" "

^ Klein MS, Buttchereit N, Miemczyk SP, Immervoll AK, Louis C, Wiedemann S, Junge W, Thaller G, Oefner PJ, Gronwald W (February 2012). "NMR metabolomic analysis of dairy cows reveals milk glycerophosphocholine to phosphocholine ratio as prognostic biomarker for risk of ketosis". Journal of Proteome Research. 11 (2): 1373–81. doi:10.1021/pr201017n. PMID 22098372.

It’s also important to note there have been no long-term studies on the ketogenic diet, nor has there been research that details what may happen to the body if it’s in a constant state of ketosis itself. But given how the body needs carbs to function properly, diets that are based on fat burning may lead to nutritional deficiencies, and supplements and multivitamins are recommended because you’re cutting out entire food groups, warns Alyssa Rothschild, RDN, who is in private practice in New York City.
So if your high-fat diet includes a high amount of roasted seeds or roasted nuts, nut butters, heated oils such as heated coconut oil or heated extra virgin olive oil, barbecued meats or meats cooked at very high temperatures, then your triglyceride count is going to go up. You should have triglycerides that are less than 150mg/dL, and a triglyceride to HDL ratio that is no more than 4:1, and in most of the healthiest people I’ve worked with, triglycerides are under 100 and the triglyceride to HDL ratio is less than 2:1. If your ratio is whacked, your ketotic diet isn’t doing you any favors.
“Adequate dietary carbohydrate is critical to raise muscle glycogen to high levels in preparation for the next day’s endurance competition or hard training session. Accordingly, during the 24 h prior to a hard training session or endurance competition, athletes should consume 7-12 g of carbohydrate per kilogram of body weight. However, during the 24 h prior to a moderate or easy day of training, athletes need to consume only 5-7 g of carbohydrate per kilogram of body weight.”
The low glycaemic index treatment (LGIT)[49] is an attempt to achieve the stable blood glucose levels seen in children on the classic ketogenic diet while using a much less restrictive regimen. The hypothesis is that stable blood glucose may be one of the mechanisms of action involved in the ketogenic diet,[9] which occurs because the absorption of the limited carbohydrates is slowed by the high fat content.[5] Although it is also a high-fat diet (with approximately 60% calories from fat),[5] the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40–60 g per day.[18] However, the types of carbohydrates consumed are restricted to those that have a glycaemic index lower than 50. Like the modified Atkins diet, the LGIT is initiated and maintained at outpatient clinics and does not require precise weighing of food or intensive dietitian support. Both are offered at most centres that run ketogenic diet programmes, and in some centres they are often the primary dietary therapy for adolescents.[9]

