Ketone Bodies

KETones are a beneficial product of fat metabolism in the body. When carbohydrate intake is restricted, it lowers blood sugar and insulin levels. As insulin levels fall and energy is needed, fatty acids flow from the fat cells into the bloodstream and are taken up by various cells and metabolized in a process called beta-oxidation.
The end result of beta-oxidation is a molecule called acetyl-coA, and as more fatty acids are released and metabolized, acetyl-coA levels in the cells rise.  This causes a sort of metabolic “feedback loop” which triggers liver cells to shunt excess acetyl-Coa into ketogenesis, or the making of ketone bodies. 
Once created, the liver dumps the ketone bodies into the blood stream and they are taken up by skeletal and heart muscle cells at rates of availability.  In addition, the brain begins to use ketones as an alternate fuel when blood levels are high enough to cross the blood brain barrier.

---

---

There are three major types of ketone bodies present in the human blood stream when the metabolic process of ketosis is dominant:

1. Acetoacetate (AcAc) is created first
2. β-hydroxybutyrate (BHB) is created from acetoacetate
3. Acetone is a spontaneously created side product of acetoacetate

In times of starvation, or a low carbohydrate intake resulting in low insulin levels, ketone bodies supply up to 50% of the energy requirements for most body tissues, and up to 70% of the energy required by the brain.
Glucose is the main source of fuel for neurons when the diet is high in carbohydrates. But when carbs are restricted, ketogenesis becomes the primary fuel process for most cells.
During fasting or low carbohydrate intake, levels of ketone bodies in the blood stream can rise to levels between 0.5mM and 5 mM, depending on the amount of protein and carbohydrates consumed.  This state is called nutritional ketosis.

---

Nutritional Ketosis is NOT Ketoacidosis

Contrary to what some medical professionals are taught, nutritional ketosis is not the same as ketoacidosis. 
Ketoacidosis is a dangerous condition associated with a lack of insulin in the body.  Diabetics who don't inject  or make enough insulin can experience ketoacidosis if an illness causes their blood sugars to rise above 200 mg/dL, and insufficient insulin is available.  In these cases, diabetic ketoacidosis may occur.  This is NOT nutritional ketosis.
Ketoacidosis is a wildly out of control ketotic state in which blood levels of ketone bodies may rise above 10-25 mM.  This type of metabolic derangement happens because there is no insulin to put the brakes on fat burning, and this results in a flood of fatty acids flowing out of fat cells, which are then converted to ketone bodies in the liver and dumped into the blood stream. These much higher levels of ketone bodies result in the blood pH becoming too acidic and causing the health issues associated with ketoacidosis.

---

Measuring Ketones

After a few weeks of adapting to a ketogenic diet, most people's blood ketone levels go above the 1 mM level. As the levels of ketone bodies rise, the brain begins to use more than half of them for fuel.
In addition, the muscles of the body use all of the ketone body types. But after a few weeks of keto-adaptation, the muscles start converting the acetoacetate into β-hydroxybutyrate (BhoB) and returning it to circulation.  Although BoHB is the more stable molecule, when it is taken up by muscle tissues, it has to be converted back to acetoacetate so that cells can metabolize it.  The conversion between BHoB and Acetoacetate goes back and forth depending on where in the metabolism it is being used.  The third type of ketone, acetone is very volatile and released in the breath and urine.  However it also has some effects on brain signaling and it prevents neuron hyperexcitability, which may explain why being in ketosis can calm neurological conditions such as epilepsy.
As time on a ketogenic diet progresses, the body becomes more efficient at using ketones for fuel.  The kidneys adapt and get better at reabsorbing larger amounts of acetoacetate and the brain and muscles get more efficient in using circulating BoHB.  This is important to know because the urine Ketone test strips that you buy in the drugstore only test for acetoacetate ketones.
So the longer you are eating low carb, the less MEASURABLE ketone bodies will show up in your urine and on the Ketostix because the kidneys get better at absorbing them. In other words, it will seem like ketosis is slowing. However, at this point, your brain and muscles will be happily burning ketones for fuel, and as long as you stay under your carb sensitivity levels, you will be burning stored fat as your main energy source.
The good news is that just recently, several companies have developed a blood meter to check for blood levels of BHoB at home. I've included links to these new products in the side bar at right. Note that the strips are pretty expensive. Other companies are working on a breath ketone analyzer, which may be cheaper, and have a better correlation to blood ketones as acetone is not filtered or reabsorbed by the lungs.

