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 >>
Everything You Need To Know Before Going On A Low-carb Diet
Much like Oprah, we LOVE bread. So naturally, the thought of cutting it out of our lives (along with any other carbs) is terrifying. But then again, if everyone and their mom (and lots of scientific research) claim that quitting carbohydrates is the key to weight loss, there's got to be something to it, right? Whether it takes the form of Atkins or the Paleo Diet, the low-carb trend has been around for a long time. But chances are you might not fully understand where it came from, how it works, and why experts are torn on whether this eating plan is smart. Here, we break down all of that so you can decide if carb-cutting in the name of weight loss is worth it. What Low Carb Actually Means Depending on who you talk to, there are different definitions of a low-carb diet. Plans can range from 100 grams of carbohydrates per day to zero grams (yikes), says Susan Kleiner, Ph.D, R.D., author of Power Eating. To put that into perspective, a small piece of fruit has about 15 grams of carbs and a banana contains up to 30 grams. For the sake of this article, though, we'll talk about a diet containing 100 grams of carbs per day, for someone who exercises three times a week at a moderate pace. For everyone else, a true low-carb diet would be about 50 grams per day, says Kleiner. What’s Considered a Carb? Unfortunately for Regina George, butter is not a carb. But according to the USDA’s Nutrient Database, lots of foods, including fruits and veggies, contain high amounts of carbohydrates. Though you probably know potatoes and bananas are packed with the carbohydrates, over 20 grams of the macronutrient are also found in a serving of grapes, apples, pears, and cauliflower. Plus, dried fruits, such as apricots, cranberries, and raisins, have a whopping 80 grams per serving. You’ll Continue reading >>
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 >>
How Much Protein Can You Eat In Ketosis?
Having been a low-carb enthusiast and team Diet Doctor member for years, you would have thought I’d nailed ketosis ages ago. I haven’t. In the last post, Why You’re Not in Ketosis, I revealed why, and how I fixed it (by reducing my carb and protein intake to 20 and 60 grams per day respectively). But, I had a problem. Though it felt awesome to be back in ketosis, it sucked to eat so little protein – 60 grams a day isn’t much for a meat lover like me. Could I eat more protein AND remain in optimal ketosis? I was going to find out. The protein experiment I designed the following experiment: First, I would increase my protein intake from 60 grams a day to the level where I would no longer be in optimal ketosis. Then, I would reduce my protein intake until I was back in optimal ketosis, using what I ate on the last day to define my daily-protein limit. Finally, I’d eat to this daily-protein limit every day for a week to test its accuracy, adjusting my protein intake if necessary. To increase the trustworthiness of the experiment, I added five rules: 1. Keep eating 10-20 grams of carbs a day 2. Keep eating during a four-hour window (5-9pm) 3. Adjust my protein intake gradually 4. Make no other major changes to my life 5. Measure my blood-ketone levels every morning before eating “Nice plan”, I thought. But there was one thing I hadn’t taken into account… Preparation To start off the experiment, I measured my blood-ketone levels: 2.0 mmol/L. Not exactly shocking news – I had been eating 45-60 grams of protein and 10-20 grams of carbs a day for weeks, being in optimal ketosis almost every morning. But all that could end soon – it was protein time. Day 1: Taco-cheese shells On the first day of the experiment, I ate similarly to how I’d eaten lately – Continue reading >>
No More Dragon Breath!
