Failure Of Urine Dipsticks To Detect Ketosis In Rats Maximilian Bielohuby Dominik Menhofer Barbara J.m. Stoehr Martin Bidlingmaier
Letter to the Editors Dr. med. Martin Bidlingmaier Endocrine Research Unit, Medizinische Klinik â€“ Innenstadt University Hospital of the Ludwig-Maximilians University ZiemssenstraÃŸe 1, 80336 Munich, Germany Tel. +49 89 5160-2310, Fax -4457 [email protected] Â© 2011 S. Karger GmbH, Freiburg 1662-4025/11/0041-0081$38.00/0 Accessible online at: www.karger.com/ofa Fax +49 761 4 52 07 14 [email protected] www.karger.com Endocrine Research Unit, Medizinische Klinik â€“ Innenstadt, Ludwig-Maximilians University, Munich, Germany Among the dietary strategies to overcome adiposity and obesity, the omission of carbohydrates in low-carbohydrate, high-fat diets (LC-HFDs) has been proposed as a tool for weight loss . Popular weight loss guidebooks, including the Atkins diet books , claim that the lack of carbohydrates in LC-HFDs always triggers ketosis which would contribute to the weight-reducing effects of these diets. However, this the- ory was widely criticized in literature. Apart from attempts to reduce body weight with LC-HFDs, ketogenic LC-HFDs are also used to intentionally induce ketosis in patients with epi- lepsy and lately also as a potential beneficial treatment in other neurological diseases such as Alzheimerâ€™s and Parkin- sonâ€™s disease . Both indications to use LC-HFDs are sub- ject to intense research including rodent models. Quantifica- tion of ketosis in these models often is a crucial part of the investigation. The method of choice to analyze the level of ketosis is measurement of Î²-hydroxybutyrate (HBA), ace- tone and acetoacetate, collectively known as ketone bodies. The gold standard to quantify ketone bodies is analysis of HBA in circulation and acetone in urine or breath. However, urine keton Continue reading >>
Monitoring For Compliance With A Ketogenic Diet: What Is The Best Time Of Day To Test For Urinary Ketosis?
Go to: Methods The KetoPerformance study with its before-and-after comparison design was registered at germanctr.de as DRKS00009605 and took place from February to June 2016. Exclusion criteria included underweight, obesity, kidney stones, pregnancy, diabetes mellitus and any fatty acid-metabolism disorders. The study protocol was approved by the Ethics Commission of the Albert-Ludwig University Freiburg (494/14) and all subjects signed a written consent form. Twelve of the 42 subjects from the KetoPerformance study could be recruited for the present substudy. Experimental design and dietary intervention The experimental intervention consisted of a KD without caloric restriction lasting 6 weeks with a previous preparation period including detailed instructions during teaching classes and individual counselling by a dietitian. The subjects were free to follow a KD according to their personal preferences but were advised to reach a ratio by weight of approximately 1.8:1 fat to carbohydrate and protein combined, yielding a diet with 80, 15, and 5 % of total energy intake from fat, protein and carbohydrate, respectively. During the KD intervention's sixth week, our substudy subjects were instructed to measure urine and blood ketone concentrations at regular intervals in as close proximity as possible during a 24-h period from 07:00 to 07:00 in the morning. During the day (07:00 till 22:00) blood and urinary ketones were measured every full hour and every three hours, respectively. During the night, blood and urinary ketones were measured once at 03:00. In total blood and urine and ketones were measured 18 and 8 times, respectively, and were recorded in a table sheet. Subjects were asked to drink 400 ml of water every 3 h during the day to ensure sufficient urination and to Continue reading >>
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How To Identify Ketosis
Expert Reviewed Ketosis is a normal metabolic process by which your body breaks down stored fat for energy, which can also result in a dangerous buildup of ketones in the body called ketoacidosis. Ketosis is often the product of a low-carbohydrate diet that people use to lose weight and gain muscle or it can also be a product of malnutrition. Although the long-term risks of ketosis are not clear, there is some evidence that it can increase your risk of heart disease and certain cancers. By recognizing the signs of ketosis, you can help minimize your risk for developing ketoacidosis. Continue reading >>
How To Tell If You Are In Ketosis Without Strips
A ketogenic diet is having a minor resurgence as of late, surpassing low carb diets for fat loss. The idea of keto dieting is to use all of your bodies glucose reserves and burn ketones for energy. The body eventually reaches a state of ketosis from the result of reducing your net carb intake. People who are new to a low carb high fat, ketogenic diet often ask what are the signs, symptoms and how to tell if you are in ketosis without strips. If you’ve never been in ketosis before then you may not even realize you are in it. The human body is quite remarkable being able to switch from burning glucose for energy to ketones. Your body experiences many physiological adaptions, including a decline in insulin and breakdown of fats. While Ketosis may be confirmed by urine ketone sticks and blood ketone tests, it is not always practical or convenient. You may be at work, out to eat with friends and don’t need the hassle of measuring your blood or urine levels of ketones. There are many small signs and symptoms of ketosis which can help your analysis. Sleep and Ketosis No matter what type of diet you follow, after a good nights sleep you are already in light ketosis. While you have fasted for over 8 hours you are on your way to burning ketones. Once our liver glycogen stores have been depleted we begin to produce ketone bodies at an exponential rate. Despite that, it doesn’t mean that we’ll be utilizing them efficiently. We will not be able to effectively use ketone bodies for our muscles, brain, digestive system if we are not keto-adapted. When following a ketogenic diet some people may experience all symptoms of ketosis, some may only feel a few signs or none at all. If you are brand new to low carb high fat dieting then achieving the optimal fat burning state takes ti Continue reading >>
Measuring Ketosis: What Are Keto Sticks And Keto Strips?
