Keto on Vacation - Berman Cosmetic Surgery

Published by David Berman on Sep 23, 2019

Intermittent Fasting and Ketone Supplements

If you have been reading my blogs on this topic, you know that I am a huge fan of intermittent fasting (14-16 hours) and taking a ketone supplement (by Pruvit) first thing in the morning and again when I exercise. I keep carbs (including fruit) very low (ketogenic) until dinner.

For dinner, I always have some carbs but I almost always eat “healthy carbs” eg fruit or a potato, making sure to never eat junk food such as, sodas, diet sodas or processed food. I also stress to my patients that there is no one size fits all as I personally would like to lose 4-6 lbs.

Most of my patients need to lose much more. To do this they need to be stricter with their carbs and other leniencies.

Stopping Keto on Vacation – What should you do? What do I do?

Just quick background:

If you keep your carbs under 25 grams per day for about 4-5 days, your body will start to break down your fat (especially visceral fat) for energy. This fat gets broken down into chemicals called “ketone bodies” which can be measured in your blood with a simple finger stick.

(It can also be measured using a device that measures ketones on your breath or with urine strips. The problem with the urine strips, is that as your body gets more “efficient” at using your ketone bodies you will “waste” or spill, fewer of them in your urine. Hence you can be ketogenic but your urine strips may suggest that you are not in ketosis.)

When you eat more than 25 grams of carbs (don’t get too hung up on exact numbers since it will vary from person to person), your body will now have a source of glucose and will no longer need to break down fat to make ketone bodies. This happens because your body will prefer to use carbs for energy rather than ketones. You will thus lose your ketotic state.

Ketogenic Diet – The Best Approach

There is controversy over what is the best approach for ketosis. Some experts advocate you do this for months or years or forever. Some experts recommend cycling in and out of ketosis over long periods. This means you can be ketogenic for days or a few weeks, then go off of the ketogenic diet for days or weeks and then keep repeating.

What I personally prefer (and coincidentally Ben Greenfield, who is another expert in this field, does) is to get ketogenic during the day, which begins with an intermittent fasting, and then take in some carbs each evening. This issue is not black and white and I feel you have to see what works best with your lifestyle and how you feel.

It is even better if you can follow measurable parameters such as your total body fat (get a DEXA scan), (though your weight is a good approximation if you are overweight, you should see it decreasing), insulin and glucose levels, inflammatory markers, cholesterol and triglyceride panels etc.

I feel my daily cycling in and out of ketosis is a lot easier than trying to stay in a prolonged ketogenic state, but others may feel differently.

What About Vacations?

I believe the purpose of healthy eating and exercise is to enhance your life – to feel better, stay healthy both physically and mentally. Vacations are a great part of life. It seems crazy to me to travel for a vacation and not try their bread, their beer and their pasta etc. You, of course, have to look at how many vacations you have, how long they are for and how much you indulge.

For myself, I am always active on my vacations. I love hiking so many of my vacation days are spent hiking. We just got back from 12 days in Newfoundland, Canada. We stayed in bed and breakfast for many of the days, which meant we got wonderful high carb breakfasts. I don’t have a sweet tooth but I do enjoy home made bread and rolls with homemade jam.

However, to try to balance this out, most days, we either skipped lunch or had a late lunch. There were also 3-4 days, where we did not get breakfast, so I followed my normal routine of having a ketone supplement (they are super easy to bring with since they are so small and light) and no breakfast. Also there were several nights that I indulged in a beer.

However, note that this means I had a beer, rarely two, and never more. Most days, I hiked 12-15 miles to help use up some of these carbs.

My Keto Vacation Break – What I discovered

Here is what I noticed when I went off my normal routine of intermittent fasting, ketone supplement and ketogenic diet until dinner:

When I follow my usual routine, I never get that tired feeling with lack of energy that occurs around 4 pm. However, when I indulged in carbs, this definitely occurred and I hated that tired, sluggish feeling. I also put on about 3 pounds, which is not ideal but not the end of the world.

The Best Way to Get Back Into Ketosis

Restart the intermittent fasting (and maybe even try and do this a few times on your vacation).
Restart the ketone supplements first thing in the morning. This will boost your natural ketone levels which you will have from fasting all night. I find it also definitely made it much easier for me to fast.
Exercise, especially while fasted. This uses up your carbs and increases your ketone levels. I, always, take a second ketone when I exercise.
Drink lots of water – when you flush out the carbs, you will lose water. Most people do not drink enough water.
Increase your salt intake, especially one of the natural salts, like Himalyan salt. When you flush out the carbs, you will lose sodium. If your sodium levels get low, you will feel lousy. This is one of the principle causes of the “keto flu” and is almost entirely avoidable.
Make sure you are getting enough healthy fats and proteins such as avocados, eggs, nut butter (that has no sugar in it or other fake stuff) salmon, sardines, tons of vegetables, MCT oil (Pruvit also makes a MCT oil and MCT powder which is great fuel for your brain.)
Get enough sleep. Sleep actually helps you lose fat and is vital for all of your repair process that go on in your body.
Learn to deal with your stress. Everyone has stress in their life. How you deal with it determines if it makes you stronger or breaks you down. Stress that you do not deal with well, causes your cortisol levels to rise and this raises your insulin levels. This causes you to store fat.

Remember everyone has pain in their lives. Suffering, which is your reaction to the pain, is a daily choice. (Incidentally, I am a certified life coach if you want to pursue this further. I only work with a small number of clients – they don’t have to be a patient of mine and it is entirely done by phone or skype so they can live anywhere on the planet.)

The longer you have been following my regime, the quicker you will get back to feeling excellent again. For me, it literally took about 48 hours. I don’t regret deviating from my diet but I am certainly glad to have gotten back to it, since I feel so much better when I am on it.

Personal Update

I have been following my body fat with a DEXA scan, which is the most accurate way to track body fat (other than water immersion, which is almost impossible to find anywhere) and costs between $100-150. I have been as high as about 20.4% and my most recent scan which I had done about 3-4 weeks ago showed I was around 16.2%.

I would love to get it down to 12% but as you would expect, it gets harder and harder to lose those last few lbs of fat:) It is important to remember, that no matter how much we improve, we always wish we were a bit more buff (again life is a balance. It is good to strive for further improvement but it is equally important to be proud of who you are!)

The most important thing for me is that on my routine, I feel great, have way more energy with no drop in my energy levels late in the afternoon. I have gotten more shredded since starting this routine. For my patients, that follow my routine, I have seen dramatic improvements in both their blood work and their appearances.