Too many people who eat low carb diets believe that they have to live with the intense bad breath nicknamed "ketobreath" if they are to keep their carbs down either to control their blood sugar or lose weight. That's because they believe that the bad breath is a sign that they are eating what is called a "ketogenic diet" which some dieters and low carb enthusiasts believe makes it much easier to burn off fat. The term "ketogenic" simply means "producing ketones." Ketones are a byproduct of fat digestion. They become significant when you are eating so few grams of carbohydrate each day because at that point most of your cells switch over to burning fats, including ketones, rather than glucose. You can tell when you have entered a ketogenic state because your body will dump a great deal of water when this happens, causing a weight loss of anywhere from two to six pounds within a day or two. When you exit the ketogenic state, those same water-related pounds come right back. Why this happens is explained in greater detail on this web page. Unfortunately, most people who cut carbs low enough to remain in a ketogenic state for more than a few weeks develop a distinctive and truly awful bad breath that they assume is a necessary part of eating a ketogenic diet. This is not true but widely believed. It is also the major reason why the loved ones of low carb dieter, after a period of patience, may start undermining the low carbers' diet, tempting them with carbs in the hope that if they ruin their loved one's diet they will no longer have to live with the wretched smell of that "ketobreath." This is rational behavior on the part of those loved ones. The bad breath--which the dieter usually can't themselves smell--is often so strong it makes riding in a car with the dieter unplea Continue reading >>
5 Most Common Low-carb Mistakes (and How To Avoid Them)
A few months ago, I read a book called The Art and Science of Low-Carbohydrate Living. The authors are two of the world's leading researchers on low-carb diets. Dr. Jeff S. Volek is a Registered Dietitian and Dr. Stephen D. Phinney is a medical doctor. These guys have performed many studies and have treated thousands of patients with a low-carb diet. According to them, there are many stumbling blocks that people tend to run into, which can lead to adverse effects and suboptimal results. To get into full-blown ketosis and reap all the metabolic benefits of low-carb, merely cutting back on the carbs isn't enough. If you haven't gotten the results you expected on a low-carb diet, then perhaps you were doing one of these 5 common mistakes. There is no clear definition of exactly what constitutes a "low carb diet." Some would call anything under 100-150 grams per day low-carb, which is definitely a lot less than the standard Western diet. A lot of people could get awesome results within this carbohydrate range, as long as they ate real, unprocessed foods. But if you want to get into ketosis, with plenty of ketoness flooding your bloodstream to supply your brain with an efficient source of energy, then this level of intake may be excessive. It could take some self experimentation to figure out your optimal range as this depends on a lot of things, but most people will need to go under 50 grams per day to get into full-blown ketosis. This doesn't leave you with many carb options except vegetables and small amounts of berries. If you want to get into ketosis and reap the full metabolic benefits of low-carb, going under 50 grams of carbs per day may be required. Protein is a very important macronutrient, which most people aren't getting enough of. It can improve satiety and incr Continue reading >>
The Basic Ketogenic Diet
Note: Please note that if you are interested in a Ketogenic Diet used to treat Epilepsy or Pediatric Epilepsy, please start at Johns Hopkins who are the pioneers in this field. The wikipedia page for the Ketogenic Diet diet also has information on the diet as it relates to treating epilepsy. The diet below is simply for rapid and effective weight loss and uses a 1 to 1 fat to protein ratio rather than the 4 to 1 fat to combined protein and carbs ratio of the Ketogenic Diet pioneered by Johns Hopkins used to treat epilepsy. [wp_ad_camp_3] Disclaimer: I am neither a doctor nor self proclaimed nutrition expert so please consult your doctor before starting any diet or taking any action that affects your health and wellbeing. After finishing Gary Taubes latest book, which seems to have rapidly become the cornerstone of a new approach to nutrition, I’ve become very interested in the Ketogenic diet. The speed of weight loss I’ve seen is incredible and my energy level has remained high. The science behind a ketogenic diet is solidly backed up by Taubes research published in “Good Calories, Bad Calories” and “Why we get fat“. According to Taubes’ research, it may also be the only way for people who have become severely insulin resistant, to effectively lose weight. The Ketogenic diet has always lived on the fringes of diet lore and has been seen as extreme. But the reality is that the low glycemic index diet (Low GI Diet) is effective because it is close to, but not quite, a ketogenic diet. Other diets like the South Beach Diet are also only effective because of the reduction in carbs and consequently insulin levels. The science behind this diet looks solid and it is part of the massive shift in nutrition research we’ve seen in the last few years. Prominent sport Continue reading >>
How Many Carbs Will Kick You Out Of Ketosis?
