A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital and followed-up by a report published in 2001. 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.
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.
While it is believed that carbohydrate intake after exercise is the most effective way of replacing depleted glycogen stores, studies have shown that, after a period of 2–4 weeks of adaptation, physical endurance (as opposed to physical intensity) is unaffected by ketosis, as long as the diet contains high amounts of fat, relative to carbohydrates. Some clinicians refer to this period of keto-adaptation as the "Schwatka imperative" after Frederick Schwatka, the explorer who first identified the transition period from glucose-adaptation to keto-adaptation.
1. If a set number ketones in the blood is an indicator that my body has transitioned to ketosis and not necessarily the cause (the cause being limited access to glycogen because of limited carb intake) then how does using exogenous ketones put me in ketosis as opposed to mimic being in ketosis (because when measuring blood ketones suddenly there are more because I put them there, I didn’t create them)?
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?
Keto breath, on the other hand, is less of a side-effect and more of a harmless inconvenience (your breath literally smells like nail polish remover). Basically, when your body breaks down all that extra fat on the keto diet, it produces ketones—one of which is the chemical acetone, Keatley previously told WomensHealthMag.com. (Yes, the same stuff that's in nail polish remover.)
Once inside the mitochondrion, the dominant way that the bound fatty acids are used as fuel in cells is through β-oxidation, which cleaves two carbons off of the acyl-CoA molecule in every cycle to form acetyl-CoA. Acetyl-CoA enters the citric acid cycle, where it undergoes an aldol condensation with oxaloacetate to form citric acid; citric acid then enters the tricarboxylic acid cycle (TCA), which harvests a very high energy yield per carbon in the original fatty acid.
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!
“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.
In fact, most folks have enough stored body fat to fuel aerobic activity for days and days without running out of energy. For example, a 150 pound dude at a hot, sexy and ripped at 8% body fat still carries 12 pounds of storage fat – which at 3500 calories per pound of fat can easily liberate 42,000 calories of useable fuel for exercise. You’ve got those same thousands of calories sitting around your waist, abs, hip, butt and thighs – just sitting there, waiting to be burnt.
Ben, great article! I recently did my own ketosis experiment and didn’t catch the 100-200g advise until later than I should have, I’m guessing. Great results for 1-2 months but after 3 months I quit sleeping through the night and would wake after about 4 hours of rest each night. My guess is that the extra carbs at night coupled with iodine supplements should allow me to “have my cake and eat it too?” Any other suggestions on the sleep issue? I’ve gone back to High Fat/Low Carb, have improved sleep but I do miss nutritional ketosis and want to try again once my sleep is stable. Thank YOU!!!
When your body burns its stores of fat, it can be hard on your kidneys. And starting a ketogenic diet -- or going back to a normal diet afterward -- can be tricky if you’re obese because of other health issues you’re likely to have, like diabetes, a heart condition, or high blood pressure. If you have any of these conditions, make diet changes slowly and only with the guidance of your doctor.
When you burn key tones as a funeral, whether they are from a supplement or whether they are the ones that your body makes, you do indeed become more efficient utilizing ketones. So that is one advantage. You are correct in that if you simply use these and you do not restrict carbohydrate intake then you're not going to get quite as much benefit. I am a fan of combining these with intermittent fasting, MCT oil, and a high-fat diet.
Hi, I am a parent of son with epilepsy. On our last EEG we found out he is having 10 absence seizures per hour as well as bimonthly grandmal seizures . People have been using the ketogenic diet for seizure control for years. Our neurologist mentioned that seizure control is effected by blood insulin as well as ketones. I know the original Keto esters came from DR. D’Augustino’s work with Navy Seals who were having seizures due oxygen toxicity. The main reason we have not been using the Keto diet is lack of compliance and it so easy for kids to get out of ketosis. I am wondering if we could get seizure control with a zonish/adkins diet with keto os, brain octain supplementation. Even an educated guess would be appreciated. Thanks, Mike
Ken, not 100% sure I understand your question but if you're asking if you should take any more supplements through out the week, it's hard to know without getting some blood testing done. If you want to go into detail, book a consult at bengreenfieldfitness.com/coaching and choose 20 or 60 mins and we'll get you scheduled. If you want to know specifically about fueling for your runs, have a read through this: https://bengreenfieldfitness.com/2013/07/what-…
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.
I talk about that quite a bit here :https://bengreenfieldfitness.com/2015/09/things-your-pee-can-tell-you-about-your-body/
Normal dietary fat contains mostly long-chain triglycerides (LCTs). Medium-chain triglycerides (MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate, leading to more food choices and larger portion sizes. The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil. Consuming that quantity of MCT oil caused abdominal cramps, diarrhea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant. The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.
Fairly recently, the diet was introduced as a weight-loss diet by an Italian professor of surgery, Dr. Gianfranco Cappello of Sapienza University in Rome. In his 2012 study, about 19,000 dieters received a high-fat liquid diet via a feeding tube inserted down the nose. The study showed an average weight loss of more than 20 pounds in participants, most of whom kept it off for at least a year. The researchers reported a few minor side effects, like fatigue.
Thanks for all of the great info!! I have Hashimoto’s and would really like to try a high fat/low carb diet. You mentioned that this might not be a good option for people with thyroid issues. How do you recommend I modify my diet to lose weight taking into consideration the Hashimoto’s. I take Westhroid, a non-synthetic thyroid supplement to help with my sluggish thyroid. Thanks so much for any advice you can give me. :)
Exogenous ketosis comes from an external source. Consuming exogenous ketones, like a ketone drink containing a ketone ester or a ketone salt, raises blood ketone levels. The body isn't producing ketones in this state, but still remains in ketosis from having ketones introduced from an outside source. However, the body isn't ketogenic–that specifically means the body is producing its own ketones.
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.
A lot of changes are happening in your body and you’re going to feel it! The first five to seven days can be pretty rough, but your body is getting over its dependency on sugar. During this time of transition it is essential that you supplement electrolytes. Your body is flushing out lots of water, and with that goes electrolytes. The Keto Flu can be greatly reduced if you add sodium, potassium and magnesium to your diet. Check out our supplements page for a list of electrolyte supplements we recommend. Stay on course and you’ll start feeling better in no time!