If you're not fully succeeding on the keto diet, does it make sense to try to "keto harder" or to instead experiment with tweaking the amounts, and timing, of the protein, fat, and carbs you are eating?
For Chantal, it was definitely the latter. After years of trying to keto harder, she finally experienced better physical and mental health, including much better sleep, when she increased the amount of protein she eats throughout the day and added more low-sugar carbs every evening at her dinner.
She now describes her diet as "whole, simple, real foods" with high protein, moderate carbs, and moderate fat, built on the model of Dr. Ted Naiman's P:E Diet (Protein to Energy Diet.)
"For so long, I felt guilty that I was not getting better on keto, or that I must be doing keto wrong because my bipolar was not getting better," explains Chantal. "Well the answer is not always doing more keto or carnivore... you have got to find out what works best for you."
Now at age 61 she is experiencing the best health of her life. Her weight is 105 pounds (47.6 kilos) on her 5'1" frame "perfect for me," she says. Her bipolar is stable. She is sleeping well, and she is strong and fit. In fact, she regularly performs routines on the aerial hoop.
Chantal's story has been condensed and edited.
What's your name, age, and where do you live?
My name is Chantal. I'm 61, and I live in Montreal, Canada.
Your email to us said "My success through the P:E Diet." Tell us more about that.
I feel like the Diet Doctor site, just like me, has been experiencing a constant evolution, a real journey, to better educate people about tweaking their diets and helping people find out what works best for them.
I found the Diet Doctor site when it was just starting out, when it was just Dr. Eenfeldt doing all the filming and blogging himself.
I would say that my journey over the last 10 years has been my own discovery that I do best when I prioritize protein. I've found that a diet with more protein, more carbs (mostly from low sugar fruits), and moderate fats gives me the best results formy mental health, sleep, weight, energy, and fitness. I combine my high protein diet with regular exercise.
Dr. Ted Naiman's P:E Diet has been the solution for me. He is, from afar, my mentor and my hero. And I am so glad that Diet Doctor has evolved in that direction. Diet Doctor supports those on keto for whom it works well, but is now helping others like me, who did not do so well on keto. For us, the answer can be to still be low carb, but we need to personalize our macros with more healthy carbs for better results.
Dr. Eenfeldt's video in November 2021, about low carb, moderate carbs, and liberal carbs (and how people can find their place on that spectrum) warmed my heart.
The guilt of not being keto is lifting. I loved how Dr. Eenfeldt said: "Finding the right balance (of carbs) is the key to low carb success." Ted Naiman also says that for a diet to work it has to be "sustainable" which keto was not for me.
I have a BSc in exercise physiology and an MSc in metabolism and nutrition, so I have always been very conscious of diets and exercise. But you have to find what works best for you. We are not all the same.
Have you had health struggles?
I've had many. Since infancy, I had recurrent bowel problems, constipation, and pain that caused so many problems for me, including mouth sores, constant eating problems, stunted growth, and much more.
It was only when I was 49 that my digestive issues were finally diagnosed as celiac disease. The disorder also caused me to be hospitalized for bleeding from my digestive tract and was likely the cause of my 10-year unsuccessful struggle with infertility, which was a very difficult time for me and my husband.
I also have severe food allergies as well as fructose and lactose intolerance.
On top of that, I was also diagnosed with bipolar 2 disorder, with a couple of hospitalizations. I was put on quetiapine (Seroquel) which makes you hungry all the time. I gained weight, going from 105 pounds [47.6 kilos] up to 157 pounds [72 kilos] on my 5'1" frame. There are no pictures from that time because I would not allow them to be taken. But since I did not want the weight, I purged. So I also developed the eating disorder of bulimia, which fortunately resolved with therapy and the right diet.
How did you discover Diet Doctor and what difference did it make?
With all my food issues, it was not easy to eat, so I was constantly looking for information about what I could eat.
It was when I was looking for information for my fructose intolerance that information about Dr. Robert Lustig came up, who has been very important in my journey. I found the video where he first appeared on the Diet Doctor site. That was many years ago.
I then became hooked on Diet Doctor and all its resources. But I went down the rabbit hole of keto. I was doing a good keto diet, following Diet Doctor information and guidelines, but I was chasing ketones to elevate them to around 3 mmol because I thought it would "cure" my bipolar. I read in many keto blogs that more ketones were needed to help with mental health issues, so I upped fats to reach the magic number. But the higher my ketones, the worse my insomnia.
My insomnia landed me in the hospital again for hypomania. So I was still looking for solutions and strict keto was not it.