You are asking what level of circulating and stored glucose is required to prevent you from primarily burning fat. Typically, one begins while primarily burning glucose and must virtually exhaust that before you begin adapting to burning fat. During that period the best answer is zero grams. After that, some tissues (such as red blood cells) can burn only glucose. Small amounts can be made from fats but usually one will cannibalize amino acids from muscle and converting them to glucose. About 30–40 grams of glucose is the minimum that one can achieve in a mixed diet and should suffice to preserve muscle. Protein will also kick one out of ketosis because as much as half may be converted to glucose on first pass through the liver. One would normally plan for 50–60 grams rather than the recommended 30–40 grams of protein to reduce muscle catabolism. Since the above totals 400 Calories, most Calories must come from fat and that is what actually drives ketosis. Fat kills appetite. The proportion of glucose and protein in a food would not matter if one is not hungry enough to eat. I keep using the term glucose because sucrose and HFCS contain 50% fructose which does not count. Fructose is metabolized into fat on first pass through the liver. Some long molecules are not digested and bacteria convert them to fats in the gut. Assume that those would be reported as fiber on a label. Finally, humans react to the circulating glucose/insulin level, not a written number. Very slowly digesting starches won’t break established ketosis. I find that beans and green vegetables do not count if served with enough olive oil. Continue reading >>
What Is Keto Flu? (plus 6 Ways To Cure It)
You’re tired and dizzy, you crave sugar, bread, pasta, and your mind wanders like crazy. You just started a ketogenic diet (or a Paleo or other low carb diet) and you’re suspicious if your new diet is making you feeling this crappy. Removing carbohydrates from your diet all of a sudden may well be the reason why you’re barely able to concentrate on this sentence! This can happen even on a Paleo diet if you remove too many carbs from your diet. And all this feeling of crappiness is due to something people call Keto Flu (or Carb Flu). Read on to find out what is keto flu, how long keto flu lasts, and of course, how to cure keto flu. (CARB FLU = KETO FLU) KETO FLU INFOGRAPHIC – please pin! Please feel free to pin and share this infographic about the keto flu. WHAT IS KETO FLU? Keto flu describes the flu-like symptoms that people starting a low-carb diet often experience. These symptoms are caused by your body being too used to receiving carbohydrates from the food you eat and not being able to change your body’s energy source when you stop eating carbs. (If you’re interested in the science, then this article provides a very detailed explanation of why keto flu happens.) Some people explain keto flu as symptoms resulting from withdrawal from carbohydrates (think drug addiction here). And indeed, there are studies showing that sugars (which are a form of carbohydrates) can cause drug-like additions. But don’t panic if you think you have keto flu. I’ve listed several ways to shorten that period of feeling crappy below. WHAT ARE THE SYMPTOMS OF KETO FLU? If you just started a low carb or ketogenic diet, then you might experience keto flu symptoms like: Fatigue Sugar cravings Dizziness Difficulty focusing (or Brain Fog) Nausea Difficulty Getting To Sleep Irritab Continue reading >>
How Many Carbs Should You Eat On A Ketogenic Diet?
