I see a lot of people say that ketosis is great for insulin sensitivity. BUT, in my experience ketosis causes physiological insulin resistance whereby the muscles and liver are sparing glucose for the brain. Hence, glucose tolerance actually goes down during ketosis. As such, is it possible that post workout carbs could do a lot more damage than they would on a non-ketogenic diet? Or maybe, as Kiefer suggests, glucose uptake post workout is not moderated by insulin at all i.e. muscles soak up glucose regardless of their insulin sensitivity? Or maybe cyclical ketosis doesn’t allow liver glycogen to get low enough to trigger physiological insulin resistance?

"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."

It seems strange that a diet that calls for more fat can raise “good” cholesterol and lower “bad” cholesterol, but ketogenic diets are linked to just that. It may be because the lower levels of insulin that result from these diets can stop your body from making more cholesterol. That means you’re less likely to have high blood pressure, hardened arteries, heart failure, and other heart conditions. It's unclear, however; how long these effects last.
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.
An interview with University of Florida researcher and scientist Dominic D’ Agostino. In that episode, “A Deep Dive Into Ketosis: How Navy Seals, Extreme Athletes & Busy Executives Can Enhance Physical and Mental Performance With The Secret Weapon of Ketone Fuel“, Dominic highlights his research into the use of ketones to enhance breathhold time and reduce the brain’s requirements for oxygen.
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. :)

Adherence to a keto diet food list isn’t always great, though. A review published in January 2015 in the Journal of Clinical Neurology found that only 45 percent of participants were able to follow the approach as prescribed. “The poor compliance was attributed to side effects, social isolation, and cravings,” says Yawitz. And some people in the study “reported the diet simply wasn’t helping them lose weight,” she adds. Brissette agrees with this line of thinking. “In my opinion, the keto diet isn't sustainable and takes the joy and fun out of eating,” she says.
This answer made me sad. Having lived in New York all of my life, I from a young age saw loved ones fall victim to spontaneous gluten intolerance and restaurants run to their rescue with accommodating menus.  This is why I get annoyed. What’s a dietary prescription for someone who wants to go to a dinner party and be able to eat a meal that was prepared for them? Keto is cultish not for its members’ radical commitment to a dietary restriction but for their lack of full participation in the outside world.
There are many misconceptions about ketosis. The most common is mixing it up with ketoacidosis – a rare and dangerous medical condition that mostly happen to people with type 1 diabetes if they don’t take insulin. Even some health care professionals tend to mix up these two situations somewhat, perhaps due to the similar names and a lack of knowledge about the distinct differences.
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!
Another possible nutrient deficiency: potassium, a mineral important for both electrolyte balance and blood pressure control, notes MedlinePlus. “Inadequate intake of potassium is likely when consumption of fruits and starchy vegetables are decreased,” says Asche. She recommends adding lower-carb sources of potassium to the diet, including avocado and spinach — as well as lower-carb sources of fiber, such as chia seeds and flaxseed (be sure to enjoy ground for the best health benefits).
These affect your brain and spine, as well as the nerves that link them together. Epilepsy is one, but others may be helped by a ketogenic diet as well, including Alzheimer’s disease, Parkinson’s disease, and sleep disorders. Scientists aren’t sure why, but it may be that the ketones your body makes when it breaks down fat for energy help protect your brain cells from damage.

This answer made me sad. Having lived in New York all of my life, I from a young age saw loved ones fall victim to spontaneous gluten intolerance and restaurants run to their rescue with accommodating menus.  This is why I get annoyed. What’s a dietary prescription for someone who wants to go to a dinner party and be able to eat a meal that was prepared for them? Keto is cultish not for its members’ radical commitment to a dietary restriction but for their lack of full participation in the outside world.

In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.[54]
I’ve been experimenting with MCT Oil Brain Octane. I have one questions. I’ve been eating about 20 – 25 gr. of carbs per day on a high fat, medium protein diet. I’m measuring ketones in the morning before taking the MCT and after. I’ve been taking btw. 1-2 tbsp of MCT Brain Octane with butter (Bulletproof coffee) – I measure again after 30 min., 1hr, 2 hrs. and don’t see a raise in my blood ketones. Anything I’m missing, would love to hear your thoughts, Ben. – Thx I’m measuring with Precision Xtra and Ketonix Red.

