Because of the data, the research team stated that “the low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrates may be an option for persons seeking to lose weight and reduce cardiovascular risk factors.” [18] They also noted that “no serious adverse events were reported during the course of the study.” [18] Thus, the ketogenic diet might be a both a safe and effective weight-loss plan for you.
This is a great post and very informative. I have been following a keto diet now for almost 3 mths. I have only lost 8 pounds but lost all my bloating and lost lots of inches. I have severe IBS and fear eating anything outside of my own home and bathroom. Since on keto diet that has all gone away and I have no fear anymore!!! I know keto isn’t for everyone and I want to lose more weight but I will give up the weight loss to have my IBS corrected any day!!
Humans have always relied on ketones for energy when glucose sources were scarce (i.e. no fruits available during winter). It is a normal state of metabolism. In fact, most babies are born in a state of ketosis. However, with abundant sources of carbohydrate, people rarely access ketosis and it becomes a dormant metabolic pathway.Our ancestors likely had frequent periods of time when high carbohydrate food wasn’t immediately available. For this reason, our bodies are amazing at adapting to burning of ketones for fuel.
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.

There is a transition period in ketosis while the body is adapting to using fats and ketones instead of glucose as its main fuel. There can be negative symptoms during this period (fatigue, weakness, light-headedness, headaches, mild irritability), but they usually can be eased fairly easily. Most of these symptoms are over by the first week of a ketogenic diet, though some may extend to two weeks.
Recent studies indicate that mood disorders such as depression and anxiety can be linked to a range of physical changes in the brain, such as inflammation or change in gene expression71. Early results from animal studies have shown that ketosis could improve mood disorders, although the mechanism is still unclear. Rats fed exogenous ketones for several weeks showed reduced anxiety behaviours72. Similarly, endogenous and exogenous BHB alleviated depressive behaviour in mice subjected to stress73. This was found to be linked to altered epigenetic markers (modifications to DNA that affect the degree of gene expression) and an increased amount of brain derived neurotrophic factor (BDNF) in the brain. At this time, there are no trials investigating the effects of ketosis in human patients with mood disorders. 
Acetoacetate diester did not improve performance37: a different ketone ester to that used by Cox et al (an acetoacetate diester) decreased cycling performance by 2% given before a 50’ cycling race. Reasons for the difference in findings could be: this ketone ester drink was given along with a can of diet cola 30 mins before exercise and caused GI upset in many athletes. Delivering acetoacetate causes the muscle cells to become more ‘oxidised,’ which is a less favourable state for ATP production. Risk of some gastrointestinal upset with all ketone supplements. The dose, tonicity, time taken before competition and overall volume of a ketone drink will affect how easy it is to tolerate. Many athletes take ketone supplements without side effects, however there are differences between individuals, so practice with ketone supplements in training is advisable to ensure they don’t experience any GI side effects in competition. Geoff Woo discussed this study in a blog post.
There seems to be an assumption sometimes that the more obsessed with losing weight we are, the lower our self image must be. Mine’s just fine….I’m 63 and I am happy to look 63….but I do NOT See the sense in inviting all the very well researched obesity related health issues into my life. Getting older is hard enough on the bod! So yes, I’m incredibly keen to drop more weight (obsessed if you like) but only because I want to deal with joint pain, avoid diabetes and cardiovascular disease … and simply to function better for longer.

The keto diet is known for helping people lose a few pounds very quickly, says Becky Kerkenbush, RD, a clinical dietitian at Watertown Regional Medical Center. Carbs hold on to more water than protein or fat, so when you stop eating them, your body releases all that extra H2O by making you pee more. As a result, the scale might read a few pounds lower, and you may look a bit leaner.


