Quick answer: To track keto macros, set targets for net carbs, protein and fat, log what you eat in an app or spreadsheet, and record your weight and how you feel. Review weekly: if progress stalls or you feel unwell, adjust your carbs, protein or calories gradually, ideally with your provider.
Key takeaways
Macro targets start from the keto calculator and are then personalized to your health and goals.
Logging foods as you eat them, including oils and sauces, gives an accurate picture of net carbs, protein, fat and calories.
Reviewing your log weekly and changing one thing at a time makes it easier to see what works.
Setting macro targets
Start with the keto macro calculator. These ranges are general education, not a prescription; your needs depend on your health, medications and goals, so personalize them with your provider.
Tracking your macros
Use a food tracking app or a simple spreadsheet, and log foods as you eat them, including oils and sauces. Track net carbs, protein, fat and total calories, and record your weight, energy, sleep and symptoms.
Sample tracking columns
- Date
- Meal and foods
- Net carbs
- Protein
- Fat
- Calories
- Weight
- Notes (energy, cravings, sleep)
Adjusting your macros
Review your log weekly. If your weight stalls, check hidden carbs and portion sizes, and if you feel weak, check electrolytes and protein. Make one change at a time.
Healthy aging lens
Tracking for a few weeks teaches you portion sizes and food patterns that last. See measuring your results.
When to see a naturopathic doctor
It may be time to see a naturopathic doctor if you have diabetes or take insulin, sulfonylureas or SGLT2 inhibitors (risk of low blood sugar or ketoacidosis), or if you take blood pressure medication or diuretics. The same is true if you have kidney, liver, gallbladder or pancreas disease, or high cholesterol, if you are pregnant, breastfeeding, or have a history of disordered eating, or if you want a keto plan tailored to your labs and goals.
See a medical provider promptly for nausea and vomiting, abdominal pain, confusion, fruity-smelling breath with rapid breathing, or very high blood sugar or ketone readings, which can signal ketoacidosis.
What the research shows
Tracking matters partly because most of us misjudge what we eat. In a 1992 New England Journal of Medicine study by Lichtman and colleagues, 10 adults who said they could not lose weight on fewer than 1,200 calories a day were measured carefully for 14 days. Their metabolism was normal, but they underreported their food intake by an average of 47% and overreported their activity by 51%. It was a small, select group, so the size of the gap will vary from person to person.
Keeping records seems to help. In the Weight Loss Maintenance trial reported by Hollis and colleagues in 2008, 1,685 overweight adults on blood pressure or cholesterol medicines attended 20 weekly group sessions and were asked to keep food records. They lost 5.8 kg on average in 6 months, and behaviors such as the number of food records kept and minutes of activity explained most of the difference in weight loss between people. This program was not a keto diet and had no control group in this phase, so it shows that self-monitoring goes along with better results rather than proving it causes them.
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Questions to bring to your clinician
These questions can help you get the most out of your next visit.
How should I adjust my macros if my weight stalls or I feel weak?
How closely should I track my macros and weight on keto?
What is a healthy rate of change for me to aim for?
How can I keep tracking from becoming stressful?
Frequently asked questions
Do I need to track macros on keto?
It helps, especially at first.
What’s the best way to track?
An app or spreadsheet, whichever you’ll use consistently.
How often should I adjust my macros?
Review weekly and make small changes.
Should I count calories too?
Sources
- Lichtman SW, Pisarska K, Berman ER, et al. Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. N Engl J Med 1992. PMID: 1454084. https://pubmed.ncbi.nlm.nih.gov/1454084/
- Hollis JF, Gullion CM, Stevens VJ, et al. Weight loss during the intensive intervention phase of the weight-loss maintenance trial. Am J Prev Med 2008. PMID: 18617080. https://pubmed.ncbi.nlm.nih.gov/18617080/
- Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc 2011. PMID: 21185970. https://pmc.ncbi.nlm.nih.gov/articles/PMC3268700/
- Zheng Y, et al. Self-weighing in weight management: a systematic literature review. Obesity (Silver Spring) 2015. PMID: 25521523. https://pubmed.ncbi.nlm.nih.gov/25521523/
- Hall KD, et al. Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men. Am J Clin Nutr 2016. PMID: 27385608. https://pmc.ncbi.nlm.nih.gov/articles/PMC4962163/
- MedlinePlus: Carbohydrates
- MedlinePlus: Weight Control
This article is for educational purposes only and is not medical advice. It does not replace an individual evaluation. Talk with your healthcare provider before starting supplements or changing medications, especially if you are pregnant, nursing, or managing a health condition.
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