It usually takes three to four days for your body to go into ketosis because you have to use up your body's stores of glucose, i.e., sugar first, Keatley says. Any major diet change can give you some, uh, issues, and Keatley says he often sees patients who complain of IBS-like symptoms and feeling wiped out at the beginning of the diet. (The tiredness happens because you have less access to carbs, which give you quick energy, he explains.)
Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:

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.
I am not an athlete. I am a mid 30’s male with a sedentary lifestyle. I am 5’10” and 250lbs. I have mild hypertension, high triglycerides, and pre-diabetes. I have eaten whatever I want and as much as I want for years. I have recently started walking/jogging 3-4 times a week, taking fish oil, and eating significantly less carbs plus added fish and steak. Is this diet appropriate and safe for me?
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.
Now I though about taking keto supplement to boost my ketosis (I’m also looking to boost my overall electrolyte and vitamin/mineral). I’m unsure what product to take. Should I take keto os or ketocana (or else)? Should I take it in the morning while I’m empty stomack for the next 6 hours (wake up at 5) with my mg cap so I get a boost in electrolyte and keto in the morning? Should I take more? Depending on the set, I might not have to take mg cap anymore since they all include some in it.

I am not a doctor and this is not to be taken, interpreted or construed as medical advice. If you have poor liver or gallbladder function, it can be a good idea to take care of that prior to a high fat diet, yes. But a healthy high fat diet would not cause liver issues per se. These are just my own personal thoughts and not a prescription or a diagnosis or any form of health care whatsoever.

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]

I talk about that quite a bit here :https://bengreenfieldfitness.com/2015/09/things-your-pee-can-tell-you-about-your-body/


Cyclical keto diet: The Bulletproof Diet falls into this category. You eat high fat, low carb (less than 50 grams of net carbs a day) five to six days of the week. On day seven, you up your carb intake to roughly 150 grams, during what’s called a carb refeed day. Carb cycling this way helps you avoid the negative effects some people experience when they restrict carbs long term, like thyroid issues, fatigue and dry eyes.[9][10]  Learn more here about how carb cycling works.
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. 

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!
Weight loss benefits ushered the keto diet into the spotlight. That’s how most people have likely heard about ketones, a fuel source created naturally by the body when burning fat. But more and more research points to diverse applications of ketones in the blood outside of just fat loss, from improved endurance performance to the treatment of medical conditions like epilepsy.
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.

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.[24] 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.[25][26]


Next, you need to ease yourself into this stuff. As I mentioned earlier, KETO//OS is blended with MCT’s, which can cause digestive distress if you’re not used to consuming them. This is due to the fact that your body has not yet adapted to the increased fats in your diet, and is less efficient at utilizing ketones as its fuel source. Once your body has adapted to MCT in the diet, the digestive distress will resolve.  But I recommend you start slowly with just about a half a serving a day, and over two weeks, build up to a full serving twice a day.

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-…


-Cardiovascular Disease: High blood sugar has been shown to increase the risk for cardiovascular events, cardiovascular disease, and cardiovascular mortality—while lower glucose levels result in lower cardiovascular risk. Coronary artery disease risk has been shown to be twice as high in patients with impaired glucose tolerance, compared with patients with more normal glucose tolerance. The risk for stroke increases as fasting glucose levels rise above 83 mg/dL. In fact, every 18 mg/dL increase beyond 83 results in a 27 percent greater risk of dying from stroke. Incidentally, glucose can “stick” to cholesterol particles and render these particles extremely dangerous from a heart health standpoint, which is why it’s all the more important to control blood sugar levels if you’re eating a “high-fat diet.”


Ketosis is a nutritional process characterised by serum concentrations of ketone bodies over 0.5 mM, with low and stable levels of insulin and blood glucose.[1][2] It is almost always generalized with hyperketonemia, that is, an elevated level of ketone bodies in the blood throughout the body. Ketone bodies are formed by ketogenesis when liver glycogen stores are depleted (or from metabolising medium-chain triglycerides[3]). Ketones can also be consumed in exogenous ketone foods and supplements.
Keto is short for ketogenic. If you didn’t already know, it’s a high-fat, low-carb diet. The goal of the ketogenic diet is to get your body into a “ketogenic state,” or a physiological state in which your body is not burning carbohydrates -- which break down to glucose -- but an alternative energy source called ketones, which are produced by the liver when your body is depleted of glucose. Ketones are formed from fat stores. In order for your body to start producing ketones, it needs to first run out of glycogen stores. After you deprive your body of carbs, it takes a bit of time for the glucose to clear out.

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)

Sensational article. I am experimenting with a low carb diet, high fats and moderate protein. I am not keeping strict notes on what I eat but I cut out almost all fruit and I eat eggs, spinach, kale, chard, avacados, hard cheese, walnuts (raw organic) and grass fed meet and butter. I take about 25-30ml of Brain Octane straight a day. I take your probiotic and colostrum (I need to get more regular) and I consume bone broth four days a week. I am looking to live longer and be healthier during that long life. In the short term I want to be smarter and be able to handle stress better. I would also love to avoid cancer and drop a deuce every day. My question is: Is there a point of carb consumption where even combining it with exogenous ketones using your recommendations it would be less effective or cause negative outcomes? Could one consume all the cards and sugar one wanted and use the supplements and still be getting into ketosis and reaping the benefits?

