What Everybody Ought To Know About Ketosis
Recently I wanted to explore the world of Ketosis. I thought I knew a little bit about ketosis, but after doing some research I soon realised how wrong I was. 3 months later, after reading numerous books, listening to countless podcasts and experimenting with various diets I know have a sound understanding of ketosis. This resource is built as a reference guide for those looking to explore the fascinating world of ketosis. It is a resource that I wish I had 3 months ago. As you will soon see, a lot of the content below is not mine, instead I have linked to referenced to experts who have a greater understanding of this topic than I ever will. I hope this helps and if there is something that I have missed please leave a comment below so that I can update this. Also, as this is a rather long document, I have split it into various sections. You can click the headline below to be sent straight to the section that interests you. For those that are really time poor I have created a useful ketosis cheat sheet guide. This guide covers all the essential information you should know about ketosis. It can be downloaded HERE. Alternatively, if you're looking for a natural and sustainable way to improve health and lose weight head to this page - What is Ketosis? What Are The Benefits from being in Ketosis? Isn’t Ketosis Dangerous? Ketoacidosis vs Ketosis What Is The Difference Between a Low Carb Diet and a Ketogenic Diet? Types of Ketosis: The Difference Between Nutritional, Therapeutic & MCT Ketogenic Diets Is The Ketogenic Diet Safe? Long Term Effects Thyroid and Ketosis - What You May Want To Know What is a Typical Diet/Macro Breakdown for a Ketogenic Diet? Do I Need to Eat Carbs? What do I Eat On a Ketogenic Diet? What Do I Avoid Eating on a Ketogenic Diet? Protein Consumption a Continue reading >>
Is It Possible To Be Extremely Active And Eat A Low Carbohydrate Diet?
In today’s interview, I speak with a surgeon, engineer and relentless self-experimenter, Dr. Peter Attia (pictured above as he swims across the Catalina Channel), about whether it is possibly to be extremely active and eat a low carbohydrate diet. If you’ve ever wondered whether it’s possible to keep yourself in a “ketogenic”, low carbohydrate state and still swim, bike, run, lift and do other extreme sports and activities, then this audio will answer all your questions. Let’s begin with a video of a workout being done by Dr. Attia, who I interview in today’s podcast: And he does all that while eating only 30-50 grams of carbohydrates per day! Dr. Attia (pictured right) of Canada is a relentless self-experimenter who has spent the last two years examining the role of nutrition on all aspects of personal performance. He is a former McKinsey & Company consultant, surgeon, engineer, calculus teacher and an author of numerous medical and research papers. Dr. Attia received his medical degree from Stanford University and holds a B.Sc. in Mechanical Engineering and Applied Mathematics from Queen’s University in Kingston, Ontario, Canada, where he also taught and helped revamp the calculus curriculum. He did his surgical training at the Johns Hopkins Hospital in Baltimore, Maryland. He also did a fellowship in surgical oncology at the National Cancer Institute in Bethesda, Maryland. Dr. Attia’s website, which we discuss during the interview, is WarOnInsulin.com. Here are the questions that I ask him: You have an interesting story. How did you come to start your website, WarOnInsulin.com, and what is it that you are trying to achieve? You appear to keep yourself very fit. Walk us through a typical week of exercise for you. For any given day, especially on thes Continue reading >>
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
- The interpretation and effect of a low-carbohydrate diet in the management of type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials
- Pre-diabetes goes into remission on higher protein, lower carbohydrate diet (Zone diet balance)
Do You Need To Exercise On Keto Diet?
