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December 4, 2016 by Leanne Vogel August 17, 2017
Solo episode, chatting about how to know you’re in ketosis, overcoming symptoms of fat adaption, balancing adrenal dysfunction, strategies for amenorrhea, and more. For podcast transcript, scroll down. SHOW NOTES + LINKS
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If you’re starting to panic about the holiday season coming up, and you’re thinking, “How am I going to balance a ketogenic diet, and also feed my family, and also be the star of the show, making all the awesome things that people love?” I put together dinner party menus that serve four or more, including a low-calorie holiday menu, a classic holiday menu, a meat-free keto holiday menu. I also did the Thanksgiving ones. You can save that for next year. It allows you to continue to eat keto, feel great, share things like sugar drop cookies, cream of asparagus soup, celery root salad, eggnog pudding, sausage skewers, which are my personal favorite, with your family. Totally rock the keto thing, and perhaps encourage your friends and family to look into a ketogenic eating style without forcing them. If they eat this brilliant keto meal, they’re going to be like, “What? This is how you eat every day? This is so amazing.” The second announcement is from one of our sponsors, Primal Kitchen. You can stock up on all Primal Kitchen goods by visiting HealthfulPursuit.com/primal and entering the coupon code FAT, all in caps, no spaces, for 15% off. They just launched a bunch of new things. I can’t even imagine. They hustle. It’s so encouraging to be partnering up with such a thriving business and a really, really awesome team. I like to partner up with companies that treat customers well, and treat me well, and have an awesome product. It’s so much more than just the project. The creativity in that group is just so fabulous, and I love supporting companies that align with my values as well. They love fat, which is so great, and I’m so happy that we got the coupon code FAT. How cool is that? So you can stock up on all of the goodies, again that’s coupon code FAT, all in caps, no spaces, for 15%. If you go to HealthfulPursuit.com/primal, it will redirect you to that store. My favorite thing is their classic mayo. I have also been loving their chipotle mayo lately, but I’m pretty sensitive to nightshade, so I had to take it pretty easy. I had it on a burger last night, with pickled turnips and sauerkraut, and that mayo with a burger recipe from, I think it was the Keto Beginning, the Everything Awesome Burger. I think it’s what it’s called. I don’t know. I write too many books, I don’t even know which recipe in which book. One of my books, it might even be Fat Fueled … Yeah, it is Fat Fueled. It’s totally Fat Fueled, where I mix mustard powder and a little bit of horseradish in my burgers. It was awesome. Okay. Let’s get right into it because I have a ton of thing to share. The first question is from Kara and Paula on how to know you’re in ketosis. My main question is how do you know if you’re in ketosis? I eat fairly low-carbs, maybe 50 per day, and try to stay away from sugar, but when I check ketones with the blood ketone meter, there doesn’t seem to be any. What do I do? The second question is from Paula, and she writes, “Hello Leanne. My question for you is how do I know if I’m in ketosis?” After the first couple of days of feeling not so great when I adapted the ketogenic protocol, I started to feel energetic around the third day. But come the fifth, I was experiencing keto flu. When I tested my urine for ketones, it said that I was producing moderate ketones. It’s now been two weeks, and I’m still feeling rather off. What can I do? Okay, this is a three-part question, plus a bunch of parts of answering. The first part of the question that I read is, how do you connect your body to know what it needs? With Kara’s question, she was talking about 50 grams of carbs per day, and she’s staying away from sugar, so that made me think, “Okay. How do you connect to your body, know what it needs?” Also with Paula, she was saying that she was testing for moderate ketones, it’s been two weeks. I mean that could be keto flu. Then the second piece of the question is, how do you know when you’re eating right for your body? Then the third piece is, how do you know when you’re in ketosis? Okay. For the first, how to connect to your body. In the case of Paula, she was talking about keto flu. This could very well be keto flu, and for some people, when you’re adopting, it just takes longer to adapt, and that’s totally normal. I would encourage you, Paula, to drink your keto lemonade. Make sure that you have enough electrolytes. I cannot stress this enough. When you think you’ve had enough electrolytes, double that. I’m not even kidding. What I like to do is do the keto lemonade, which you can find in either of my programs, or you could get something like a Vega electrolyte powder. I really like Ultima electrolyte powder, and shake that up and drink it a couple of times a day. You could also get potassium supplements, magnesium supplements. I like the powder more because I can drink it, and it’s way easier. Knowing what your body needs, and if you find two, three, four days, it’s not improving, you’re still feeling like garbage, you may want to try having a little bit of carbs in the evening just to see if that helps things. I’m not talking about a lot, just like a handful of some carb, like a sweet potato, or