---

Staying in Ketosis

For most people, eating more than 100 grams of protein along with more than 60-100 grams of carbohydrate on a daily basis will stop the process of ketogenesis and halt nutritional ketosis.  Blood levels of ketone bodies will fall below levels which can be used efficiently by the brain.
This is because protein in excess of body requirements is metabolized into glucose in the blood stream. About 56% of excess protein is metabolized into glucose, and this impacts ketosis as well.
For others who are super sensitive to carbohydrate, eating  more than 20 carbs and 80 grams of protein per day may interfere with ketosis as well.

20 Low Carb Avocado Recipes

I scream, you scream, we all scream for…avocado? Well, why not? That creamy green fruit is so good and so good for you. And it goes well with just about everything you can think of, from shellfish to chocolate. So here are 25 of the best low carb avocado recipes the internet has to offer. From sweet to savory, we’ve got you covered!

Mini Flourless Chocolate Avocado Muffins from A Sweet Life
Buffalo Chicken Stuffed Avocados from SheKnows.com
Shrimp and Avocado Ceviche from All Day I Dream About Food
Avocado Sorbet from Keto Adapted
Avocado Dip from Sweet As Honey
Crab-Stuffed Baked Avocado from Domestic Fits
Cajun Salmon Burgers with Avocado Crema from A Sweet Life
Bourbon Chocolate Truffles from I Breathe, I’m Hungry
Pan-Seared Salmon with Avocado Remoulade from Simply Recipes
Chocolate Avocado Raspberry Smoothie from All Day I Dream About Food
Zesty Lime Shrimp and Avocado Salad from Skinny Taste
Tuna Avocado Salad from Peace Love and Low Carb
Mayo-Free Avocado Coleslaw from Sugar-Free Mom
Chocolate Avocado Pudding Pops from A Sweet Life
Mexican Steak and Avocado Salsa from Tastes of Lizzy T
Shrimp, Avocado and Red Grapefruit from Low Carb So Simple
Avocado Green Tea Power Shake from All Day I Dream About Food
Avocado Feta Salsa from Fake Ginger
Fajita Salad from Fluffy Chix Cook
Blackened Chicken with Avocado Salad from A Sweet Life
Avocado Hummus from Peace, Love and Low Carb
Avocado and Salmon Low Carb Breakfast from The Nourished Caveman
Egg Salad Stuffed Avocado from Keto Diet App
Mini Bacon Guacamole Cups from All Day I Dream About Food
Chocolate Almond Pudding from Holistically Engineered

Coffee. Butter. Oil.
Separately those ingredients don’t exactly tick all the traditional boxes for a balanced breakfast. But together they are the three components you need to make Bulletproof coffee, a frothy, energy-igniting beverage that has surged in recent years to become the toast of Silicon Valley. Its promises are multitude, at least according to its creator, cloud-computing pioneer and "Bulletproof Executive" Dave Asprey, who refined his recipe after trying a tea made with yak-butter in Nepal.
Among Bulletproof coffee's listed benefits: It triggers weight loss by way of ketosis, a metabolic state triggered by a lack of carbs that kicks fat-burning into overdrive; it kills pesky cravings; and it boosts cognitive function, mainlining a shining dose of mental clarity into your foggy morning skull. Maybe it would even fold my laundry.
Most of all, though, Bulletproof coffee is intended to be efficient, an easy way for the biohacking crowd to slurp down fats and calories (460 of them!) without so much as sniffing a processed carbohydrate. Why eat a muffin that goes straight to your muffin top, the thinking goes, when you could drink down the metabolic equivalent of supercharged battery acid every morning?

Ketogenic Weight Loss Plateau.. Tips on how to beat it!!