If you’re considering going “keto,” keep in mind you’ll need to consider everything — worked out down to the last gram — regarding how many carbohydrates you can consume. One thing’s for sure: the statement “low carb” isn’t open to interpretation. This isn’t a quick fix “fad” diet; it’s meant to promote real and lasting change for your body — change that’s ultimately going to help you become less dependent on glucose and able to melt through fat for energy instead! You need to actually cause a metabolic shift, and just simply guessing if your carbs are low enough isn’t going to be the most efficient way to do that. While you’re on the ketogenic diet, you absolutely must keep your carbohydrate count within the specified range your body operates in — at all times. If not, you won’t reach a state of ketosis, thus rendering the entire program null and void. With that in mind, it’s important to realize you’re doing this as a more long-term process for lasting results. No matter what your goals or desired outcome, eating a lower carb diet than you are now is certainly going to benefit you in the long run. So, How Many Grams of Carbs Should I Have? If you’re a “normal” person — and by normal, we simply mean “non-athlete” — then you’ll be alright following the standard ketogenic dietary ratios. (And we use the word “standard” here because there isn’t just one version of the ketogenic diet — but more on that in a bit.) You can enjoy fantastic benefits going keto, including effortless fat loss, increased lifespan, improved energy, and sharper mental focus. Everyone responds differently to different amounts of carbohydrates, but there are some general starting points. But to achieve those, you’ll need to make yo Continue reading >>
How Many Grams Of Carbs Keep The Average Person Out Of Ketosis?
I realize that this is highly variable, but what number of grams have you guys found to be the threshold? I suppose if you are right at the threshold, you'll be passing in and out of it, so maybe we'd want a 10g buffer or something? Personally, I'd like to stay outside of it, but only just, and am wondering what the general rule of thumb is these days. I do strength-increasing workouts and walk around a lot, but I avoid what most consider to be "exercise." 1 Worst Carb After Age 50 If you're over 50 and you eat this carb, you will never lose belly fat. HealthPlus50 I was at 3 servings of fruit a day for a while (roughly 75g of carbs) but feel like I might be able to go a little lower. I think the 3 cups (pre-cooked) of steamed spinach would add a largely negligible amount. The 50g of natto per day has something like 5-7g. No other beans or legumes to speak of. Continue reading >>
The Causes And Solutions For Bad Breath (ketosis Breath)
If you’re on a low-carb diet, not all the outcomes are good. One of the side effects you could notice is bad breath. It’s commonly nicknamed ketosis breath, whether it happens when following the ketosis diet, but it can happen with all low carb/high protein diets. In fact, bad breath is becoming an epidemic. This is because so many people now are following these low carb diets. So, you’re definitely not alone. In fact, scientists say that 40% of people on these types of diets report bad breath as one of the worst side effects. I’ve been in your position before with my low carb diets. Your best friend likely has, too. We just get so embarrassed about our bad breath that we tend not to mention it. We just hope that we can mask it with some breath mints. But what is the real cause of bad breath on the ketosis diet? Just why do low carb diets make us stink? And is there anything that we can do to stop the problem? I can share some very positive news. You can stop ketosis breath becoming an issue. You don’t need to become part of the growing epidemic. I’m going to share everything that you can do to stop ketosis breath becoming a problem. So, Why Do We Get Bad Breath? Let’s start with how low carb diets work. When we stop feeding ourselves as many carbs, our bodies have to get the energy in other ways. They do this through the burning of fat, which means the release of ketones in the body. It’s a chemical process since the body can’t create the carbohydrates that it would need to help It’s this process that is causing the bad breath. The great news is that you’re sticking to your diet and you will see a smaller waistline. It will be successful, and you will be able to lose weight. Of course, the downside is that you have to deal with the breath. The mos Continue reading >>
The Top 10 Ketosis Mistakes And How To Prevent Them
What mistakes are you making when it comes to your health? I know I’ve been making plenty. That’s why I’m tracking my data in this recent ketosis experiment that I’m doing. What about you? Most people think that the ketogenic diet is just “low-carb” which leads them to make many mistakes that prevent them from not reaping all of the benefits of ketosis that they could. What benefits? How about an improved immune system, increased longevity, lower inflammation, effortless weight loss, decreased hunger, reduced risk for disease and more. Read on to know the top 10 ways that people make mistakes with ketosis and how you can prevent them. 1: Not tracking protein intake By far the biggest problem with a ketogenic diet is not tracking how much protein you are eating. The far majority of people are simply eating too much lean protein, which ends up kicking them out of ketosis. Protein can turn into carbs by a metabolic process called gluconeogenesis, meaning “making new carbs.” This then spikes insulin, and reduces ketone levels. Even though you are eating super low carb, this could make your body switch back and forth between energy systems, which will lead to high levels of fatigue or “low carb flu.” The easiest way to avoid this mistake is by tracking your ketone levels to see how you respond to different amounts and different types of meat. Everyone is different, so the only way you can tell is by tracking. I “listened to my body” before and it didn’t work. I wasn’t in ketosis when I thought I was. I also thought ketosis kind of sucked. It didn’t, I was just wrong. The only way you know is by tracking. If you consume more fat with protein, it will slow this effect. So think fattier cuts of meat, and less muscle meat. But wait, are you going to Continue reading >>
How Many Carbs Should I Eat To Prevent Ketosis?