It is often said that one of the best things about following a ketogenic diet for weight loss is that you don’t have to adopt an exercise regime to lose weight. Many people don’t like the idea of working out, or think they don’t have time, and this makes the ketogenic diet appealing to them. But is it true? Constant Fat Burning Through Ketosis In essence, yes, you can lose weight, and at quite a good rate, without adding additional exercise to your daily routine. This is for two reasons inherent to the way the ketogenic diet works, which are different to the way a traditional low fat diet works: Firstly, when you are on a ketogenic diet, your body is in a state called ketosis where it is burning fat you eat and your own body fat for energy. Energy of course, isn’t just used up by exercise and conscious activity, but by everything you do. Even when your sleeping, your body needs fuel to keep itself going. Because all of this fuel is coming from fat, you don’t need to exercise to burn it off and lose weight. Secondly, because a ketogenic diet curbs your appetite, even though you don’t count calories you are likely to be eating a low calorie diet naturally. This means that your calorie use every day is likely to exceed your calorie intake, even without burning through extra calories by exercising. So, this is good news for people who are too unfit to exercise safely, or who can’t exercise because of injury or disability. It is also good news for people who just don’t want to exercise, however, don’t rule it out just on that basis… Why You Should Still Work Out if You Can If you are able to work out, from a physical perspective (everybody can make time, so being too busy is no excuse!) then you will find it has an even greater impact on the speed and eff Continue reading >>
How To Eat Carbs And Lose Weight
INDYPULSE How to eat carbs and lose weight When trying to lose weight, many people cut out carbs. But this is a huge misconception, according to a top nutritionist. Thanks to the rise of the Atkins diet decades ago and the Keto (high-fat low-carb) diet more recently, not to mention slogans like “No carbs before Marbs” gaining popularity through reality TV shows, many of us fear carbs. But the science behind carbohydrates is actually very complex, and demonising an entire food group is not wise, Rhiannon Lambert, author of Re-Nourish, A Simple Way To Eat Well, explained to The Independent. Refined and complex carbs are very different, and it’s important to distinguish between the two. “Our brains can only process glucose for fuel efficiently and lots of studies conducted at respected universities and research centres have shown resistant starch (found in carbs) help you eat less, burn more calories, feel more energised and less stressed, and lower cholesterol,” Lambert says. Of course, there are carbs and there are carbs - choose oatcakes over a pastry and you’ll be kept fuller longer and won’t have such a spike and drop in energy levels. It is possible to eat carbs and lose weight, you just need to know the low-down. 1. Eat the right carbs Let’s take potatoes as an example - Lambert calls them “a nutrition powerhouse”, full of fibre, filling and with a low energy density. “On the other hand, potato chips, deep fried in oil, with salt and pepper and maybe even a dipping sauce... now you've got a highly fattening food that is easy to over-consume,” Lambert explains. Instead of chips, she recommends roasting potato wedges with olive oil and rosemary for a healthy alternative. 2. Low-carb does not mean ketogenic On a keto diet, you’d usually eat un Continue reading >>
Low-carb/ketogenic Diets And Exercise Performance
Low-carb and ketogenic diets are extremely popular. These diets have been around for a long time, and share similarities with paleolithic diets (1). Research has shown that lower-carb diets can help you lose weight and improve various health markers (2). However, the evidence on muscle growth, strength and performance is mixed (3, 4, 5). This article takes a detailed look at low-carb/ketogenic diets and physical performance. The guidelines for a low-carb diet vary between studies and authorities. In research, low-carb is usually classified as less than 30% of calories from carbs (6, 7). Most average low-carb diets consist of 50–150 grams of carbs per day, a fairly high amount of protein and a moderate-to-high fat intake. Yet for some athletes, "low-carb" can still mean over 200 grams of carbs per day. In contrast, a well-formulated ketogenic diet is more restrictive, usually consisting of only 30–50 grams of carbs per day, combined with a very high fat intake (8). This extremely low carb intake helps you achieve ketosis, a process where ketones and fat become the main sources of energy for the body and brain (9). There are several versions of the ketogenic diet, including: Standard ketogenic diet: This is an extremely low-carb, moderate-protein, high-fat diet. It typically contains 75% fat, 20% protein and 5% carbs (8). Cyclical ketogenic diet: This diet involves periods of higher-carb refeeds, such as 5 ketogenic days followed by 2 high-carb days. Targeted ketogenic diet: This diet allows you to add carbs, usually around periods of intense exercise or workouts. The pie charts below show the typical nutrient breakdown of a low-fat Western diet, a low-carb diet and a typical ketogenic diet: In most low-carb and ketogenic diets, people restrict food sources like grain Continue reading >>