My dad was diabetic even though he was a competitive cyclist and ate "healthy". I grew up in a Weight Watchers household where everything was sugar-free and fat-free. Back then, if you had diabetes, you switched your white bread, rice, and pasta to whole wheat and you were fine. My dad died of pancreatic cancer when I was 19 years old. They say there’s no cause for this cancer, but I think the stress from his diabetes on his pancreas had a lot to do with it.
The goal of a ketogenic diet is to force your body to stop burning its favorite fuel—glucose from the carbs you eat—and start burning fat stores for energy. The body does this by converting the fats to ketones—a state called ketosis. Keto dieters accomplish this digestive feat by cutting way back on their carbohydrate intake. But to do it right, it’s not enough to just guesstimate your carb intake; you could get it wrong and undermine all your efforts. “If you are a beginner to the ketogenic diet, counting carbs is an absolute necessity to avoid frustration in the future,” says Steven Santo, a spokesman for Kegenix/Real Ketones, a keto supplement company. Track your food intake with an app like MyFitnessPal or LoseIt, or just use old-fashioned paper and pen. What you learn may surprise you. “You may be wearing ‘carb-blinders,’ meaning you are unaware of how many carbohydrates you are really consuming in a day,” says Santo. “If you can’t see the number of carbs sneaking into your day, you may be eating many more than you think.”
Hey Alex, thanks for commenting and great to have you as a new listener! For this kind of thing, because it requires so going into detail, I'd suggest you book a consult with me by going to
I started with completely cutting sugar. This was after B.Cancer. Also estrogen caused I decided to cut carbs to loose body fat which produces estrogen. I kept carbs to 15-20 grams. I researched and learned alot about research, nutrition and health. Primarily it gave me some semblance of control over the Russian Roulette that is cancer, chemo and radiation which all take a mighty toll on your body and mind. It has been 2 years of low carb and intermittent fasting. I have introduced a few seasonal foods, I eat chocolate, and the occasional celebratory cake. Just a bite or 2 not a huge serving. There are several alternative treats that are yummy and satisfying. Not a struggle. I am 67, lost specific fat that I could never shed even on the best eating plan. Belly fat especially. I am 3 years post and hope to live many more years.

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.

I like this product a lot. I am on my 2nd bottle now and I'm working on low carb/ketogenic lifestyle. this has helped with keeping me out of energy crash and burns, no jitters, and no headaches. If you are a coffee drinker it specifically says to avoid more caffeine if you take the full dose (3 capsules) during the day, just so you know. (Guarana is a source of caffeine). Everyone is different. I started with 1 capsule then worked my way up to 3 within a few days to see how my body handled it.