I keep hearing people talk about their weight loss plateaus, and how they can get around them. Some go the extreme route of doing liquid fasting, others will ignore it and keep on keeping on.
I wanted to put together a short list of common things that may be wreaking havok on the average ketogenic dieter, and go over some solutions that might help out. Keep in mind, this does not cover everything and it also covers a wide range of topics.
As you read this, please read to the end. Don’t form ideas about your own body and apply the things that I am saying with no thought behind it.
This is strictly for people that are hitting weight loss plateau’s and need some help. If you have only lost 1 or 2 pounds in a week, that is still weight loss and does not require action against it.

Hidden Carbohydrates

People on ketogenic diets eat more carbohydrates than they think. They’re hidden in vegetables, nuts, and certain meat products. Yes, that peanut butter you’re chomping on could be causing a problem! Especially if it’s store bought – that stuff is loaded with extra sugar.
Some vegetables like Brussels sprouts, broccoli, and squash are common culprits that find their way into our lives on a frequent basis. You might think that they’re low carb, but in large consumption, those carbs really do add up. You can look at the list of the best low carb vegetables we’ve put together, so that you can be more aware of the vegetables you eat.
Meat is the center of most of our lives, and there’s sugar everywhere you look. Some bacon is honey smoked, adding unnecessary carbs to an already delicious product. Why the madness? Look for bacon with no sugar added. When you start to look into Italian sausages, chorizo, and canned meats, there’s more carbs than most think. Some brands have up to 5g carbs per serving when it comes to sausage – so make sure you are being diligent.
Medicine. Seriously!? Next time you think you are breaking down with a cold or flu, take a look at the nutritional information on the back of that Dayquil. 2 tablespoons of the stuff has a whopping 19g of carbs. You should opt for the low-sugar or sugar-free varieties they now offer for diabetics.
Make sure you check the nutrition labels on everything, before you buy it! You have to be weary of all the extra carbs that are hidden in the products you buy. We put together a ketogenic diet food list that you can read through before you plan your next shopping trip.

Calorie Counting

Most people I talk to have a misconception about ketogenic diets. They get the idea that all they have to do is count carbs to lose weight, and that’s simply not true. Think of it as a mathematical formula, instead. If you are putting more calories into your body than you are burning, that gives you excess calories. Do you think those excess calories just disappear? No, they are stored. Keep in mind that we eat a lot of calories from fat. This is because it’s the highest calorie per unit of nutrient, at 9 calories per 1g.
The misconception comes about because this large amount of fat also offers a great satiated feeling, allowing us to be full for a very long time. Most people don’t hit their necessary calories for the day, leaving them in a calorie deficit – and able to lose weight.
Making sure you’re in a calorie deficit is very important, and allows you to lose weight. You can use the keto calculator to help you figure out your macros, if you’re having trouble.

Food Sensitivity

Some people find themselves following their daily macros perfectly, but still seem to hit a stall. That might mean they have sensitivity to certain types of food.
From what I’ve come across, many people seem to have sensitivity to dairy. That includes cheese – one of the staples in all of my meals. That also includes cream, butter, and yogurt. If you’re having trouble losing weight, try cutting these out of your diet for a few weeks to see where it takes you.
Gluten is also something that many people have food sensitivities to. For some, low carb pastas and protein bars are a great way to keep weight loss slowed. Low carb processed foods can also have gluten in them. Yes, that means the lovely low-carb tortillas you’ve been eating might actually be stalling your weight loss.
If this sounds like you, cutting out gluten intake from processed foods might help out. It might also have a huge impact on your health over time.

Staying Consistent

Being consistent with a ketogenic diet is extremely important. Being as it can take a few days for your body to become keto-adapted, a cheat day can really take a long time to recover from. By the time your body is back in ketosis, a week may have passed – and that’s a week of no fat burning. This is also where the dreaded water weight will come back on.

If you are weighing yourself on a weekly basis, you may see a 4-6 pound gain of water weight if you did a cheat day 5 or 6 days ago. It also means it will take a few more days for the weight loss to start again. What may seem like a weight loss plateau is really just a delay from your body trying to become keto-adapted again.
Tracking your daily macros is a great way to keep consistent. It adds a layer of strictness into your diet, making it easier over time to realize where the mistakes are. We use MyFitnessPal, and wrote an article to help you get it set up.
If you’re not tracking your carbs, it can be very easy to let those hidden carbs creep up on you and knock you out of ketosis.

