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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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June 11 2019

Dear Mark: Electrolytes and Keto Carbs

By Mark Sisson
12 Comments

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!

References:

Granchi D, Caudarella R, Ripamonti C, et al. Potassium Citrate Supplementation Decreases the Biochemical Markers of Bone Loss in a Group of Osteopenic Women: The Results of a Randomized, Double-Blind, Placebo-Controlled Pilot Study. Nutrients. 2018;10(9)

Nicar MJ, Peterson R, Pak CY. Use of potassium citrate as potassium supplement during thiazide therapy of calcium nephrolithiasis. J Urol. 1984;131(3):430-3.

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12 thoughts on “Dear Mark: Electrolytes and Keto Carbs”

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  1. But ossifer … I’m Keto adapted … hick … so we can just ignore the alcohol …

    I know, drinking and driving NOT funny.

    My two big challenges are controlling anxiety and addressing fatigue, alcohol does not really help with either of those two issues so I just don’t drink any more. My wife loves her organic red wine (in the evening and never gets behind the wheel after drinking). She has cut back carbs considerably but not willing to give up the vino. I suggested maybe one glass daily instead of two … to which she asserted that I should mind my own business LOL.

    1. Well, maybe those two glasses benefit you more than you know……Perhaps…..?? He, he, he
      I will say, the less I eat the less I can drink, I don’t believe in getting to a “drunk point” which means to me if there’s no lunch there’s no 2nd glass of wine with dinner. It will let me fall asleep but then wake me up in 4 hours (now that I’m apparently “old”).
      I’m currently on a fast from wine, my husband needs to lower his blood pressure so he’s being mostly primal for 30 days to see if he can lower it with some self control. His drink of choice (doesn’t give him a headache afterwards) is Jack n Coke, he’s not drinking that for the next 30 days. Maybe a glass of red wine here and there but he really doesn’t like it much.

      1. Ha ha … she does says I become almost tolerable after the second glass. Very cool about your husband!

    2. I cut down from 2 glasses of wine to 1. I also switched from a regular wine glass to a pint glass… but hey, that’s just details.

      1. LOL … why do I get the feeling you’re a person that can beat the system when you put your mind to it!

  2. Just a note on the apple, while it doesn’t have protein or fat to slow the sugar absorption, they do have fiber which slows it down (as opposed to apple juice) as far as I understand. And I’m not doing keto but I love apples with almond butter as an afternoon snack which is a delicious way to get fat and protein with it.

  3. I have incredibly painful leg cramps if I don’t watch my electrolytes when low carb or keto. The stricter, the more I need to watch it. The NoSalt seems to work ok, but I like the balanced mixtures like Vega or the old Emergen-C, before it was sugared into oblivion. I’ll have to try the K-Citrate to compare.

    1. I forgot to mention, there are water remineralizing filters similar to Brita, but the purpose is to put minerals in. Worth a look. I use one and the water tastes really good.

      1. What about ionic trace minerals? I add to my water and feel a immediate clarity and lift.

  4. So no above ground, green, leafy vegetables count toward the 50g net per day? I’ve been using Carb Manager and have been fully counting everything. I’m vegetarian (eggs ok, making an exception for dairy for this diet) and tend to eat lots of salads (no below ground vegs, but I do add peppers) which have lots of “carbs” according to my app. I’ve been assuming I’m not/can’t do true keto because of this since I can’t keep under 20g net carbs per day and get as many veggies in as I prefer.