March 17, 2014

Ketosis

What I actually eat, part III (circa Q1 2014)

Craving vegetables.

Read Time 10 minutes

This week I had dinner at a great steakhouse in New York with a very good friend.  Like any two “normal” guys after a long day, all we could talk about was science, and on this particular night the topic du jour was NAFLD (non-alcoholic fatty liver disease for the non-cognoscenti).  We ate, we drank, and we shook our heads in disbelief at the thought of 7 million children in the United States being afflicted with NAFLD.  In the next few years NAFLD will become the number one indication for liver transplantation (not a typo).

After dinner, my friend, who I dine with almost every time I’m in NYC, made a comment about how many vegetables and how much fruit I consumed.

I had the following: a chopped salad, tuna tartare, a 12 oz filet; and we split an order of sautéed onions, brussels sprouts, and a bowl of berries.

He asked, “How are you able to stay in ketosis with all of those carbs?” I responded, basically, that for the past few months I have not been consistently in ketosis, and when I am it’s only following a long bike ride where my BHB levels may get back into the 2-3 mM range. Most days, however, I live in the 0.3 to 0.8 mM range, depending on the time of day. (In my mind, to reap the benefits of nutritional ketosis, one probably needs to consistently be in the 1-3 mM range, and for some “applications” 3-4 mM is probably ideal.)

So what gives, you may be thinking. Is Peter Attia not Mr. Ketosis? Well, my friend suggested it might be time for another one of the dreaded what-do-I-eat posts.

Anyone who knows me or who has read this blog for a while will appreciate the fact that I loathe talking about what I eat. Why? Because, it unfortunately gets interpreted by many as what they should eat. It’s like asking me what exercises I do, and inferring you should do the same. It doesn’t make sense.  I have specific genetic factors, epigenetic alterations, and goals.  These factors coalesce to shape my behavior – how I exercise, what I eat, what I supplement.

A little backstory first

In September of last year, for my wife’s birthday, we went to our favorite restaurant in San Diego, where we live. The day before I emailed the owner and general manager, both friends, and asked for them to have one of our favorite off-menu items on hand (the best sushi in San Diego).  They happily obliged and asked which of their desserts my wife would most like.  I said something to the effect of: well, they are all great, so you pick.

The next evening, after eating more sushi and sashimi than I could imagine (I ate 3 platters myself), they brought out a platter with a full size serving of each of their signature SIX desserts, each with a lit candle.  We sang Happy Birthday, blew out the candles, and my daughter and wife, themselves already stuffed, proceeded to have a small forkful of each of the six desserts.  My daughter said, “Daddy, these are so yummy! Why don’t you have a bite?” To which my wife echoed, “Yea, they really are ridiculous…”

And in that instant, I made a decision. I did something I had not done in 4 years (to the month, actually). The decision was this: about 3 or 4 times a year (I opted for my wife’s and daughter’s birthdays, Thanksgiving, and maybe something else), I would – for one meal – eat whatever the hell I wanted.

In the next 15 minutes I devoured the remaining 4/5-ths of EACH of the six culinary masterpieces in front of me.  From cheesecake, to carrot cake, to decadent ice cream, and stuff I didn’t even recognize, I ate it.  In an instant I felt both wonderful and horrible.  The look on my wife’s and daughter’s faces – alone – was worth it. Their jaws on the table the whole time. The taste was beyond what I remembered (actually, much sweeter than I remembered, probably because when you don’t eat sugar for 4 years, well, you know).

I could barely get up from the table. That night, when we got home, I had a horrible headache. 1,000 mg of Tylenol and 2 glasses of water later, I still couldn’t sleep. I eventually got a few winks of sleep. The next day I felt hung over – a feeling I had not experienced since my 26th birthday. My fasting glucose was 126 mg/dL and BHB was 0.2 mM. Clearly I was out of ketosis.

I decided to go out for a glycogen-depleting workout (multiple sets of 3 min all out intervals on the bike) and about 36 hours later, after resuming my normal diet, I was right back into ketosis and felt just fine.  I told my wife I was going to repeat this experience on Thanksgiving. As such, and despite how far in advance this was, I asked her to plan to make an extra bowl of my favorite Thanksgiving dish – candied sweet potatoes – baked sweet potatoes coated in melted marshmallows.

