Better Nutrition March 2019

SOLUTIONS TO COMMON KETO DIGESTIVE PROBLEMS
Tamara Duker Freuman, RD, a New York-based dietitian and author of The Bloated Belly Whisperer, often sees clients who are
following a keto diet and experience digestive problems. “People are prone to eating extremely large portions of a limited number
of staple foods, such as an entire avocado in a meal, sometimes even more than once daily,” she says. “This can lead to digestive
issues that people consuming a more varied diet may be less likely to encounter due to more modest portions of any given food.”
These are some of her solutions to common keto pitfalls:
AVOCADO, CAULIFLOWER, AND CELERY: These foods can cause gas when eaten in large amounts. Eat smaller portions at any one
time, and diversify with vegetables that are less gassy, such as spinach, zucchini, peppers, string beans, cucumbers, and arugula.
Try alternatives to cauliflower rice, such as spiralized zucchini or kelp noodles.
BRUSSELS SPROUTS, CASHEWS, AND PISTACHIOS: Enzyme supplements of alpha galactosidase can reduce gassiness or other
digestive issues.
HEARTBURN: Large amounts of romaine or other lettuces make the stomach work hard to break them down and can trigger
heartburn. Try cooked vegetables instead.
DIARRHEA: A combination of high fat and low fiber can lead to diarrhea. Soluble fiber, such as an acacia fiber supplement, can help.
CONSTIPATION: Lack of fiber is usually the cause. Eat the full amount of low-carb vegetables that fit your keto plan and, if
necessary, take a soluble fiber supplement. Or, take magnesium at night, which can loosen stools if you take enough.
LOW-CARB FLOURS: Coconut flour is very dense, absorbs a lot of water, and can be hard to digest. Almond flour is easier on the
stomach and a good source of fiber.
INULIN: Found in many low-carb packaged foods, and in low-carb pasta made with Jerusalem artichoke flour, inulin is a type of fiber
that can cause digestive problems.
SUGAR ALCOHOLS: Sugar-free sweeteners whose names end in “-ol,” even if they’re considered natural, can cause digestive upset.
Look for other natural sugar-free sweeteners, such as stevia or monk fruit.
ELECTROLYTE DEPLETION
AND DEHYDRATION
A keto diet increases loss of fluids, and
electrolytes—including sodium, magnesium,
and potassium—are excreted
during the process. Drinking half your
body weight in ounces of water, eating
salt, and taking electrolyte supplements
can help to prevent a shortfall. Some
electrolyte supplements are specifically
formulated to support a keto diet.
HOW TO START A KETO DIET
Steelsmith recommends educating
yourself about the diet as a first step.
Then calculate your personal nutritional
needs. She’s found that it’s easiest to start
with a net-carb limit of 50 grams, and
once you get used to eating that way,
gradually reduce the carb limit over time.
Initially, use an online calculator or an
app (ketodietapp.com offers both) to work
out what to eat to achieve your personal
goals. And then make a plan and a shopping
list, and take the plunge: Get rid of the foods
you won’t be eating, stock up on those you
will, and get keto supplements to help you
stay on track. Doing the diet with a partner
may be easier, or you can find buddies online.
You might want to track everything you
eat for a while, but with time, you’ll develop
a new sense of what to eat. It’s a process,
says Steelsmith. “It’s re-educating your own
perception of your body.”
40 • MARCH 2019