Targeted Ketogenic Diet: An In-depth Look
The Targeted Ketogenic Diet (TKD), simply put, is nothing more than a regular keto diet – with the exception of eating carbs around your workout times. That means any day you exercise, you will be consuming carbohydrates. If your goal is still fat loss, make sure to include the extra calories from the carbs in your totals. Assuming that you ARE reading this because you exercise, this means that fewer fats should be consumed on these days. Benefits of a TKD The TKD is a “compromise” between a Standard Ketogenic Diet and a Cyclical Ketogenic Diet, meaning that you can still perform high intensity activity, but you won’t have to be out of ketosis for long periods of time. For most people’s purposes, TKD can withstand performance in high intensity exercise – although not as well as CKD. It’s most appropriate for beginner or intermediate strength trainers or for those who cannot use a CKD diet for health reasons. As of now, there are no studies out that will show the limitations of weight training based on low sources of blood glucose. There are studies that give carbs prior to resistance and strength training, but have not found increased performance over the long run. However, many SKD keto-ers report strength and endurance improvements in high intensity environments if they consume pre-workout carbs. Most people that are involved in anaerobic training on an SKD typically report improved performance with pre-workout carbs. The problem is that SKDs can even be as limiting to low intensity exercise performance due to the limited glucose and muscle glycogen. If you’re an athlete, or in the process of training, I recommend that you experiment with carbohydrates around your training. Although performance increase is a great benefit of a TKD, it is not the primar Continue reading >>
Ketones And Carbohydrates: Can They Co-exist?
For reasons I’m still struggling to understand, the idea of “nutritional ketosis” (NK, to be distinguished from starvation ketosis, SK or diabetic ketoacidosis, DKA) is often discussed and debated in much the same way as religion or politics. Perhaps this can be said of all nutrition, which is a shame. Nevertheless, in my continued defiance of such sensitive topics, I’d like to add another layer of complexity and nuance to this discussion. The “rule of thumb” for NK is that caloric intake is determined as follows (this excludes a subset of ketogenic diets known as calorie-restricted KD which, as the name suggests, is specifically restricted in calories): Carbohydrate (total, not “net”): less than 50 gm/day, but ideally closer to 30 gm/day Protein: up to 1 to 1.5 gm/kg, but ideally below about 120 gm/day Fat: to satiety Let me illustrate what this looks like for Joe (left), Jane (middle), and Jeff (right — an example of a calorie restricted KD), three hypothetical people in NK — but each with different caloric requirements. As a general rule, as caloric requirement increases the proportion of calories derived from carbohydrate and protein decreases (and the contribution of dietary fat increases), even while absolute intake of carbohydrate and protein increases. Anyone who has bought a blood ketone meter knows how tough it can be to get “into” ketosis by carbohydrate restriction (since everyone asks, I use the Abbott Precision Xtra meter which uses two different strips: one for glucose and one for beta-hydroxybutyrate, or BHB). Most practitioners consider the minimum threshold of NK to be a fasting serum level of BHB above 0.5 mM. I’m a bit more stringent in my practice and like to see fasting BHB levels above 1 mM. To give you a sense of one per Continue reading >>
Why You’re Not In Ketosis
As the COO of Diet Doctor and low-carb enthusiast for years, you would have thought I’d nailed ketosis years ago. I haven’t, and here’s why. Am I still in ketosis? To get into ketosis, the most important thing is to eat maximum 20 grams of digestible carbs per day. When I went low carb in 2012, I followed that advice to the letter – replacing all high-carb foods like potatoes, bread, rice, pasta, legumes, fruit, juice, soda, and candy, with eggs, dairy, meat, vegetables, fats and berries – counting every carb I consumed. I felt great – effortless weight loss, no stomach issues, tons of energy and inspiration. But over time, something changed – I no longer felt as great as I used to. Until recently, I had no idea why. The journey to find out started with a simple question: Am I still in ketosis? The moment of truth At a Diet Doctor dinner a while ago, our CTO, Johan, gently challenged me. “Bjarte, you’re eating quite a lot of protein. Have you measured your ketones lately?”. “No”, I said, feeling slightly defensive, “I’ve never measured my ketones. Should I?”. It was wake-up time. Johan and I grabbed two blood-ketone meters from a dusty drawer, pricked a finger each, and touched the ketone strips. His results came out first – 3.0 mmol/L – optimal ketosis. He looked happy. It was my turn. The ketone meter made a weird beeping sound and the screen started blinking – 0.0 mmol/L – no ketosis whatsoever. What?! I’d been eating strict low carb for years, how could I not be in ketosis? I felt slightly embarrassed, but mainly relieved. Was this the reason I no longer felt great? Experiment 1: Eating less than 60 grams of protein a day Several of my colleagues agreed with Johan – I was eating too much protein. To test that hypothesis, I s Continue reading >>
No Energy To Workout? Eat More Butter!
