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.
MCT oil powder is a unique form of dietary fat rapidly absorbed by the body and has a wide range of health benefits. Supplementation with MCT powder can help combat fatigue, suppress appetite[*], enhance thermogenesis (aka ‘fat burning’)[*] and help your body adapt to using ketones for fuel. A recent scientific review showed that MCTs can effectively decrease body weight, total body fat, hip circumference, waist circumference, total subcutaneous fat and visceral fat[*]. Check out this articlefor more information on how to supplement with MCTs.

I started a ketogenic diet about 5 weeks ago and have experimented with KetoCaNa and KetoForce along with Now Foods MCT oil (which is made of caprylic and capric acid) in the hopes of easing the transition into ketosis. I don’t use it every day, but often before an aerobic based workout. I was wondering if taking these exogenous ketones at the beginning of a ketogenic diet helps you become keto adapted by up regulating the body’s handling of ketones. And conversely, does taking exogenous ketones down regulate or affect lypolysis since BHB is readily available? My main priority at this point is fat loss.
The situation for Type II diabetics is different because some insulin production remains and some cells of the body can still respond to insulin. It is worth noting that insulin sensitivity can be different between the different tissues of the body such as liver, adipose tissue and muscle. A small amount of insulin release can help to prevent development of DKA unless the body is totally insulin resistant. Insulin resistance is a term used to indicate that for a given amount of insulin, the cells of the body are less responsive and take up less glucose. This means that blood glucose levels remain higher for longer when insulin resistant Type II diabetics eat a carbohydrate rich meal. Over time, the pancreas secretes more insulin to compensate for reduced insulin sensitivity, which can damage the insulin producing (beta) cells. Furthermore, having high blood glucose can lead to a number of side effects:

I love your site but your note about Diabetic Ketoacidosis is completely wrong. DKA is not something that happens because your body produces too many ketones. It is something that happens when your body produces too many ketones, and you don’t have any insulin in your system. As long as a Type 1 Diabetic takes insulin they will NOT go into DKA. Especially since DKA requires high ketones, high sugars, and low insulin.
Of course, ketosis itself comes with its own risks. Circulating ketone bodies make your blood too acidic, and your body will draw calcium from your bones as a buffer. This also happens in ketoacidosis, which is when you have so many ketone bodies that it becomes dangerous and will draw far more calcium out of your bones. Giancoli notes that dieters usually aren't in such an extreme starvation mode that they develop ketoacidosis. There are few to no studies on healthy adults undertaking a non-therapeutic ketogenic diet, but studies of epileptic children on the diet show increased bone demineralization and high calcium levels in the blood.
I have been on this Keto diet 2weeks now,have lost almost 8lbs,am strictly following this diet,the food is great,I have the cookbook,I don’t feel starved,nor deprived,am hanging in there,because according to this cookbook,your body doesn’t start to be a fat burning machine until day 30,is this correct?however,my clothes are loose on me,so I feel I am in keytosis as we speak

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
The addition of MCT powder to ketones serves the purpose of maintaining endogenous production of ketone bodies by stimulating fatty acid oxidation in the liver, which then causes the production of even more ketone bodies. In this transcript from a podcast with Dr. Dom D’Agostino it is mentioned that MCT’s cross the blood-brain barrier straight to the brain. So not only are the ketones being used by the brain as an alternative fuel but so are MCT’s.
I have changed to a Ketogenic Lifestyle for over a year and half now. This is not a Diet is a lifestyle change. I choose to be healthy and weight loss is an awesome side effect. I’m over 100lb down, no more diabetes, I reversed my fatty liver disease, and I am totally off all blood pressure medication. I have more energy and now able to work out 5 days a week. My blood work had never been better including my cholesterol levels. I’ve tried every diet and nothing worked. I respect your opinion and your post on the blog, but Keto has been a lifesaver for not only me but my family as well. I wish you well in your journey and I’m glad you found a WOE that works for you. I’m living proof Keto works.
Your body composition. Do you have a lot of fat to lose? How much muscle do you have? The people who have the most to lose will tend to shred the fat at a much faster rate than those who have a few extra pounds to burn off. This phenomenon is mostly explained by the fact that obese individuals can easily maintain a much larger calorie deficit, which will result in faster weight loss. Muscle mass also plays a vital role in weight loss because it helps keep your metabolic rate from dropping significantly as you lose weight. This can help stabilize your weight loss rate and may even prevent a dreaded weight loss plateau.
10 pound weight loss , chicken broth works to relieve . But have to be careful of salt intake . I retain fluid, Dr gave script for dieuretic before I even started Keto . I have had the retention problem for a long time , when I took the dieuretic on a normal high carb diet ( I would drop 4 lbs ) but would make me really tired , afraid if I take it now on Keto I will pass out. Any idea what I should try other than the chicken broth