maybe an apple of with your dinner over a salad, and see how that feels in your body, and that’s totally okay to maintain that flexibility. Now with Kara, when it comes to connecting your body and knowing what it needs, you’re talking about 50 grams of carbs per day, and you’re staying away from sugar. That sounds pretty awesome. For the second piece of how to know when you’re eating right for your body, both of you sound like you’re pretty committed to this ketogenic things. In the case of Paula, she mentioned that he had been eating low-carb for a year, so that’s awesome. It sounds like it’s resonating with you. For Kara, it sounds like you’re pretty sensitive to sugar. Eating Keto sounds like it’s a pretty natural progression to you. For those listening, if you’re forcing yourself to do something that your body just doesn’t love. There are people out there that resonate with eating vegan, and I don’t understand it personally. I was a hot mess when I was vegan, but some people that are meant to be vegan and then tried ketogenic and it just isn’t working for them. It’s okay that your body just doesn’t like this eating style. Just like my body doesn’t like super, super strict keto, it doesn’t make me a bad person, or it doesn’t make me less worthy of talking about keto. It just means that my body is a little bit different, and everyone’s body is different. To the third piece that I notice in both of your questions is how do I know when I’m in ketosis. What are the signs? Fat adaption is where our bodies are using fat as energy, which is the preferred method of fuel for all humans. One of the reasons why we carry fat on our bodies, so we can use this fuel when dietary fuel is unavailable or scarce. What does burning fat as energy, AKA being fat adaptive, feel like? There are clear signs, the point to you being in fat burning mode. I want to differentiate the between fat burning mode, fat fueled, ketosis, because there’s a lot of misconception in the ketogenic community that if you’re not eating severely high fat, like more than 75% fat, you are not ketogenic. It doesn’t matter what your ketone say. You can be fat-adapted and still have quite a lot of carbs. The process of becoming fat-adapted comes when you lower your carbohydrates. For example myself, I can get away with 80 grams, 100 grams of carbohydrates now that I’m fat-adapted and still maintain a good ketone number. Whereas my friend Jimmy Moore, he always says that if he goes too high in the carbohydrates, we’re talking single digits here, even 10, maybe 20 grams, he says that it kicks him on a ketosis. He feels like garbage. Whereas if I go that low, I don’t feel well. It really, really depends on your body, and there are paleo people out there that can eat paleo, like a more higher carb paleo approach and be fat-adapted. You don’t need a ketogenic diet to become fat-adapted. Where the ketogenic diet worked well for me is getting off that carbohydrate train of the blood sugar highs and lows and the hypoglycemia, and all the craziness cravings, everything that was going on. When I became fat-adapted through ketogenic diet, I found like I could eat more carbohydrates. That’s just on the side there. How do you know if you are in ketosis? Well, the best way to know is to test, and there are three ways to test. One is urine; one is breath, one is blood. I think urine … Well, I know that urine doesn’t necessarily test correctly. What should happen is when you start to eat ketogenic, your body should become better and better at using those ketones, instead of dumping them into your urine. At a certain point, ideally or what a lot of people experience, is that the ketone stop showing up in the urine, so it’s not a really awesome way to test because it can be quite inaccurate. Breath, I have looked at breath monitoring, as well as blood ketone monitoring and put them side by side and test them at the same time, and I can’t really find a really good correlation. I find that the breath can be a little bit wonky in the breath testing. My option and what I love to do the most is blood ketone testing. I haven’t tested in quite a long time, because I find it triggering to my experience. I know that I’m in ketosis, and I know that I’m fat burning when I kind of hit a couple of markers for myself. For me personally, now that I’m fat-adapted, I’ve been eating ketogenic for over a year and a half. I know that when I wake up in the morning and I’m not hungry, and I can go until around 11:30 to 1:30 without feeling like I need to eat, when I crave fat when I’m hungry, those are good indications now that I’m fat-adapted that I’m continuing to fat burn. If your first getting started, some signs that you may want to watch for if you don’t want to test or you don’t have the cash to test, because it can be quite expensive to test your blood, some signs you may want to look for are the ability to skip meals without getting angry. The second one is that it’s easy to go three, four, five hours without a snack. The third one is you don’t get ravenous or crave carbs two to three hours after your last meal. The fourth is you crave high-fat foods over high carb foods. The fifth, exercise doesn’t require carbs to push through plateaus. In the case of Paula, she was mentioning in her question about working out and not having the energy to do that. It may be a sign that you’re not quite fat-adapted yet. When you start to gain that energy and you start to be able to push through plateaus without needing those carbohydrates