KBs can cross the BBB but not in a homogenous manner. For example, past experiments have demonstrated that BHB utilization is different in various brain areas (Hawkins and Biebuyck, 1979). Areas without BBB, hypothalamic regions and the lower cortical layers have a higher BHB metabolism compared to the lower one of the basal ganglia (Hawkins and Biebuyck, 1979). Also the metabolic meaning of the three KBs is different: while the main KB produced in the liver is AcAc, the primary circulating ketone is BHB. The third one, acetone, is produced by spontaneous decarboxylation of AcAc, and it is the cause of the classic “fruity breath.” Acetone does not have any metabolic functions, but it can be used as a clinical diagnostic marker. BHB acid is not, strictly speaking, a KB because the ketone moiety has been reduced to a hydroxyl group. Under normal conditions the production of free AcAc is negligible and this compound, transported via the blood stream, is easily metabolized by various tissues including skeletal muscles and the heart. In conditions of overproduction, AcAc accumulates above normal levels and a part is converted to the other two KBs. The presence of KBs in the blood and their elimination via urine causes ketonemia and ketonuria. Apart from being the fundamental energy supply for CNS, glucose is necessary for the replenishment of the quota of oxaloacetate, since this intermediate of the tricarboxylic acid cycle (TCA) is labile at body temperature and cannot be accumulated in the mitochondrial matrix. Hence it is necessary to refurnish the TCA with oxaloacetate via the anaplerotic cycle that derives it from glucose through ATP dependent carboxylation of pyruvic acid by pyruvate carboxylase (Jitrapakdee et al., 2006). This pathway is the only way to create oxaloacetate in mammals. Once produced by the liver, KBs are used by tissues as a source of energy (Fukao et al., 2004; Veech, 2004; McCue, 2010): initially BHB is converted back to AcAc that is subsequently transformed into Acetoacetyl-CoA that undergoes a reaction producing two molecules of Acetyl-CoA to be used in the Krebs cycle (Figure ​(Figure22).


The history of keto goes much farther than an attempt to stem weight gain during our fat-fearing era. In 1921, it was observed that fasting decreased incidence of seizure in epileptic patients. The same year, reports noted cognitive improvement and reduced seizure activity in epileptics who fasted for two to three days (fasting has been used as far back as 500 B.C. to treat 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.
I also found that I put on weight quite easily while eating low carb. I thought that being in ketosis meant I was burning my body fat, when in fact, I was just burning the fat that I was eating. Eventually, my female sex hormones tanked and I started gaining weight no matter what I did. I firmly believe this was because my body was in such a state of stress from not eating enough carbs.
And what I’m writing has nothing to do with taking supplements to induce ketosis or whatever. I believe these things are covered in Volek & Phoney’s book The Art and Science of Low Carb Living, which I would have thought you to be very familiar with. The iodine stuff you can read about in Iodine, Why We Need, Why We Can’t Live Without It by Brownstein.

