I’m guessing your desire to change your diet stems from a need to “fix” something. Maybe drop a few pounds, cure your arthritis, or, as was the case for me, get rid of your migraines.
As your metabolism shift from burning sugar to burning fat, your body will undergo significant changes. Hopefully mostly positive, but not everything will always go your way. It’s critically important to measure, monitor and adjust as needed.
I highly recommend you start tracking what’s important to you. Establish a baseline before switching to a low-carb diet, so you know where you came from. Periodically check-in with yourself to make sure you’re going in the right direction. If you don’t measure it, it doesn’t exist.
Here’s a list of items you might want to consider tracking …
Daily macros: At the very top of the measurement pyramid is food intake and macro breakdown. If you only track one thing, this would it, particularly if using the keto diet to treat an underlying disease or metabolic condition. As previously noted, most people are terrible at judging food portions and caloric intake. There are many great calorie tracking apps out there, and most now include fast-food chains, restaurant meals and private labels. I use FatSecret, which links to my Apple Health app. Find one you like and start logging every bite.
Weight and body measurements: Aside from weight, which most people already track, women need to measure waist and hip circumference, while men generally only need to monitor their waistlines, as this is where most body fat is stored. The Apple Health app has a tracker for weight and waist measurement. I personally prefer to use a spreadsheet to track key body measurements, such as hips, waist and thighs. I log my weight into my calorie counter, which is linked to Apple Health.
Body fat: Body fat is one of the key indicators of being in ketosis, and the main driver that changes your body shape. If you’re looking for a rough estimate, I recommend the US Navy Calculator, which uses just weight, height and key body measurements. For the highest accuracy, you can get a DEXA scan, which gives an accurate measurement of body fat, muscle mass, bone density and resting metabolic rate. Somewhere in the middle would be a Skinfold Test, available at most gyms and training facilities. I’ve never had any luck with household body fat scales, but that’s another option. Body fat composition can also be logged into the Apple Health app.
Sleep: Sleep is something that has changed drastically for me in my keto journey. In fact, I saw a big change in my sleep patterns when I first started, then another major shift about two years later. I now log my sleep every morning into my Apple Health app.
Headaches and migraines: Every migraine sufferer should track their migraine frequency, medication use and key triggers, regardless of diet. I’ve been keeping a paper log since 2010. If you suffer from headaches, it would be useful to track those as well. Be sure to include possible triggers and medication use.
Digestive health: If you suffer from constant indigestion, constipation, heartburn and bloating, this is something also worth tracking. I’ve had digestive issues almost every day since I was a kid, so I never bothered tracking it. Post-keto, my gut health dramatically improved, but I will make note any occasional bouts of indigestion. Tracking any stomach issues will help you to determine your own individual triggers. Some key triggers for me are meal timing, volume, menstrual cycles and food intolerances.
Blood sugar: If you’re diabetic or pre-diabetic, this is something you should already be tracking. I’m not diabetic, and therefore don’t track my blood sugar. However, if this is an issue for you, the folks at Diet Doctor give a good explanation of what you can expect when switching to a low-carb diet. Blood glucose measurement can be logged into Apple Health as well.
Blood pressure: My blood pressure dropped sharply post-keto, and this is something I needed to monitor closely at the beginning of my journey. Nowadays, I just check my blood pressure when I’m feeling tired or rundown for some unexplained reason. I log my blood pressure data into the Apple Health app.
Allergies and food intolerances: If you suffer from allergies, you may also want to track your attacks and medication usage. In my case, I was allergic to oily nuts, especially peanuts, walnuts and pecans. I had crazy seasonal allergies in the summertime. I couldn’t digest eggs. Most non-citrus fruits, like peaches, cherries, pears and apples, would swell-up the inside of my mouth. Post-keto, all of my seasonal allergies are gone, my food intolerances mostly went away, and my nut allergies are now far less severe[1]. Again, if this is a big issue for you, I would definitely track your allergies and food intolerances, as this is likely to be significantly improved post-keto.
