New to the keto diet? One of the first things to understand is that this low carb, high fat diet has a ton of benefits. A few benefits, which are also discussed in the Body Reboot book, include increased energy levels, mental clarity, and speeding up weight loss. However, there are still some common side effects some people may experience when starting the keto diet. Luckily it’s easy to get past these side effect by knowing what to do ahead of time. One side effect is keto constipation. No one knows why it happens, but what we do know is how to combat it. Keep reading to learn about some common ways on how to deal with this annoying side effect.
First of all, how do you even know if you are constipated? You probably already have a good idea if your stomach is upset and you feel like you have to go to the bathroom but are unable to. Some people may have the assumption that you must pass stool more than a few times a week, but studies, like Kiss My Keto mentions, tell us that that isn’t always the case.
A lot of people think that if they don't pass stool every day that they're constipated. This is simply not true. Medical textbooks define normal bowel frequency as anywhere between three bowel movements a day to two bowel movements a week.
Constipation is when stool is hard, dry, and difficult to pass in addition to being infrequent. But if you have well-formed and easy-to-pass stool occurring just once a week, then you're ok. Also, normal stool is bulky and sausage-shaped while small and lumpy stool means you're constipated. To evaluate the normalcy of your stool, take a look at the Bristol stool chart and see where you fit.
When you're constipated, you'll also feel very uncomfortable. Bloating, gas, and abdominal pain are common complaints. Some even develop hemorrhoids from chronic constipation. But there are many other complications that can happen if constipation goes untreated, so you do have reason to worry.
When you're on a keto diet, you may experience keto constipation. It's not a different type of constipation, it's simply constipation resulting from the ketogenic diet. There are several reasons why it could happen. Determining the cause will help you find the right remedy.
You may also be wondering why constipation on keto happens. Dr. Lauryn Lax, a guest author on the Robb Wolf blog, does an excellent job at summarizing all of the incredible benefits the keto diet has to offer but also explains why you may get constipated as well.
Your gut is home to upwards of 15-30,000 different species of bacteria and trillions of individual bacteria critters.
Gut bacteria DIVERSITY (different strains of bacteria) is associated with better health overall.
Ketogenic diets have been shown to improve gut bacteria diversity in the presence of disease as a “therapeutic” diet (such as Autism, Diabetes, and Epilepsy).
However, in healthier individuals and long-term dietary implementation, gut bacteria diversity appears to diminish , as well as increase systemic inflammation (1 Short-term impact of a classical ketogenic diet on gut microbiota, 2 Low-carbohydrate ketogenic diets, glucose homeostasis, and nonalcoholic fatty liver disease) in the body—particularly without enough butyrate (prebiotic fiber) present.
Low carb, high fat, and higher protein diets can also decrease beneficial bacteria, while spiking overgrowth of negative bacteria in the gut, when dietary “balance” is lacking—particularly DIVERSITY of healthy fats (Influence of diet on the gut microbiome and implications for human health).
In addition, while many people believe that carbohydrates and sugars alone are the culprits for breeding “bad” gut bacteria, “bad” gut bacteria can EQUALLY breed from ketone bodies (the substances formed in the body from fatty acids to replace glucose—sugar—on a keto diet). Excess ketone bodies (such as from long term ketosis) have been linked to symptoms of IBS—explaining close ties for some who experience constipation or other gut symptoms (loose stools, bloating, diarrhea) when following a Ketogenic diet. (Campbell et al, 2010).
If you do have trouble with constipation, one of the first things you can try and should make sure you’re regularly doing anyway is drinking enough water. Not only is drinking enough water vital to your health, but it will help relieve or prevent constipation, as Keto Vale mentions:
Getting dehydrated can have a direct effect on your bowel movements and make them difficult and painful. The keto diet is diuretic (you’ll notice that you pee more than usual), so you need to make sure you’re drinking sufficient amounts of fluids to keep you hydrated.
If you’re drinking tea or coffee in the morning, you should be aware of the fact that they also have a mild diuretic effect, and that you might need to up your water intake accordingly.
You don’t need to drink excessive amounts of fluid, though, as you risk flushing your electrolytes at a higher rate than replenishing them. Use your thirst to guide you and add salt to your water to make sure you’re getting your sodium in.
The blog Bulletproof has some excellent ways to combat constipation, such as making sure you have enough salt in your diet as well as keeping a food diary can also help you figure out what change in your diet may have caused a sudden onset of not being able to pass a hard stool.
