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On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.
Look into cold showers and ice baths for relief from depression along with all the other benefits it provides. If you’re willing to push your comfort zone, you’ll find that cold showers/baths provide a monumental difference. There’s some research out there that identifies the benefits of combining specific ketogenic diets and ice baths. And I used this to increase gains in the gym, reduce inflammation, feel better in general, builds patience and raises tolerance levels. It’s impressive stuff. Cold and heat thermogenesis for the win (heat would be sauna/steam room, but cold is what helps you sleep better and will help you with depression). Good luck mate!
I don’t know about you, but I find these risks pretty damn concerning. The fact is that I want to be around to play with my grandkids, and considering that my genetic testing with 23andMe has revealed that I have a higher-than-normal risk for type 2 diabetes, I doubt that shoving more gooey gels and sugary sports drinks into my pie hole is going to do my health any favors. So if I can achieve similar levels of performance and body composition with carbohydrate restriction, I’m all in.
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[19] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[56]
High levels of circulating ketones may have a direct appetite-suppressant effect. In fact, the exogenous ketone ester used in HVMN Ketone rapidly increased blood levels of beta-hydroxybutyrate and lowered appetite as well as levels of ghrelin - the hormone that increases hunger. While this still needs to be explored further, it is possible that exogenous ketones may be useful for appetite control as part of a holistic weight loss strategy.11 

People use a ketogenic diet most often to lose weight, but it can help manage certain medical conditions, like epilepsy, too. It also may help people with heart disease, certain brain diseases, and even acne, but there needs to be more research in those areas. Talk with your doctor first to find out if it’s safe for you to try a ketogenic diet, especially if you have type 1 diabetes.


Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.

That was really interesting and useful information. But I wanted to ask you about what Dom said at time (52min). What does he mean,when he says 1 mml increase is about 10% increase of substrate to the brain? Is that (same glucose amount in brain) + (typical ketone amount in brain)+ and 10% more? Or does it substitute glucose? And if it is so, does the brain use that energy or does it just stay around the brain without being used? I know we can’t know for sure, but it would be helpful if you said what you think. Thanks in advance!
Acetone, the least abundant ketone, is present in the breath and is responsible for the unpleasant odor. Acetone is a solvent in nail polish, if that gives you an idea of what it might smell like. But it's not as bas as it sounds; acetone breath is a sign of ketosis and fat burning. It's the ketone measured in breath tests used for detecting ketosis.6
Therefore, more people experiencing "keto crotch" need to visit doctors to determine what's really happening. It could be that some of the people claiming "keto crotch" are instead detecting smells that are not related to their diets. Many different smells could emanate from your crotch, some are normal, some are not. Conversely, who knows for sure what a drastic change in your diet may do to different parts of your body? There is still a lot unknown about the links between nutrition and your various bodily functions. You are a complex system with many unknowns. The keto crotch could be a real phenomenon, but more scientific evidence and studies are needed.
“To achieve the relatively high rates of intake (up to 90 grams/hour) needed to optimize results in events lasting longer than three hours, athletes should practice consuming carbohydrates during training to develop an individual strategy, and should make use of sport foods and drinks containing carbohydrate combinations that will maximize absorption from the gut and minimize gastrointestinal disturbances.”
In addition, most studies that compare carbohydrate utilization with fat utilization fail to take into account the fact that full “fat adaptation” that allows you to gain all the benefits of using fat as a fuel actually takes time – often more than four weeks – and up to a couple years. But since most studies that compare fat and carbohydrate burning are short-term, you rarely see the benefits of this kind of fat adaptation actually fleshed out in research. Instead, the average research participant begins the study in a non-fat adapted state, gets either a high fat or high carb diet, then launches into exercise. But in an ideal study, that person would have followed either a high-fat or high-carb diet for many months before getting their fat burning capability investigated.
Remember how important it is to measure ketone blood levels accurately? Same goes for food tracking. A food tracking app, like MyFitnessPal, provides insight into macronutrient intake and thus the ability to tweak the diet to achieve ketosis. Tracking diet (inputs) and measuring ketones levels (outputs) delivers the best shot at optimizing the keto diet plan.
Those issues can be part of what's known as the “keto flu,” Warren says. Other side effects of the keto diet, all of which are tied to carb withdrawal, can include lightheadedness, nausea, mental fog, cramps, and headaches, in addition to tiredness. Luckily, the keto flu doesn't usually last more than a week—which is coincidentally about when people start to see the number on the scale go down, says Warren.
Hi Ben – Great article. I had trouble at the end figuring out if you were now eating high fat (60-80% of calories), or if you went back to something closer to 50% fat calories and higher carbs and are using exogenous ketones to get int ketosis when needed. Are you doing any carbs at night or a refeed, or just having higher carbs on most days? Thanks

"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.

You said you saw Dr. Jeff Volek at UCONN. I am interested in ketosis to help me with my M.S. I still have questions related to M.S. and not so much as it effects on athletes. I do live in CT, but was unable to locate Dr. Volek at either the Storres or Farmington campus. Would you be able to give me either his e-mail address or telephone number so that I can contact him directly? Your help would be greatly appreciated.
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