Dear Mark: Electrolytes and Keto Carbs

June 11, 2019

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For today’s edition of Dear Mark, I’m answering questions from the comment sections of the recent posts on daily keto carb limits, within-meal keto carb limits, and electrolytes. I’m addressing questions about alcohol, uniform carb allowances versus personalized, potassium supplementation, salt appetite, salt water, electrolytes after the transition, whether fruits fit in, and why I don’t count above-ground non-starchy vegetables.

Without further ado, let’s go:

How does alcohol count towards the 50g of carbs per day? Would that be measured proportionate to the caloric values (ratio 7 (a) : 4 (c) ) or is it easier to simply ignore alcohol along with the fiber … ?

Alcohol doesn’t “count” as a carb, but I wouldn’t ignore it.

The body stops burning other macronutrients in the presence of alcohol until the alcohol is metabolized. When you consume alcohol, the body suppresses oxidation of fat, carbohydrates, and protein. The alcohol itself can’t really be stored as fat, but its inhibition of traditional fuel oxidation means you’re more likely to store rather than burn dietary fat.

If you’re keeping carbs low to improve body composition, you should definitely take alcohol calories into account.

Mark,
Why is 50g of carbs set as the upper limit for everyone? Wouldn’t it make more sense to set the limit using macro percentage?

My BMR is roughly 1300 kcal, so 50g of carbs corresponds to a macro ratio of 15% (a bit above the suggested 5-10%).
Is it more important to follow the 50g upper limit or the macro percentage?

Ease of use. I want to make this as effortless as possible for as many people as possible.

And again, it’s total carbs, not net, and you’re eating whole foods, so a good number of those 50 grams will be fiber and thus indigestible (by you).

It all seems to balance out in the end and end up “lower carb” than one might assume by looking at “50 grams of carbs”—for most people.

If people try this and it doesn’t work, then they can come with follow-up questions and get the detailed guidance they need. They can get more specific and take the (admittedly small amount of) time to calculate their macros.

How about low-sodium salt for extra potassium?

Not a big fan. Potassium citrate powder seems to work a lot better than potassium chloride (low-sodium salt) in several areas:

Bone density.

Kidney stone formation.

It’s quite tasteless, whereas potassium chloride’s taste is quite distinct.

Just make sure you clear potassium supplementation with your doctor, especially if you have or suspect you have kidney health problems; the kidneys excrete excess potassium, and a bad kidney can make potassium supplementation dangerous.

I’ve struggled with postural hypotension since childhood, but it used to be caused mainly by excessive heat. Recently I made the connection that if I don’t drink caffeine, it goes away completely. Soon as I drink it I’m lightheaded again, *especially* if I’m also pregnant. I could probably benefit from increasing my salt intake dramatically. I find that if I add 1/4tsp sea salt to a cup of water it tastes amazing, so that probably indicates I need more salt. I heard an interview where someone recommended adding salt to water especially if you drink coffee, and they said it tastes gross like you’re drinking sweat, but I really think it tastes delicious.

This is a really important point. Your craving for salt appears to track closely with salt requirements.

The more sodium you need (and the more you’ve excreted), the better salt will taste if you’re eating a natural, whole foods diet without the skewing effect of processed food products. That’s probably why salt in your water “tastes amazing.” This jibes with my personal recommendation for salt:

“Salt food to taste. Don’t avoid added salt if your taste buds and intuition suggest you could and should have some extra.”

I hesitate to offer iron-clad numbers for potassium and magnesium (even though I gave some ranges in the last post). “Sisson says take 200 mg of this and 300 mg of that.” We don’t want that. We don’t know everyone’s needs. We don’t have a “potassium appetite” or a “magnesium appetite,” but potassium tracks largely with sodium and most people aren’t getting enough magnesium so I feel comfortable saying “eat more of them” and having people follow their salt appetite.

Still, I’ll also mention that some people are clinically salt-sensitive, and the effects can be significant, especially in terms of blood pressure. It’s always best to let you doctor know. It’s a definite must if you’re salt sensitive.

Does anyone make a “sole” by diluting pink Himalayan salt, Red Hawaiian Alaea, etc. into water?

Any success with that method?

I’ll sometimes put a few healthy pinches of Hawaiian red salt into a glass of water before bed. When I wake up, it’s totally dissolved and I throw it back. Tastes good for sure.

What I do often is have a couple of mugs of black coffee in the morning with the last one having butter and coconut oil in it.
Then walk 18 holes while drinking a couple of bottles of spring water each with a pinch of Himalayan sea salt.
Seems to work for me

Thoughts?

I like it. If it seems to work, it’s working.

Thank you so much for this articles, Mark. You are the first keto expert I have read who says to add electrolytes “for the transition”! I am no longer in the transition period…but I still take all my electrolytes daily. Is a person who is fat-adapted supposed to wean themselves from supplemental electrolytes?? I’ve been keto for over 18 months, and I really do not think I have heard that particular advice before. Could you clarify? Thank you again!

While transition is the most important and full fat-adaptation means you won’t be shedding water/glycogen as often and all the electrolytes with it, you’re not out of the woods entirely because you’ll still be enjoying low insulin levels. And what doesn’t change post-transition is the inhibitory effects of low insulin on sodium retention. If you’re living a low-insulin lifestyle, you won’t retain as much sodium—you’ll expel more—and you should probably maintain higher levels in your diet long-term. Keep your doctor in the loop.

Since potassium loss is downstream of sodium loss (from the kidneys trying to balance out your potassium:sodium ratios), you’ll also need to keep potassium intake up.

And pretty much everyone could use more magnesium, so taking some extra there, too, is likely a good idea.

Question, so should the carbs be coming from below-ground vegetables like beets and onions and carrots, or if it falls under said carb amount per meal, does it matter if it comes from higher sugar fruits or from potatoes? My meals tend to be usually proteins and above ground vegetables, so I wouldn’t be counting any of those. For example I really like pink lady apples. The ones I buy state 16g carbs per apple. Having one of those with a meal would be fine? How about without a meal, would that be more likely to knock someone out of ketosis?

Below ground vegetables and potatoes and fruits all work and count. An apple counts, is completely fine to eat if it fits your personal carb allowance (and even if it doesn’t—it’s your choice!). If you have an apple by itself, there won’t be any fat or protein to slow down the assimilation of glucose, so you’ll get a “faster hit” that could “knock you out” of ketosis. But ultimately it’s about that meal in the context of your daily carb intake, your exercise levels, whether you’ve just trained or gone for a long walk, your fat-adaptation progress, and your goals.

I’m unclear as to why Mark says “don’t count above ground, non-starchy vegetables”. I mean, they have net carbs after you subtract the fiber. Surely a carb is a carb? I can easily eat 15 grams of carb per day in kale and broccoli alone; sometimes in a single meal..

It generally takes more glucose to digest the glucose in leafy greens, broccoli, and other non-starchy vegetables than they actually contain. The result is a net loss or a wash in terms of useable glucose.

You won’t ever find an athlete carbing up with kale before a race.

That’s it for today, folks. If you have any further questions or comments, let me know down below!