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.
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.

"Mushrooms are mostly made of protein, fiber, and water, making them very filling," said Alex Ruani, nutrition science educator at The Health Sciences Academy. Low-starch foods like mushrooms are unlikely to kick you out of ketosis, she suggested, making them an ideal staple during low-carb eating. To add mushrooms to your diet, she recommended stirring them with scrambled eggs. Doing so makes a delicious and very filling low-carb meal, she explained.
It is true that, "The liver will make ketones from body fat, the fat you EAT, and from alcohol --- the ketone strips have no way of distinguishing the source of the ketones. So, if you test every day after dinner, and dinner usually contains a lot of fat, then you may very well test for large amounts of ketones all the time."This is why we recommend testing at the same time every day. The morning, before breakfast, is the best time because it will reflect what your body is doing, and not the previous meal. Unless someone tests negative in the morning, then we will recommend testing before bed.
Some of the benefits of ketosis occur due to the restriction of dietary carbohydrate. Others occur due to the presence of ketones in the blood. Two of the most commonly sought after effects are weight-loss and improved insulin sensitivity. These are conferred by the low carbohydrate content of the diet allowing increased fat burning and the gradual restoration of insulin sensitivity. In this article we discuss the basics of ketone production and metabolism, and some of the many ways that KETONES themselves (endogenous AND exogenous) can benefit health and performance. 
The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients.[3] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[47] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.[3]

Despite what health science has beaten into us over the last fifty or so years, humans thrive on high-fat, low-carb diets. Millions of people around the world have discovered that a ketogenic lifestyle is the key to weight loss, disease prevention and intervention, and a more vibrant life. Gone are the days of constant hunger and low energy. This book leads you on a path to better health, a slimmer waistline, elimination of cravings, and endless energy.

The Standard American Diet (SAD) is predominantly composed of carbohydrates making the body very good at breaking down carbohydrates for fuel but not as efficient at breaking down stored fat. The ketosis diet truly trains the body to burn fat for fuel and even after discontinuing a ketogenic plan the body is still much more efficient at breaking down stored body fat.


Due to the high-quality design and data of the study, it was published in the Journal of American Medicine, one of the most prestigious research journals in the world. The research team stated that “in this study of overweight and obese premenopausal women, those assigned to follow the Atkins diet had more weight loss and more favorable outcomes for metabolic effects at 1 year than women assigned to the Zone, Ornish, or LEARN diets.” [16]
“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.”
Ketone esters (BHB-BD) increases activation of protein synthesis 31. Following exercise, complex signalling pathways within the muscle are activated to trigger the synthesis of muscle protein. A key regulator of muscle protein synthesis is a ‘kinase’ enzyme called mTOR. When athletes mixed ketone ester with a protein and carbohydrate recovery drink , muscle samples revealed that mTOR was much more strongly activated with ketone drinks compared with carbohydrate control drinks. This could help to promote gain of muscle mass occurring as a result of exercise.   