Have you heard all the buzz about the keto diet and want to know more? Did a friend tell you they’re “in ketosis” and you got interested? Here’s everything you need to know about ketogenic diets and being in ketosis for fat loss, brain function, satiety, and performance. Editor’s Note: This article is being updated … Continue reading The Keto Diet: Next Big Thing or Dangerous Fad?
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]
The brain is composed of a network of neurons that transmit signals by propagating nerve impulses. The propagation of this impulse from one neuron to another is typically controlled by neurotransmitters, though there are also electrical pathways between some neurons. Neurotransmitters can inhibit impulse firing (primarily done by γ-aminobutyric acid, or GABA) or they can excite the neuron into firing (primarily done by glutamate). A neuron that releases inhibitory neurotransmitters from its terminals is called an inhibitory neuron, while one that releases excitatory neurotransmitters is an excitatory neuron. When the normal balance between inhibition and excitation is significantly disrupted in all or part of the brain, a seizure can occur. The GABA system is an important target for anticonvulsant drugs, since seizures may be discouraged by increasing GABA synthesis, decreasing its breakdown, or enhancing its effect on neurons.[7]
As a matter of fact, it’s more dangerous to have high levels of cholesterol and high levels of CRP than low levels of cholesterol and high levels of CRP – even if your high levels of cholesterol are “healthy”, big fluffy LDL particles, and not small, dense vLDL particles. In other words, no matter how many healthy fats you’re eating, these fats may actually come back to bite you if you’re creating high inflammation from too much exercise, not enough sleep, exposure to toxins and pollutants, or a high-stress lifestyle.
If you are already in ketosis and accustomed to high-fat, low-carb diets, you can take one heaping scoop in about eight ounces of water fifteen minutes prior to working out. It stays in your system and will provide your body with elevated ketone levels for about three hours. When taken as a pre-workout, KetoCaNa has also been shown to decrease the amount of oxygen consumed at a given power output.
As you may know, "keto diet" is short for ketogenic diet, because who has the time to say "genic." It is a high-fat, moderate-protein, and low-carb diet with approximately 80% of your calories from fat, 15% from protein, and only 5% from carbohydrates. The goal of the diet is to induce ketosis in your body. The theory is that typically your body may rely on burning the carbs that you eat rather than the fat stores in your body for energy. The thinking is that by severely restricting the amount of carbs in your diet your body may then be forced to burn your body fat instead. Breaking down this fat then results in ketones, which is not some acapella group, but instead organic compounds made up of carbon, hydrogen, and oxygen atoms. One type of ketone produced is acetone, which is in certain types of nail polish removers. This accumulation of ketones may result in "keto breath", which is a rotten fruit or metallic smelling bad breath that can smell a bit like, surprise, surprise, nail polish remover.

I’m not sure if I really understand the idea of exogenous Ketones putting ones body into a state of KETOSIS, in that their own fat cells will be burned for fuel. Won’t the body just use the exogenous ketones and energy and continue to use glucose sources as well? How does taking ketones, make the body burn it’s own fat stores? I always thought that one would have to be in a state of energy deprivation for the body to actually begin to use the TG in the fat cells to generate ATP. Please let me know what I’m missing…


But sadly, whether due to government subsidy of high carb foods like corn and grain, funding from big companies like Gatorade and Powerbar, our sugar-addicted Western palates, or the constant (unfounded) fear mongering about saturated fats and heart disease, the type of research that shows these fat-burning and performance benefits of carbohydrate restriction simply get shoved under the rug.
“Adequate dietary carbohydrate is critical to raise muscle glycogen to high levels in preparation for the next day’s endurance competition or hard training session. Accordingly, during the 24 h prior to a hard training session or endurance competition, athletes should consume 7-12 g of carbohydrate per kilogram of body weight. However, during the 24 h prior to a moderate or easy day of training, athletes need to consume only 5-7 g of carbohydrate per kilogram of body weight.”
On the ketogenic diet, carbohydrates are restricted and so cannot provide for all the metabolic needs of the body. Instead, fatty acids are used as the major source of fuel. These are used through fatty-acid oxidation in the cell's mitochondria (the energy-producing parts of the cell). Humans can convert some amino acids into glucose by a process called gluconeogenesis, but cannot do this by using fatty acids.[57] Since amino acids are needed to make proteins, which are essential for growth and repair of body tissues, these cannot be used only to produce glucose. This could pose a problem for the brain, since it is normally fuelled solely by glucose, and most fatty acids do not cross the blood–brain barrier. However, the liver can use long-chain fatty acids to synthesise the three ketone bodies β-hydroxybutyrate, acetoacetate and acetone. These ketone bodies enter the brain and partially substitute for blood glucose as a source of energy.[56]
These are the widely recognized LCT’s, or long chain fatty acids in coconut oil, mostly saturated, including stearic acid (C18:0), oleic acid (C18:1), and linoleic acid (18:2). The exact percentage of each depends on region the coconut is grown, time of harvest, and other growing variables. They are good as a fuel source in your food, and have some of the tastiness of coconut oil, if your goal is getting into ketosis fast, you won’t benefit from eating a lot more of them compared to eating true medium chain fatty acids.
Meat products make up a big part of the keto diet, but experts stress the importance of choosing quality. "Since the keto diet is based a lot on animal proteins, it's important to buy organic poultry and grass-fed, organic beef," says Aimee Aristotelous, RD. "Not only do organic selections help with limiting environmental toxins, but grass-fed options of red meats even change the composition of fats." The result, she explains, is that your body is able to better absorb those healthy fats.

Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.


One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.
2) I have a hard time eating real food soon after rides/workouts. I had used Hammer Recoverite (1scoop instead of suggest serving of 2 and add 1scoop whey isolate protein) in the past because I feel a significant difference the day after with less muscle fatigue. Then I read a previous posts on your opinion of post-workout supplementation ( https://bengreenfieldfitness.com/2013/07/what-to-… ) and I realized the primary ingredient in Recoverite is maltodextrin. Since the 2013 article, has anything changed in your research that you might suggest I add PWO to aid in the muscle fatigue/recovery? (In other words, Is there anything more healthy I can take to replace the Recoverite or should the aminos/electrolytes/carbs/MCT’s from the recipe in this article be sufficient?) Thanks in advance, I appreciate all of your work!
Signs of diabetic ketoacidosis include a high blood glucose level, a high ketone level, dehydration, frequent urination, nausea, difficulty breathing, and dry skin. If you have poorly managed type 1 or type 2 diabetes, test your blood glucose level regularly before and after meals, and make sure you check your ketone level whenever your blood sugar is higher than 240 milligrams per deciliter (mg/dL). (11)

The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]


Wondering what fits into a keto diet — and what doesn’t? “It’s so important to know what foods you’ll be eating before you start, and how to incorporate more fats into your diet,” says Kristen Mancinelli, RD, author of The Ketogenic Diet: A Scientifically Proven Approach to Fast, Healthy Weight Loss, who is based in New York City. We asked her for some guidelines.
Nutritional ketosis is a natural metabolic state in which your body adapts to burning fat rather than carbohydrates as its primary fuel. It is clinically proven to directly reduce blood sugar (as measured by HbA1c), improve insulin sensitivity (as measured by HOMA-IR) and reduce inflammation (as measured by white blood cell count and CRP). Nutritional ketosis can be induced by following a ketogenic diet. Learn more in our FAQ below!
Whether ketosis is taking place can be checked by using special urine test strips such as Ketostix. The strips have a small pad on the end, which the user dips in a fresh urine specimen. Within seconds, the strip changes color to indicate the level of acetoacetate ketone bodies, which reflects the degree of ketonuria, which, in turn, gives a rough estimate of the level of hyperketonemia in the body (see table below). Alternatively, some products targeted to diabetics such as the Abbott Precision Xtra or the Nova Max can be used to take a blood sample and measure the β-hydroxybutyrate ketone levels directly. Normal serum reference ranges for ketone bodies are 0.5–3.0 mg/dL, equivalent to 0.05–0.29 mmol/L.[29]
A small Feb. 20, 2017, study looked at the impact of a six-week ketogenic diet on physical fitness and body composition in 42 healthy adults. The study, published in the journal Nutrition & Metabolism, found a mildly negative impact on physical performance in terms of endurance capacity, peak power and faster exhaustion. Overall, researchers concluded, “Our findings lead us to assume that a [ketogenic diet] does not impact physical fitness in a clinically relevant manner that would impair activities of daily living and aerobic training.” The “significant” weight loss of about 4.4 pounds, on average, did not affect muscle mass or function.
I’ve been on and off of my Keto diet with the primary purpose of losing weight. I’m 30 years old, workout daily – I’m in decent shape but have some extra fat around the mid-section that I’d like to get rid of, I am hoping to lose ~20 pounds of fat. However, the problem is that I am an extremely picky eater with tremendous cravings for some of my favorite carb-heavy foods – I only eat a number of high-fat / low-carb foods that help me attain Ketosis, so cycling through them multiple times a week becomes excruciating. I find myself cheating on my diet every 2 – 3 weeks, which causes a 3 – 5 pound setback that takes me a few days to overcome and get back into ketosis.
I have never been able to fix the electrolyte loss symptoms I get on the ketogenic diet (heart palpitations, dry mouth, air hunger) by supplementing with electrolytes. Blogosphere says that is just the transition, but mine seem to only get worse over time. I’ve tried about 2 grams of extra potassium, 800 mg extra magnesium, and 3 grams extra salt (in addition to my already liberally salted foods) spread throughout the day. This did not help. Also does eating salt alone cause you to retain water and therefore retain the rest of the electrolytes without supplementing them?
The ketogenic diet is a medical nutrition therapy that involves participants from various disciplines. Team members include a registered paediatric dietitian who coordinates the diet programme; a paediatric neurologist who is experienced in offering the ketogenic diet; and a registered nurse who is familiar with childhood epilepsy. Additional help may come from a medical social worker who works with the family and a pharmacist who can advise on the carbohydrate content of medicines. Lastly, the parents and other caregivers must be educated in many aspects of the diet for it to be safely implemented.[5]

