It is not necessary to eat a high-fat, moderate-protein, restricted-carb diet (one that includes only green vegetables) to get into ketosis. In fact, we can eat less or move more to get into ketosis—which is simply the state in which your body is burning fat, and you can test your ketones each morning with urinary Ketostix to ensure you are in ketosis.

I suggest getting into ketosis by choosing to consume fewer calories and knowing when you should eat less—for instance, on the days when you are moving less. This can be achieved by reducing starches and eliminating sugars, by reducing fat—the highest-calorie macronutrient—by not eating after 6 or 7 p.m., or even by reducing meals from four to three on days with less activity. You should never eat less than your required amount of protein to maintain your muscle mass. 

Nutritional ketosis can be defined as the intentional restriction of dietary carbohydrate intake to accelerate the production of ketones and induce a metabolic effect that stabilizes blood sugar and minimizes insulin release, and thereby mitigates the downstream anabolic and tumorigenic effects of long-standing insulin resistance. This approach represents the best and safest approach and is referred to by some researchers as the “well-formulated” ketogenic diet. It is composed of 5–10 percent carbohydrates (less than 30–50 grams per day mostly in the form of one fruit and plenty of vegetables and starch consumed based on activity), adequate protein (1–1.5 grams per kilogram of body weight per day. My approach, however, recommends 1.6 to 2.2 grams per kilogram of body weight per day for most healthy adults) and fat and starchy carbs based on activity and satiation.

The hallmark of nutritional ketosis is blood ketone levels between 0.5 and 3 milligrams per decilitre. While in nutritional ketosis, the body can maintain normal blood glucose levels and a normal pH, as opposed to the extremely elevated blood sugars and acidic pH associated with diabetic ketoacidosis.

Every metabolism is different. When and how ketosis occurs varies from person to person, which naturally means dietary restrictions, permitted foods and serving sizes need to be adjusted, especially with respect to an individual’s daily activity level. For instance, some people are able to consume one serving of fruit with a low glycemic index in the afternoon and still remain in ketosis, while others do fine if they eat a starchy carb with a low glycemic index, like beets or carrots, on strength-training days. 

Let me give you an example to help you modify and implement this suggestion into your daily life: I suggest that, instead of a two-egg meal with avocado, you switch to six egg whites with herbs and veggies (stir-fried or raw in the form of a salad). This change increases protein and decreases fat—helpful especially on days when you are sitting at your desk and you want your body to burn the fat on your body as a fuel source, rather than existing on the fat you take in from your diet. 

Here are a couple of days of meals that fit with Nutritional Ketosis dietary approach:

Day 1

Meal 1: one serving of protein powder and one serving of marine collagen with vitamin C (30 grams protein)

Meal 2: Six egg whites, sheep feta, sautéed zucchini, and peppers with sea salt spice mixture and optional Frank’s RedHot sauce (30 grams protein, two cups/500 milliliters cooked veggies)

Meal 3: Sprague’s cauliflower soup with four ounces (125 grams) of grilled Cajun chicken or one to two spiced chicken kabobs (26–30 grams protein)

Meal 4: Roasted veggies (cauliflower, zucchini, carrots, onions, Brussels sprouts and chopped sweet potato in spices and olive oil) with lemon zest baked sole (30 grams protein, two cups/500 millilitres veggies, one starchy carb)

Day 2

Meal 1: One serving of protein powder and one serving of marine collagen with vitamin C (30 g protein).

Meal 2: Rainbow Thai Chicken Stir-fry (recipe includes chicken, shredded cabbage, carrots, peppers and zucchini with a tamari-honey-red pepper flake sauce). Weigh out 4½ ounces (135 g) of chicken, which provides about 30 grams of protein.

Meal 3: One kiwi sliced with 1½ cups (375 mL) plain Greek yogurt and 1–2 tablespoons (15–30 mL) of chia seeds (30 g protein)

Meal 4: Carb-Conscious Chicken Taco Lettuce Wraps (made with ground chicken, peppers, zucchini and cauliflower rice, cooked in olive oil and spices, topped with Manchego cheese –measure out four to five ounces of the cooked taco filling to provide approximately 30 grams of protein.