Therefore the combustion enthalpy (∆H) of each fuel is an important factor in the energy it can provide to the cell. When expressed as the energy per 2 carbons in the molecule, ketones (BHB) have a higher combustion enthalpy (∆H) than pyruvate, lactate and glucose (see table). This means that the amount of energy that could possibly be transferred to ATP is higher than for those other substrates:
In the 1920s, doctors began to realize that when fed a high fat and extremely low carbohydrate diet their patients began to notice a remarkable reduction in frequency and severity of seizures. They found that the breakdown of dietary fat caused the body to produce ketones which have GABAergic and glutamatergic effects causing a reduction in nerve impulses thus having an anticonvulsant effect. The ketogenic diet was used as the mainstream therapy until the development of new anticonvulsant medications in the late 1930s.

"When you are on the keto diet, you drastically cut your carbs to only 20 per day. That's less than one apple!" said nutritionist Lisa Drayer, a CNN contributor. "The keto diet is just not sustainable over the long term. It doesn't teach you how to acquire healthy eating habits. It's good for a quick fix, but most people I know can hardly give up pasta and bread, let alone beans and fruit."
The keto diet (also known as ketogenic diet, low carb diet and LCHF diet) is a low carbohydrate, high fat diet. Maintaining this diet is a great tool for weight loss. More importantly though, according to an increasing number of studies, it helps reduce risk factors for diabetes, heart diseases, stroke, Alzheimer’s, epilepsy, and more1-6.On the keto diet, your body enters a metabolic state called ketosis. While in ketosis your body is using ketone bodies for energy instead of glucose. Ketone bodies are derived from fat and are a much more stable, steady source of energy than glucose, which is derived from carbohydrates.
Hi Ben great science & sound advice. May I share with the group? I’m 42, in australia, have been an alcoholic for 10 yrs. In April 2016 I gave up drinking & started living strictly ketogenic. In 3 months I dropped 25 kilos. I have cheated on weekends but I go through a fast of sorts on Mondays to get back into ketosis by Tues. I work afternoon / evenings so I wake at 10.30am take a pre workout drink with raspberry ketones & a splash of mct oil & all my vitamins as well. I then do weights for an hr then get ready to go to work. I take 2 800ml protein shakes consisting of 20 ml mct & 30grm amino enhanced protein. I work in warehousing so I walk anywhere between 10 km & 5 km a nite. I feel great all the time, thanks largely to your research & advice. If have any thoughts or opinions I’d love hear them.
In ketogenesis, two acetyl-CoA molecules instead condense to form acetoacetyl-CoA via thiolase. Acetoacetyl-CoA momentarily combines with another acetyl-CoA via HMG-CoA synthase to form hydroxy-β-methylglutaryl-CoA. Hydroxy-β-methylglutaryl-CoA form the ketone body acetoacetate via HMG-CoA lyase. Acetoacetate can then reversibly convert to another ketone body—D-β-hydroxybutyrate—via D-β-hydroxybutyrate dehydrogenase. Alternatively, acetoacetate can spontaneously degrade to a third ketone body (acetone) and carbon dioxide, although the process generates much greater concentrations of acetoacetate and D-β-hydroxybutyrate. When blood glucose levels are low, ketone bodies can be exported from the liver to supply crucial energy to the brain.[28]
Following a low calorie diet: The exact mechanism whereby caloric restriction can slow or prevent cancer is unknown. It may be linked to: decreased blood glucose (less fuel for cancer cells), raised ketones (antiinflammatory, decreased oxidative stress, decreased ability to use glucose) . Animal models have shown that caloric restriction is closely related to tumour incidence and progression94.