Ketosis is a metabolic state where the liver breaks down fat to produce ketones. Ketones, on a ketogenic diet, are the primary fuel source for the body. If you’re new to the ketogenic diet and you still have questions, consider reading our Comprehensive Beginner’s Guide to Keto > There are three main ways to measure the ketones in your body, all of which have their advantages and disadvantages. The most common ways to measure are: Blood Ketone Meter. Very accurate but the strips are extremely expensive. Breath Ketone Meters. More accurate than the urine strips, but can sometimes vary in accuracy. Cheaper than blood strips in the long-run. Urine Stricks. This will answer the question “Am I in ketosis?” but will not provide an accurate measure of blood ketones. Scroll down to read a more in-depth analysis of each, and what we recommend for you. Measuring Ketones with Urine Sticks Urine sticks will always be the cheapest and easiest way to measure ketosis. For beginners, this should cover everything you need – there is no point in getting more complex blood strips so early on when you are still trying to understand the nuances of a ketogenic diet. Ultimately, keto sticks are very easy to use – you hold the sticks in your urine stream for a few seconds, and within 10-15 seconds you should notice a color change in the strip (if you are in ketosis). The color of the stick typically is measured in red: light pink being low in ketone production and dark purple being high in ketone production. While keto sticks can be ideal for a general answer to the question “Am I in ketosis?”, they aren’t precise with their accuracy. They measure the acetoacetate in your urine, which is an unused ketone by the body. As you get deeper into ketosis and your body adapts, your b Continue reading >>
The Beginners Guide To Ketosis: Investigating Low-carb, High-fat Eating
The only hard and fast rule of health is that health is personal and what works well for one person may not work for someone else. Aside from that rule, there are “frameworks” that seem to benefit large groups of people. One more level down from that are alternative strategies that benefit smaller groups. Ketosis is likely one of those alternative strategies that works well for certain, smaller groups of people. So, right off the bat I want you to understand that Ketosis might not be for everyone. I’m going to lay out the case for potential benefits of Ketosis. If it sounds interesting and beneficial to you, then consider trying it. (see our free cheat sheet to help you). What is Ketosis Ketosis occurs when liver glycogen gets depleted and the body burns fatty acids for fuel. The primary driver of this state is a very low carbohydrate intake. Often, it also requires a low protein, higher fat intake. You can also achieve a state of ketosis by not eating altogether. The creation of ketones is a byproduct of this metabolic state. Ketones are a source of fuel, just as glucose is a source of fuel. Ketones tend to have some added benefits, though. What role does Ketosis play in human health? Ketosis allows our bodies to function in the absence of carbohydrates, both physically and mentally. Instead of burning carbohydrates, or converting protein to glucose, the body burns ketones. This is pretty much a survival mechanism. It allows your body to function in a state of caloric deprivation. This is why ketosis often gets bad press (as it’s linked to “starvation”). Being a survival mechanism doesn’t make it invalid as a strategy, though. There can still be potential benefits to be had. Let’s cover a few of them… Ketosis and Accelerated Fat Loss Being in ketosis Continue reading >>
How Do I Know If I Am In Ketosis?
