A recurring theme here on Physio Answers is using Active Solutions for problems with activity. Stretching, massage, manipulation, needling etc, are all passive and temporary ways to make you feel better. In the end, they have rapid but fleeting effects. If you really want to change the perception of tightness or pain, you need to take active steps in your own recovery.

Dr. Leon Knight, aka @theperformancedoc is back with a simple loading strategy for neck pain or a chronic tight neck. Thoughts?

The ketogenic diet is low in carbs, high in fat and moderate in protein.
Carbs are typically reduced to less than 50 grams per day to reach and maintain ketosis — a metabolic process in which your body burns fat for fuel instead of glucose (12).
Since this way of eating is composed mostly of fat — generally around 75% of your intake — keto dieters often turn to high-fat animal products, such as meats, butter and full-fat dairy.
However, those who eat plant-based diets, including vegans, can follow a ketogenic diet as well.
People on a vegan diet consume only plant-based foods, such as vegetables, fruits and grains, and avoid animal-based foods like meat, poultry, eggs and dairy.
Vegans can reach ketosis by relying on high-fat, plant-based products like coconut oil, avocados, seeds and nuts.
SUMMARYThe vegan keto diet is a low-carb, high-fat, moderate-protein diet that excludes all animal-based foods.

Several health benefits are associated with vegan and ketogenic diets. However, no studies focus specifically on vegan keto diets.
Following a vegan diet has been shown to lower the risk of chronic health conditions, such as heart disease, diabetes and certain cancers.
For example, studies have observed that vegans have a 75% lower risk of developing high blood pressure and up to a 78% risk reduction of type 2 diabetes (3).
What’s more, vegans tend to weigh less than non-vegans, and those who adopt vegan diets are more successful at losing weight than people who eat animal products (4).
A review of 12 studies found that over 18 weeks, people who followed vegan diets lost an average of 5.5 pounds (2.52 kg) more than participants on non-vegetarian diets (5).
Like the vegan diet, research has shown that following the high-fat, low-carb ketogenic diet may positively impact your health.
The keto diet is well known for its effectiveness in weight loss, blood sugar control and reduced heart disease risk factors.
A study in 58 obese children and teens showed that participants following a ketogenic diet lost significantly more weight and fat mass than those on a low-calorie diet.
In addition, the keto diet significantly raised levels of adiponectin, a protein involved in blood sugar regulation and fat metabolism (6).
Higher levels of adiponectin have been associated with better blood sugar control, reduced inflammation and a lower risk of obesity-related diseases, including heart disease (78).
Ketogenic diets have also been shown to reduce heart disease risk factors, including high triglycerides, blood pressure and “bad” LDL cholesterol (9).
Being that both vegan and ketogenic diets may benefit your health in similar ways, it’s likely that combining the two by following a vegan keto diet would positively impact health as well.
SUMMARYBoth vegan and ketogenic diets have been linked to health benefits, including weight loss and a lower risk of heart disease and diabetes.

When following a vegan keto diet, you must significantly reduce your carb intake and replace carbs with healthy fats and vegan sources of protein.
Animal products, including eggs, meat, poultry, dairy and seafood, are excluded on a vegan keto diet.
Here are examples of foods that should be completely avoided:
  • Meat and poultry: Beef, turkey, chicken, pork.
  • Dairy: Milk, butter, yogurt.
  • Eggs: Egg whites and egg yolks.
  • Seafood: Fish, shrimp, clams, mussels.
  • Animal-based ingredients: Whey protein, honey, egg white protein.
Here are examples of foods that should be significantly reduced:
  • Grains and starches: Cereal, bread, baked goods, rice, pasta, grains.
  • Sugary drinks: Sweet tea, soda, juice, smoothies, sports drinks, chocolate milk.
  • Sweeteners: Brown sugar, white sugar, agave, maple syrup.
  • Starchy vegetables: Potatoes, sweet potatoes, winter squash, beets, peas.
  • Beans and legumes: Black beans, chickpeas, kidney beans.
  • Fruits: All fruits should be limited. However, small portions of certain fruits like berries are allowed.
  • High-carb alcoholic beverages: Beer, sweetened cocktails, wine.
  • Low-fat diet foods: Low-fat foods tend to be high in added sugar.
  • High-carb sauces and condiments: Barbecue sauce, sweetened salad dressings, marinades.
  • Highly processed foods: Limit packaged foods and increase whole, unprocessed foods.
The level of carbohydrate restriction when following a vegan keto diet varies depending on your health goals and individual needs.
In general, healthy, high-fat vegan foods and vegan protein sources should make up the majority of your diet.
SUMMARYAnimal products, as well as high-carbohydrate foods such as grains, sweetened beverages and starchy vegetables, should be restricted when following a vegan keto diet.

