How I Stayed Keto-Adapted on Vacation

Is it possible to stay keto-adapted on vacation?

For anyone who has been eating keto, it is pure joy to come back from a vacation and still be keto-adapted. In fact, our last vacation to Costa Rica started out with great intentions, but by the end of the trip, we had indulged in everything and completely fell off the wagon.

Now, there is absolutely nothing wrong with indulging on a vacation.

But what my husband and I both noticed was that every time we fell off the keto wagon due to indulgences related to travel or special occasions, it took a long time–sometimes, many months–for us to get on track again.

And because we’re both eating keto for our health, not just for weight loss, staying keto-adapted, as much as we can, is important to us. (My husband, now in remission from cancer–Oct 2018 will be three years–used keto specifically during his cancer from 2014 to 2016, as an adjunct to conventional treatment; I’m eating keto primarily for prediabetes and its impact on my mental health, namely anxiety and depression, and focus, having been diagnosed with Adult ADHD.)

So how did I manage to stay keto-adapted this time? Especially to a carb-laden destination full of temptations such as Taiwan?  As I have never accomplished this feat before on past vacations, I’ve decided to document what worked this time, in case I forget and need to jog my own memory.

First of all, what does it even mean to be keto-adapted (aka fat-adapted)? Dr. Stephen Phinney, who coined the term, “keto-adaptation” and wrote, along with Dr. Jeff Volek, the books,  The Art and Science of Low-Carbohydrate Living and The Art and Science of Low Carbohydrate Performance, has a great article to learn more about the science behind it.

From Phinney and Volek’s The Art and Science of Low-Carbohydrate Living (p.22):

Keto-adaptation is a term coined by Steve Phinney in 1980 to describe the process in which human metabolism switches over to using almost exclusively fat for fuel (i.e., a combination of fat burned directly and as ketones derived from fat). While well studied and documented mainly in the context of starvation, ketone metabolism is not well-understood by most physicians (let alone nutritionists, dietitians, trainers, and athletes) as an approach to improve health and performance. This is primarily due to the emphasis in standard nutrition training placed on dietary carbohydrates as the preferred fuel for physical performance.

Basically, it’s when your body switches from being a sugar/glucose burner to a fat/ketone burner. It’s when you’ve been compliant with a ketogenic diet, keeping your carbs low, fats high, and protein moderate. And the cravings for carbs (sweets, bread, pasta) go away. You find yourself being able to go for hours without wanting to eat. This can take a while, about several weeks or so, if not longer. You’re also, depending on your metabolic state, able to get away with eating some carbs once in a while, and easily get back into ketosis. At least, that’s what I experienced during this recent vacation in Taiwan.

Even though I began eating a keto diet in December 2014, when we first began using keto for my husband’s cancer, I had always had trouble becoming keto-adapted because I had a half-assed approach to keto eating. What this means is that I’d get into ketosis for a few days, then go have a pizza (the kind with a wheat crust) when stressed out, then attempt once more, battling the keto flu all over again.

But even with my half-assed, lazy, version of keto, I ended up reducing my HbA1C from a prediabetes level of 5.8% to a more “normal” number of 5.2% within a year. So it shows that some keto eating is better than none. Even if it’s the kind of keto eating where you never become keto-adapted, like how I was until recently, finally keto-adapted from August 2017 until now (March 2018). Although I’ve been keto-adapted before, it was never for long, and soon I had succumbed to carbs back again.  What finally helped me get keto-adapted this time–and actually stay this way–was having accountability.  In July 2017, I signed up for an early bird discount for Shawn Mynar’s Fat Burning Female Project ,  an online program with lots of support and advice on how to eat keto and become keto-adapted, aimed specifically for women. I loved Shawn’s approach of not focusing on the number on the scale, that weight was something that falls off once your body begins to truly heal. And she brings you down from carbs slowly, so your body isn’t shocked from going from high carbs to suddenly low. (Of course, you can get keto-adapted on your own, with discipline and compliance, but I’m someone who craves accountability, and this was, in my eyes, an investment in my health.)

Here’s an informative article by Amber O’Hearn on keto-adaptation. I especially love the section on “How to make keto-adaptation as quick and painless as possible.” Great tips for those trying this on their own.

My 8-Day Extended Fast, in Therapeutic Ketosis (GKI 1 or under)