Thanksgiving came and went, and I repeated the same act of debauchery during the big feast. Sure enough, by the Sunday morning of Thanksgiving weekend, I felt back to my baseline.  I haven’t gone on a bender like that since, but I’m probably due for one.

I’m sure at least some of you are asking, “Does Peter still think sugar is metabolically deranging?” The answer is absolutely, at the levels it is consumed by most Americans.  If you want a refresher on my point of view on sugar, definitely give this post a re-read.

So what did I take away from this?

Somewhere between “every day” and “never” there is a tolerance I have developed to consume massive amounts of carbohydrates, and specifically sugar.  Now, there are two components to this: a purely physiologic one and a behavioral one (which I suspect is heavily influenced by my physiology).

Focusing just on the physiology, I would guess I could probably “tolerate” a binge like that every few weeks with little measurable or discernable adverse effect.  I won’t even attempt to argue whether it’s every 7 days, every 14 days, or every 30 days.  But, it’s probably somewhere in that vicinity.

What about the behavioral side? Well, I suspect there exists a different “frequency distribution function” that describes how often I could binge like this without resuming unhealthy eating habits in the long run.  If I had to guess, I think the threshold for recidivism is higher from the behavioral tipping point than it is for the physiologic one. In other words, habits matter. I can probably tolerate – physiologically – more sugar today than I can tolerate behaviorally.

One last point I’d be remiss to leave out. You should keep in mind that for a period of 4 years, my consumption of sugar (sucrose, HFCS, liquid fructose in the form of any beverage, etc.) has been less than about 5 grams per day.  The average American, depending on which stats you believe (I think they are all pretty weak), consumes somewhere in the neighborhood of 100 to 120 grams per day of sugar, NOT including the liquid fructose in juice!

So, I have to at least entertain the hypothesis that 4 years of avoiding sugar has been a sufficient enough period of time to offer me some sort of “metabolic reset.” Now, I have no intention of testing this. If I was once susceptible to insulin resistance, I’m pretty sure I will always be. But, an interesting Gedankenexperiment would have me going back to one of several different dietary patterns – vegan, but with no sugar; standard American diet with lots of sugar; modestly higher carb, but still sugar-restricted – all could offer insights into the physiology of adiposity and fuel partitioning in my metabolically reset condition. 

How has this shaped my current eating behavior?

Sometime early in the New Year, I started really craving more vegetables. I’ve always loved them. Even in ketosis I still ate one or two salads each day most days, but I was pretty restrictive about the quantity of vegetables that had much carbohydrate in them (e.g., tomatoes, carrots).  But now, I wanted even more.  Big heaping bowls of curry stir-fry. (I have to toot my horn on this one thing. I make a really good, creamy, spicy curry stir-fry.) I realized this would probably knock me out of ketosis, especially with the large amount of tofu I mix with it and the yogurt I use to make the sauce.

My lunchtime salads were getting bigger and bigger, and I was piling more and more “stuff” into them. Almost laughable by the standards of those around me.

And I noticed I was eating less meat. Not at all by “design,” but somehow by seemingly craving less.  It seemed an average week would have maybe 2 servings of red meat.  When a great steak is placed in front of me, believe me, I enjoy every bite, but I found I just wanted it less. I also started craving a bit more fruit, especially berries and even apples, the former I consumed in modest amounts in ketosis, the latter I did not at all. (Because I know someone will ask – do I think red meat is harmful? – the answer is no, I do not believe so. Certainly not based on evidence I’ve seen to date, including the recent story about protein. For those looking to brush up on the state of evidence implicating red meat, I’d recommend three posts – one I wrote many moons ago in response to one of the dozen epidemiology stories, one written by Chris Masterjohn in response to the TMAO data, and one recently by Zoe Harcombe in response to the protein epidemiology).

I don’t know what to make of this, of course, and it may be nothing at all, other than an evolution of preference. I’ve checked mineral levels in my body in search of a clue (none showed up). Maybe I’m over- or under-saturated in some key nutrient?