When following a vegan keto diet, it’s important to focus on vegan, healthy foods that are high in fat and low in carbs.
Foods to eat on a vegan keto diet include:
  • Coconut products: Full-fat coconut milk, coconut cream, unsweetened coconut.
  • Oils: Olive oil, nut oil, coconut oil, MCT oil, avocado oil.
  • Nuts and seeds: Almonds, Brazil nuts, walnuts, hemp seeds, chia seeds, macadamia nuts, pumpkin seeds.
  • Nut and seed butter: Peanut butter, almond butter, sunflower butter, cashew butter.
  • Non-starchy vegetables: Leafy greens, Brussels sprouts, zucchini, broccoli, cauliflower, peppers, mushrooms.
  • Vegan protein sources: Full-fat tofu, tempeh.
  • Vegan full-fat “dairy”: Coconut yogurt, vegan butter, cashew cheese, vegan cream cheese.
  • Avocados: Whole avocados, guacamole.
  • Berries: Blueberries, blackberries, raspberries and strawberries can be enjoyed in moderation.
  • Condiments: Nutritional yeast, fresh herbs, lemon juice, salt, pepper, spices.
Though the keto diet cuts out many food groups that vegans rely on, such as whole grains and starchy vegetables, a vegan keto diet can be followed with careful planning.
Vegan keto dieters should get their calories from whole, unprocessed foods while avoiding highly processed vegan foods.
SUMMARYVegan keto diet foods include non-starchy vegetables, avocados, nuts, seeds, coconut, vegan protein sources and healthy oils.

Though the vegan keto diet may seem very restrictive, many meals can be constructed using vegan-friendly ingredients.
Following is a one-week sample menu for the vegan keto diet:


  • Breakfast: Keto porridge made with full-fat coconut milk, ground flaxseeds, chia seedsand unsweetened shredded coconut.
  • Lunch: Vegan cream and low-carb vegetable soup.
  • Dinner: Cauliflower rice stir-fry with tofu.


  • Breakfast: Tofu scramble with vegan cheese and avocado.
  • Lunch: Zucchini noodles with walnut pesto and vegan cheese.
  • Dinner: Vegan walnut chili with vegan cheese and sliced avocado.


  • Breakfast: Chia pudding made with full-fat coconut milk topped with sliced almonds.
  • Lunch: Creamy coconut and cauliflower soup.
  • Dinner: Shirataki noodles with mushrooms and vegan Alfredo sauce.


  • Breakfast: Full-fat coconut yogurt topped with nuts, seeds and unsweetened shredded coconut.
  • Lunch: Tofu, vegetable and coconut curry.
  • Dinner: Cauliflower crust pizza topped with non-starchy vegetables and vegan cheese.


  • Breakfast: Tofu scramble with vegan cheese, mushrooms and spinach.
  • Lunch: Vegetable and tofu salad with avocado dressing.
  • Dinner: Eggplant lasagna made with vegan cheese.


  • Breakfast: Vegan keto smoothie with full-fat coconut milk, almond butter, cocoa powder and vegan protein powder.
  • Lunch: Vegetable and tofu salad with avocado dressing.
  • Dinner: Cauliflower fried rice.


  • Breakfast: Coconut almond chia pudding.
  • Lunch: Large green salad with tempeh avocado, vegan cheese, non-starchy vegetables and pumpkin seeds.
  • Dinner: Vegan cauliflower mac and cheese.

Vegan Keto Snacks

Try out these vegan-friendly snacks to keep your appetite in check between meals:
  • Sliced cucumber topped with vegan cream cheese
  • Coconut fat bombs (high-fat snacks made with coconut butter, coconut oil and shredded coconut)
  • Nut and coconut bars
  • Coconut milk and cocoa smoothie
  • Trail mix with mixed nuts, seeds and unsweetened coconut
  • Dried coconut flakes
  • Roasted pumpkin seeds
  • Celery sticks topped with almond butter
  • Coconut milk yogurt topped with chopped almonds
  • Olives stuffed with vegan cheese
  • Guacamole and sliced bell pepper
  • Cauliflower tater tots
  • Coconut cream with berries
SUMMARYThere are many delicious foods to choose from when following a vegan keto diet. Meals and snacks should be high in healthy fats and low in carbs.

via Authority Nutrition 
Photo by Wiktor Karkocha on Unsplash

Many people worry about gaining weight when eating later than a particular time.
One common suggestion is to not eat after 8 p.m., but advice about eating at night is misleading.
In reality, what you eat is much more important than when you eat.
This article separates fact from fiction when it comes to late-night eating and weight gain.
Eating at Night

