A step-by-step guide to starting a ketogenic or carnivore diet

Tank Green/ November 4, 2023/ Health

On this week’s edition of Tank’s Continuing Dietary Adventures, I have good news to report. I mentioned back in September that I had started a strict ketogenic diet, as my HbA1c result still had not improved. I made the switch to keto on August 21st and by 1st September, my long-term (i.e. over a year) achilles tendinpathy had resolved itself. I can now run, jump, do the boingy-boingy exercise, and so forth, with no issues whatsoever. Unexpected win one for the ketogenic diet! (I haven’t actually had my blood glucose tested again, but I assume that’s fine now.)

Another unexpected positive result relates to my neutrophils (a type of white blood cell). These have been on a downward spiral since at least 2015 when they were 1.8; by August 2023, they were down to 1.25 (the reference range is: 2 – 7.5 x 10^9/L). I just had them retested and they are back up to 1.9. I am convinced this is due to changing to a ketogenic diet. This presentation by Gary Fettke cites some research which suggests it might be.

Also, completely random, but my hair is really shiny and clean. I hardly need to wash it at all. I used to have to wash my hair every other day as it would start to look greasy, but now I can go 4 or 5 days between a wash. My hairdresser even commented on it when I had my hair cut last week. She remarked how clean it was, and asked when I last washed it. She was genuinely shocked when I said 3 days beforehand.

Despite deciding to try a ketogenic diet this time, I am now more or less carnivore again. I seemed to naturally want to remove almost all plants once I had transitioned from being a glucose burner to a fat burner. I maybe eat 5-10g of carbohydrates a day: a hot lemon drink, coffee, a few slices of raw red pepper, a few blueberries in my cheesemousecakes. That’s it.

The transition this time has been much easier than my first attempt at carnivore, so I thought I would share a few tips I have learnt on how to shift your diet radically. I’m just going to list the steps I think someone should take who eats like crap (aka the standard American or British diet) but who wants to go ketogenic and/or carnivore.

Start at whatever step you are currently on. Once you have accomplished each step, move onto the next. As you do each step, start slowly increasing the amount of fat and protein you eat as this will help you later on. Make sure you eat healthy fats like: lard, butter, tallow, goose fat, coconut oil, olive oil. Yes, these really are healthy fats. Chuck that sunflower oil and margarine away.

  1. Remove (almost) all sugar from your diet. Do not replace it with artificial sweeteners, so no “diet” fizzy drinks (aka soda). I do eat a square of 90% chocolate most days, and put a tiny amount of Demerara in my cheesemousecakes, but no more.
  2. Remove all cereals and grains from your diet. This means: wheat, oats, rice, barley, amaranth, quinoa, rye, etc., AND anything made from them (e.g. pasta, bread, chapattis, etc.). Once you have done steps 1 and 2, you will have eliminated junk / processed food from your diet, and only be eating real food. You will likely be cooking from scratch now. Lucky for you there’s a billion recipe websites out there to help you.
  3. Remove (almost) all fruit from your diet. A very small amount (5g) of low sugar fruit like blueberries is okay, but the rest must go. This includes fruit juice and smoothies. This was the hardest step for me as I ate a lot of fruit. Don’t kid yourself that it’s healthy and natural as the fructose will impede your journey towards nutritional ketosis. Wave goodbye to the deliciousness that is fruit. (Still sad about this, but the cravings have gone.)
  4. Pause here and congratulate yourself. Your diet is mega clean! At this point, you should have ramped up your protein and fat intake in ways which shock your former self. Both are important as you are now going to start transitioning away from using glucose/carbs as your primary fuel source. Things may now start to get a little bumpy, but hold onto your horses and know that once you have transitioned, things will be fine. Actually, things will be better than fine.
  5. Remove all starchy vegetables from your diet. This means: potatoes, yam, sweet potatoes, plantain, etc. I suppose technically you could have a tiny amount of starchy veg instead of the low sugar fruit, but not both. Replace the calories with fat and protein, not vegetables.
  6. At the same time as you remove starchy vegetables, start using MCT oil. The easiest way to do this is to have a couple of bulletproof coffees a day. Having done this transition to carnivore twice now, I think the MCT oil helped my transition to becoming a fat burner significantly quicker than not using it (i.e. days, not weeks). Here’s some research which validates my experience.
  7. Reduce your carbohydrate intake down to ~40g per day. You can do this in one go or in stages. However, the longer you take, the more you prolong the (uncomfortable) transition period. The only carbs you should be eating now are non-starchy vegetables and maybe a tiny amount of low sugar fruit. The point of severely restricting carbohydrates is to force your body to stop relying on carbohydrates for fuel, and to force it to transition over to using fat for fuel.
  8. You are now on a very low carbohydrate (VLCD) diet. You may be crazy hungry at this time but this too shall pass. I found that without the MCT oil, I was eating 3,000-3,500 calories a day (I am only 55kg) and really struggled with my hunger and weight maintenance for weeks. I think this is because my body found it difficult to switch from being a glucose burner to a fat burner. However, the second time I did this (with the MCT oil), I was only insanely hungry for a few days before I settled into a feeling of almost constant energy and eating a normal amount of food (in terms of my height, weight, age, sex, and activity level).
  9. You can stay here and eat a ketogenic diet. Make sure that you are eating 70-80% of your calories from fat, 20-25% of your calories from protein, and 5-10% of your calories from non-starchy vegetables. There are still a lot of vegetables that can be had at this juncture, so long as they are non-starchy ones. More than your “5-a-day” for sure. That said, I do think you want to err on the side of under-eating carbs as otherwise you may risk your body getting confused about fuel sources. Bouncing back and forth between fat burning and carb burning is ROUGH at first. Get yourself used to burning fat for fuel before you experiment with higher amounts of carbs.
  10. Next step is full carnivore. You do this by removing the last vestiges of vegetables from your life. It’s super easy to do at this point, as you are a fat burner and your body doesn’t use carbs for fuel. Fuck a vegetable, imo.

I personally found it useful to count my macros using an app (Cronometer) when I was at stage 7 as I had no idea what constituted 40g of total carbs. I only did that for a couple of weeks though, as you quickly learn what is a “safe” amount to eat. This keto calculator may also be of use in determining how much to eat if you also need to lose or gain weight.

A note on carb cravings: these are intense when you first start to restrict your carb intake to switch to a ketogenic diet. This is why I really think it is a good idea to use MCT oil for that period to speed up the process of becoming fat adapted. The first time I tried to become carnivore was horrendous at times—in part due to oxalate dumping which causes some horrible symptoms—but this second time was a dream due to a quick transition to being fat adapted and because I had already eliminated oxalate-rich foods from my diet.

The moral of this story is that eating a fuckton of fatty (red) meat makes you healthy. No, like, really, it does. In addition, eating this way means you eat less and have an incredible amount of endurance. Energy is in abundance.