In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[54]
Fortunately, Drs. Kevin Hall and Juen Guo had the same burning question. In 2017, they analyzed the data and published a meta-analysis of controlled feeding studies that compared diets of equal calorie and protein content with variations in carbohydrate and fat content. [24] By filtering out the diet data in this way, the researchers could finally find out whether restricting carbs or limiting calories is more important when it comes to weight loss.
One more thing that I noticed is that my HR does not move Beyond a certain point. I can still perform quite at a high level and faster than most people at my box but weirdly enough it’s like there’s a block on my HR which doesn’t allow it to move beyond 160 bpm. I’m not sure if this is good or bad! Could I go even faster if my HR would pass this limit?? It is a physiological barrier created by the glycogen sparing mechanism that doesn’t allow my body to move after a certain point so it won’t have to tap into my glycogen stores or force my body to go into gluconeogenesis?? If I added some more carbs around my workouts would it be easier to get the glycolytic pathway to work more effectively since it’d be faster and easier fuel? I read about the downregulation of PDH enzymes after prolonged keto and I constantly worry that I dont use my glycolytic pathway as effective anymore. I LOVE this lifestyle but at the same time, as athletes; we’re always thinking on how to improve performance. What are your thoughts?! Thank you so much!!
Other kinesiologists think the keto diet could have dangerous effects on athletic performance, and it's tough to know what potential side effects a long-term high-fat diet might have for a healthy person, since we don't have any solid study results yet. Low-carb diets like keto can make it easy to neglect key nutrients like magnesium, calcium, and potassium found in fresh, high-carb foods like beans, bananas, and oats.
Fortunately, Drs. Kevin Hall and Juen Guo had the same burning question. In 2017, they analyzed the data and published a meta-analysis of controlled feeding studies that compared diets of equal calorie and protein content with variations in carbohydrate and fat content. [24] By filtering out the diet data in this way, the researchers could finally find out whether restricting carbs or limiting calories is more important when it comes to weight loss.
For example, a key component of safe and lasting fat loss is your capability to tap into your body’s own storage fat for energy. This access to fat cannot happen if your body is constantly drawing on carbohydrate reserves and blood glucose for energy. In the type of moderate- to high-carbohydrate diets you’ve learned are widely recommended by prevailing nutrition science, not only does the utilization of fat for energy become far less crucial (since you’re constantly dumping readily available sugar sources into your body), but your metabolism never becomes efficient at using fat. There is a growing body of evidence proving that a high-fat, low-carbohydrate diet results in faster and more permanent weight loss than a low-fat diet. Furthermore, appetite satiety and dietary satisfaction significantly improve with a high-fat, low-carbohydrate diet that includes moderate protein.
In order to best investigate the efficiency of different fuels, one needs a closed system, where the substrate conditions can be changed and the oxygen consumption and work done can be accurately measured. Isolated (ex-vivo) animal hearts are the best model to study these variables, as it is easy to manipulate the fuel provided (i.e glucose, ketones), to measure the oxygen use and also the amount of work (how much fluid is pumped). 
This review is coming both from the perspective of an individual who chooses this WOE and as a dually board certified physician in family practice and medical bariatrics (weight loss medicine). This book provides an invaluable resource in both of these worlds. I deeply appreciate the evidence based information and the straight-forward, easy to understand delivery. It is a wonderful complement to the numerous cookbooks filled with amazing keto recipes Maria and Craig have published. If you are looking for a resource to go to over-and-over again look no further. This is the one!
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.
Day 10: I'm starting to get sick of the same foods that I know are safe bets. And the number of times I've Googled: "Is _____ keto?" is getting out of hand. I've realized that the only real gripe I have with the keto diet is that there are so many healthy, nutritious foods that you can't eat while on it. (Maybe that's why experts say you should give up restrictive diets once and for all.) Carrots? Sweet potatoes? Brussels sprouts? What vitamins and nutrients am I missing out on by leaving these foods off my plate?
"My suggestion is to start with changing your mindset first and foremost around three very important facts: this is not just another diet, you don’t have to live in Ketosis forever, and you will not be depriving yourself. Having said that, if you are used to eating highly-processed sugary food and refined carbohydrates you’ll need to ease into it," she explains.
Fortunately, Drs. Kevin Hall and Juen Guo had the same burning question. In 2017, they analyzed the data and published a meta-analysis of controlled feeding studies that compared diets of equal calorie and protein content with variations in carbohydrate and fat content. [24] By filtering out the diet data in this way, the researchers could finally find out whether restricting carbs or limiting calories is more important when it comes to weight loss.