as a previous runner. I can attest to the fact that if I ran more than 15 kilometers, I needed the carbs in my body. Otherwise, I’d bunk, and that sucked. The sixth is you have copious amounts of energy. Again, Paula was mentioning that after a couple of days, she had more energy and stuff. In the case of Paula, I feel like you’re pretty well fat-adapted, other than the fact that you do not have the energy. This could be two things. One is you’re not having the energy because you’re not fat adapted, but the reason I feel like you’re on the right path is that you’ve said after two days you were totally crashing it and you had a lot more energy. I think in the case of Paula, it’s a matter of your electrolytes and making sure that those are balanced, and you should just slide into ketosis and match all of these signs that you are now using fat as fuel. The seventh is you experience steady even energy throughout the day, without afternoon crashes. The eight is that your thoughts seem lighter, clearer, and more concise. If you’ve been fat adapted for quite some time, you know exactly how awesome your brain feels on ketosis. Any of the fat fuel profiles that you chose, and the fat fuel profiles are from my program, Fat-Fueled, you should be able to fat adapt. Whether your carbohydrates or lower, it shouldn’t matter. If you are on the right fat-fueled profile for your body and you’re adapting, the eating styles work well for you; then you should be able to completely feel awesome on a ketogenic diet, assuming that it’s right for your body. For Kara, I think I answered your question on how to know if you’re in ketosis. Everything looks pretty good there because you mentioned that you were checking your ketones with a blood ketone meter and there didn’t seem to be any. I would give it time. Know that fat adaption takes time, and be comfortable with that, and be okay with that. I would say that if after 30 days, your blood ketone meter is still registering zero, there are a couple of things that you can do. The first one starts eating more and start fasting. Starting eating more food and start fasting, and don’t restrict your food when you’re fasting. Please don’t restrict your food when you’re fasting. The second one could be to lower your carbohydrates. Now we’re not talking about a lot. Maybe lower them five grams and see how that goes, and then maybe another five. I wouldn’t go from 50 grams of carbs per day down to 20. That might be a little bit too drastic for your body. Start with that and see how you go.
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I have low DHEA, and I’m taking 10 milligrams a day, and my doctor has recommended that I start supplementing with pregnenolone. I also have adrenal dysfunction. My numbers were lower than Leanne’s when she went through her adrenal dysfunction. I end up wondering how does all of this work together. If I take DHEA and pregnenolone, will it help balance my adrenal dysfunction? This is a question I get all the time. It usually comes in the form of, “I’m tired all the time. What the heck?” I flush it out a little bit to give you more details about really the pathways to all of this. First off, my recommendation would be to check out the episode with Dr. Uzzi Reiss, so good, on The Keto Diet Podcast. I loved interviewing him. Well, DHEA and adrenal dysfunction, they often occur side by side. This is something that I have worked on balancing for quite a long time. For those who aren’t familiar with DHEA, it’s a natural steroid and a precursor hormone produced by the adrenals. It’s synthesized from cholesterol. If your cholesterol levels are low, a high-fat diet will level them out and aid in hormone production long terms. This was the case in my experience with going ketogenic. Once my cholesterol balanced out, I was able to produce some of the hormones I couldn’t because my cholesterol was too low. A lot of people supplement with DHEA when it’s not needed so it’s anyone. It this conversation triggers interest in you, I highly advise that you test your DHEA-S before supplementing and know that it declines as we age. A lower DHEA number on a 70-year old compared to 20-year old is normal, but you may want to work with a hormone specialist to figure out your DHEA. In the case of my adrenal dysfunction, once I started supplementing with DHEA, it helped my adrenals. When using circumstances where people need it, DHEA can assist in jump starting our hormone balance because it’s a precursor to estrogen, progesterone, and testosterone. It’s like the mama hormone, it’s so great. In addition to taking DHEA, your adrenals also make stress hormones called cortisol and adrenaline. Many of us know that our adrenals create cortisol. Maybe a lot of us know about adrenaline, but I don’t think a lot of people know about DHEA. Upon supplementation, some women may use it to make more estrogen, while others will use it to make more testosterone. It totally depends on your body. That’s why testing, even when you start taking DHEA, is so, so important. Some of the sign of adrenal dysfunction and where you may want to focus if you also have low pregnenolone could be chronic stress, yo-yo dieting, emotional turmoil, and this includes negative body image, poor nutrition, and job related stress. After a while, what happen is that your adrenal get tired of pumping of cortisol and they simply can‘t manufacture enough DHEA to support healthy hormonal balance. When you have enough DHEA, so say your adrenals are totally awesome, and your