Now, since everyone seems to care how much carbohydrate I consume, here is my current framework.  I put carbohydrates into 5 essentially MECE categories:

  1. Those I consume daily – mostly salad stuff and other vegetables; about twice a week I make a curry stir fry with tofu, for example.
  2. Those I consume often – nuts, berries, almond butter (which I just spoon out of the jar), super starch (both as a meal replacement and post-workout drink).
  3. Those I consume intermittently – a couple spoons of rice here and there, especially when I make Indian food or when we have sushi; a piece of baked potato when it looks particularly appetizing. If my daughter “makes” spaghetti, which she loves, I’ll usually have a forkful to remind her that her dad is not a complete freak.
  4. Those I consume only on very special occasions – exceptional desserts, for example – about 2 or 3 times a year, like the ones I consumed on my wife’s birthday, or the candied yams. (NB: One thing I decided in an instant – if I’m going on a bender, it’s not going to be for “average” dessert like some lame birthday cake; it’s got to be best in class.)
  5. Those I still completely refrain from – I call these the “cheap” carbs – basically all else (including cookies, potato chips, cereals, and the candy bars they keep handing me on this flight as I type this), including any liquid form of fructose, such as juice or sports drinks.

Below is a “typical” 5 days of eating over the past few months. Keep in mind, I virtually never consume breakfast, maybe once a month (e.g., if I have a breakfast meeting). Essentially, I do all of my exercise (current routine, below) in a fasted state only consuming the BioSteel’s high performance sports drink (HPSD), which contains virtually no calories – maybe 8 kcal of BCAA per serving.  So, despite the dietary changes I’ve made, and the fact that I’m not in ketosis most of the time, I remain seemingly well fat adapted, though RQ is a bit higher than before.

I should point out that I spend much less time exercising than I have historically, due to time constraints. But, I still aim for the following schedule, which is interrupted by travel during at least 2 or 3 weeks each month. The schedule below amounts to about 14 to 16 hours per week of training.

Monday – high intensity lift, followed by swim

Tuesday – ride (tempo)

Wednesday – swim

Thursday – ride (TT practice or threshold)

Friday – high intensity lift

Saturday – ride (VO2 max intervals), followed by swim

Sunday – group ride or solo TT practice

I can’t believe I’m about to do this…I just have this horrible feeling someone is going to attempt to replicate this, bite-for-bite, for no good reason. Please refrain. Remember, this is what I eat because of how my body works.

Wednesday

Lunch – huge salad (bowl larger than my head) with romaine lettuce, kale, carrots, tomatoes, cucumbers, olives, mushrooms, chicken breast, 2 tbsp olive oil, 3 tbsp lemon juice, 1 tbsp white vinegar, 1 cup of almond slivers

Snack – a cup of macadamia nuts

Dinner – Another large salad, but no chicken or nuts in this one; 1 pound of salmon; bowl of berries to follow

Thursday

Lunch – huge salad (bowl larger than my head) with romaine lettuce, kale, carrots, tomatoes, cucumbers, olives, mushrooms, can of tuna, 2 tbsp olive oil, 3 tbsp lemon juice, 1 tbsp white vinegar, 1 cup of walnuts

Snack – 2 or 3 tbsp of almond butter (a zero sugar variety)

Dinner – Omelet made from 6 eggs (white + yellow), shredded cheddar, lots of other veggies; side of steamed broccoli in butter; 2 more spoons of almond butter after dinner

Friday

Lunch – same as Wednesday (I basically rotate salad back and forth about 3:1 in favor of chicken over tuna)

Snack – none

Dinner – Curry stir-fry containing tofu, carrots, broccoli, bell peppers, mushrooms, zucchini, and squash, in a sauce made from curry paste and Greek yogurt.  I typically consume two heaping plates of this.

Saturday (post ride and swim)

Lunch – 7 hardboiled eggs, an avocado, 2 oz of cheese

Snack – a Fuji apple covered in almond butter

Dinner – 8 oz of steak (fillet, rib-eye, or tri-tip), 8 oz of salmon, large salad (sans meat and nuts, which I only do with lunch salads).

Sunday (post longer ride)

Lunch – The “Peter Kaufman” super starch shake (heavy cream, zero-sugar almond milk, a package of chocolate super starch, 2 tbsp of almond butter, an extra 20 g of Biosteel whey protein, frozen strawberries, ice – blend to a thick shake); I’ll drink 2 liters of this. Literally.

Snack – none

Dinner – Family sushi night! I’ll have a seaweed salad or two, huge platter of sashimi, California roll, and another specialty roll.