“I would make broccoli rice or cauliflower rice to at least feel like I was eating some carbs,” she wrote on her blog. “Then I would add protein, so I often ate grilled chicken and fish over broccoli rice, cauliflower rice or spaghetti squash. I mixed in roasted vegetables, fresh salads with homemade dressing, and smoothies made with avocados and bananas.”
In recent times there has been an exponential increase in the rates of obesity and diabetes. Popular opinion has blamed (in turn) overconsumption of fat, overconsumption of carbs and sugar and overconsumption of calories. Whilst the overall calorie balance is a crucial factor that cannot be overlooked, it is also the case that different macronutrients in the diet (especially carbs and fat) have different effects on the body when consumed.  
If you do try the diet outside of medical supervision, Kizer says it’s important to test your urine with urinalysis ketone test strips to ensure your ketone levels don’t become dangerously high. Ketone urine test strips are also used by people with diabetes to determine if they’re at risk for ketoacidosis (DKA), a life-threatening complication that occurs when an individual doesn’t have enough insulin in their body. (Healthy ketosis is considered 0.5 to 3.0 mM blood ketones.)
The first group of 75 consumed a low-carbohydrate diet with less than 40 grams of carbohydrates per day. The second group of 73 consumed a low-fat diet with less than 30% of calories from fat and less than 7% of calories from saturated fat. Both groups regularly received nutritional counseling periodically throughout the study meeting with each participant meeting with a dietitian for a total of 10 sessions
Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH, “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat,” Arch Intern Med. 2004;164(19):2141-2146. http://archinte.jamanetwork.com/article.aspx?articleid=217514.
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]
Including greens powder in your supplement regimen is an excellent way to boost your intake of nutrient-dense vegetable. Most greens powders come with a mixture of powdered plant-based nutrients from spinach, spirulina, chlorella, broccoli, wheatgrass and more that are all beneficial for health. Adding greens powder to your drinks, shakes, and smoothies is a good way to help optimise nutrition and promote fat loss, especially when on a keto diet.
Probably, and there are a few reasons why, Keatley says. For starters, people usually reduce their daily caloric intake to about 1,500 calories a day because healthy fats and lean proteins make you feel fuller sooner—and for a longer period of time. And then there’s the fact that it takes more energy to process and burn fat and protein than carbs, so you're burning slightly more calories than you did before. Over time, this can lead to weight loss.
No and yes. The liver can make ketones out of alcohol, so technically, when you drink you'll continue to produce ketones and so will remain in ketosis. The problem is ... alcohol converts more easily to ketones than fatty acids, so your liver will use the alcohol first, in preference to fat. Thus, when you drink, basically your FAT burning is put on hold until all the alcohol is out of your system.
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“So I was talking about that and making sure everyone was hearing about that, and then there was one the Journal of the American Heart Association published a few years later that isolated the people who had had a heart attack in the past, the cardiology population that we're seeing, and they were doing a ketogenic diet," Williams told Plant Based News. “It was a 53 percent increase in mortality. No one should be doing this."
Long story short I’ve had the most terrible diet and mindset about food of anyone you’ve ever met my entire life. It consisted of pretty much only carbs. After studying them I’ve realized that it’s the reason that I got so big.. 570 at my known largest when I was weighed in the hospital. First time seeing a doctor in over 20 years. I bought a scale and tried random diets but couldn’t keep to them. I stayed at 530 ish for a year.

Most obese people become so adept at releasing insulin that their blood is never really free of it and they're never able to use up their fat stores. By primarily burning fat instead of carbohydrates, lipolysis breaks the cycle of excess insulin and resultant stored fat. So by following a fat containing, controlled carbohydrate regimen, you bypass the process of converting large amounts of carbohydrate into glucose. When your carbohydrate intake drops low enough to induce fat burning, abnormal insulin levels return to normal - perhaps for the first time in years or decades.
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.

"Listening to podcasts while I run has completely changed my fitness routine. I thought I hated running, but what I hated was pop music. Keeping my mind engaged has helped me push passed physical barriers. Podcasts about keto, fitness, and nutrition is motivating to me to learn about my body while I’m actively working it. My favorite podcasts are Keto for Normies, The Keto Savage podcast, Seth Godin's podcast and Hiding in the Bathroom."
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).
It’s a common misconception that the keto diet is a high-protein diet – it’s a moderate-protein diet where 20-25 percent of your calories come from protein. While it’s helpful to have a portion of protein at each meal to satiate you, you don’t want to overdo it. Too much protein can actually kick you out of ketosis, says Davoodi, through a process called gluconeogenesis, where your body converts extra protein into sugar. Your body will reach for the glucose first and no longer burn fat for fuel.

The keto diet changes the way your body converts food into energy. Eating a lot of fat and very few carbs puts you in ketosis, a metabolic state where your body burns fat instead of carbs for fuel. When your body is unable to get glucose from carbs, your liver converts fatty acids from your diet into ketones, an alternative source of energy. Burning ketones in place of glucose reduces inflammation and spurs weight loss.[1] 
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