“Constipation when going keto or low carb, especially in the early stages, can commonly be attributed to not getting enough salt,” says Maria Emmerich, nutritionist and author of “Quick & Easy Ketogenic Cooking.” “The colon is a master extractor of moisture and if you are getting enough sodium to retain enough water, the colon will remove it from the stool to retain it.”
Make sure you get 2 to 2 ½ teaspoons of salt a day. Keep it Bulletproof with pink Himalayan salt or a high-quality sea salt — they contain dozens of trace minerals and are generally free of heavy metals and pollutants.
Track what you eat and make a note of what you do and don’t digest well. Each body is unique and metabolizes food differently, says Pedersen. “Some people digest lamb beautifully, but struggle with beef,” she says. “For some other people, avocado is not a problem, but coconut oil causes constipation. If you notice you’re particularly constipated, do a mental rundown on what you’ve eaten that day and try to identify the culprit.”
Are you getting enough fiber? Keto Vale also recommends upping your fiber intake, especially if you haven’t been incorporating enough fiber in general. Watch your portions though. It’s essential to have the right balance between your fiber intake and the other nutrients you’re eating as well.
Getting enough dietary fiber from food can greatly help regularity.
You can find fiber in all plant foods, and green vegetables are a particularly good source of it, as they are low in net carbs and will help you get other essential micronutrients in.
Some of the best vegetables for keto are, among others:
tomato (technically a fruit, but very low in net carbs)
Diagnosis Diet says that it’s not about not having enough of something in your diet, it’s about what you may have recently added to your menu. Disrupting your body’s digestive system by suddenly eating a lot of dairies, for example, can cause constipation.
If you experience constipation on a ketogenic diet, it is not because you are eating less fiber; it is most likely because you have started eating something that you were not eating before (or a larger amount of something you didn’t eat much of before) that is hard for you to digest. In order to eat a ketogenic diet, which is a high-fat, limited protein, ultra-low-carb diet, most people find themselves turning to high amounts of foods that are notoriously difficult to digest, including nuts, low-starch vegetables such as crucifers, and full-fat dairy products.
Shape supports what the author on Diagnosis Diet mentions as one of the potential causes of keto constipation (which is dairy), and discusses why it may not be in your best interest to eat a lot of it while on a low carb diet:
When people talk about the upsides of a keto diet, one of the main points is that foods that are typically banned on restrictive diets—such as butter, cheese, even yogurt—all get the green light thanks to their high amounts of fat. But “these foods are high in lactose, which is a naturally occurring sugar that is hard for most people to digest,” says Dr. Palma.
According to the National Institutes of Health, it's estimated that up to 75 percent of the population is unable to digest dairy properly, partly because of lactose. Dr. Palma says this mucks up your intestinal health and, in turn, contributes to inflammation—which can cause all sorts of health problems if the inflammation becomes chronic.
That doesn't mean you have to shift these foods to the no-go list, though. Dr. Palma says it's okay to enjoy dairy in moderation, but it doesn't need to be a part of every meal and should be limited to one serving to help keep digestion in check.
In summary, here are seven ways Dr. Lauryn Lax recommends to try to combat constipation. Hopefully, by applying one or more of these tips, you can kick constipation to the curb!
7 quick-hit tips to bust constipation on a Keto diet:
Prebiotic & Probiotic Up. Reach for a soil-based probiotic and partially hydrolyzed guar gum prebiotic fiber as part of your supplement routine.’
Swig 1-2 tbsp. apple cider vinegar in water around meals.
Incorporate at least three different colors at each meal of real foods. Consider a serving of prebiotic fiber each day (cooked and cooled sweet potatoes/potatoes, winter squashes and starchy tubers – carrots, taro, etc.)
Drink LOTS of clean, filtered water (aim for half your bodyweight in ounces)
Replace coffee with herbal tea, like ginger, licorice or Dandelion
Consider taking Ox Bile supplement if you feel queasy after eating fats
Check in with your stress—be real. How’s your sleep? Are you pushing it too hard at the gym? Saying yes to everything? Neglecting your body cues in the name of keto perfection? Permission to stop one stressor wreaking havoc on your health.
At the time of writing this post, we're currently giving away free copies of the Body Reboot book because it's our mission to increase awareness and to help people lose weight and get healthy! If you help us cover the cost of shipping, we’ll send a copy to your door FREE. Go over to this page to see if there are any copies left.
Sources: Kiss My Keto, Keto Vale, Robb Wolf, Diagnosis Diet, Shape, Bulletproof
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