After that happened, I set out once again to find some kind of carbohydrate source that allows one to maintain elevated liver glycogen and muscle glycogen stores without getting all the blood-sugar level roller coaster rides or gut rot and fermentation that many typical sports nutrition carbohydrate sources such as fructose and maltodextrin can cause.
What are the ideal levels of blood sugar? A blood sugar or blood glucose chart identifies ideal levels throughout the day, especially before and after meals. The charts allow doctors to set targets and monitor diabetes treatment, and they help people with diabetes to self-assess. Learn more about guidelines, interpreting results, and monitoring levels here. Read now
In nondiabetics, ketosis (also called nutritional ketosis) is regulated and controlled in the body so that ketone levels never reach the harmful levels associated with diabetic ketoacidosis. Ketoacidosis is an acute, life-threatening condition that occurs in severely uncontrolled diabetes (mainly type 1) when ketones rise to massive, supranormal levels.

The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals, and calcium-rich foods. In particular, the B vitamins, calcium, and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient's age: a multivitamin with minerals and calcium with vitamin D.[18] A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises three small meals and three small snacks:[28]

Hello, I have a quick question. I’ve been on keto since March 2017. Already lost about 45 pounds, down to 140 at 5’7 and about 16.4% fat. I take a magnésium cap each morning to be sure I got enough and eat at least 1 serving of baby spinach a day with olive oil or fatty dressing that have no carbs. My last meal is always between 5 and 9 pm (mostly around 6) and I don’t eat back before 12pm the next day on week days and not before next dîner on week end. Fasting isn’t something new to me and when I read it help getting in ketosis I continued.

Hi Ben, great article. I have been a keto-adapted athlete for over 2 years, all through nutrition (65/25/10). I have recently discovered UCAN, KetoOS and MAP Aminos. So, here’s my question: If I am going out for a 4-hour ride, and I want to fuel myself just on these supplements and my body’s natural fat stores, how and in what order should I take them? If I take them all together, will the aminos in the KetoOS interfere with MAP Aminos? Or should I just make a mix of the UCAN and KetoOS in 10oz of water and use it to wash back my 6 MAP tablets, 15-mins before my ride? Thanks for your advice!
Ben – curious about your thoughts on this. I went into ketosis (using LOTS of coconut oil) but it raised my cholesterol and doc was worried about my lp(a) level (17mg/dL on VAP) even though crp was 0.5, trigs 51 and a1c was 5.2. Advised a low fat diet. Have you seen this before with folks on a lchf/ketosis diet and is there anything to be concerned about? Off to read your coconut oil article. 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.

C8 is the rarest MCT found in coconut oil, comprising about 6% of coconut oil. It has potent anti-microbial properties (way more potent than lauric acid) to help you maintain a healthy gut, and it is the fastest MCT to metabolize in the brain. (hence the name Brain Octane). Your liver does not need to process C8, and it only takes the steps for your body to turn it into ATP cellular energy (sugar takes 26 steps). You would need 18 tablespoons of coconut oil to get just one tablespoon of Brain Octane.
"If you're going to do keto, there's a better and a worse way to do it," registered dietician Kim Yawitz told Everyday Health. "Loading your plate with meats, and especially processed meats, may increase your risk for kidney stones and gout... High intake of animal proteins makes your urine more acidic and increases calcium and uric acid levels. This combination makes you more susceptible to kidney stones, while high uric acid can increase your risk for gout."
Can’t get enough of avocados? You now have a great excuse to eat more of them. A ½-cup serving of the creamy fruit has almost 12 g of fat and only 2.6 g of net carbs. Avocados are also low in calories (about 138 for the same serving), making them an ideal snack in between meals. One serving also has about 6.4 g of dietary fiber (25.6 percent daily value, or DV), 404 milligrams (mg) of potassium (8.6 percent DV), and only 2.8 g of sugar. Try topping your salad with cubed avocado for a keto-friendly lunch.
"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.
No-sugar diet plan: What you need to know Eliminating sugar from the diet can help prevent weight gain, diabetes, heart disease, and other problems. Whether cutting sugar out of the diet completely or simply cutting back, we have eight important tips for following a no-sugar diet, and some advice about fruits and other natural foods that contain sugar. Read now

