Ketogenic diet? I am so confused

Even some health care professionals seem to confuse ketosis with ketoacidosis—the latter of which is dangerous (and usually a complication of diabetes) but the former of which is not. When I was on dead-animals-and-leaves low-carb, I heard the misguided conflation of ketosis with ketoacidosis all too often. I fully agree that starch & sugar are “necessary” only to the continued well-being of agribusiness. I salute your discipline; but gastronomy is one of my few pleasures in life (one of which is travel—of which cuisine is an important part). If ever travel and dining out becomes impossible, I may go back to a near-keto eating lifestyle.

Here's what's for dinner. Tuna Thai Yellow Curry Fried Riced Cauliflower with fresh herbs from my garden. I have been on a Thai curry kick lately and it is so easy to make.

Curries are a good way to use up whatever you have in the fridge at the time, and ingredients are adjusted to taste and desired heat level, so the recipe is never the same, but I can share tips for how to make it.

For the fried riced cauliflower (really sauteed in coconut oil) I save time and money by buying pre-riced frozen organic cauliflower. Whole Foods sells it under its 365 brand. I live on an island and even a non-organic fresh cauliflower costs an arm and a leg. WF actually has really good prices on all of its frozen organic veggies, as does Costco.

I buy what is on sale and throw whatever other veggie I want at the time in with the cauliflower rice. Leftovers work really well here. Last night I used mushrooms and frozen organic mixed greens. Green beans are also good, or asparagus. Bell peppers add a little zing but you have to be careful about quantity so I buy an organic frozen chopped blend (also 365) so I don't have to waste any. A scrambled egg mixed in at the end can also give it more of that fried rice familiarity but I don't always do that. Then spice it up however you want. Don't forget to count all of the carbs which can add up if you're not careful. This dish is good just as is, as a side dish or with some protein mixed in for a meal. I used the tuna, which of course is low-mercury from a BPA-free can, but you can use anything.

The basic way to make a Thai curry sauce that you can put on anything, is coconut oil in a hot skillet, then you bloom your curry paste and other fragrant spices in the oil for a few minutes. The minimum you want to use is the curry paste, but you can add ginger and garlic or anything else you want. My favorite curry paste is the Mae Ploy Brand. It's so much more authentic than the kind you can usually find in the regular grocery store, and the only place I can get it is on Amazon. It also lasts forever. I keep a container of red, green and yellow curry paste in the fridge at all times. Start with a teaspoon and work your way up depending on your heat tolerance.

Then you're going to add some coconut milk, a little healthy sweetener like stevia, some fish sauce (Red Boat makes one that is gluten- and sugar-free - very strong, use sparingly), and some kind of acid like lime or lemon juice, or vinegar (put it in at the end). I don't eat much soy, but sometimes I do use organic gluten-free tamari, which is a more concentrated form of soy sauce so you don't have to use very much at all (good mixed into the "rice" as well). If you want to leave that out use more salt and other spices to compensate for the loss of flavor. You can also add nut butters and turn it into a satay-type sauce.

This gives you your basic Thai flavors. You don't have to go crazy on authentic Thai ingredients but you can if you want to. Like galangal or kaffir lime leaves - lots of recipes online. It's really good with a mixture of cilantro, Thai basil and mint leaves, which I always have growing.

My pleasure, I really do like to share my love of food.

The San-J brand of tamari is non-GMO made from whole soy. They carry it at Whole Foods but I have also seen it at normal stores. It's more expensive, but so is everything else I eat and we have adjusted to spending too much money on food. You can't put a price on your health. I figure I will either be paying for the clean organic food or paying for the doctor.

Another good thing to do with the curry sauce is to marinate chicken thighs or other parts in it then throw it on the grill. Boil the remaining marinade to kill the raw chicken germs and you have a little sauce to put on the chicken and your veggies when it is done. It was leftover sauce from chicken a couple of nights ago that I used on the rice last night, so all I really had to do was cook the veggies, open a can of tuna and tear up some herbs.

