Avoid the following common pitfalls of keto to help ensure you’re following this approach as safely as possible:
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1. Cutting Your Carbs and Increasing Your Fat Too Much Too Quickly
One day you’re eating cereal, sandwiches, and pasta, and the next you decide to hop on keto and eat only 20 grams (g) of carbohydrates a day, which is often the recommended amount to start with. (A medium apple has 25 g of carbs, for reference.) That may be a drastic change for your body. Consider easing in. “Prior to starting a keto diet, individuals may benefit from tapering down their carbohydrate intake, instead of reducing carbs cold turkey,” says Lara Clevenger, a ketogenic dietitian-nutritionist with a private practice in New Smyrna Beach, Florida.
2. Not Drinking Enough Water on Keto
For all the focus on what you’re eating, don’t forget about what you’re sipping. Dehydration is an increased possibility on keto. “The drastic decrease in carbohydrate intake on the ketogenic diet can cause shifts in your fluid and electrolyte balance. Carbs are stored along with water in the body, so as these stores are depleted, that water is lost along with them,” says Alyssa Tucci, RDN, nutrition manager at Virtual Health Partners in New York City. She also says that the body flushes out the buildup of ketones in urine, which also depletes water and sodium from the body. All that to say: Drink up. Tucci recommends waking up to a large glass of water and sipping regularly throughout the day to reach a goal of consuming half of your body weight in ounces of water daily.
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3. Not Preparing Yourself for the Keto Flu
As your body transitions from a carbohydrate burner to a fat burner, you may experience what’s known as the “keto flu,” or flu-like symptoms (including muscle cramps, nausea, aches, and fatigue) during the first two weeks of the keto diet. (It doesn’t happen to everyone, FYI.) If you’re not prepared for this feeling, you may think something is drastically wrong and give up the diet completely. More than that, you can help yourself through the transition period of low energy by planning out your meals or meal prepping, says Clevenger. She also recommends eating foods rich in potassium, magnesium, and sodium, as well as hydrating to help ease keto flu symptoms.
4. Forgetting to Eat Foods Rich in Omega-3 Fatty Acids
While fat reigns supreme on the diet, don’t just turn to bacon, cheese, and cream. When choosing your fats, aim to include more anti-inflammatory omega-3s, particularly EPA and DHA, the type that are found in salmon, sardines, oysters, herring, and mussels, says Clevenger. (If seafood isn’t your thing, you can also take cod liver oil or krill oil.) Other healthy fats are a good choice, too; if you haven’t stocked up on avocado, olive oil, and seeds such as chia seeds and flaxseed, definitely do. They’re not only keto friendly — they also offer healthy polyunsaturated and monounsaturated fat that your body needs to perform at its best.
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5. Not Salting Your Food Enough
With people consuming more sodium than ever in a diet rich in processed food, you’re probably not used to hearing the call to eat more salt. But on keto, it’s necessary. Not only does the clearance of ketones cause the body to lose sodium, but you may be getting much less table salt (which is comprised of 40 percent sodium and 60 percent chloride) now that you’ve kicked out the top source of salt in the standard American diet: packaged, processed foods, including bread, chips, crackers, and cookies. “Chances are if you’re following a ketogenic diet you will need to prepare most, if not all, of your own meals and snacks from scratch, so simply season with salt,” says Tucci.
6. Going It Alone and Not Clearing the Diet With Your Doc
Many followers of the keto diet try it because they’re hoping to use it therapeutically for a medical condition. If that’s you, talk to your doctor first and make sure they’re on board with your plan — especially if you’re also taking medication, says Clevenger. “Some medications may need to be adjusted by your healthcare practitioner as your signs and symptoms improve,” she says. Just one example is insulin, as a lower dose may be needed now that you’re severely limiting carbohydrates.
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7. Not Paying Attention to Your Veggie Intake
Vegetables have carbohydrates. And that means that you have to watch how much you eat — even lettuce. If you're not careful or are eating them as a free-for-all, you could overconsume carbs, and thus get kicked out of ketosis. On the other hand, you may be skipping veggies altogether if counting every baby carrot is getting too complicated. But it’s important to get in vegetables (these contain fiber that prevent constipation, a potential side effect of keto) while minding portions and properly counting carbs. Go for nonstarchy options in a rainbow of colors for a variety of nutrients, says Tucci, like leafy greens, cucumber, tomato, broccoli, cauliflower, bell peppers, and asparagus.
8. Getting Caught Up in Carb-Counting and Forgetting That Food Quality Matters
When it seems as if the sole goal of keto is to drastically cut carbs, the rest can feel like an afterthought. “Reducing your carbohydrate intake is great, but focusing on higher-quality products when budget allows will help improve your health, too,” says Clevenger. That means choosing omega 3–rich foods, like wild salmon, grass-fed, local, or organic meats, and snacking on whole foods rather than processed keto-approved treats. It also means trying to follow a balanced diet as best you can by incorporating as many nutrient-rich fruits and veggies as you can. Many registered dietitians aren’t a fan of keto because it may lead to nutrient deficiencies. You can help avoid these by working with an RD yourself as you follow keto. Find one at EatRight.org.
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