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.
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.
When you’re eating the foods that get you there (more on that in a minute), your body can enter a state of ketosis in one to three days, she adds. During the diet, the majority of calories you consume come from fat, with a little protein and very little carbohydrates. Ketosis also happens if you eat a very low-calorie diet — think doctor-supervised, only when medically recommended diets of 600 to 800 total calories.
Many athletes would not consider following a ketogenic diets due to the limited evidence of a performance enhancing effect, the risk of side effects having a negative impact on performance and the difficulty in maintaining the lifestyle changes required to stay in ketosis. Exogenous ketones offer a method to deliver some of the benefits of ketone metabolism without requiring athletes to follow a strict ketogenic diet. Taking exogenous ketones creates a metabolic state that would not normally occur naturally: the state of having full carbohydrate stores as well as elevated ketones.
These types of back-and-forth weight fluctuations can contribute to disordered eating, Kizer says, or can worsen an already unhealthy relationship with food. “I think this diet appeals to people who have issues with portion control and with binge eating,” she says. "And in many cases, what they really need is a lifestyle coach or a professional counselor to help them get to the bottom of those issues."
Cancer is a broad term that refers to the presence of abnormal cells in the body that have the potential to grow and spread to other sites in the body. Cancer develops over time as cells acquire defects that affect their function, growth, proliferation and metabolism. Recently a list of ‘Hallmarks of Cancer’ was proposed by some of the leading investigators, Hannahan and Weinburg90 . These hallmarks include:
Fat: Most of the calories in a ketogenic diet come from fat, which is used for energy. The exact amount of fat a person needs to eat will depend on carbohydrate and protein intake, how many calories they use during the day, and whether they are losing weight (using their body fat for energy). Depending on these factors, somewhere in the range of 60 to 80 percent of calories will come from fats on a ketogenic diet (even up to 90 percent on, for example, the Ketogenic Diet for Epilepsy). People tend not to overeat on diets this high in fat, so calorie counting is rarely necessary.
The Gatorade Sports Science Institute (GSSI) is widely considered one of the world’s top go-to resources for cutting-edge exercise and nutrition science advice – which is probably why Gatorade vending machines dot the campus here, and the majority of the kids seem to be walking around campus with a never-ending big gulp-sized cup full of sports drink.
Even though intracellular metabolism and activation of the ATP-sensitive K+ channels appear to be necessary for some signaling effects of FAs, a great amount of the FA responses in the ventromedial hypothalamic neurons are mediated by interactions with fatty acid translocase (FAT)/CD36. Translocase is a FA transporter/receptor that activates downstream signaling even in the absence of intracellular metabolism (Moulle et al., 2014).
An increase in fat burning ability could improve endurance capacity: as body fat represents a larger store of energy (150,000 kCal) compared to carbohydrate (2000 kCal), a greater ability to burn fat during exercise could prolong endurance performance. Whilst the theory appears sound, there is only one study showing an IMPROVEMENT in performance with a low carbohydrate diet18, with many showing no clear benefit of a low carbohydrate diet 19 ,20.    

Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[18] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[3]

There is a transition period in ketosis while the body is adapting to using fats and ketones instead of glucose as its main fuel. There can be negative symptoms during this period (fatigue, weakness, light-headedness, headaches, mild irritability), but they usually can be eased fairly easily. Most of these symptoms are over by the first week of a ketogenic diet, though some may extend to two weeks.