Lastly, because I know someone will ask, the few times I now take to measure, record, and tabulate exactly what I consume, it works out to about 3,500 kcal per day.  But some days, especially when I travel, it can be as low as 2,000 kcal when I only consume one meal per day (dinner). Other days it can be as high as 5,000 kcal. But, 3,300 to 3,600 kcal per day is the typical range. 

So, there you have it – the most irrelevant information you’re likely to find on this blog (except for what’s below… this is actually valuable stuff!)

Fashion tip of the month

While in NYC I realized – about 15 minutes before leaving my hotel for a very important meeting – that I had forgotten to bring cufflinks. My heart sank. I’ve never made this mistake before. I immediately realized why.  While packing, and just about as I was going to grab a set, my phone rang and I was distracted.  But that was neither here nor there. What was I going to do?  I didn’t have time to buy a new set, and the hotel concierge didn’t have a set to lend me, so I grabbed some dental floss and tied the cuffs of my shirt together using precise surgical knots.  I was pretty self-conscious that someone would notice and ask or comment, especially on a day stacked with so many back-to-back important meetings. Amazingly, no one said anything, though I could see some people looking at them and doing the double-take. Over that lovely steak dinner I alluded to at the top of this post, I told this story to my friend (who snapped the picture, below).  His response?  “Yea, I noticed it right away. I thought it was a new style. Very cool, actually. Kind of European.” So there you have it.  Don’t say I never shared anything of value on this blog.

Photo by Toa Heftiba on Unsplash

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.

727 Comments

  1. Peter,
    You stated this is nothing what your eating today?? I eat kinda like you listed, following the perfect health diet. What is your view of the Perfect Health Diet? I see you eat tofu, is the soy not a concern to you at all.
    I have been in ketosis many times and it does wonders for my cognitive performance and focus, but following The Perfect Health Diet, I begun to think it was not the best thing for my body.

  2. Hi Peter,

    I have followed your blog and enjoyed it, its great to see scientific information and literature citations (I am a chemistry professor and I appreciate the scientific approach, which is missing in so much of nutritional studies).

    I have a question for you. I have been following a low carb/high fat diet with a focus on paleo style foods (lots of meats, eggs, vegetables, and healthy fats) since 2012. Due to food intolerances, I am also dairy and wheat free. Initially this helped with energy levels and not needing to eat every 2 hours and IBS. Recently my IBS symptoms returned. I had a stool sample tested and I have malabsorption of fat. I am awaiting a GI specialist appointment to get a firm diagnosis on the cause. Should I rethink the high fat diet since I have malabsorption and occasional diarrhea? Should I increase healthy carbs (e.g. sweet potatoes)? Or should i just vary the type of fat… e.g. more coconut products that are easily absorbed? Is there a certain type of fat to avoid for IBS-D? I recently added in a Mg supplement 2x per day (200 mg x 2) and I have experienced some relief of the IBS symptoms already, but I think the malabsorption issue is still there. I track my food intake occasionally, and my calories (roughly 2000-2500) come from 55-78% fat, 26-9% carbs, and 19-13% protein. The second numbers (78/9/13) are more typical for me but lately I have tried to increase carbs and decrease fat to try and find some relief.

  3. Great write up… I’ve been eating LCHF for a couple of years now. Had to go off it for a trip to Tanzania last year and took the opportunity to stay on carbs for 6 months to “reset” and then jump back to LCHF. I did the reset so I could get, per your series about cholesterol, an Apo B and an NMR LipoProfile done to use as a baseline for measuring the effects of LCHF on MY Lipid Profile.

    My initial tests revealed an incredibly high risk for heart disease (95th percentile for men my age). I knew I was at risk and originally had changed my diet to reduce my risk of CHD as both my father and grandfather had their first heart attacks in their 40’s and I’m 43 now.

    Anyways – just had my follow up Apo B and NMR Lipoprofile done again… awaiting the results now.