When you’re on a low-carb diet, your body kicks into action, breaking down fats into ketone bodies to use for energy. This increase in ketones -- called ketosis -- is a normal adaptation to cutting carbs. In fact, the switch to ketosis is why low-carb diets work. Even though you could eat enough carbs to prevent ketosis, it's important to clarify why you want to avoid it. There's nothing unhealthy about ketosis, so you may just need to correct any misinformation to make the best decision for your weight-loss goals. Video of the Day Deal With Concerns Over Ketosis Ketosis is often confused with ketoacidosis, which is unfortunate -- ketosis is normal, while ketoacidosis is a dangerous condition related to type 1 diabetes. Most people on a low-carb diet tolerate ketosis without any problems. Then after the pounds are dropped, carb intake is gradually increased so you're out of ketosis by the time you reach the maintenance phase. If you decide to stay in an induction phase longer than the low-carb plan recommends, consult your doctor to be safe. People with type 1 diabetes are at risk for developing ketoacidosis from lack of insulin. Due to the complex metabolism of diabetes, they end up with high levels of blood glucose and ketones, which upsets the body's normal acid-base balance. When that happens, ketosis becomes ketoacidosis, causing symptoms like thirst, frequent urination, dry mouth, nausea, belly pain, rapid breathing and fruity-smelling breath. If you have symptoms, contact your doctor immediately -- diabetic ketoacidosis is a medical emergency. You may be wary about ketosis because you've heard about "ketosis flu." It's not really flu, but in the first few days or weeks of a low-carb diet, some people experience headaches, dizziness, fatigue, constipation or wea Continue reading >>
Ketosis: What Is Ketosis?
Ketosis is a normal metabolic process. When the body does not have enough glucose for energy, it burns stored fats instead; this results in a build-up of acids called ketones within the body. Some people encourage ketosis by following a diet called the ketogenic or low-carb diet. The aim of the diet is to try and burn unwanted fat by forcing the body to rely on fat for energy, rather than carbohydrates. Ketosis is also commonly observed in patients with diabetes, as the process can occur if the body does not have enough insulin or is not using insulin correctly. Problems associated with extreme levels of ketosis are more likely to develop in patients with type 1 diabetes compared with type 2 diabetes patients. Ketosis occurs when the body does not have sufficient access to its primary fuel source, glucose. Ketosis describes a condition where fat stores are broken down to produce energy, which also produces ketones, a type of acid. As ketone levels rise, the acidity of the blood also increases, leading to ketoacidosis, a serious condition that can prove fatal. People with type 1 diabetes are more likely to develop ketoacidosis, for which emergency medical treatment is required to avoid or treat diabetic coma. Some people follow a ketogenic (low-carb) diet to try to lose weight by forcing the body to burn fat stores. What is ketosis? In normal circumstances, the body's cells use glucose as their primary form of energy. Glucose is typically derived from dietary carbohydrates, including: sugar - such as fruits and milk or yogurt starchy foods - such as bread and pasta The body breaks these down into simple sugars. Glucose can either be used to fuel the body or be stored in the liver and muscles as glycogen. If there is not enough glucose available to meet energy demands, th Continue reading >>