I consulted with Maria Emmerich and she was the first to help me up protein. She had some wise advice for my gut issues. But my insomnia remained.
Then in 2020-2021 the Diet Doctor site started to talk about protein leverage and I watched videos with Dr. Naiman and started following his P:E protocol.
I was always craving carbs, but I was afraid to reintroduce them in my life. But in effect, Dr. Naiman gave me permission to eat good carbs again. Dr. Naiman's guidelines for more protein, more healthy carbs, and moderate fats made sense to me, especially when Dr. Eenfeldt and the Diet Doctor team also started talking about this.
So very carefully I added some carbs back into my life. From strict low carb I went to moderate carb, and then liberal low carb. I upped my proteins as per Dr. Naiman's recommendations:100 gram for the first 5 feet for women and 5 grams more per inch. At 5'1 it put my target at 105 grams of protein each day.
It was when I added back some healthy carbs at dinner, mostly berries and sweet potato, that I slept a full night for the first time in a long time. That was huge for my bipolar.
Now my weight is healthy and stable. My gut is calm and pain-free as long as my diet is strictly no gluten because of my celiac. My bipolar is not cured, but is much better. I can keep it stable on lower doses of medication combined with good sleep.
What does your typical day look like for you now?
Right now my diet is not for weight loss, I am at my goal weight of 105 pounds. I choose foods to help with health and wellness, with keeping my bipolar stable, and with sounder sleep.
Here is a what and when I eat each day
- 105 grams of protein: 1 gram for my body weight. My go-to protein for breakfast is Maria Emmerich protein-sparring modified fast (PSMF) bread. I use it every morning to make french toast. (Diet Doctor's high protein bread is similar.)
- Then lunch is 1 cup low fat cottage cheese with some berries or chicken breast with low carb vegetables.
- For dinner we vary different animal proteins and vegetables such as green beans, asparagus, or spinach. I also have some sweet potato, cooked in my air fryer, every night.
- I now eat 80 to 90 grams of net carbs daily, which comes mostly from low sugar fruits or the sweet potato, as per the P:E diet. I will have some citrus fruit, along with berries, but I am very careful because of my fructose intolerance.
- I eat my carbs at dinner. I think this is what has done the trick to finally help me sleep.
- My fats are around 45 grams per day. Mostly that comes, naturally, with the protein I eat. But I also eat walnuts to get more omega 3 & 6 and some lactose-free cream.
- I keep my protein: energy ratio at 1 since I am at my goal weight and stable.
- I eat three squares of dark 70% chocolate
- I just discovered on your website the High protein chocolate pistachio cookies. I use those as a special treat. I always have some in the freezer.
- I use the Cronometer app to ensure I get a minimum of 1,200 calories a day as I don't want to slow my metabolism.
Regular exercise is a must for my bipolar. I do resistance training until muscle failure. I am an aerialist -- I practice with a circus group on the aerial hoop and I continue to perform on it. In the last 6 months, I am seeing muscles, at age 61, that have not been there in a long time. I also spend a good 20 minutes daily stretching. We have to keep strong and flexible as we age.
What advice do you have to others who are struggling to find the best way to eat for them?
Listen to your body. It talks to you. It is your own personal journey to health. No one else's. You have to find what is right for you. There is danger in comparisons that can lead at any age to an eating disorder.
I am convinced nutrition science will continue to surprise us and find that many pathologies in medicine are actually tied to diet. I think my health problems were all connected to my diet from infancy on.
I am feeling better at age 61 than at any other time in my life. To me it shows that, even at this age, it is never too late. I feel at peace with food for the first time in my life.
Also for the first time in my life, especially since being on the P:E Diet, I find eating enjoyable! And yes some people heal some mental health issues with keto but more research is needed.
I think it's important for those of us who have mental health issues to understand that keto is not the only answer. For so long I felt guilty that I was not getting better on keto, or that I was doing keto wrong because my bipolar was not getting better.
I had to trust myself and my body to be able to tweak what I was eating so that I empowered myself to know the food choices that worked best for me.
So this is where I am for the first time in my life on my journey to a healthy relationship with food in a way that also helps my bipolar. And it all started here on Diet Doctor!
Thank you, Chantal. Your story is so important for giving people permission to experiment and explore; you found the right way of eating that delivers the best health - for YOU!
Diet Doctor's mission is to empower people to find better health. And your journey is a great story of using our expanding array of tools to build your own personal empowerment.
~ Anne Mullens