It appears that nutritional ketosis has been studied over the past few years, and it is safe. Just how safe? you may ask. Well, in a study from Current Nutrition Reports (September 2018), nutritional ketosis has been found to improve metabolic and inflammatory markers, including lipids, HbA1c, high-sensitivity C-reactive protein, fasting insulin and glucose levels, and aid in promoting the breakdown of excess fat stores and sparing lean muscle. It also has favourable effects for promoting weight loss, decreasing hunger and increasing satiety. The take-home message is that ketosis is great, but you have to use the new ketosis—nutritional ketosis—to enjoy the best long-term outcome and benefits. And the secret to that is eating enough protein. 

Case Study: I am eating protein.Natasha: Yes, but is it enough?
Initials:I.M	Age: 54	Gender: F
History and/or concerns: Newly trying to implement the diet but not losing weight and not seeing ketones in the urine. Works at a bank, working remotely, no exercise. Menopausal.  Focus and Protein Requirements:• Support getting into Nutritional Ketosis  • Protein calculation 1.6 grams per kg of body weight  • Desired Daily Total Protein Mark: 130 grams at least. Fat sources beyond olive oil and all starchy carbs need to be avoided until ketones appear on the strips and during in the metabolic reset.
What they are eating now….		What they should be eating on Their Protein Plan
Meal/Time	Food Choices	Meal/Time		Food Choices
Rising time:     7 am 0 grams protein		Rising time: 7 am 0 grams protein
8:30 am  20 grams protein	2 scrambled eggs 2 slices of chicken bacon	8:30 am 30 grams protein		While trying to get into ketosis, skip the fats sourced in this instance from the bacon and the egg yolks; and increase protein with more eggs; and include two cups cooked veggies to keep feeling full and, in a fiber-rich state – option could look like:sautéed kale salad with 1 small zucchini sliced, sea salt and spices as desired or hot sauce and 6 egg whites (or 1 cup egg whites)
Midmorning 0 grams protein		Good work! My only suggestion are to reduce the raspberries to ½ cup to keep to your recommended serving size for Nutritional Ketosis. Also, make sure your smoothie contains 30 grams of protein which may look like one to two servings of the protein powder supplement. Ensure the smoothie contains 8 grams of fiber so add a fiber supplement in addition to the chia or Use Fit Food Lean Whey that contains Whey protein and 8 grams of fibre per serving.
Noon – 1 pm 20 grams protein	Good work! My only suggestion are to reduce the raspberries to ½ cup to keep to your recommended serving size for Nutritional Ketosis. Also, make sure your smoothie contains 30 grams of protein which may look like one to two servings of the protein powder supplement.Ensure the smoothie contains 8 grams of fiber so add a fiber supplement in addition to the chia or Use Fit Food Lean Whey that contains Whey protein and 8 grams of fibre per serving.	Noon – 1 pm: 30 grams protein		Good work! My only suggestion is to reduce the raspberries to ½ cup to keep to your recommended serving size for Nutritional Ketosis. Also, make sure your smoothie contains 30 grams of protein which may look like one to two servings of the protein powder supplement. Ensure the smoothie contains 8 grams of fiber so add a fiber supplement in addition to the chia or Use Fit Food Lean Whey that contains Whey protein and 8 grams of fibre per serving.
4:00 pm Approx. 10 grams protein	Nuts	Midafternoon 30 grams protein		Nuts are mostly fat than protein and not the best option to go for while getting into ketosis.  Instead opt for a high protein like 2 to 3nitrite free slices of turkey with mustard, sugar-free sliced dill pickles, and wrapped in low fat Swiss cheese – or have leftovers, or a meal replacement/protein powder drink like Fit Foot Lean Whey.
6:45 pm  30 grams protein	Grilled wild salmon with green and yellow beans	120 grams of protein and avoid all fats except one serving of olive oil		For some people the high fat content in the salmon can be enough to prevent getting into ketosis. Try opting ting for a serving of low-fat white fish, chicken, shrimp, or scallops instead.
Total Protein Intake:	80 grams protein	Total Protein Intake:		120 grams protein and avoid all fats except one serving of olive oil
How They Are Feeling Now:	As she increased her protein and reduced the hidden fats, her ketones began to appear in her urine as she started burning fat. Inches off began shrinking off her abdominal area first.  She had better energy and was free from cravings or hunger.