^ Greenberg CR, Dilling LA, Thompson GR, Seargeant LE, Haworth JC, Phillips S, Chan A, Vallance HD, Waters PJ, Sinclair G, Lillquist Y, Wanders RJ, Olpin SE (April 2009). "The paradox of the carnitine palmitoyltransferase type Ia P479L variant in Canadian Aboriginal populations". Molecular Genetics and Metabolism. 96 (4): 201–7. doi:10.1016/j.ymgme.2008.12.018. PMID 19217814.
“Loss of muscle mass as we age has a number of serious consequences,” notes Clark. “Muscle is metabolically active and helps boost daily energy expenditure and mitigate age-related weight gain.” Losing muscle mass can also decrease functional strength and heighten the risk of falls, notes Clark. Falls are the top cause of death from injury in older populations, according to the Institute of Medicine Division of Health Promotion and Disease Prevention.
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[20] and followed-up by a report published in 2001.[21] As with most studies of the ketogenic diet, no control group (patients who did not receive the treatment) was used. The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction, and 3% were seizure-free.[Note 7] At 12 months, 55% were still on the diet, 23% had a good response, 20% had an excellent response, and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive, or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three, and four years was 39%, 20%, and 12%, respectively. During this period, the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction, and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free, but had had an excellent response.[21][22]
In the US especially, coconut oil and MCT oil manufacturers are legally allowed to claim that lauric acid is an MCT because chemists named it that way, even though it does not act like other true biological MCT oils. If you are relying on plain coconut oil or “MCT-labeled” oil to get enough useful MCTs, think again and check the label: odds are you’re getting very few of the potent, ketogenic shorter chain MCTs (also known as “C8” and “C10”), and instead getting mostly cheaper but ineffective lauric acid.

For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks), but the long-term seizure reduction rates are unaffected.[44] Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.[9]


