a fat burning state and help me recover for the next session. I understand that it would depend on intensity, duration and weather conditions, but are there any guidelines I can use.

    Tks Charles

  45. Pingback: Making Sense Of The Nutrition Maze For Ultra Runners – Part 2: The Low Carb High Fat Diet | Fun Times Guide to Running/ Biking/ Swimming

  46. Hi grant
    Been on LCHF diet for about 3 weeks now, went to gym today to do some cardio, 1 min into rowing and I felt extremely nausea and had to fight throwing up, lasted good hour afterwards, even when I ate. What’s the deal with this?

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