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Comment by artellectual | Hacker News Reader

Actually, I've tried the ketogenic diet. It's great, however it does have negative side effects. That is the lack of fiber. This can lead to hemorrhoids. Which can be extremely painful. Everything was great, I burned a lot of baby fat, but it was painful in the toilet, there was bleeding involved.

You need to supplement yourself with fiber if you want to try the ketogenic diet.

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When I did keto for a while, I actually got a LOT of fiber, since any carbs bound up to fiber don't get processed and kick you out of ketosis. I was always on the look out for 'em, to help with food variety.

I am often doing a variation of this meal:

- take 2 salmon fillets, crush whole garlic and spread over the top; put for 10 minutes into air fryer. Put a few drops of olive oil on top of garlic texture

- take frozen vegetables (it's up to you what you like), put them for 3 minutes to air fryer

- take frozen "frutti di mare" and frozen spinach, put them for 10 minutes to air fryer

This should be a balanced ketogenic meal, very tasty with lots of fiber as well and added benefit of garlic compounds fighting imbalances caused by sugar-based diets (fungus, candida etc). I lost 20 pounds in the past three months (took a lot of sports as well) giving me a nice sixpack. I used those urine strips to monitor if I indeed had ketones in my blood or not.

Why do you air fry if you need high fat intake with keto?

I feel sick when eating food fried with oil; for example eating french fries with oil sits in my stomach for ages and I feel really bad; with air fryer it just passes through with no bad effects I can notice.

Flax seeds and meal are low carb and high fiber. I put them in my smoothie every morning and am an olympic-class pooper.

I would recommend ground flax seeds. They pretty much go straight through otherwise.

Edit: sorry, just saw you mentioned meal too.

You can eat practically unlimited amounts of green leafy vegetables (and hence fiber) on a ketogenic diet. Perhaps that wasn't a major part of you diet before you went keto?

Also important is to supplement with potassium or magnesium citrate. The ketosis diet will push down urine PH, which can cause uric acid kidney stones

Magnesium does double duty helping with leg cramps.

There are many options for avoiding your problem. Vegetable fiber using vegetables with minimal or zero reserve carbohydrate should do it. Cabbage for instance also offers additional benefits from its phytochemicals. See for instance http://www.sciencedirect.com/science/article/pii/S0304423806...

You can even go one step further and eat Sauerkraut. A lot of the (limited) carbohydrates in the cabbage are fermented into lactate, which has some health benefits, and if you make it yourself it is a good probiotic.

Yup - and it's got a lot of potassium too! Definitely a keto staple for me.

Consider stir fries containing broccoli and cabbage. Its a good strategy.

Just stay away from traditional corn syrup sauces.

You can take fiber pills or powder and mix it with water. The carbs in the fiber do not contribute to blood sugar at least not very much.

Actually, there is the idea of "net carbs" on keto. This means if the package says: Carbs: 4g Fiber: 3g

Your net carbs is 1g. You always subtract out the fiber from the carbs. There's a long explanation for why you do this, I'll leave it to you to find.

Yup. That is what I should have said.

There's ample opportunity to get enough fiber on a ketogenic diet.

This seems more like a negative side effect of your version of the ketogenic diet, not a negative side effect of the ketogenic diet itself.

However, if you feel you were still taking in enough fiber, perhaps you weren't taking in enough water? Not drinking enough water while eating/supplementing high fiber will result in some constipation as well.

thanks for sharing the experience!

How long did you stay on this diet?

I am on high protein diet (proteins in grams ~= my weight in pounds) and I take a fiber supplement to make sure I am Ok on the bathroom side of the things. I noticed I need to take more fiber (27-30 grams, which is above recommended 25 grams) comparing to the days when I do not eat a lot of proteins.

I wonder how much fiber one needs to take when on ketogenic diet.

I did it twice, the first time was 3 months long, the second time was only 4 weeks (I couldn't deal with the pain)

I've heard some people also suffer from ammonia breath from ketosis. Maybe you have experienced that?

It's acetone breath, it is a temporary side effect of keto-adaptation. Other ones include excessive thirst, light headedness and headaches.

Most people never heavily use ketones, so it takes the body some time to re-build the machinery to do so.

Yeah, the symptoms sound like detoxication, those generally having foul smells and needing extra water to wash away our old fears.

I confirm I did have all of the above. Possibly the light-headedness was also cause by not having eaten enough, but it was too strong for that to be the only factor.

as mentioned in the article-- It's acetone, not ammonia.

Acetone is one of the byproducts of keto metabolism, and, unlike other byproducts which are expelled in the urine, acetone is breathed out, resulting in the slightly-sweet-smelling "keto breath".

"I burned a lot of baby fat, but it was painful in the toilet, there was bleeding involved"

Best comment i've read on HN.

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