How do you know if a strict ketogenic diet or simply cutting some carbs is the right dietary approach for you? First, consult with your doctor and a dietitian to see if it is a suitable plan for you based on your medical history. Then, use the guides, articles, and recipes on Ruled.me to create a well-organized weight-loss plan. Remember to make healthy diet choices, such as eating fatty fish and high fiber vegetables, and supplement with exercise to get the best results.
Jump up ^ Fumagalli M, Moltke I, Grarup N, Racimo F, Bjerregaard P, Jørgensen ME, Korneliussen TS, Gerbault P, Skotte L, Linneberg A, Christensen C, Brandslund I, Jørgensen T, Huerta-Sánchez E, Schmidt EB, Pedersen O, Hansen T, Albrechtsen A, Nielsen R (September 2015). "Greenlandic Inuit show genetic signatures of diet and climate adaptation". Science. 349 (6254): 1343–7. Bibcode:2015Sci...349.1343F. doi:10.1126/science.aab2319. hdl:10044/1/43212. PMID 26383953.
I’ve done a lot of soul searching this past year, and I actually thank keto for that. Because without it, I may not have reached this point in my life. The point where I care more about experiences rather than the food that goes in my mouth. The point where I love my body just as it is, no matter what size I am. The point where I wake up everyday and don’t worry about food, but rather look forward to being present in my life and my family’s lives.
In sheep, ketosis, evidenced by hyperketonemia with beta-hydroxybutyrate in blood over 0.7 mmol/L, occurs in pregnancy toxemia.[78][79] This may develop in late pregnancy in ewes bearing multiple fetuses,[78][79] and is associated with the considerable glucose demands of the conceptuses.[80][81] In ruminants, because most glucose in the digestive tract is metabolized by rumen organisms, glucose must be supplied by gluconeogenesis,[82] for which propionate (produced by rumen bacteria and absorbed across the rumen wall) is normally the principal substrate in sheep, with other gluconeogenic substrates increasing in importance when glucose demand is high or propionate is limited.[83][84] Pregnancy toxemia is most likely to occur in late pregnancy because most fetal growth (and hence most glucose demand) occurs in the final weeks of gestation; it may be triggered by insufficient feed energy intake (anorexia due to weather conditions, stress or other causes),[79] necessitating reliance on hydrolysis of stored triglyceride, with the glycerol moiety being used in gluconeogenesis and the fatty acid moieties being subject to oxidation, producing ketone bodies.[78] Among ewes with pregnancy toxemia, beta-hydroxybutyrate in blood tends to be higher in those that die than in survivors.[85] Prompt recovery may occur with natural parturition, Caesarean section or induced abortion. Prevention (through appropriate feeding and other management) is more effective than treatment of advanced stages of ovine ketosis.[86]
Between the butter and the so-called “Brain Octane Oil” that are part of the Bulletproof coffee recipe, any increased energy one feels after consuming it could have something to do with the nearly 500 calories of fat that are in it. As has been pointed out, those calories displace other more nutrient-dense sources of fuel. Asprey also claims that his coffee is better for you because it doesn’t contain mycotoxins, i.e. toxins produced by fungi. Though it’s true that mycotoxins can be dangerous for your health, the possibility of any roasted coffee available on store shelves containing mycotoxins is slim to none. It’s like slapping “this coffee was not made with white rhino horn” on the label.
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).
Day 2: There's a bagel shop less than a block from my office. I pass it every single day and never really think anything of it. Well, not today! The smell of the freshly baked everything bagels—and was that veggie cream cheese I smelled?—was wafting out the door as I walked by extra quickly. (Though I found out later that there is a way to have bread and still stay in ketosis.) 
#3: Next, calculate your protein requirements. If you are active, Target 0.8-1.2 g of protein per pound of weight. This is a simplified version of a complex calculation you can do, which is dependent on your lean body mass, how active you are, etc. If you have a lot of weight to lose, you’ll wan to adjust this number down to more like 0.5-.6g per pound (consult the above calculator) You can multiply this by 4 to see how many calories total that would be.
“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.”
So, the other day I bought some broccoli and I was staring at the stems thinking "I know I can do something besides just slice and sauté these (I am aware that people rice them, but now that bagged frozen riced cauliflower is a thing I will never rice anything again) I pulled out my mandolin and sliced them up figuring i could ten sauté or do something else, and then realized that they were the perfect "Chip" size! First I ate some raw with labne (yogurt cheese) Delicious! Very good option for when you want to dip something! Then today decided to try frying them...
I also was told to go on Keto but by my doctor as it was recommended for my insulin resistance. Initially I lost weight but then gained and every tip on every Keto diet site (more fat, increase calories, decrease protein ,etc) made me gain and gain. Finally I said enough. I still eat low carb but not crazy low and healthy fats still but not heavy fat load. I don’t eat rice pasta rarely bread and keep veggies to those lower in sugars. Weight is down and for a 62 yr old post menopausal woman I’m doing ok.
That can be a shock to the body. “One of the challenges that many people encounter when they try the ketogenic diet for the first time is the drastic lack of energy that is experienced in the first few days. This is the time when the body is learning to use fat for energy rather than readily available carbs,” says Susan Kieffer, DBA, the department chair for the School of Nursing at Purdue University Global. “You can feel very tired during this time and even a little fuzzy in your thinking.”
BHB is the primary ketone your body can most efficiently use as fuel during exercise and at rest (especially when you’re keto-adapted), it is the most stable of the ketones, and it is actually found in nature in many foods including eggs and milk. A “BHB salt” is simply a compound that consists of sodium (Na+), potassium (K+), and the ketone body beta-hydroxybutyrate.
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.
Ketolysis is the process of breaking down ketones to ultimately provide energy through the Krebs Cycle and mitochondrial oxidative (using oxygen) phosphorylation. Ketone bodies are broken down in the mitochondria of virtually all tissues in the body. The liver is a notable exception, being unable to utilise ketones as a fuel because liver cells lack acetyl-CoA thiolase, a key enzyme in the ketone oxidative pathway. BHB enters the mitochondria of the cell through a monocarboxylate transporter, undergoes conversion to acetoacetate by BHB dehydrogenase and then addition of a CoA group from succinyl-CoA by 3-oxo-acid transferase. The resulting acetoacetyl-CoA acts a substrate for the formation of two molecules of acetyl-CoA in a reaction catalysed by acetyl-CoA thiolase. Acetyl-CoA is then available to condense with oxaloacetate and enter the Krebs cycle.
You likely heard that a high-fat, low-carb keto diet can melt fat. Because it contains virtually no carbs, a ketogenic diet forces your body to burn fat instead of glucose for fuel. Ketosis is the state your body enters when your liver effectively breaks down fats into ketones to use as energy. Without glucose, your body doesn’t have all the highs and lows that lead to hunger pangs, energy crashes, and cravings. Instead, your blood sugar levels stay stable. Your body also sheds excess weight — fast.
Amazing article – gonna have to print it and read it again. To much to break down in one sitting. Thanks Ben – you’ve pulled together so much insight and references that’s given me greater confidence and conviction. I’m 50 and use to be super active and a seasoned athlete but after a few ‘mid life surgical interventions’ I had to find a better way… Ketogenics has been that for me… no more inflammation… I can’t tell you how great it’s been to be pain free! Keep leading from the front.
The chemical reagent is very sensitive to moisture, including what's in the air. It's important to keep the lid of the container tightly closed at all times, except for when you're getting a strip to take a reading. Make sure your fingers are dry before you go digging in! They also have an expiry date, so make note of this when you purchase the strips ... that's for the UNopened package. Once opened, they have a shelf-life of about 6 months -- you may wish to write the date you opened on the label for future reference.