You can also make curry dishes with shirataki noodles vs. the fried rice.

I dug up this old photo of the Moroccan Meatballs. Looks a lot like the other one because of the herbs on top but you can sort of see the meatballs under there. These were lamb meatballs in a red curry, and served on cauliflower rice with green beans, mushrooms and chopped asparagus. There is really no end to the different variations you can come up with.

Totally agree with Momine -- those meatballs look so good Solfeo. I'm also not keto (yet), but have been restricting my carbs. Last night I tried sauteeing the riced cauliflower in coconut oil. What a difference from how I was cooking it (I had been boiling it or trying to saute it in olive oil)! It was delicious. I put lemon on it and then a touch of the San-J tamari you recommended. Thank you again for the great recipes and I'm excited to do some cooking this weekend.

Hopeandlove: I don't do this often but for an occasional splurge, cooking the cauliflower rice in bacon grease takes it to a whole new level. With crumbled bacon mixed in the final dish. Yes it is as good as it sounds. That's the kind of "cheating" I do now. Something that is still keto, but a food I wouldn't normally eat, like bacon or cream cheese. No low-carb food is off limits on a special occasion. Everyone wants to feel like they can have a treat every once in awhile, but with this approach I don't have to pay for it afterward with weight gain, elevated blood sugar and re-awakened food cravings.

It will never taste just like rice but it is good nonetheless, and the longer you go without eating real rice the difference will seem even less obvious.

I don't hate chicken breast but it's easy to get tired of it. Brussels sprouts are a favorite vegetable. I love them roasted in the oven tossed only with EVOO and plenty of salt and fresh cracked black pepper. I could eat them by the pound but have to limit to 1/4 lb. for carbs.

Funny about the chicken - breast is all I have ever liked (ditto for turkey) and never been a fried anything fan. Since living in N KY now, which is somewhat Southern, fried chicken is all over the place!

Brussels sprouts - DH just roasted some about 1/2 ago along with carrots, so had some lovely veggies for lunch. Agree on the EVOO, salt & pepper.

Apple a day - I, too, enjoy this and not ready to give it up.

You do have to limit your total net carbs to stay in ketosis, so no vegetable is truly unlimited, although it would be hard to go overboard on certain ones like lettuce. 4 oz of raw Brussels sprouts have almost 6 grams of net carbs, 2.5 grams of sugar and over 3 grams of starch. I would only even eat that much at one meal if I wasn't eating other carbs with them. I try to stay under 20 grams of net carbs per day but I can eat up to 30 without raising my blood sugar or affecting ketosis. Everyone is different so you have to experiment to find out what works for you,

Too much protein will kick you out of ketosis too. It also raises insulin, IGF-1 and activates mTOR which is not good for cancer. So if you are doing keto for cancer and not just weight loss you especially don't want to eat more protein than your body needs to repair itself. I eat around 4 oz of animal protein per day and I try to get the rest from plant foods for total protein of around 50-60 grams per day. Again, that amount will be different for different people, and depending on how much exercise you get. There are so many opinions about how much is enough that you have to come to your own conclusions. If you're not losing weight and carbs are in line, then too much protein is very likely the culprit.

Fat doesn't have a metabolic effect but if you eat too much of it your weight loss can be stalled from the excess energy (AKA calories - and this becomes more important the closer you get to your goal weight). Strangely enough, too little fat can also stall weight loss so it's another balancing act. I don't limit fat the way someone on a low fat diet would, but I don't eat more than my body needs to fulfill my energy requirements. I do limit animal fat though because of the hormones. Even if the animal is not raised on added hormones there will be some naturally occurring in their fat, just like estrogen lives in our body fat.

Dark chocolate is OK (the higher the percentage of cacao the better), but again, only within your carb limit. There are concerns about cadmium contamination in even organic products so it would be good to do some research on the subject.