[Some of the links in this post are affiliate links. If you choose to purchase something by using one of those links, I may receive a small financial compensation, at no cost to you.] Ketone testing strips are not reliable, so it can often be difficult to know if you are in ketosis, especially, if you are not losing weight as quickly as you had hoped. Weight loss isn't a sign of being in ketosis, so even if the scale isn't moving, you could still be using dietary fats to fuel your daily activities. To put your mind at ease, we have put together a list of the signs and symptoms of ketosis for you, as well as advice on what you can do to be more comfortable during Atkins Induction. "How do I know if I am in ketosis?" I have been getting quite a few emails and comments lately from people who have been asking me if they are in ketosis. After a bit of discussion back and forth, the conversation usually reveals that: 1) The ketone strips that Dr. Atkins recommended are only turning pink; and 2) They are not losing much weight. Both of the above ideas show a misunderstanding about: the purpose of ketosis weight loss and low-carb diets So, I went searching through the archives to see what I had already written on the topic. During that extensive search, I found this old post on how to tell if you are in ketosis. This post was originally written in 2012. It contained a bullet list of symptoms that could help you know if you are in ketosis. It also explained what you can do to ease the symptoms and make yourself more comfortable while going through the change. I decided that since so many of you are struggling and don't know if you are in ketosis, or not, I would give the post a major overhaul. I wanted it to accurately reflect what we know about ketosis today. Many people believ Continue reading >>
10 Signs And Symptoms That You're In Ketosis
The ketogenic diet is a popular, effective way to lose weight and improve health. When followed correctly, this low-carb, high-fat diet will raise blood ketone levels. These provide a new fuel source for your cells, and cause most of the unique health benefits of this diet (1, 2, 3). On a ketogenic diet, your body undergoes many biological adaptions, including a reduction in insulin and increased fat breakdown. When this happens, your liver starts producing large amounts of ketones to supply energy for your brain. However, it can often be hard to know whether you're "in ketosis" or not. Here are 10 common signs and symptoms of ketosis, both positive and negative. People often report bad breath once they reach full ketosis. It's actually a common side effect. Many people on ketogenic diets and similar diets, such as the Atkins diet, report that their breath takes on a fruity smell. This is caused by elevated ketone levels. The specific culprit is acetone, a ketone that exits the body in your urine and breath (4). While this breath may be less than ideal for your social life, it can be a positive sign for your diet. Many ketogenic dieters brush their teeth several times per day, or use sugar-free gum to solve the issue. If you're using gum or other alternatives like sugar-free drinks, check the label for carbs. These may raise your blood sugar levels and reduce ketone levels. The bad breath usually goes away after some time on the diet. It is not a permanent thing. The ketone acetone is partly expelled via your breath, which can cause bad or fruity-smelling breath on a ketogenic diet. Ketogenic diets, along with normal low-carb diets, are highly effective for losing weight (5, 6). As dozens of weight loss studies have shown, you will likely experience both short- and long Continue reading >>
When And How Should You Measure Ketosis?
If you are following a low carbohydrate diet that is based on the ketogenic principles then measuring if you are in ketosis may be an important goal for you. There are times when measuring the specific ketone level may not be required. When is measuring ketosis really needed? My advice to people is if you are following a ketogenic diet for a therapeutic reason (such as epilepsy, cancer, MS, diabetes etc.) then measuring the ketogenic level will be important for you. This is because from the evidence that we have to date, we can see some correlation that in order for the ketogenic diet to be effective, the ketone bodies need to be consistently elevated. If you are someone that is following a ketogenic diet for weight loss, then measuring ketosis through objective ways (I will go over them below), really may not be necessary. There is still this notion that I see online form various Keto Coaches that having a high ketone level in the blood or breath will automatically mean you will lose more weight. I want to say categorically that this is NOT the case. “High blood ketone levels do not automatically mean you will experience a fat loss”. In the next few weeks I will detail in a weekly email exactly why this is the case but for now back to the topic of how to measure ketosis. How to measure ketosis? Subjective Measurements: There are several ways in which you can detect if you are in a ketogenic range. The first way is looking at more subjective measurements. What I mean by this is measurements that focuses more on how you are feeling. In the beginning, you can experience certain symptoms including: nausea, headaches, fatigue, bad breath and weak legs. These symptoms are a sign that your body is now switching from using glucose to using fat for energy. Another subjectiv Continue reading >>
The 4 Ketosis Symptoms You Should Be Looking For
Ketosis is the condition in which your body begins burning fat instead of carbs for its energy source. The benefits of ketosis range widely, but some of the best include: fat loss increased endurance less cravings shredded physique neurological optimization But how do you know when you’re in ketosis? Are there symptoms that you’re in ketosis? Is there a way to “feel” like you’re in ketosis? Obviously the best way to see if you’re in ketosis is to test you breath, blood, or urine. However, we’ve constructed the following list to help you detect the signs that you’ve transitioned into ketosis and turned your body into a fat burning machine! If you’ve been on the Ketogenic Diet for at least a week, run through this list of ketosis symptoms, and see if they fit what you’re experiencing! 1. Ketosis Breath A popular report from many low-carb and keto dieters is that their breath is less than desirable. The smell has been compared to fingernail polish remover, which is believed to come from the presence of acetone. Acetone is, of course, a ketone body, and is also found in many brands of nail-polish remover. 2. Keto Flu After a life full of ingesting large portions of carbs for energy, dropping carbs and moving into ketosis can often result in ketosis symptoms known collectively as the “keto flu.” It’s not unheard to feel light-headed, fatigued, or anemic when your body runs out of carb stores and begins turning to fat for its fuel source. You might feel irritable, or short-tempered; this is your body’s natural reaction to having sugar removed. Much like an addict in rehab, when you cut out mass amounts of processed sugars, you turn into a bit of a monster. Ketosis symptoms also include nausea, or stomach aches. These can be caused by your stomach r Continue reading >>
Measuring Ketosis With Ketone Strips: Are They Accurate?