Cyclical keto diet: The Bulletproof Diet falls into this category. You eat high fat, low carb (less than 50 grams of net carbs a day) five to six days of the week. On day seven, you up your carb intake to roughly 150 grams, during what’s called a carb refeed day. Carb cycling this way helps you avoid the negative effects some people experience when they restrict carbs long term, like thyroid issues, fatigue and dry eyes.[9][10]  Learn more here about how carb cycling works.
Two years after my first oatmeal binge, I found myself in an All Ages and Genders eating disorder support group, sandwiched between a bulimic father/bodybuilder and a teenage girl who had to drop out of high school for inpatient treatment. We would sit around and discuss incentives to eat normally, such as “I don’t want to die of osteoporosis” and “I’d like to have a friend or two sometime in the future” and “I want to enjoy a croissant again.” Together we relearned how to eat, because we had a new and sustainable goal -- we wanted to live a life without shame and obsession.
Anticonvulsants suppress epileptic seizures, but they neither cure nor prevent the development of seizure susceptibility. The development of epilepsy (epileptogenesis) is a process that is poorly understood. A few anticonvulsants (valproate, levetiracetam and benzodiazepines) have shown antiepileptogenic properties in animal models of epileptogenesis. However, no anticonvulsant has ever achieved this in a clinical trial in humans. The ketogenic diet has been found to have antiepileptogenic properties in rats.[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 
For any long 90+ minute workouts or competitions for which glycogen depletion is a potential issue, use Glycofuse, but use half of the recommended serving of it, and add one scoop of Catalyte electrolytes, one scoop of Aminos, and one serving of medium chain triglycerides in the form of Brain Octane, KetoCaNa or KETO//OS (pick your poison, it’s up to you).
You also get incredible gains in metabolic efficiency when you use fat as a primary source of fuel – especially when doing high-intensity interval training – with this one-two combo causing potent 3–5 percent decreases in the oxygen cost of exercise, which is extremely significant. Translated into real- world numbers, this increased fat utilization from carbohydrate restriction and high-intensity interval training would allow you to pedal a bicycle at a threshold of 315 watts, whereas a high-carbohydrate, aerobic-only program (the way most people train) would allow for only 300 watts. Talk to any cyclist and you’ll find out that an 15 extra watts of power is huge in a sport like cycling, and something most cyclists train years and years to achieve.
2) I'm currently using Ketocana and in that section you state "Similar to the BHB salts and MCT’s from the KETO//OS I discuss above, powdered forms of ketones are excellent if you don’t want to completely eliminate carbohydrates or fat or eat copious amounts of fats, but want to simultaneously maintain high levels of blood ketones." – How would eating copious amounts of fat be a negative? Wouldn't that help contribute to a ketogenic state?
Bulk buy and cook. If you’re someone who doesn’t like to spend a lot of time in the kitchen, this is the best of both worlds. Buying your food at bulk (specifically from wholesalers) can reduce the cost per pound tremendously. Plus, you can make ahead food (bulk cook chicken thighs for pre-made meat, or cook entire meals) that are used as leftovers, so you spend less time cooking.

But while carbohydrates can help you have a better workout, go faster, or go longer, this only applies to acute, in-the-moment performance. Once you take a look (which you’re about to do) at the long-term effects of chronic high blood sugar levels, things change drastically. If the damage that you’re above to discover is worth it to you, then you are either mildly masochistic or you value performance much more than health.


Some Inuit consume as much as 15–20% of their calories from carbohydrates, largely from the glycogen found in raw meats.[43][44][47][45][50] Furthermore, the blubber, organs, muscle and skin of the diving marine mammals that the Inuit eat have significant glycogen stores that are able to delay postmortem degradation, particularly in cold weather.[51][52][53][54][55][56]
-Cardiovascular Disease: High blood sugar has been shown to increase the risk for cardiovascular events, cardiovascular disease, and cardiovascular mortality—while lower glucose levels result in lower cardiovascular risk. Coronary artery disease risk has been shown to be twice as high in patients with impaired glucose tolerance, compared with patients with more normal glucose tolerance. The risk for stroke increases as fasting glucose levels rise above 83 mg/dL. In fact, every 18 mg/dL increase beyond 83 results in a 27 percent greater risk of dying from stroke. Incidentally, glucose can “stick” to cholesterol particles and render these particles extremely dangerous from a heart health standpoint, which is why it’s all the more important to control blood sugar levels if you’re eating a “high-fat diet.”
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