I have posted this before but in case you haven't seen it, I use Cron-O-Meter to track my macro- and micro-nutrients. It has presets for different levels of keto strictness.

regarding protein, I recently read a very interesting article about new research which says that while cancer cells need glucose for metabolism, it is actually protein that constitutes the tumor mass: http://news.mit.edu/2016/how-cancer-cells-fuel-the...

I also read an article that implicates the specific amino acid, methionine, in the growth of cancer: https://integrativeoncology-essentials.com/2014/07/kill-cancer-restricting-methionine-rich-foods/

Dr. Rosedale's new book will be released in early October. Co-author Maria Emmerich is a favorite keto life coach of mine. Most of you who have been doing a low carb diet for awhile have probably also heard of Jimmy Moore.

The Rosedale Plan: Redefining Ketogenic: A Revolutionary Approach to Reducing the Risk of Cancer and Diabetes, Slowing Aging, and Maximizing Health Paperback – October 3, 2017

by Ron Rosedale MD (Author), Jimmy Moore (Author), Maria Emmerich (Author)

I have read studies on all sides and most if not all of them are not definitive enough to prove or debunk any of the others, just like everything else in nutrition and cancer. That is why I individualize my program so much based on the totality of what I have read. I don't follow Rosedale's recommendations exactly (and I am sure they have changed since his last book) but he and the others have useful information and experience to add to the conversation.

I wish it wouldn't take so long to explain everything that goes into my personal choices, because there really are so many individualizing factors that should be considered, and you can't find out what they are if you entrench yourself in a single point of view.

I did sign up for OKL for a short time to check it out but I had to use my husband's FB account because I don't have one. I didn't see anything that changed my direction at this time, but my program evolves.

I don't think I said anything to indicate I don't trust scientific evidence or base my opinions on it. Plainly stated, the issue is that there is no science that clearly defines the best nutritional approach to cancer or we would all be on it.

I think we are disagreeing about the finer points of keto, and that doesn't matter so much, but I don't want others to be misled into believing that anyone's version of keto (including mine), or any other diet, has been proven as the best one after a breast cancer diagnosis. That is what I was talking about. I read significantly more science than most people would ever have time for, and it's not just the stuff specific to keto that has gone into the creation of my personal program. My approach has been to incorporate the best elements of all of the research into nutrition and cancer. I have something I can learn from a vegan, and they could probably learn something from me too. I also don't discount all of a source of information because I disagree with one part of it.

I don't think either one of us wants to come across as arguing, we're just trying to share our point of view, but I am going to strongly disagree with you about one thing. You cannot judge the quality of the information based on someone's looks or personal imperfections. I do not judge the science based on the appearance of the researchers, and I don't judge Jimmy Moore for gaining his weight back at one point, because most people who lose weight don't keep it off. I don't pay that much attention to him so I don't know where he is at right now, but he has been up and down in the past just like most humans who have ever been overweight. You said something like that before about Dr. William Davis, like his information and experience as a cardiologist can't be worth anything because he had a little gut on him when you saw him in person once. That's really not fair, and it's a lower form of criticism that doesn't address the substance of the matter at all.

We're all just doing the best we can and I wish you great success with your program. The only thing I am sure of is that there is usually more than one right way to do anything.

IAmElaine -- I enjoyed hearing your experience with the diet. I like your philosophy that if you focus on healthy eating, the rest will take care of itself.

FlaviaRose -- thank you for the information about methionine. I had never heard of this before.

Solfeo - again thank you for all the information that you have provided! I really appreciate all the research you have done and that you share it. What has worked for you may or may not work for me, but I think you have several good ideas that I want to try to incorporate into my life.

I downloaded Cron-O-Meter and it was truly eye-opening when I entered my food choices. I was shocked at the amount of carbs and protein I have been eating -- WAY too much of both, even though my food choices are healthy. Needless to say I'm working to correct this.

I am so grateful for this thread!