Many people following keto diets want to be in ketosis, a natural state in which the body burns fat for fuel. For this reason, people are curious about whether they are doing enough (via carb restriction) to achieve this state. As a result, ketone strips are a popular tool that numerous people use as a way of measuring ketosis. However, just how accurate are they? And how do they compare to alternate methods of measuring ketones? What is Ketosis? Anyone following a standard high-carbohydrate diet will be burning glucose for energy. However, the body can use both carbohydrate and fat for fuel (1). When carbohydrate intake is very low, the body switches to burning fat for energy. As this happens, our body enters a state of ketosis. Ketosis is a natural biological state during which our body burns fat for fuel. While we are “in ketosis,” our blood levels of ketones—a by-product from the breakdown of fats—rise. Measuring these ketones (also known as ‘ketone bodies’) can, therefore, provide a hint as to how deeply our body is (or isn’t) in ketosis. For this reason, ketone strips—which measure the level of ketones—have become increasingly popular in recent times. Key Point: Ketosis is a biological state where the human body burns fat rather than carbs. What are Ketone Test Strips? For people who want to know if they’re in ketosis, ketone test strips are a cheap and simple way of detecting ketone levels. They are otherwise known as ‘ketone sticks’ and work by urinalysis to tell us the volume of acetoacetate in our urine. If you don’t know what acetoacetate is, then let’s start at the beginning. First of all, there are three types of ketone body; Acetoacetate Acetoacetate is one of the two main ketone bodies, and it is present in urine. We can test f Continue reading >>
7 Signs You Are In Ketosis
The Ketogenic Diet (also known as “keto”) has been all over social media. You’ve probably seen ripped fitness models claiming that Keto gave them their physique, and the even more inspiration stories of normal people like you and me, who lost weight and reclaimed their lives through this diet called Keto. If you’re not sure what the Ketogenic Diet is, head on over to What is a Keto Diet? (Ketogenic Diet 101). Over there I’ve detailed what exactly Keto is and isn’t, given you meal plans, snacks, and answered all of your questions about the diet. But let’s say you’ve jumped into Keto with both feet, and now you want to know “Is this working?” I don’t blame you. It can be hard to tell what’s going on inside your body. Are you in Ketosis? Are you eating few enough carbs? Are you shedding fat? Well, there are 7 obvious ways to tell if you’re in ketosis, without testing your blood or urine. Here are the signs you’re in Ketosis: 1. Weight Loss Weight loss is the first and most obvious sign that you’re in ketosis. The weight loss happens for a variety of reasons, but it’s important to note that it’s very fast in the beginning. This is because when you switch to a low-carb diet, your muscles start losing water. Carbohydrates are what bind water to your muscles, so when you’re not eating carbohydrates, your muscles start dumping them, and the attached water. That’s one of the things that causes Keto Flu (which you can read about in Keto 101), but drinking plenty of water and keeping your salt intake up will keep you hydrated and feeling healthy. After the initial water leaving your body, then you’ll start to see steady fat loss. Related Reading: My 60 Day Keto Challenge Results (I lost 23 pounds!) 2. Little or No Appetite When you stop eati Continue reading >>
Ketosense – An Arduino Based Ketosis Detector
In this post I will go through the hardware and software of the instrument I have made. If you are curious to why I have made it, I would recommend that you start reading the other posts I have done about this project and work your way forward. Just click on Ketosis detector under categories. Introduction The instrument´s purpose is to detect the amount of acetone gas that is present in a persons breath. By measuring the amount of breath acetone gas present in a persons breath, it should be possible to determine wether or not a person is in a state called ketosis. Ketosis is, very simplified, when the body runs on fat rather then carbohydrates. If you eat a ketogenic diet, your ketone levels will be elevated. Currently, the only way to monitor your ketone levels are either to take a blood based test or a urine based test, with test strips that changes color depending on the amount of ketons that are present. Both