    I track my ketosis pretty strictly (via blood levels) and usually maintain a state of nutritional ketosis pretty well. I’m now at a point where I am experimenting with different amounts of natural carbs / sugars (mostly fruits and tried a potato which totally knocked me out) to see what my tolerance levels are. Have found that I can eat a whole banana without getting knocked out (which is great because I now add them to my “fat bomb”, post ride, smoothies). Veggies almost never knock me out but that’s probably because I always cook them in Bacon Grease, Butter, or Olive oil and often use Sour Cream as a “dip”…. plus I eat huge steaks (fatty steaks) with them…

    I don’t now how you tolerate the sugar in such massive quantities. What’s I’ve discovered is that my taste buds have become so sensitive to the sugar that it leaves a horrible after taste in my mouth. What I usually do is just take a bite or 2 of my kids (or my dates) dessert… that’s enough to remind me that I don’t want that entire piece of cake or bowl of ice cream AND keep me from getting knocked out of ketosis or (I suspect) having adverse affects to the sugar / carbohydrates…

    When I started writing this comment – it was not going to be this long! 🙂

  4. Hi Peter,

    Fantastic blog/website, thanks for all the great info.

    I was just wondering how long after a workout you recommend eating? Say for example you skip breakfast, just eating within a 4-6 hour window from lunchtime, when would be optimal to exercise?

    Does it make a difference if you eat 4-5 hours after training? Or should you time your exercise so that you have lunch immediately after?

    Thanks

  5. Hi Peter:)

    I was wondering your thoughts on Dr. Wahls and her protocols – she does have a ‘keto-like’ protocol that is based on 6 -9 cups of veggies per day in order to ‘feed’ the mitochondria.

    Thanks!

  6. So, I read most of your blog posts and I understand your pov.

    I have a specific question though and maybe others have asked this already and maybe you have answered this already in one of the several hundreds of comments on this website but i havent found it yet and hence this specific question from me.

    I am a very skinny guy. I have been trying to bulk up through exercise and food. For someone like me who is NOT FAT and NOT OVERWEIGHT (pardon the emphasis on those words as I feel so left out in this obesity obsessed world) and who wants to put on weight, mass, bulk, muscle – HOW can I be successful in that attempt if I don’t eat enough carbs to pump glycogen into the muscles on a regular basis? I have noticed that when I am on low carb, my muscles (Which are scrawny) look scrawnier and the moment I bring carbs back in, there is bulk to my muscles and a healthy look on my face!

    How can I pump glycogen into my muscles on fat without overworking my liver to make the glycogen out of protein and fat? How do I have enough energy to do my workouts without bonking??? How do I eventually continue to grow/bulk up as I am not obsessed with losing weight?????

  7. Hi Doc – I have never “blogged” before or done any commentary on anything like this in my life. However, I ran across your blog in my research on healthy eating plans and got hooked on your articles on Ketosis. I found your sense of humor and candor refreshing and it kept me reading even though I didn’t understand most of the chemistry review 🙂

    I also wanted to tell you that I am absolutely going to follow what you eat bite-by-bite for a while even though I know it is for you haha….just because I have no other guidance that is better than what you laid out…and it doesn’t sound like it could hurt. Last year I had to face the fact that I was more fat than anything else with a Body Fat of 52%. Yep – that would explain my blood pressure and other lab values. Sooooooo, I began a journey to do “body recomposition” – I hit a wall and finally said enough. Since last year I have lost 13% body fat while preserving most of my lean muscle on a very strict and controversial diet using HCG injections (and my OBG and PCP’s support – after all what did I have to lose at that point was my thinking….they did not recommend it – but supported me along the way). I am proud to say I have accomplished this over the past 11 months using a “lose for a few weeks then maintain” method to create some ability for me to enjoy long term success. I would ask for your opinion on HCG for the truly obese – but I am betting it is “elsewhere described on your blog” 🙂 (so I will just search for that on my own)….if you have not yet commented, I would be very interested in your opinion.

    I guess I will close by saying I will be one of those you were concerned would follow your eating plan in precise details 😉 and will let you know how my experiment eating your meal plan goes 🙂 I am extremely detailed and precise when I follow a plan (any plan really)…so I am looking forward to sharing my results whether you are able to respond to this post or not….and thanks for doing this…for being out there…and for not seeming judgmental to those of us who have admittedly not taken care of our nutritional health but instead looking to add intelligent discussion and support/resources so those of us who really need the wake up call can reclaim our bodies to live life to the fullest…

    Thanks from a overweight (down from obese) single 46 y/o working mother of an amazing miracle little boy named Sam (now 4 y/o)…who I will have more enjoyable time with thanks to folks like you who give me encouragement and facts I can stand on to gain a healthy advantage…wish I lived near San Diego – I would come give you and your team a hug…Steph

    • Steph, you’re very sweet, but please don’t follow what I *ate* (past tense) without using your common sense. If you start gaining weight…it’s not right for you, which is always a possibility.