cortisol balance, and you have enough DHEA, your body can produce the hormones it needs when it needs some. Your mood will be stable. You will feel clear headed. You’re joyful without meaning to like you don’t need to really necessarily have a gratitude practice. You’re just snapping your fingers to the beat and feeling happy all the time, or most of the time. You have a refreshing zest for life, and you’re just feeling good. If you don’t feel these things, it could be a sign that your DHEA is a little bit off. If you’ve determined that DHEA supplementation is required, as we mentioned in the episode with Dr. Uzzi Reiss, bio-identical sublingual is the best. In addition to supplementing with DHEA, what you might want to do in order to balance out the DHEA, pregnenolone, cortisol, stuffs that’s going on in your body is connecting with people, going out with friends, going out with family for dinner, for snacks, for activities, and really connecting with people. Not so much like, “How was your day?” “Oh, mine was good.” “How is Sam?” “Oh, he’s good.” But just like connection, talking about things that matter to you. Finding play in every day. If you have a dog, they’re great for playing, and they can make you feel good about a lot of things. Finding positive movements. In my case, it’s continuing with my yoga practice and making time for myself with that positive movement that makes me feel good. Not that I feel guilty, and I’m comparing myself to others, but just at the moment, loving the way that my body moves. Finding your people either in a spiritual group or community, really connecting with people ties in line with that connection of just feeling like you’re part of something. Let’s go through a little bit about hormones and how they’re made in your body so that you can understand the flow of things. There’s cholesterol, and I imagine this being like a big umbrella. Cholesterol is the very top, and then you have pregnenolone which then converts over to DHEA, and DHEA then makes testosterone and estradiol estrone. That’s part of that pathway. Under pregnenolone, progesterone is also created. Cortisol is created through the pregnenolone piece. What can happen is if you’re super, super stressed out, it’s called the pregnenolone steel. Instead of being used to create sex hormones, pregnenolone can be used to make copious amounts of cortisol instead, so kind of switches out that whole process of producing progesterone or moving over to DHEA and producing testosterone and estradiol, and go straight to cortisol. This is called the pregnenolone steel. It’s not a very good thing. Pregnenolone is the memory enhancer. If you’re finding like your memory is a little bit off and you’re not having a good time mentally, often that’s a good sign that your pregnenolone is being used to convert cortisol, instead of doing what it needs to do to balance out your hormones. Where we see this most is people suffering from stage three or four adrenal fatigue, and this is where your cortisol becomes low, low, low, low. The individual that were asking this question about adrenal dysfunction and where my levels were at, I was moved on to stage three, almost at stage four. My cortisol was super, super low. Some things you may want to do to mitigate this, in addition to checking out your DHEA, even testing your cortisol and seeing where that’s at, is some pieces of supplementation. I find that pregnenolone replacement improves energy, vision, memory, clarity of thinking, well-being, and sex drive. However, it may worsen existing fatigue and may even trigger adrenal crashes. If you are working with a doctor and they’re like, “Heck yeah, just take pregnenolone.” make sure that you chat with them about what your options are. It’s not like I’m saying don’t do it, but just be mindful of that because it can further your adrenal issues. The more advance adrenal weakness, the more likely such experiences are common. If you have stage on or maybe even two adrenal dysfunction, it may be worthwhile looking at pregnenolone to supplement. If you are beyond that stage, what I did is supplement with DHEA and Cortef, which is hydrocortisone, in order to get my levels back up, so that my pregnenolone could happen naturally. Often times, and in my case, people with adrenal dysfunction are prescribed DHEA and hydrocortisone. That’s that Cortef that I was talking about. As someone who struggled with the cortisone treatments, it’s not something that I would personally recommend unless you are chatting with a doctor and working with that. I go off and on it. I’m currently back on it because writing a book is hard, and it’s a lot of work, and stressful. I was finding that I needed that Cortef to bump up my levels and make me feel pretty good. If you are approaching your health from a place of balance and listening to your body, which I wasn’t, then it shouldn’t be a problem. It kind snuck up on me and made it a little bit challenging. There are other adrenal support items that you could take. You could look at supplementing with adrenal gland, sny of the B vitamins are great. I found that any of the adaptogen herbs made it worst for me, but one step at a time, positive movement. I would highly recommend if you’re doing things like spin classes or running, or high intensity workouts, you might want to stop doing that at least for now. I know everyone hates when I say that. It can be real, really, really helpful to just give your body a little bit of time to do its thing and heal and feel great.