Protein Intake

Too much excess protein is just a bad thing when you’re in ketosis. As mentioned in a previous article, up to 56% of the excess protein is broken down into glucose. We all know that the body loves to use glucose as the primary form of fuel, and that’s exactly what we don’t want it to do.
The body and brain need small amounts of glucose to survive. The liver will always make sure you get this glucose, and it will strip it from your muscle tissues if necessary. Eating protein allows your body to get enough glucose needed to perform as needed, but it will also allow your muscle retention to stay healthy.


If you exercise, protein levels should be hovering around 0.8g – 1.0g protein per lean pound of body mass a day (source). This helps with muscle mass retention and growth.
However, if you are not exercising – your protein intake should not be as high. Sitting around 0.6g – 0.8g of protein per lean pound of body mass is going to be fine (source).

Eating Too Little or Exercising Too Much

This can slow your metabolism down. The body will slow itself down in response to a lack of food or excessive amounts of exercise to conserve itself. Studies show that if you do aerobic exercise for more than 1 hour a day, your metabolic rate can drop by as much as 15%.
In addition, eating too little can have the same effect. If you are eating too little, so much so that your fat stores cannot cover your calorie deficit, your body will begin to use lean mass to get the energy that it needs. This study shows that over a 6 month period of a 25% calorie deficit, your metabolic rate will only drop about 6%.
Studies show that as long as you’re eating at enough of a deficit that your fat stores can cover, your metabolic rate doesn’t change too much. If you do go over that deficit, though, your metabolic rate will severely drop in order to protect vital organs (this is a real “starvation mode” response from your body).
So, how much can your fat stores actually cover? You can get about 31.4 calories per pound of fat per day, from your fat stores.
Let’s say you’re 240 lbs (162 lbs lean mass, 78 lbs fat, 31.2% body fat) and want to get down to 180 lbs (162 lb lean mass, 18 lbs fat, 10% body fat):

• At 240 lbs (162 lean mass, 78 lbs fat) you can get about 2449 calories from fat stores.
• At 220 lbs (162 lean mass , 58 lbs fat) you can get about 1821 calories from fat stores.
• At 200 lbs (162 lean mass, 38 lbs fat) you can get about 1193 calories from fat stores.
• At 180 lbs (162 lean mass, 18 lbs fat) you can get about 565 calories from fat stores.

Against all logic, adding some extra calories from fat and protein to your daily macros may help. Try it for a few days, and see the results. If you exercise a lot, try cutting it back some and give yourself some extra rest days. My personal advice is 4 days maximum of hard training during the week.

Eating Too Often

Snacking when you’re hungry is great, but it can also be a setback. Try restricting yourself to eat on a regular schedule, with no meals (however small) in between. This is similar to intermittent fasting, and works very well for some people. Intermittent Fasting will allow your blood sugar and insulin to drop down to baseline levels, and allow your body to go into its fasting state – where it will burn fat for fuel.

When insulin is heightened, we can also show signs of hunger, according to this study, which can also lead to being in a calorie surplus. If you eat 5 meals a day spaced out over 10 hours, try eating 2 or 3 times a day in an 8 hour window. For example, from 10am until 6pm you can eat all the calories you want. After that, don’t allow yourself to eat until the next day.

Fat Fasting

If you’re finding yourself still at a plateau, you can apply a technique called the fat fast. It is normally a 3 day window of low caloric intake and high amounts of fat to kickstart your body to use your stored fat as fuel. If you’re interested, I went into more detail on fat fasting in another post.
This will consist of:

• 1000 – 1200 calories a day.
• 80-90% calories from fat.
• Eating 4-5 times a day.

Exercise and Protien on a Keto Diet

Eat More Protein if You Exercise

It's simple: those who are physically active will need more protein than those who are less active. Finding your ideal protein intake is easy - just use our keto calculator.

