Megan’s Ketogenic Challenge – August Update

By Jason Fung, MD

By Megan Ramos, IDM Program Director & Clinical Educator

Good morning everyone!  Sorry for the delay.  Some really exciting stuff has been going on in the IDM Program this month – all unexpected.  We will be posting an update very soon about our program’s newest addition!

Megan’s August Update

 Before I went to write this blog post, I decided to change into my favourite ‘comfy’ pants.  I’ve had these pants since I was in undergrad.  They were a Costco special and are one of my most favourite possessions.  It has been hot as hell in Toronto (yes, it gets warm in Canada…), and I haven’t worn them in a couple of months, but I’m feeling the A/C a bit more than usual this evening.  Well, my favourite pants just slipped off of me.  The elastic waist band is still intact.  They just don’t fit anymore.  Ketosis just sent my favourite pants to an early retirement.

In my previous blog post, I mentioned that I have been experimenting with a ketogenic diet for most of this year.  I have probably been in ketosis for the majority of this year, but monthly and sometimes weekly indulgences have prevented me from becoming fully keto-adapted.  I decided to commit to eliminating those frequent indulgences and do my best to stay in ketosis each and every day for the next 6 months in hopes of becoming keto-adapted.

Since August 1st, I have had one long weekend, two weddings out of town, a mini family vacation on a deserted island in cottage country surrounded by oatmeal chocolate chip cookies (a.k.a. my kryptonite) and my birthday.   Also, my American husband just received Permanent Residency status in Canada, which was probably the most exciting day of my life aside from our wedding day.  Talk about celebrations happening out of my ying-yang.   Being on a ketogenic diet this month has been the ultimate test of my willpower.

Despite the many challenges of staying in ketosis, it has also been one of the most rewarding experiences.  I am beyond proud of myself for resisting all temptation.  I feel like I’ve regained control over my mind and body.  I didn’t realize how out of control I actually was until this month.  Every celebration I was able to resist only made it easier to resist temptation with more ease at the next celebration.

In the next two months I have one girls weekend in wine country, two weddings (in Orlando, Toronto and Atlanta), two major work galas, and Canadian Thanksgiving.  It doesn’t stop after October either.  Holiday parties start in November.  I’m married to an American, so I get to have a second Thanksgiving.  We celebrate Christmas and have decided to move 5 days before Christmas Day.  We’re insane like that.  To make things even more fun my husband will be relocating from California to Toronto so it isn’t just your usual move across town.

All I hear from patients is ‘how busy things are’ or ‘how stressful things are’.  Life is always busy.  Life will always throw you curve balls.  It will never stop.  And you won’t be round for the good or the bad either if you succumb to metabolic syndrome.  I’m hoping my dedication will inspire you to make time to be healthy.

My Plan

  • Fasting: I continue to fast three days a week.  Sometimes I do all three days back-to-back.  Sometimes I do 24- or 42-hours intermittently throughout the week.  I really fit it into my schedule and around my social activities, but I do my three days a week since I’m actively trying to lose body fat.  I do water fasts now when I fast with the addition of approximately 1 teaspoon of Himalayan salt in my water spread throughout the day.  I usually take ¼ of a teaspoon at a time.
  • Eating: I eat lunch and dinner on my eating days.  I don’t eat them more than 7 hours apart, and I don’t eat past 7:00 PM at night since I go to bed between 10:00 and 11:00 PM.
  • Macronutrient Breakdown: I have stuck to 30 grams or less of TOTAL carbohydrates per day. I consume no more than 40 grams of protein on my very sedentary days, 55 grams on my moderately active days, and 70 grams on my workout days.

My Results

  • Ketones: Since August 1st, I have measured my blood ketone levels every morning. They have ranged from 0.5 mmol/L to 7.8 mmol/L (the 0.5 mmol/L reading was the morning after a wedding where I have .   Also, I have been keeping track of my urine ketone levels, which have ranged from 0.5 mmol/L to 16.0 mmol/L.
  • Weight and Inches: My weight has been fairly stable, ranging from 101 to 104 pounds.  I have lost a total of 1.5 inches in the last three weeks.  This is great because it means I’m not just losing body fat, but I’m getting stronger at the same time.

Goal: I had 24.6% body fat at the start of August.  My goal is to get to 18% body fat.  I don’t have a ‘weight goal’ but I have a body fat goal.

  • Miscellaneous: My energy levels have skyrocketed. I no longer get home from clinic each and every night and pass out before I can even wash my face.  My sleep has also improved.  I have become an extremely anxious person over the last year, which is very unusual for me.  My anxiousness has subsided so dramatically that I am able to sleep through the night.  Also, I have started to look like a normal human again.  Many patients have commented on how ‘refreshed’ I look over the last couple of weeks.  I even took my usual red eye flight back from San Francisco on Sunday night and went straight to work on Monday form the airport.  Not one person could tell I just got back into town.  I don’t even feel jet lagged. It’s incredible.  I’m automatically back to being a normal human being without a week of recovery.

Upcoming Posts (Posted on Tuesday mornings starting on August 30th)

Ketosis I:         Ketosis 101
Ketosis II:        Ketosis & Macronutrients
Ketosis III:       Ketosis & Protein
Ketosis IV:       Exogenous & Endogenous Ketones
Ketosis V:        Guide to Getting into Ketosis & Fat Fasting

Sample Eating Day


  • Spinach salad (3 cups) with cherry tomatoes (4), cucumber (1/4 cup, chopped), walnuts (6).
  • Chicken bone broth (1 cup) with collagen (2 tablespoons).
  • Matcha tea (1 teaspoon)


  • Chicken thigh (3 ounces) cooked in herb and garlic butter (2 tablespoons), skin eaten
  • Asparagus (6 medium spears) cooked in butter (1 tablespoon) and wrapped in bacon (1 slice)
  • Coconut oil (1 tablespoon) mixed with pure cocoa powder (1/4 of a teaspoon), frozen
Macronutrient Breakdown



Daily Total

Total Carbs

10 g

5 g

15 g


5 g

2 g

7 g

Net Carbs

5 g

3 g

8 g


21 g

27 g

48 g

Total Fat

43 g

60 g

103 g


3.3 g

1.2 g

4.5 g

By The Fasting Method

For many health reasons, losing weight is important. It can improve your blood sugars, blood pressure and metabolic health, lowering your risk of heart disease, stroke and cancer. But it’s not easy. That’s where we can help.

Jason Fung, MD

By Jason Fung, MD

Jason Fung, M.D., is a Toronto-based nephrologist (kidney specialist) and a world leading expert in intermittent fasting and low-carb diets.

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