On the ketogenic diet I feel very shaky/anxious from when I wake up til about noon. Eating doesn’t really help. It could be electrolyte related but seems possibly more related to excess cortisol/adrenaline as noon is also when I start to crash and get tired on a more normal diet, and because those 3 am awakenings that worsen simultaneously in ketosis seem to also have to do with HPA axis stuff. Does this side effect potentially also have to do with my fasting blood sugar being elevated?
Peak fat oxidation was 2.3-fold higher in the LC group (1.54 ± 0.18 vs 0.67 ± 0.14 g/min; P = 0.000) and it occurred at a higher percentage of VO2max (70.3 ± 6.3 vs 54.9 ± 7.8%; P = 0.000). Mean fat oxidation during submaximal exercise was 59% higher in the LC group (1.21 ± 0.02 vs 0.76 ± 0.11 g/min; P = 0.000) corresponding to a greater relative contribution of fat (88 ± 2 vs 56 ± 8%; P = 0.000). Despite these marked differences in fuel use between LC and HC athletes, there were no significant differences in resting muscle glycogen and the level of depletion after 180 min of running (−64% from pre-exercise) and 120 min of recovery (−36% from pre-exercise).
In the US especially, coconut oil and MCT oil manufacturers are legally allowed to claim that lauric acid is an MCT because chemists named it that way, even though it does not act like other true biological MCT oils. If you are relying on plain coconut oil or “MCT-labeled” oil to get enough useful MCTs, think again and check the label: odds are you’re getting very few of the potent, ketogenic shorter chain MCTs (also known as “C8” and “C10”), and instead getting mostly cheaper but ineffective lauric acid.

Acetyl-CoA can be metabolized through the TCA in any cell, but it can also undergo a different process in liver cells: ketogenesis, which produces ketone bodies.[27] Ketone bodies are also produced in mitochondria, and usually occur in response to low blood glucose levels.[28] When glucose levels are low, oxaloacetate is diverted away from the TCA cycle and is instead used to produce glucose de novo (gluconeogenesis). But when oxaloacetate is unavailable to condense with acetyl-CoA, acetyl-CoA cannot enter the cycle, and so the body has evolved an alternative way to harvest energy from it.


Fascinating stuff and I am quite curious how we know for certain one is actually in ketosis i.e. using ketones as primary fuel source BECAUSE we do know that glucose has a shorter metabolic pathway to burn and under most conditions, given the presence of glucose, that is what the body will default to which is why high fat and high sugar together in diet is so detrimental. So if we use one or more of the above “boosters” and show high levels of blood ketones but also highish levels of glucose (during initial transition) will be mostly burning ketones or still defaulting to glucose?
My question is: what if I want to be in ketosis for all the reasons mentioned in the Life Extension article and because I don't feel a strong urge to eat in between meals when I go lower carb and if I up carb intake I get hungrier more frequently and get urges . . . BUT on the flip side, I don't seem to digest fat all that well(dairy in particular is a no-no) and constipation is an issue and starchy carbs seem to help with that. It's a bit of a catch-22.
^ Bechtel PJ (2 December 2012). Muscle as Food. Elsevier Science. pp. 171–. ISBN 978-0-323-13953-3. Retrieved 19 May 2014. Freezing does stop the postmortem metabolism but only at about −18ºC and lower temperatures. Above −18ºC increasing temperatures of storage cause an increasing rate of ATP breakdown and glycolysis that is higher in the comminuted meat than in the intact tissue (Fisher et al., 1980b). If the ATP concentration in the frozen tissue falls below ~ 1 µmol/g no contraction or rigor can occur because they are prevented by the rigid matrix of ice.
In theory, all of this is possible. A study published in the Journal of Nutrition did find an association between having more severe bacterial vaginosis and consuming diets higher in total fat and saturated fat. But the keto diet is still a relatively new rage, and not enough scientific studies have been done to determine whether "keto crotch" is really a risk of the keto diet.
Considered a symptom of the keto flu, your breath on this diet often smells fruity at first. This is because acetone is a by-product of ketosis and is eliminated mostly through the lungs and the breath, according to a study in the journal International Journal of Environmental Research and Public Health in February 2014. Acetone is a type of ketone known for having a fruity aroma in smaller concentrations. “It’s hard to say exactly how long it will last as it depends on the person, but it’s common for someone to experience this side effect for a few weeks,” says Asche.
The keto diet isn’t new, and it’s been around for nearly a century. It was originally developed to treat people with epilepsy. In the 1920s, researchers found that raised levels of ketones in the blood led to fewer epileptic seizures in patients. The keto diet is still used today to treat children with epilepsy who don’t respond well to anti-epileptic drugs.[2]
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