The process of generation ketones (ketogenesis) is kept in check by the presence of insulin in the body. Insulin regulates the flow of fatty acids from our fat cells, and it acts in a feedback loop to regulate ketogenesis. As long as insulin is circulating within the body, in general, the flow of fatty acids and the production of ketone bodies will be limited to a range that is not dangerous.  In contrast, ketoacidosis is a condition associated with a lack of insulin.  For example, it can manifest in type 1 diabetics who fail to inject enough insulin, or who are newly diagnosed.
Having tempting, unhealthy foods in your home is one of the biggest reasons for failure when starting any diet. To maximize your chances of success with the keto diet, you need to remove as many triggers as you can. This crucial step will help prevent moments of weakness from ruining all your hard work.If you aren’t living alone, make sure to discuss with your family or housemates before throwing anything out. If some items are simply not yours to throw out, try to compromise and agree on a special location so you can keep them out of sight.
I have read your article and lots of other stuff on Keto, but I still don’t understand why it has to be so high in fat? I am on a calorie controlled diet which should also be pushing me into ketosis (Optifast + veges) nutritionist suggestion to go hard for a month. But after that was looking at moving to a Ketogenic diet. I am just having a hard time with understanding why it has to be high fat. Can you help me understand? Also love your writing style (particularly referencing Ace Ventura).

Though the hunger-reduction phenomenon reported during ketogenic diets is well-known, the underlying molecular and cellular mechanisms remain uncertain. Ketosis has been demonstrated to exert an anorexigenic effect via cholecystokinin (CCK) release while reducing orexigenic signals e.g., via ghrelin. However, ketone bodies (KB) seem to be able to increase food intake through AMP-activated protein kinase (AMPK) phosphorylation, gamma-aminobutyric acid (GABA) and the release and production of adiponectin. The aim of this review is to provide a summary of our current knowledge of the effects of ketogenic diet (KD) on food control in an effort to unify the apparently contradictory data into a coherent picture.
Ketone esters (BHB-BD) lowers blood lactic acid 30. Lactic acid build up occurs during exercise as a result of burning carbohydrate at a high rate without enough oxygen. Blood lactic acid levels during exercise were 30% lower after ketone ester drinks compared to carbohydrate drinks. This is because high blood levels of BHB from the ketone ester drink slow down carbohydrate use and increase oxygen efficiency, which could decrease blood lactic acid levels. 
The process of generation ketones (ketogenesis) is kept in check by the presence of insulin in the body. Insulin regulates the flow of fatty acids from our fat cells, and it acts in a feedback loop to regulate ketogenesis. As long as insulin is circulating within the body, in general, the flow of fatty acids and the production of ketone bodies will be limited to a range that is not dangerous.  In contrast, ketoacidosis is a condition associated with a lack of insulin.  For example, it can manifest in type 1 diabetics who fail to inject enough insulin, or who are newly diagnosed.
I’m missing one key-step in this whole process … I understand (vaguely) how to get into ketosis via diet, starvation, or supplementation. But, my confusion really is with the supplementation method (such as XCT Oil, for example). If I supplement with these to get into ketosis quicker, but haven’t significantly altered to a high-fat diet, won’t I just shift back into glucose-use as soon as I burn out the supplemented ketones?? like within minutes / hours?
The ketogenic diet tries to bring carbohydrates down to less than 5 percent of a person’s daily caloric intake — which means eliminating most grains, fruit, starchy vegetables, legumes and sweets. Instead, it replaces those calories with fat. That fat is turned into ketone bodies, which are an alternative energy source: besides glucose derived from carbohydrates, ketones from fat are the only fuel the brain can use.
"Mushrooms are mostly made of protein, fiber, and water, making them very filling," said Alex Ruani, nutrition science educator at The Health Sciences Academy. Low-starch foods like mushrooms are unlikely to kick you out of ketosis, she suggested, making them an ideal staple during low-carb eating. To add mushrooms to your diet, she recommended stirring them with scrambled eggs. Doing so makes a delicious and very filling low-carb meal, she explained.
You’re funny. Why influence someone to not try something that works for so many people, just because you didnt like that it made you afraid to eat things. Come on, really? I recommend every single person interested in learning about this way of eating to do some actual research for themselves. Find credible sources. Dr. Stephen Phinney is a great source. He has a ton of science and research backing his statements up. I also recommend not knocking something until you try it for yourself and not believe all the fear inducing “opinions” you hear.

