“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.”
Great article! As someone who just started a “ketogenic diet” two weeks ago, I am opting to hold off on using ketone supplements for the following reason. You state how “Keto-adaptation occurs when you have shifted your metabolism to relying on fat-based sources, instead of glucose (sugar) sources, as your primary source of fuel.” If the goal is to “switch” our body’s energy supply to ketones and one uses supplemental ketones, how do they really ever know if their body has successfully accomplished this goal if they are using supplemental ketones? Aren’t they getting a false sense of ketosis if their blood or breath tests show them above 0.5 millimolar through the use of the supplements? I understand that it may take me longer to reach ketosis naturally but I guess I see it was worth it to truly reap all of the benefits that you outline in your article.

On the ketogenic diet, carbohydrates are restricted and so cannot provide for all the metabolic needs of the body. Instead, fatty acids are used as the major source of fuel. These are used through fatty-acid oxidation in the cell's mitochondria (the energy-producing parts of the cell). Humans can convert some amino acids into glucose by a process called gluconeogenesis, but cannot do this by using fatty acids.[57] Since amino acids are needed to make proteins, which are essential for growth and repair of body tissues, these cannot be used only to produce glucose. This could pose a problem for the brain, since it is normally fuelled solely by glucose, and most fatty acids do not cross the blood–brain barrier. However, the liver can use long-chain fatty acids to synthesise the three ketone bodies β-hydroxybutyrate, acetoacetate and acetone. These ketone bodies enter the brain and partially substitute for blood glucose as a source of energy.[56] 

Ketosis is a metabolic state where most of the body's energy supply comes from ketone bodies in the blood, in contrast to a state of glycolysis where blood glucose provides most of the energy. Ketosis is characterized by serum blood concentrations of ketone bodies over 0.5 millimolar with low and stable levels of insulin and blood glucose. However, with ketone supplementation (as you’ll learn about later in this article) ketosis can actually be induced even when there are high levels of blood glucose.
After reading the article I shopped around and I noticed there are types of MCT oil that are derived from Palm Oil and are considerably less expensive. (http://prototypenutrition.com/keto8.html ) There is a litany of research that says that Palm Oil is on the same level a High Fructose Corn Syrup when it comes to your body. Is this true for MCT oil made from Palm Oil? Is Coconut derived superior to Palm Oil or a blend of the two?
There’s also some evidence that it might help with type 2 diabetes. “An emerging body of research is finding that a keto plan may have some real benefits thanks to its ability to improve the body’s ability to use insulin and also help control appetite, which can result in easier weight loss,” says Karen Ansel, R.D.N., co-author of Healthy in a Hurry.
You also get incredible gains in metabolic efficiency when you use fat as a primary source of fuel – especially when doing high-intensity interval training – with this one-two combo causing potent 3–5 percent decreases in the oxygen cost of exercise, which is extremely significant. Translated into real- world numbers, this increased fat utilization from carbohydrate restriction and high-intensity interval training would allow you to pedal a bicycle at a threshold of 315 watts, whereas a high-carbohydrate, aerobic-only program (the way most people train) would allow for only 300 watts. Talk to any cyclist and you’ll find out that an 15 extra watts of power is huge in a sport like cycling, and something most cyclists train years and years to achieve.
^ Jump up to: a b Sinclair, H. M. (1953). "The Diet of Canadian Indians and Eskimos" (PDF). Proceedings of the Nutrition Society. 12 (1): 69–82. doi:10.1079/PNS19530016. ISSN 0029-6651. It is, however, worth noting that according to the customary convention (Woodyatt, 1921 ; Shaffer, 1921) this diet is not ketogenic since the ratio of ketogenic(FA) to ketolytic (G) aliments is 1.09. Indeed, the content of fat would have to exactly double (324 g daily) to make the diet ketogenic (FA/G>1–5).
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’m not sure if I really understand the idea of exogenous Ketones putting ones body into a state of KETOSIS, in that their own fat cells will be burned for fuel. Won’t the body just use the exogenous ketones and energy and continue to use glucose sources as well? How does taking ketones, make the body burn it’s own fat stores? I always thought that one would have to be in a state of energy deprivation for the body to actually begin to use the TG in the fat cells to generate ATP. Please let me know what I’m missing…
^ Lawrie 2014, pp. 92-. "A much delayed onset of rigor mortis has been observed in the muscle of the whale (Marsh, 1952b). The ATP level and the pH may remain at their high in vivo values for as much as 24h at 37ºC. No adequate explanation of this phenomenon has yet been given; but the low basal metabolic rate of whale muscle (Benedict, 1958), in combination with the high content of oxymyoglobin in vivo (cf 4.3.1), may permit aerobic metabolism to continue slowly for some time after the death of the animal, whereby ATP levels can be maintained sufficiently to delay the union of actin and myosin in rigor mortis."