methods work fine but the blood method is very expensive, about 2$ per test, and the urine method is not very precise. Being the curious type of person, and getting inspired by a podcast where Steve Gibson was talking about building an instrument like this, I decided to give it a shot myself. On a very high level, the instrument consists of an electrochemical gas sensor that is sensitive to various types of gases, a combined hygrometer/thermometer and an Arduino Uno board. The electrochemical gas sensor and hygrometer/thermometer has been placed in a plastic case that serves as a ”gas chamber” that you blow into to collect the gas sample. If there is gas present in the air, the resistance of the sensor will decrease. The decrease of resistance is dependent on three factors; gas concentration, humidity and temperature. If these values are known, it is possi Continue reading >>
3 Ways To Measures Ketones: Which Is Best?
Intro: the age of Do-It-Yourself at-home medical technology The medico-technological age we’re in goes by many names, such as biohacking, self-experimentation or the quantified self. A lot of it is about tracking biochemical markers and performance metrics that can tell you something about your past and present state, usually in an attempt to predict or change it in the future. Ketones are one such biochemical marker of metabolism that can be measured in blood, breath and urine (see our What’s a ketone? section for more details). Some people use a ketogenic diet to manage cancer, epilepsy, obesity or diabetes and may find it helpful to monitor their ketone levels. Alternatively, they may simply be curious and interested in physiology. Whatever the case may be, since ketones can be measured in blood, breath and urine, which method might you chose for your circumstance and why? Measuring blood ketones The ketone bodies measured in blood are acetoacetate and is β-hydroxybutyrate (BhB), the latter being the most commonly measured. A well-known at-home device for doing so is the Precision Xtra. It can also measure blood glucose using glucose-specific strips. The portable device can measure BhB concentrations ranging from 0.1 mmol/L (1.0 mg/dL) to 8 mmol/L (or 83.3 mg/dL). Measuring blood ketones is the most accurate method compared to breath and urinary ones but the ketone strips are still quite expensive. One case in which blood ketones are measured is when doctors ask their diabetic patients to monitor their blood BhB levels so as to stay below 0.6 or 1.5 mmol/L. These doctors are worried that a rise above these levels may lead to a pathological condition called diabetic ketoacidosis (DKA). DKA is distinct from the normal physiological state of ketosis, where insulin Continue reading >>
How To Know If You Are In Ketosis Without Strips.
To know whether or not you’ve entered ketosis you can measure your blood ketone levels. But how to know if you are in ketosis without strips? Well, we’re already mildly ketogenic after an overnight fast. Once our liver glycogen stores have been depleted we begin to produce ketone bodies at an exponential rate. Despite that, it doesn’t mean that we’ll be utilizing them efficiently. If we’re not adapted, then our brain and muscles won’t be able to put those ketones into use. Nutritional ketosis begins if our blood ketone levels are over 0.5mMol. To indicate that, you can use either urine strips like Ketostix. There are also breath takers. The most optimal range for ketosis is between 0.5 and 3 mMol. Ketoacidosis occurs over 10mMol, which is quite hard to reach. It usually happens with people who are diabetic or after excessive alcohol consumption. But there are a few problems with measuring ketones. Having elevated levels of ketones doesn’t mean you’re in ketosis. These urine strips are expensive and taking several measurements a day is very costly. That’s why there’s another way how to know you’re in ketosis without strips. Like said, elevated ketone levels doesn’t necessarily mean ketosis. It might even be the opposite. If we’re not putting ketones into use, then we’re probably urinating it out. That’s why urine strips are not ideal. What we want to know as well is our blood sugar levels. Glucose and ketones are contradicting fuel sources. If one is elevated, then the other has to be decreased. If we have high blood sugar levels, then we won’t be able to use fat for fuel. We definitely won’t be in ketosis. Quantifying is great because it gives us an accurate interpretation of our condition. However, we shouldn’t get stuck with the dat Continue reading >>