Have you ever felt like you have no energy to workout? Maybe you start strong but can’t make it through to the end (that’s why you sign up for group classes, right?). Or maybe you just skip your workout entirely, too exhausted to even get out the door. If you think that food has something to do with it, you’re right. But, what you’ve read in magazines may have led you astray. See, they probably told you that you need more “quick” energy in the form of carbohydrates, like whole grains or fruit. Or maybe they suggested you carb-load the night before. Turns out this information is pretty outdated and there’s a whole ‘nother approach to this topic. If you are exercising to try to lose weight, embracing this alternative way of eating will help you drop the pounds fast. (I mean, really how many of us are exercising to gain weight…) Today I’m sharing an article written by Emily Jenkins, who has both a BS and MS in nutrition and will soon be starting her training to become a registered dietitian. Like me, she’s a bit of a nutrition science junkie. She reached out to me to help on some projects and when I heard about her research into sports nutrition and the effects of a ketogenic diet on athletic performance at Auburn University, I asked her to write about it! It takes far too long for research to get into practice, which may be why you haven’t heard of this way of eating yet. If you like BUTTER or BACON, you’ll be pretty happy after reading this. Emily breaks it all down for you below. Why You Have No Energy To Workout PICTURE THIS, it’s early in the morning and you’re getting ready for your routine workout. You’ve got your exercise gear on, positivity is coursing through your veins, you’re eager for the challenge that awaits. But wait, what Continue reading >>
Is It Dangerous To Exercise While On A Ketogenic Diet?
Ketogenic diets restrict carbohydrate consumption. Dieters employ ketogenic diets for rapid weight loss. When subjected to a ketogenic diet, your body enters ketosis. Carbohydrates serve as the primary source of energy for the human body. Fat acts as a secondary source of energy. Because ketogenic diets restrict carbohydrate intake, energy needed for exercise comes from other sources. Scientists differ in opinion on the safety of exercise during a ketogenic diet. During ketosis, keto-acids build up in the blood, and are eliminated from your body through your kidneys. If keto-acids in the blood build up beyond the ability of the kidneys to eliminate the acid, fatigue, irregular heartbeat or dizziness may occur. Avoid exercise if you experience dizziness or irregular heartbeat while on a ketogenic diet. Both may represent serious conditions like dehydration or electrolyte imbalance. The aim of a ketogenic diet is to burn fat instead of carbohydrates. The human body uses fat as the primary source of energy during extended ketosis. Initially the body will use stored carbohydrates for energy. After depleting carbohydrates, the body switches to fat for fuel. Keto-acids or ketones, the end-product of incomplete fat metabolism, serve as a source of energy. While on a ketogenic diet, ketones provide energy for brain function. In their book "The Treament of Epilespy," Dr. Eric Kossoff and Dr. Eileen Vining note that ketones maintain 65 percent of brain energy when in ketosis. Inuit populations in the Arctic survived on low carbohydrate diets prior to the introduction of modern carbohydrate-based nutrition. Dr. Stephen D. Phinney, professor of Medicine Emeritus at University of California at Davis, suggests the carbohydrate-restricted diets of the Inuit population prove that ketog Continue reading >>
Diet 911: Ketosis For Dummies