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.
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)?
Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
Thank you for this article as it cleared up a bunch of stuff for me. I started trying to get into ketosis back in August and lost 20lbs in about 6 weeks. Then it all stopped but had another 20lbs I wanted to loose. I had a hard time staying in ketosis and gave up about a week ago with the holidays approaching. Anyways I glazed over all the technical and science facts as it makes my head spin and might of missed it but my only question is what is the food portion of the diet like? The drinks are the easy part, do you have a diet plan that is good for someone that hits the gym hard 4-5 days a week for and hour and half. 45 min weights and 30-45 min cardio? It’s what I struggle with most the food and what attracted me to a ketogenic diet in the first place is eating 1 or 2 meals a day and being satisfied.
Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[46]

After 2 years in ketosis suddenly I find my blood glucose has risen to high levels even while in ketosis. I thought it was the dawn phenomenon, stress hormones like cortisol but now I am beginning to think I am eating too many exongenous keytones like too much MCT oil? I am not taking exogenous keytone supplements but wondering if too much oil/ fat in the diet generates exogenous keytones which inhibits the livers production of endogenous keytones. I have read if the liver is producing endogenous keytones it is not at the same time producing glucose through gluconeogenisis?

Ben. I do not read epidemiological studies anymore… Just biology. There are plenty of examples of traditional cultures consuming high carb (and high fat) without any of the health issues those studies in your article claim. So either high fat or high carb both work if done properly… AND in the right environment. Both are ancestral not just one of the two and have posit and negat because it has to do with the climate and environment around. I do not listen to anybody that pushes JUST one because they are ignoring the reality. I hope you join this "common sense" wagon.
Some clinicians[37] regard eliminating carbohydrates as unhealthy and dangerous.[38] However, it is not necessary to eliminate carbohydrates from the diet completely to achieve ketosis. Other clinicians regard ketosis as a safe biochemical process that occurs during the fat-burning state.[35] Ketosis, which is accompanied by gluconeogenesis (the creation of glucose de novo from pyruvate), is the specific state that concerns some clinicians. However, it is unlikely for a normally functioning person to reach life-threatening levels of ketosis, defined as serum beta-hydroxybutyrate (B-OHB) levels above 15 millimolar (mM) compared to ketogenic diets among non diabetics, which "rarely run serum B-OHB levels above 3 mM."[39] This is avoided with proper basal secretion of pancreatic insulin. People who are unable to secrete basal insulin, such as type 1 diabetics and long-term type II diabetics, are liable to enter an unsafe level of ketosis, eventually resulting in a coma that requires emergency medical treatment.[citation needed] The anti-ketosis conclusions have been challenged by a number of doctors and advocates of low-carbohydrate diets, who dispute assertions that the body has a preference for glucose and that there are dangers associated with ketosis.[40][41]
"Some people stop working with me because they're not going to be proven wrong. You’re dissing their religion," said Libby, a registered dietician who asked that her full name not be used because of the private hate messages she's received from the community.   “If there was a diet or a pill or something that really was this miracle diet weight-loss thing that lasted and was healthy for you, we wouldn't have all these different diets all the time, there wouldn't be health complications, there wouldn't be so much controversy about it and the first time that you'd be learning about it wouldn't be on a 3pm talk show."

Ideally, you combine supplemental ketones with a relatively low carb diet, especially if metabolic efficeincy is important to you. HOWEVER, you can achieve most of the benefits of ketosis aside from the fat burning efficiency by using exogenous ketones. So it all depends on how lean you are, what's important to you from a performance vs. fat loss standpoint, etc.
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.
They mimic ketosis, to answer your question in short. Best to get fat adapted and use ketones to get the best of both worlds and to enhance fat burning abilities. They will allow you to use glucose and fatty acids simultaneously, yes. Anyways, I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60 minute consult, whichever you'd prefer. I can schedule ASAP after you get that.
The ketogenic diet doesn’t put a cap on saturated fat or even trans fats. The latter are fats you should always avoid. Read ingredient labels and avoid any food with partially hydrogenated oils, aka trans fats. These fats heighten your LDL (“bad”) cholesterol levels and lower your HDL (“good”) cholesterol levels. They also raise your risk of heart disease and stroke, according to the American Heart Association.
No offense brother, but this whole article is a big selling advertisement. The health benefits of a “low – carb, high – fat” diet are well known and proven. I directly blame nutritionists, like yourself, for the fact that ~70% of American is considered obese now, not fat, obese. And the fact that Heart Disease is the number 2 killer in America now, second only to cancer.
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.
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.
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