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My macros are 1,250 calories, 65 grams of fat, 15 net carbs, and around 100 grams of protein because I lift weight six days a week. I lift weight six days a week.” I just wanted to reiterate that. “Also, I have noticed this incredibly irritating feeling like I’m constantly annoyed. Is this normal? I am also going through amenorrhea for the past nine years, so I’m doing keto, so I can hopefully restore my cycles.” Okay, Dana, my advice to you as somebody who struggled with amenorrhea for eight years is that my experience, you need to stop lifting weights. You need to sit down, you need to eat all the things, and you need to continue to sit down. Have you ever watched Gilmore Girls? It’s great. It has seven seasons. You could sit and watch all seven seasons, and eat when you’re hungry, and just sit and eat, and sit, and maybe you go for a walk when you want to get up, stretch your legs. Then get back to sitting and eating. What happened, it’s interesting. I’ll share a little story with you. I had amenorrhea for eight years. I got my period my back about a year and a half ago. Last month, I finally decided, “Okay. I love cycling; I’m going to start cycling again.” We cycled twice, and I didn’t change anything else, and my period is now late by ten days. I’m not even kidding. At the time, I was like, “Oh, I wonder like I’m just going to play around, a little bit more working out.” and I started getting stressed about it with the schedules. I went twice and my period is late. I am a very delicate flower, and you might be as well. Dana, the fact that you’re only eating 1,250 calories and you’re working out six days a week, this is crazy to me. If you do not want to give up the lifting weights, and you want to take things like baby steps, you need to eat when you’re hungry. Your body is starving because your body is really hungry. It’s asking you for food. If you continue on this path, given my experience on amenorrhea, not having a period for that long, restricting what you’re eating is not going to help the situation. I wish, I wish, wish, wish, somebody had like … I wish I had submitted a question on the podcast and somebody had said this to me, because the path you’re going down in my experience, will not get your period back. A period is such a great indication of health and where you at right now, so the fact that your body is telling you that you’re hungry, and you’re telling it like, “Too bad we’re on this diet, and there’s nothing you can do about it.” You need to listen to that. I would say your first step is start eating enough. When you’re hungry, eat. When you’re hungry, eat. When you’re hungry and you’re eating because … I Have a feeling, because you’ve been dealing with amenorrhea and you’re working out this much, you’re probably a lot like me, and you’re like, “Oh my God. I can’t eat that much because then what’s going to happen is I’m going to eat all the things, and I’m going to get heavy. My life is going to be over, and nobody is going to love me.” It’s okay. It’s totally fine. Everyone is still going to love you. Life is still going to go on. You know babies are still going to be born, and your friends are still going to love you, it’s totally okay. What you need to do first and foremost is, when you’re hungry, you need to eat. When you’re eating if you’re stressing out about all of the things, repeat the same things over and over in your head, “I’m nourishing my body. I’m nourishing my soul. I’m nourishing my body. I’m nourishing my soul.” If soul doesn’t feel comfortable with you, make up your mantra. For me, at that moment when I was starting to eat enough to get my period back, that’s what I needed to hear constantly. If you wake up in the middle of the night and you’re hungry, eat. If you wake at nine o’clock in the morning and you’re hungry, eat. If you don’t feel like fasting that day, eat, like just eat. Then after a couple of weeks/months, whenever you’re comfortable with that strategy, move on to perhaps maybe taking a break from lifting weights, go for a walk, just get out in the sun. There are a bunch of reasons why amenorrhea happens. First and foremost, birth control, exercise, your weight is too low, nutrition stress. For weight, it’s quite phenomenal. I have this; I call them my period-jeans. When I fit the jeans perfectly, I know that my weight has gone too low, and I won’t get my period. When the