Dear M&F, I’m trying to see my six-pack. I’m following a ketogenic diet, but my weight loss seems to have slowed down. Can you help me speed things up? —Wayne F., KS Ketogenic diets (around 50 grams of carbs per day) are extremely effective for getting lean because you reset the body’s enzymatic machinery to use fat as its primary fuel source in the absence of carbs. I see three problems with your diet that are certainly causing your fat-loss plateau—too much protein, not enough good fat, and residual carbohydrates. Play Video Play Loaded: 0% Progress: 0% Remaining Time -0:00 This is a modal window. Foreground --- White Black Red Green Blue Yellow Magenta Cyan --- Opaque Semi-Opaque Background --- White Black Red Green Blue Yellow Magenta Cyan --- Opaque Semi-Transparent Transparent Window --- White Black Red Green Blue Yellow Magenta Cyan --- Opaque Semi-Transparent Transparent Font Size 50% 75% 100% 125% 150% 175% 200% 300% 400% Text Edge Style None Raised Depressed Uniform Dropshadow Font Family Default Monospace Serif Proportional Serif Monospace Sans-Serif Proportional Sans-Serif Casual Script Small Caps Defaults Done To break your plateau, pump up the fat in your diet to about 50% of your total daily calories and reduce the protein to 30%–40%. The rest of your calories will come from vegetables. Traditionally, bodybuilders opt to get their protein from tuna and lean meats such as chicken breast. However, on a diet like this, you should switch to darker meats and oily fish. Eating salmon, chicken thighs, lamb, and lean beef allows you to get your protein and fat in one source. The last issue is your consumption of “residual” carbohydrates—the carbs you’re not even aware you’re eating, like those in nuts and meal-replacement shakes. It’s OK t Continue reading >>
Should Endurance Athletes Go Keto? Ketosis And Ketogenic Diets For Endurance Athletes
When it comes to weight loss and endurance performance, dietary ketosis is the strategy everyone is asking about this year. On the surface, ketosis or a ketogenic diet offers everything an endurance athlete could dream of: endless energy, freedom from bonking, and an efficient pathway to weight loss. The diet has been all over mainstream magazines, it’s the subject of several new books, and the supplement companies have already jumped in with new products and a ton of marketing dollars. So, is it time for cyclists, triathletes, and runners to go Keto? First, a refresher course on what a ketogenic diet is. To achieve dietary or nutritional ketosis you need to severely restrict carbohydrate intake (fewer than 50 grams of CHO/day) so the body transitions to using ketones for fueling muscles and the brain. Ketones are produced from fat, which is why nutritional ketosis is so appealing to sedentary people as a weight loss solution. It’s appealing to athletes because we have a virtually unlimited reserve of fat calories to pull from but can only store 1600-2000 calories worth of carbohydrate in muscles, blood, and the liver. An athlete fueled by ketones would be theoretically “bonk-proof”, since bonking is the result of running low on blood glucose. [blog_promo promo_categories=”coaching” ids=”” /] Dietary ketosis for athletes is one of the most hotly contested subjects right now. Proponents point to the metabolic advantage of relying on fat instead of carbohydrate, and critics point out the physiological limitations of eliminating carbohydrate as a fuel for performance. You’ll find bias in both groups, either because scientists and coaches (including me) have been in the high-carbohydrate camp for many years, or because there’s a lot of money to be made b Continue reading >>
What Are Exogenous Ketones: Can You Eat Carbs And Stay Keto?