Frankly, the results of my foray into ketosis and eventually keto-adaptation were astounding. I had the best Ironman triathlon season of my life and shocking levels of mental focus and physical ease, especially for races and workouts that lasted longer than two hours. Without experiencing muscle loss, hunger pangs or brain fog, I found I could go the entire day without eating, which was enormously helpful for business and personal productivity. My gas, bloating, fermentation and GI “issues” disappeared. My blood levels of inflammatory markers like HS-CRP and cytokines dropped to rock-bottom, while my levels of good cholesterol, vitamin D, and anti-inflammatory fatty acids skyrocketed.

Protein: Keep in mind that keto is high-fat, and not high-protein, so you don’t need to eat very much meat. Too much protein turns into glucose in the body, making it harder to stay in ketosis. Stick to fatty cuts of grass-fed, pasture-raised, or wild meat, and wild-caught fish. Red meats, offal/organ meats, pork, eggs (preferably pastured), fish, shellfish, and whey protein concentrate.
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.
Josh Axe, a doctor of natural medicine and clinical nutritionist, estimates that about 25% of people who try a ketogenic diet experience these symptoms, with fatigue being the most common. “That happens because your body runs out of sugar to burn for energy, and it has to start using fat,” he says. “That transition alone is enough to make your body feel tired for a few days.”

Is it recommended to calculate our macros using the method suggested in the article to calculate yourself or by using the linked calculator? I get two different sets of numbers and am not sure which might be the better version. The main difference is amount of caloris and amount of protein to consume. The calculator gives me about 300 less calories, about the same amount of fat and carbs, but about 40 less protein than when I calculate myself.
modified corn syrup, palm sugar,dextrin, fruit juice concentrate to name a few. People need to wake up. I learned the hard way. I got gout from drinking Vitamin Water-32 grams of sugar per bottle which equals 8 tsp. of sugar per bottle. Next time you buy pop or fruit juice or some processed food check for carbs. Our western diet is turning us into an obese society full of diseases. I find this very sad especially for the next generation. I truly believe a low carb diet could turn this around. I love Keto and all the great recipes and I will stay on it for the rest of my life. I am now off all medication and feeling great.
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?
Early studies reported high success rates: in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (what is known as a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[18]
All I can say is…Keto has been AMAZING for me and a lifesaver. Instated this journey at 240lbs. I’ve been obese for 20 years. My cholesterol was awful. Triglycerides were massively high. I was a walking heart attack. I’ve lost 40 lbs since January and 3 sizes,and a TON of inches. I’ve never felt better in my life. I have so much energy. At 51 I’m going to a local amusement park, walking ten miles and riding record breaking coasters. My cholesterol? My doctor is amazed on all levels. Hes applauding my bew health lifestyle. And I know literally thousands of people online and off line who’ve had thecssme success and some who have lived this way for more than ten years. Just because you didn’t like it doesn’t make it bad. And btw…its not a free for all. Macros depend on the person. My fat levels,aren’t nearly that high and once you reach ketosis you cut down on the fat. THAT is when fat burning starts and the fat burning absolutely happens.
Those issues are 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 the diarrhea and 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.

Six months ago I went to the doctors office for the wake up call of my life. I was almost 300 pounds, I was showing signs of prediabetes, and early fatty liver. I was absolutely shocked and horrified with myself that I let my weight and health spiral so far out of control. But hearing all of those health problems and seeing that number gave me the motivation I needed to really try and change myself. I went six months of keto and cardio without cheating once and here I am now.
Doctors at the Mayo Clinic created a formula that manipulated the ketogenic effect that came with complete fasting by instead limiting a patient’s intake of carbohydrates. This was the genesis of the ketogenic diet. To manage childhood epilepsy, the prescribed diet consisted of one gram of protein per kilogram of body mass — a max of 15 grams of carbs — and the rest of the calories from fat. Et voila: the ketogenic diet was born.
Those who’ve had their gallbladder removed may need ox bile supplementation to support their body in breaking down fats[*] and aid in overall digestion. When taken with a meal, ox bile provides a concentrated source of bile which takes the place of the bile that would have been secreted by your gallbladder. As mentioned before, proper digestion is key to helping aid in weight loss and optimizing overall health and wellness.
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