jeans are pretty snug, I know that I’m going to get my period that month. I’m not even kidding. My weight so, so, so dictates whether or not I’ll get my period. To me personally, having my period is the most important thing in my life right now. If I’m not getting my period, there’s something that I’m doing wrong. My period being 10 days late, I was like, “Oh shoot. Probably shouldn’t do spin again.” Hormones are so important. What I mentioned previously about a period being such a great sign of your health is that it helps with your menopause. Dana, if you go another 10, 15, 20 years not getting your period, your menopause is going to be a hot mess. In my case, I was diagnosed to be in menopause already, and I was in my early 20s. Having balanced hormones helps with weight stabilization, metabolism, mood, hair, skin, nails, you name it. You want estrogen. You want progesterone. You want pregnenolone. You want a little bit of cortisol running through there. You want those things to be balanced. When you’re not getting your period, you’re not going to be experiencing that. I would say that some things you might want to look at in addition to eating enough is supplementing with things Vitex. Vitamin B6 is a good option. I would take that with a good B complex, and make sure that you’re doing vitamin C. That can be helpful too for adrenal support. Then I would recommend also testing your thyroid, and seeing whether that is at. Your free T3 should be around 6.5, and your TSH should be around 1.4. Since your adrenals may be of question, making sure that your adrenals are functioning properly, I would test your cortisol a.m. That’s a test that you can do before 9:00 am and it should be tested through the blood, and the number should be around 550. Also, your state of mind is going to be really big here. We chatted about repeating, “I’m nourishing my body. I’m nourishing my soul.” while you’re eating. The food you’re eating is probably perfect for this. You’re eating keto. It’s going to help you produce cholesterol to get those hormones revving up, but you need to make sure you’re eating enough. You need to give yourself full permission to eat. Full permission. You know what? If that means that at this current time you want corn chips, you don’t have your period; I would say go for it, girl. Just get your period. Get your period. Then another thing that you might want to learn and play around with is trusting your body. Like the corn chips example, if what you want is corn chips, have the corn chips. If you don’t feel like eating this morning, don’t eat. If you feel like eating a whole bunch when you wake up at two o’clock in the morning, you got to eat a whole bunch. A changed body is not a bad body. That’s something I reminded myself of frequently. Make sure you have compassion toward yourself and future self. Practice might work if you just go to the Google machine and type in “future self-meditation,” you can find it. That might be helpful. Positive movement, maybe switching out those heavy lifts and things like that and weight with walking or yoga, and something that isn’t restrictive that makes you feel feminine and amazing and tapping into that feminine energy. Those are the questions for this episode. I loved answering your questions. If you guys have more questions or you have suggestions on upcoming episodes that you want to hear, definitely email me at email@example.com, and I’ll include everything that I mentioned in today’s episode. If there are supplements and things that you’re curious about, they’ll be in the show notes, which you can find at HealthfulPursuit.com/podcast/e10 and I’ll see you next week. That does it for another episode of The Keto Diet Podcast. Thanks for listening in. You can follow me on Instagram by searching Healthful Pursuit where you’ll find daily keto eats, other fun things. Check out all of my keto-supportive programs, bundles, guides, and other cool things over at HealthfulPursuit.com/shop. I’ll see you next Sunday. Bye
This entry was tagged: adrenals, eating high-fat, eating keto, eating low-carb, fat-adapted, how eat keto, keto basics, keto diet, keto for women, keto life, ketogenic diet, ketogenic for women, ketosis, low-carb paleo, what is keto
HI! I’M LEANNE
Nutrition educator + keto enthusiast. I want to live in a world where every woman loves her body, nourishing fats are enjoyed at every meal, and the word “restriction” isn’t in the dictionary.