The Meter Said No: Why I Jumped In Cold
June 2017 — day 1
I didn't start keto to lose weight. I want to get that out of the way. I started because of a number on a blood sugar meter, and it wasn't the number I was worried about.
The test I expected to pass
I'd been checking my blood sugar at home for a while before I changed anything. The obvious test is the one after you eat, and I passed it. I could have a soda, a muffin and mashed potatoes, and my reading after the meal would come back around 100, when anything under 140 counts as normal (video cTGYIFOTPl8).
Then I tested fasting. First thing in the morning, nothing in me. Those readings came back in the prediabetic range, and some mornings in the diabetic range (video cTGYIFOTPl8). I tested in the middle of the night too, and it all pointed the same way (video cTGYIFOTPl8).
The name for that pattern is impaired fasting glucose. From what I read, it's usually a sign of insulin resistance and it can lead to type 2 diabetes (video cTGYIFOTPl8). I didn't have an insulin meter, so I couldn't prove that was what was going on with me. But everything pointed the same direction.
That's the part that matters. The test I would have bragged about was the wrong test. The one I almost didn't take was the one telling me the truth.
Six sodas and a controller
When I looked back at how I'd eaten my whole life, it wasn't a mystery. As a kid I would drink about six sodas in a row playing video games, no problem (video cTGYIFOTPl8). One soda is something like 37 grams of carbs. A lot of people on keto are trying to stay under 20 grams for the whole day. Six of those in a row, and it's not hard to see where a lifelong American diet takes you.
I wasn't always super heavy, but I always struggled with my weight and I never felt in control of it. I always felt hungry (video cTGYIFOTPl8).
Reading my way to keto
I'm not a doctor and I'm not a dietitian. I'm a guy with a college degree who reads well and is confident he can read a journal article without blowing it up into hype (video cTGYIFOTPl8). So I did what I'd do with any problem: I looked up the treatments. I went looking for controlled, peer-reviewed studies from universities on what works for a blood sugar problem like mine, and that's how I ended up at keto (video cTGYIFOTPl8). If you want to do the same digging, here's how to search PubMed for diet studies.
I want to be clear that I didn't think keto worked for everybody, and I still don't. Genetics and the gut are a big, individual deal, and other people respond to carbs differently than I do (video cTGYIFOTPl8). This was me picking a treatment for me.
The cold pool
Some people taper into keto. They drop to 150 grams of carbs, then 100, then 50, and ease their body into it. I didn't taper (video DoSUgIr2rNo).
The way I explained it later: it's like getting into a pool. Do you take the stairs or do you jump? I've jumped in every pool since I was about five, even the cold ones. I'd rather the shock happen all at once. So on June 13, 2017, I just stopped (video cTGYIFOTPl8; video DoSUgIr2rNo).
And because this was about blood sugar and not about looking good, it felt less vain to me. It wasn't a weight loss thing. I didn't want to be diabetic, and the diabetics I'd talked to had told me it's not fun (video cTGYIFOTPl8). That gave me a reason to stay with it that a number on the scale never had.
What I'd tell you now
Test the number you don't expect to be bad. If I'd only checked after meals, I'd have told you I was fine. On the literature: the American Diabetes Association's 2019 nutrition consensus says cutting total carbohydrate has the most evidence for improving blood sugar, and lists low-carb as one of several options (doi.org/10.2337/dci19-0014); there's a plain read of what the ADA says about low-carb diets. One thing I didn't have to deal with, and you might: if you're on medication for diabetes or blood pressure, cutting carbs can change what dose you need, sometimes fast. In one non-randomised clinic study, people on a ketogenic program ended up on less diabetes medication (doi.org/10.1007/s13300-018-0373-9), and that's exactly why a doctor has to be in the loop. Read Keto With Diabetes or Blood-Pressure Medication and Who Should Talk to a Doctor Before Starting Keto first. Also, jumping in cold worked for me; if it sounds miserable, tapering is a real option, and I said so even then (video DoSUgIr2rNo). My first update on the glucose numbers is in 28 Days of Keto for High Fasting Blood Sugar.