The idea that eating at night makes you gain weight stems from animal studies, which suggest that the body may use consumed calories differently past a certain time of day.
Some researchers hypothesize that eating at night goes against your circadian rhythm, which is the 24-hour cycle that tells your body when to sleep, eat and wake (1).
According to your circadian rhythm, nighttime is for resting, not eating.
Indeed, several animal studies support this theory. Mice that eat in opposition to their circadian rhythm gain significantly more weight than mice that only eat during waking hours, even if they eat the same amount of food (234).
However, not all studies in humans support this notion.
In fact, studies in humans indicate that it’s not necessarily the time you eat, but how much you eat that matters (56).
For example, a study in over 1600 children found no link between eating dinner past 8 p.m. and excess weight. In this study, late eaters did not appear to consume more total calories (7).
However, when researchers tracked the eating habits of 52 adults, they found that those who ate past 8 p.m. consumed more total calories than earlier eaters. The extra calories consumed by late eaters could lead to weight gain over time (56).
Overall, when your total calorie intake falls within your daily needs, weight gain does not appear to happen merely as a result of eating at night.
SUMMARYThough several animal studies have linked eating at night to increased weight, human studies show that eating beyond your daily calorie needs leads to weight gain, unrelated to what time of day you eat.

One explanation for the association between eating at night and weight gain is the tendency for late eaters to eat more calories overall.
Regardless of timing, eating more calories than you need will lead to weight gain.
For example, researchers looked at the relationship between meal timing and total calorie intake of 59 people. Notably, individuals who ate closer to their bedtime ate more calories overall than those who ate their last meal earlier (8).
Another study found that people who ate between 11 p.m. and 5 a.m. consumed roughly 500 more calories per day than those who limited their intake to daytime hours. Over time, the average nighttime eater gained 10 more pounds (4.5 kilograms) (9).
Thus, eating at night may lead to weight gain only if you eat a surplus of calories.
SUMMARYThose who eat at night tend to eat more and, therefore, consume extra calories. Over time, a surplus of calories can lead to weight gain.

Not only do late eaters tend to eat more food, they often make poorer food choices as well.
At night, you may be more likely to choose unhealthy, calorie-dense foods. These are foods with little nutritional value, such as chips, soda and ice cream.
There are many possible reasons for this. For one, late-night eaters may not have easy access to healthy food.
People who work night shifts are a good example of this. Many studies suggest that night-workers tend to snack on unhealthy foods for convenience, as there may be a lack of healthy options available in the workplace at night (5101112).
Emotional eating is another factor leading to poorer food choices at night. It’s important to discern between true hunger and eating due to stress, anxiety, boredom or sadness (13).
Furthermore, tiredness has been linked to increased food intake and a desire for high-calorie foods. This is may be due to hormonal changes that influence appetite during sleep deprivation (1415).
Again, when it comes to weight gain, what you eat matters more than when you eat. If you eat within your daily calorie needs, you won’t gain weight simply by eating at night.
If you’re truly hungry after dinner, consider choosing nutrient-dense foods and beverages. These are lower-calorie foods with high nutritional value.
Some great options include:
  • Carrot and celery sticks with hummus
  • Apple slices with a small portion of your favorite nut butter
  • Plain air-popped popcorn
  • A handful of frozen grapes
SUMMARYPoor food choices are more likely late at night when fewer healthy options are available. Emotional eating or eating when tired may also lead to poor food choices. Choose nutrient-dense foods if you’re truly hungry after dinner.

Though the total number of calories you eat is what ultimately affects your weight, research shows that there may be ways to regulate your appetite through meal timing and frequency.
For example, multiple studies indicate that eating a higher-calorie breakfast may keep you fuller longer and possibly prevent overeating at night (1617).
In one study, people eating a 600-calorie breakfast had lower appetites and significantly fewer cravings during the day than those eating 300 calorie for breakfast. Especially cravings for sweets were reduced (16).
Keep in mind that breakfast may not be necessary if you eat late at night — at least not at the traditional time. Follow your hunger cues and you may find yourself eating your first meal later than usual.
You may also want to consider eating smaller meals more frequently. Some, but not all, studies suggest that this may help you manage your appetite and lessen feelings of hunger throughout the day (181920).
Therefore, changing your meal timing and frequency may be a strategy to reduce overall calorie intake by managing hunger.
SUMMARYAppetite and cravings may be managed by eating more calories earlier in the day and by eating small and frequent meals. These strategies may prevent overeating at night.

Physiologically, calories don’t count for more at night.
You won’t gain weight by merely eating later if you eat within your daily calorie needs.
Still, studies show that nighttime eaters typically make poorer food choices and eat more calories, which can lead to weight gain.
If you're hungry after dinner, chose nutrient-dense foods and low-calorie beverages.
You may also want to consider eating a higher-calorie breakfast or frequent, small meals throughout the day to manage appetite and stave off late-night cravings.