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.
With the recent research findings, and the increasing availability of exogenous ketones, it is unsurprising that some authors have said (with a hint of skepticism) that they “could be the next magic bullet’ for athletes39. More research is required to understand the best use cases, doseage protocols, compounds etc, however it is clear that exogenous ketones are a new ‘tool’ in the athlete’s arsenal that can be used to provide an alternative, energetically favourable fuel source without needing dietary manipulation. 
More recently, other hypothalamic appetite control regions have been identified, including those in the arcuate nucleus (ARC), the periventricular nucleus (PVN) and the dorsomedial hypothalamic nucleus (DMH) (Valassi et al., 2008). These are sites of convergence and integration of many central and peripheral signals, not just macronutrients, that are involved in food intake and energy expenditure mechanisms, e.g., a group of neurons in the ARC stimulating food intake via neuropeptide Y (NPY) and agouti gene-related protein (AGRP). These neurons interact with those producing the anorexigenic pro-opiomelanocortin (POMC) and the cocaine/amphetamine-regulated transcript (CART) (Williams et al., 2001). Thus, a more comprehensive, unified model should include macronutrients as well as many single amino acids and other signaling molecules.
Your daily habits. Your daily habits will make or break your weight loss efforts. Consistency is the key to keto success. Are you eating clean keto foods or high-fat junk foods with low-quality ingredients? Are you watching out for hidden carbs? Are you exercising? Eating the right foods in the right amounts for your goals and adding more physical activity to your daily life are the most important pieces of a smooth and successful body transformation.