It was a few years ago when I found out, i’ve been lied to. Everyone out there telling us that we need to be eating a lot of carbs and to stay away from fats. Anyways, what are exogenous ketones? Do they really help with fat-adaptation? Even those who went out of their way to receive a “nutrition degree” is falsely educated on what it really means to stay healthy. I figured, screw it, I’m gonna do my own experiments and see what suits me best. I did the IIFYM (if it fits your macros) diet, a low fat high carb diet, and of course, the ketogenic diet. Being someone who exercises a lot, I was told by countless people that I needed carbs if I wanted to perform optimally. They couldn’t be any further from the truth. You’re probably in the same position I was in a couple years ago. You had this belief that the only way to make the gains in the gym, drop body fat, and look sexy is by eating as low fat as possible while eating carbs to “fuel your workouts”. Because fats make you fat, right? Wrong. While every diet regimen out there can definitely make you lose weight, some diets can do some serious damage to your metabolism and hormonal function. I used to follow a strict low fat high carb diet. And it worked, I had a six pack and looked good with my shirt off. But my testosterone levels were complete shit. I had no energy to do anything and I felt like a plank of wood. Lifeless. It wasn’t until I began to follow a low carb high fat ketogenic diet did I start to have awesome energy levels and STILL look physically great. I realized that being in a state of ketosis gave me the most energy and mental clarity. What Is Ketosis? Ketosis is a State where your body’s energy comes from ketones. This is achieved by restricting carbohydrates. By cutting carbs out, you Continue reading >>
The Interplay Of Exercise And Ketosis – Part Ii
You’ll recall from last week’s post I did a self-experiment to see if I could learn something about the interplay of exercise and ketosis, at least in myself. To understand this discussion, you’ll want to have read Part I of this post. However, before getting to this, I want to digress and briefly address two unrelated issues: Some of you (about 67 or 68 as of this writing) have sent me various links to news reports released yesterday reporting on a study out of Harvard’s School of Public Health. I was planning to eventually write a post about how observational epidemiology is effectively at the heart of the nutritional crises we face – virtually every nutrition-based recommendation (e.g., eat fiber, don’t eat fat, salt is bad for you, red meat is bad for you) we hear is based on this sort of work. Given this study, and the press it’s getting, I will be writing the post on observational epidemiology next week. However, I’m going to ask you all to undertake a little “homework assignment.” Before next week I would suggest you read this article by Gary Taubes from the New York Times Magazine in 2007 which deals with this exact problem. I confirmed this week that someone (i.e., me) can actually eat too much of my wife’s ice cream (recipe already posted here –pretty please with lard on top no more requests for it). On two consecutive nights I ate about 4 or 5 bowls of the stuff. Holy cow did I feel like hell for a few hours. The amazing part is that I did this on two consecutive nights. Talk about addictive potential. Don’t say I didn’t warn you… OK, back to the purpose of this post: How is ketosis impacting my ability to exercise? Here is the summary of the results from my personal experiment: Let’s take a closer look at what may have been go Continue reading >>
How To Burn Stored Body Fat — A Ketosis Primer
“So, how do you tell your body to start burning stored body fat?” my friend and fellow mother asked. “Cut the carbs,” answered another mom. “I go into ketosis just about every afternoon.” “Ketosis? Isn’t that bad for you?” The short answer? No. I talk to a lot of people who want to lose weight. They try all sorts of things — exercise, calorie restriction, you name it. Sometimes, they lose the weight. Inevitably, they gain it back. That’s because what they’re doing is going on a diet — a temporary fix at best. What they need is a lifestyle change, a perspective shift, a new paradigm. Of course, you all know the paradigm I espouse — a conversion to eating real, traditional foods. Yet even a conversion to eating real food won’t necessarily help the pounds melt away. If you’re still eating 200 grams of carbohydrates a day — even if they’re “traditional” carbohydrates like sprouted or soaked grains, unrefined sweeteners, etc, you’re not going to lose weight without making some serious changes. If your body is regularly storing body fat (you gain a little bit of weight each year), then something is wrong with how your body metabolizes food. Let me introduce you to a new concept: the body fat setpoint. The body fat setpoint is the mass of body fat that your body attempts to defend against changes in either direction. It’s your body’s attempt to maintain homeostasis. This is why if you exercise more, you eat more. It’s also why if you restrict calories, your metabolism slows down to compensate. Why should you care about the body fat setpoint? From Stephan at Whole Health Source: We care because this has some very important implications for human obesity. With such a powerful system in place to keep body fat mass in a narrow range, Continue reading >>