By selecting your activity level and body fat percentage, you will get a fairly accurate estimate of your protein needs (based on Dr Volek's & Phinney's recommendations). Keep in mind that this number is only an estimate - your protein requirements will vary based on your daily activity.
You shouldn't significantly overeat protein. Protein is not a particularly efficient fuel source - too much of it won't be beneficial. How much protein should you be eating? Aim for 0.6 to 1 grams per pound of lean body mass.
"Aim for a protein intake between 0.6 to 1 grams per pound of lean body mass.... Significantly over-consuming protein can be problematic because some of of the extra amino acids can be converted to glucose in the body, raising insulin levels, and thus driving down ketones and suppressing fat burning."

But Won't More Protein Kick Me Out Of Ketosis...?

Although it's true that too much protein may disrupt ketosis, you don't need to worry about a few extra grams of protein. Eating slightly more protein will not kick you out of ketosis because not all excess protein converts into glucose via gluconeogenesis. I personally go over or under up to 15 grams so don't worry if you don't match your numbers precisely every day. In fact, your protein requirements are slightly different based on your daily activity: you'll need more protein on your "training" days compared to your "resting" days.
Some people don't eat enough protein because they are afraid that it will slow down their progress. As a result, they are hungry and overeat fat. Because calories do count, even on a ketogenic diet, they may end up stalling or even gaining weight. If you are trying to lose weight or build muscles, you have to eat enough protein.

Make sure you eat enough protein. Lack of protein leads to increased hunger and energy intake. Eating enough protein and not overeating fat is one of the rules you should follow if you want to lose weight on a ketogenic diet. Don't rely on high ketone levels - what matters most is your food intake.

Post-Workout Nutrition and Nutrient Timing

Contrary to common beliefs, nutrient timing is not as important as people think. It shouldn't be the main focus for those who just want to look and feel better. So unless you aim for significant muscle gain or you are an athlete, you won't need to worry about nutrient timing.
It's simple: if you want to lose body fat, you need to stay in calorie deficit (use your body fat for energy). If you want to gain muscles, you need to be in calorie surplus. You should be aiming for macronutrients that fit your individual needs (check our keto calculator for more details). More factors that play role in muscle gain are listed in this post: adequate protein intake, calorie surplus, proper training and resting.

Carbs and Ketogenic Nutrition

A common belief is that post-workout meals have to be high in carbs. The reason for this belief is that a meal high in carbohydrates will increase insulin which will increase amino acid uptake and promote muscle protein synthesis. However, loading your body with large amounts of post-workout carbs is not as effective as you may think. In fact, to get the maximal effect of protein synthesis, you only need a small amount of insulin.
This doesn't mean you should avoid carbs altogether. Depending on the type of exercise, you may benefit from small carb-ups. Just keep in mind that if you include extra carbs, time them wisely round your workouts or later in the day rather than having a high-carb breakfast meal.

Protein and Ketogenic Nutrition

The primary factor in muscle protein synthesis is your protein intake, specifically leucine. Leucine is an essential amino acid that triggers muscle protein synthesis. It has been shown that blood levels of leucine increase when in keto-adapted state (protein-sparing effect of ketogenic diets). You don't need to over-consume protein to benefit from muscle protein synthesis - just eat adequate amounts to fit your needs. What actually maximises muscle anabolism after resistance exercise is leucine and not the insulin response if you were to eat carbs.

Fat and Ketogenic Nutrition

The ketogenic diet is a high-fat diet. However, it is not recommended to eat high-fat meals immediately after a workout. A high-fat meal would slow digestion of post-workout protein intake - this is not desirable for weight loss or muscle gain.

Common Myths about Exercise Nutrition

There are several myths that are circulating over the internet and here are the most common ones...

Myth 1: Our body cannot absorb more than 30 grams of protein per sitting

You may have heard that your body cannot digest more than 30-40 grams of protein in one sitting - the rest would apparently be wasted. Don't worry, that's a myth. As you may know, intermittent fasting (IF) pairs perfectly with the ketogenic diet and if you do IF, you will likely be eating just one or two meals a day. Does this mean you are not absorbing enough protein? No. Even if you eat more protein in one sitting, it won't be wasted - your body (the small intestine) will store the amino acids and use them as needed.