  8. What do you think is the best way for one to develop meal plans that make sense for their goals, body type and exertion levels? Are there books/resources you recommend that would provide a framework?

  9. Hey Peter!!
    I’ve just discovered ketosis & stumbled upon your blog. I was particularly interested in the interplay with exercise.
    Anyway, I’m an old friend from Toronto. Do you remember the Stovel family? Your Dad and mine (Peter) were good friends and we went to your Dad’s restaurant a bit.
    Anyway, great to see that you are doing well!
    Stella (middle daughter of three)

  10. Dr Atia,

    It has been almost 2 years since this post. Are you going to do a new post with ehat you are currently eating? I am sure your readers would love to know 😉

    Thank you. Love your blog!

  11. Dr. Attia, thank you so much for the wealth of information you have given me and my family. I’m currently overhauling my life and through my families support have lost 45 lbs. in 9 weeks. More importantly my family is eating healthy and everyone is meeting and exceeding personal goals thanks to you and Dr Westman M.D. fron Duke University.
    The Munozes

  12. Hello Dr Attia,

    I really enjoy reading your research and knowledge, but now have a sudden idea that hit me whilst researching about the ketogenic diet.

    Could it be that you, myself and most of the followers of your work have a sub-clinical eating disorder, and that this is more serious than the proxy that you call obesity?

    I do feel that I have been searching for the ultimate diet since I was a teenager, and as a professional golfer I strive to achieve the levels of a Martin Kaymer, but this “obsession” keeps spinning a deeper and deeper web of complexities, every day.

    And so I carry on regardless searching for the six pack that I used to have, and never realised it.

    Just saying.

  13. I am a female amateur bodybuilder and I am having trouble with figuring out how much protein in my daily diet would be too much to keep me going into ketosis. wondering if you have directly spoken about it in any of your articles/blogs recently? I have been testing with ketostix (yes I know that this is not the most reliable method but it is the only method that I have access to currently) and my test strips only register just over negative or small amounts. My goal is fat loss and I still want to maintain my current muscle mass. I have been reading a lot on the subject and as far as I can tell I should be consuming protein in the level of .9 g / lb body weight. Most days I come in over this amount and I am wondering if this will hurt my fat loss efforts? any response would be greatly appreciated. Also do you taken on clients and if so what is the process?

  14. I have been reading some of your blogs, I am wondering if you feel Blood type has anything to do with what is best for us to eat.

  15. With low carb being constant, are there any circumstances wherr increasing fat leads to weight or fat loss? There seem to be mixed messages in the low carb community on the question of whether one should minimize fat in order to become lean.

    • Hey Sylvie –
      If I may chime in . Take a look at this blog :
      http://www.lowcarbdietitian.com/blog
      The blogger is an RD who does a very even handed job reviewing the evidence pro and con on LCHF and/or ketogenic diets . She mentions Peter’s blog in a very favorable light. Yet , also like Peter, she seems to listen carefully to opinions that are not necessarily orthodox LCHF.
      In any event , I can also attest for myself that one can be in ketosis ( measured by ketonix) and gain weight. If I eat enough fat , I will gain .
      Hope that is some help

  16. Hi, Peter. Saw you at the conference today – – you were excellent. Didn’t get to ask your latest views on a) multivitamins (I’m taking Men’s One A Day) and b) omega 3 supplements (was taking Nordic Naturals Ultimate Omega). Thank you!

  17. G’day Peter, Lisa from Australia here 🙂 Ive been doing the Atkins diet for 5 weeks now and feeling ssssoooo much better. Weight loss is slow but constant. Great to stumble upon your blog, I love reading the science behind sustainable weightloss and good nutrition. I am 49, work as a midwife and do crazy hours of shift work. We get given way to many boxes of sweets and chocolates in gratitude. So far have been able to side step these as I want to maintain ketosis. I do however enjoy the atkins low carb choccie bars with a coffee daily 😉 Im 155cm and weigh 75kg how much protein roughly, should I consume daily? I don’t want to over do it…Cheers and Merry Christmas
    Lisa

Leave a Reply

Facebook icon Twitter icon Instagram icon Pinterest icon Google+ icon YouTube icon LinkedIn icon Contact icon