How I Stayed Keto-Adapted on Vacation

1. I used a glucometer and ketone meter. Every morning, I checked my fasting glucose and blood ketones, using my favorite new health device: the Keto-Mojo. (I love how the blood ketone strips are so much cheaper than the ones I used to buy for my Precision Xtra glucometer, allowing me to actually measure my ketones daily.) This is a great way to get immediate biofeedback, helping you make course corrections as needed. I don’t even check my weight regularly on a scale anymore (just once a month, relying on body measurements of waist, hip and how clothes fit more). And I don’t track my macros (I did at first, when first learning how to eat keto, though.) Now I just rely on three numbers daily: fasting glucose, ketones, and my GKI (glucose to ketones ratio), regularly tracking every morning. These numbers give me, as someone with prediabetes, an instantaneous idea of how I’m doing health-wise.
2. I tracked my health to keep motivated and adjust as needed. I’m one of those weirdos that oscillates between analog and digital, preferring to first record my fasting glucose and ketones into my bullet journal health tracker, then log these numbers into Heads Up Health**, a health tracking site that is a phenomenal help for people like my husband and myself, who follow a keto and low-carb-high-fat (LCHF) lifestyle. Here you can easily enter your blood sugar numbers and ketones in the Dashboard and have your Glucose: Ketones Index (GKI) automatically calculated. This was a biomarker my husband tracked exclusively during his battle with cancer, following Dr. Thomas N. Seyfried‘s advice of keeping the GKI between 1 and 2. Recently we learned from a podcast with Thomas Seyfried with HVMN founder Geoffrey Woo [00:34:49] that when your GKI ratio is 1 or below, you’re in “Therapeutic Ketosis.” In Seyfried’s own words, “As I said in my book–Chapter 19–on cancer prevention…if you can get yourself down in therapeutic ketosis for three to five days, you’re blasting the crap out of these incipient tumor cells. Your body’s just going through and gobbling them up, eating them. So, before they can take off and start growing as a neoplasm, which is a dysregulated growth of cells, your body is killing them. So therapeutic ketosis, I always say, is a place to visit. But it’s nota place to live. You visit the zone periodically. But you don’t live in the zone.” (See graph where I fasted for 8 days, bringing my GKI under 1). Probably my favorite feature of Heads Up Health is the ability to graph your biomarkers using the Analyzer to notice trends. This allowed me to spot correlations between lack of sleep and high glucose, or too many carbs the day before and lowered ketones the following day. Seeing this on a graph helped me make course adjustments as needed.  
3. The incorporation of fasting.  Fasting is a great tool to use to stay keto-adapted. For example, if my fasting glucose was higher than I wanted in the morning (and my blood ketones lower) because I ended up eating more carbs than I had anticipated, I can easily, bring the numbers where I want them to be the next day by fasting. If the numbers are looking pretty bad, I might opt for a 24 hour fast. If the numbers are close enough but could use some help, I might do some intermittent fasting, going for 16:8 (e.g., fast for 16 hours and eat within an 8 hour window). I also know that an extended fast can be done once the vacation is over, as a way to cleanse damaged cells (aka autophagy), which is highly protective as a way to prevent cancer, per Dr. Thomas N Seyfried, whose book my husband read when he first began using keto for his cancer, beginning December 2014 (see above mentioned podcast link). At least once a year, my husband and I aim to get into therapeutic ketosis, tracking and monitoring our GKI using the graphing/Analyzer feature in Heads Up Health.  I should also mention that being keto-adapted already makes fasting so much easier than when you’re not. You go into the fast padded with fat and don’t experience hunger cravings that you’d normally experience if you were to go from a Standard American Diet (high carbs, low fat) diet straight into fasting.
4. Being keto-adapted already helped me finally understand what it means to “eat in moderation,” something people who don’t eat keto or low-carb love to say to you. (“Just eat in moderation! Live a little.”) But what they don’t get, is that for insulin resistant and metabolically challenged people such as myself, this advice doesn’t work. That is, UNTIL YOU ARE ACTUALLY KETO-ADAPTED. Then for the first time, I am truly able to understand what it means to “eat in moderation,” especially when it comes to refined carbohydrate-laden foods, such as many breads, cakes, cookies, and pasta. This time, being in Taiwan, I actually sampled pork dumplings, pork buns (xiao long bao), green onion pancakes, sugar-laden treats from the dessert bar at the hotel buffet, hash browns, and even Afternoon Tea savories and sweets. If you know me at all, I have never eaten like a bird. I’m one of those “All or None” folks who eat until every last morsel is gone. God forbid I waste food when so many in the world are starving! That’s the way I was raised, the way I’ve taught myself. You will rarely see me with leftovers. And I eat fast, practically inhaling the entire plate before you’ve even finished asking me a question during a meal.  So let me tell you: being keto-adapted allows something inside your mind and body to tell when you’ve eaten enough. Even some sugar-y thing. I’ve never had this capacity in my life before; I swear, this feels like a new-found super power! Now you don’t necessarily have to be fat-adapted to follow steps 1-3 above. But trust me: It’ll certainly make the process much easier.

Being keto-adapted is an amazing state of being. Your blood sugar levels are pretty even so you don’t get “hangry” as you once did when you were eating high carbs and low fat. And you just have energy and enthusiasm about life that just wasn’t there before, able to tackle things you’ve been putting off, trying new things you’d normally be afraid of, like selling your house and moving into a RV. Now my husband and I feel a sense of freedom and joy, excited about the life ahead of us with our family. With all that we’ve gone through, there’s one thing we know for sure: health is the ultimate wealth.

**Note: Before coming on board working part-time at Heads Up Health to help with writing and social media,  I had been avidly using it to track my own ketones, glucose, GKI, plus body composition measurements. I especially love how I’m able to centralize my medical records and blood tests such as my hbA1c, thyroid and cholesterol numbers, and track the data I’m self-collecting with devices like the  Keto-Mojo, apps like MyFitnessPal,  and wearables such as the Oura ring (I’ve preordered one because that’s a huge area in health I’d like to get better at: sleep.)

If interested, I wrote a blog post for Heads Up that detailed how my husband and I tracked his GKI during his battle with cancer, using the keto diet as an adjunct with conventional treatments. I also help maintain a keto for cancer resources page there.