Myth 2: You need to eat 40 grams of protein in every meal

Secondly, some people suggest that you need to eat 40 grams of protein in every meal to trigger muscle protein synthesis. This is wrong - what you need is to consume adequate protein throughout the day.
By following the 40 gram rule, you may easily be over-consuming protein, especially if you eat more than twice a day. I am quite active and my protein intake is between 80 and 100 grams based on whether I exercise on that particular day or not. As an example, if I was to have 3 meals a day, I would be over-eating protein by up to 40 grams. Finally, keep in mind that the ketogenic diet is not a high-protein diet.

Myth 3: Post-workout anabolic window of opportunity

The suggestion is that immediately after a workout (no later than 30-45 minutes), our body needs fast digesting carbs and protein. That's why it's not unusual to see people bringing their protein & carb shakes to gym so they can drink them just after exercise before the window closes.

However, it seems that this window is much bigger and nutrient timing in general isn’t that important for the vast majority of people who are trying to lose weight and get fit. Rather than sipping on protein shakes immediately after a workout, take it easy and have a proper meal at home.

Myth 4: You should never fast after a workout

Mark Sisson has admitted to fast after a workout once in a while - and so do I. The benefit is that just like intermittent fasting, and resistance training, post-workout fasting increases the level of human growth hormone (HGH). So if I don't feel hungry, I don't eat. Not feeling hungry is the main benefit of the ketogenic diet and low-carb diets in general. As Mark notes: "insulin suppresses HGH. Skipping the carb snack and the subsequent insulin upsurge goes a long way post-workout."

Easy Keto Mozzarella Sticks

Is anyone else ever baffled by how many carbs you could eat in one sitting pre-keto? I shudder to think of how I would go to an Italian restaurant, chow down on some breadsticks, eat an appetizer of cheese sticks coated in breadcrumbs and dipped in a sugary marinara sauce, and then finish it all off with a pasta dish. Insane, right?
Well I’m still searching for the perfect keto breadstick recipe, but in the meantime, this recipe for low carb mozzarella sticks is easy and delicious. It’s one of those things that’s so simple to substitute that I almost don’t understand why anyone makes them the “normal” way to begin with. By swapping out the white flour for coconut flour and the breadcrumbs for grated parmesan, you get a result that’s pretty close to identical but much lower in carbs.


These low carb cheese sticks also have the added benefit of filling the occasional need for keto-friendly convenience foods. I like to make a double batch and store some in the freezer for later use. They can be cooked from frozen, so if I keep some on hand then I’m never more than about ten minutes away from cheesy, melty awesomeness.
You don’t even have to limit yourself to mozzarella; the recipe should work with any string cheese that has similar moisture content. I’ve used it to make fried pepperjack (which you can spot in the picture above) with equally delicious results.

• Prep Time: 40m
• Cook Time: 10m
• Total Time: 50m

• Yield: 10 cheese sticks

Ingredients

• 5 one ounce sticks of mozzarella string cheese, halved widthwise
• 1/2 cup + 1 tablespoon grated parmesan cheese
• 1 tablespoon coconut flour
• 1 teaspoon baking powder (optional)
• 1/2 teaspoon garlic powder
• 1 teaspoon Italian seasoning (or 1/2 t. each of dried basil and oregano)
• 1 egg
• salt and pepper to taste

Instructions

1. Whisk egg with salt and pepper in a small bowl. In a separate shallow dish, combine the dry ingredients.
2. Dip each piece of cheese into the egg, and then roll in the parmesan mixture to coat. Repeat this twice to form a double coating on each cheese stick.
3. Place cheese sticks into a small rectangular dish or other container, and chill in the freezer for at least 25 minutes.
4. Heat about half an inch of oil in a frying pan over medium heat.
5. Fry cheese sticks until golden brown, about 60 to 90 seconds per side. Drain excess oil on paper towels.
6. Serve alone, or with a side of low carb marinara sauce for dipping.

 Each 5 stick serving comes out to about 390 kcal, 28g fat, 3g total carbs, 1.3g fiber, 1.7g net carbs, and 35g protein.

10 Incredibly Useful Cooking Tips - Gordon Ramsay