Skin conditions: Skin is the body’s largest organ, and often the first place to show signs of inflammation. Pre-keto, I suffered from a severe case of dry and itchy skin. I tried hundreds of different moisturizers, anti-itch creams and lotions, with no avail. More than 10 minutes in the sun would cause my skin to turn bright red, and burn like it were set on fire. After only a few weeks of transitioning to a high-fat diet, the itchiness went away, and my skin started to heal. Many people have also noted how their life-long battle with acne also mysteriously goes away post-keto. If you suffer from any skin conditions, I highly recommend taking pictures to document changes along the way.
Joint pain: Aside from skin, allergies and gut health, joint pain is another key indicator of inflammation in the body. I suffered from constant annoying ankle and hip pain, which I thought was caused by too much exercise, arthritis and ill-fitting shoes. I would limp when first crawling out of bed in the morning, and it would take almost an hour until my joints would function properly. Post-keto, joint pain went away almost instantly, despite now being much older and enduring much heavier workloads at the gym. If you suffer from joint pain, this is definitely something worth tracking, including suspected triggers, and medication usage.
Exercise and training logs: I’ve kept a log of all my workouts since the beginning of time, or at least the past few decades. When I first starting exercising, it was all about calories burned, which was a big waste of time in hindsight. Post-keto, I no longer need to burn calories on the treadmill, and my ability to recover has greatly improved, allowing me to focus on building muscle. My workouts now consists of strength training, aerobic conditioning and mobility work, so I use a spreadsheet to track sets, reps and weight moved. If you run, bike or swim, you might want to track miles covered, or laps completed. This is also a good place to log your energy levels, and any general aches and pains. As always, measure what matters to you, or anything you want to improve.
Menstrual cycles: The last item is specifically for the ladies. Shifting into ketosis dramatically changed my menstrual cycle for the better, a sentiment echoed by many other female-supporters of the diet. Many women use keto to cure PCOS and repair hormonal imbalances. On the flip side, many keto opponents will argue that low-carb diets mess with your monthly cycle[2], and can even be downright dangerous for women. I find it hard to believe not eating cereal, bread, candy and pasta would be hazardous to my health, but I also acknowledge everyone’s physiology is unique. What works for one women may not work for another. There are many great apps now available on your phone, and many will link to Apple Health. Aside from frequency and duration, be sure to track flow, stomach cramps, headaches and NSAID usage.
Note that the Apple Health app does not allow you to download the data, so be sure to have a backup for more critical information.
I track my food intake and weight in FatSecret (which links to my Apple Health app), blood pressure, heart rate and sleep directly into Apple Health, body measurements in Evernote, workouts and strength training logs in a Numbers spreadsheet, migraines in my Filofax agenda (aka old school paper) and migraine medication usage in my Calendar app. My menstrual cycles get logged into the Period Tracker app, which also links to Apple Health.
After keeping my macros fairly constant for the past 5 years, I can clearly see the impacts of even the smallest changes. Forgetting to pack potassium salt while on vacation, adding weight to the bar, munching on too many fat bombs during a global pandemic … they all affect my body in different ways. My journals and tracking spreadsheets have been invaluable in helping me adjust my variables, and get me back on track.
Measure what matters to you. Use whatever method you prefer. Monitor and adjust as needed.
Measurement is the first step that leads to control and eventually to improvement. If you can’t measure something, you can’t understand it. If you can’t understand it, you can’t control it. If you can’t control it, you can’t improve it.
H. James Harrington
NOTES:
1 It’s critical to make the distinction between an allergic reaction, which can be cleared with antihistamines, and anaphylaxis, which is life-threatening. My allergies caused hives, sneezing, swelling of the throat and eyes, but were never life-threatening. Someone with severe allergies should keep the same vigilance post-keto.
2 It’s been well documented that women are actually better adapted to using fat for energy versus men, likely because they have a much higher body fat content. However, hormonal fluctuation also mess with blood sugar readings, as some women do report being kicked out of ketosis during their monthly cycles.