For any long 90+ minute workouts or competitions for which glycogen depletion is a potential issue, use Glycofuse, but use half of the recommended serving of it, and add one scoop of Catalyte electrolytes, one scoop of Aminos, and one serving of medium chain triglycerides in the form of Brain Octane, KetoCaNa or KETO//OS (pick your poison, it’s up to you).


I'd recommend starting with glucose and hemoglobin A1C, along with a good multi like https://bengreenfieldfitness.com/multi and a fish oil like the one at greenfieldfitnesssystems.com – 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.

I was shocked at how easy it was (using the new supplements and methods outlined below that have been developed since my initial foray into ketosis) to get into ketosis without extreme carbohydrate restriction, without excessive, diarrhea and “diaper-moment” inducing amounts of MCT and coconut oil, and without the inflammation, triglyceride and hormonal issues, or social discomfort I outline above. I was also able to achieve a much more immediate and deeper level of ketosis than I ever achieved in previous experiments sans these newer strategies you’re going to learn about.


^ Jump up to: a b Cardona A, Pagani L, Antao T, Lawson DJ, Eichstaedt CA, Yngvadottir B, Shwe MT, Wee J, Romero IG, Raj S, Metspalu M, Villems R, Willerslev E, Tyler-Smith C, Malyarchuk BA, Derenko MV, Kivisild T (2014). "Genome-wide analysis of cold adaptation in indigenous Siberian populations". PLOS One. 9 (5): e98076. Bibcode:2014PLoSO...998076C. doi:10.1371/journal.pone.0098076. PMC 4029955. PMID 24847810.
Following the ketogenic diet and achieving ketosis may be beneficial if you’re living with type 2 diabetes and need to manage your symptoms. Limiting carbohydrate intake is crucial with type 2 diabetes because too many carbs can increase blood glucose levels, which can damage blood vessels and lead to vision problems, kidney problems, and nerve problems.
^ Jump up to: a b Cardona A, Pagani L, Antao T, Lawson DJ, Eichstaedt CA, Yngvadottir B, Shwe MT, Wee J, Romero IG, Raj S, Metspalu M, Villems R, Willerslev E, Tyler-Smith C, Malyarchuk BA, Derenko MV, Kivisild T (2014). "Genome-wide analysis of cold adaptation in indigenous Siberian populations". PLOS One. 9 (5): e98076. Bibcode:2014PLoSO...998076C. doi:10.1371/journal.pone.0098076. PMC 4029955. PMID 24847810.
You state that many athletes and very active people could benefit from 100-200g of carbs a day, and be back in ketosis in a few hours. Any particulars on which kind of activities or say how long/many training sessions would benefit from this to balance hormones. I train mma 3-4 days a week and also do lots of hiit and strength training as well. Just trying to see if this is a situation where i would benefit from your suggestions. Thanks!

In the mid-1990s, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC's Dateline programme and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1]
For example, in trained people and athletes who eat a low-carbohydrate, high-fat diet (not to be confused with a low-carbohydrate, high-protein diet), a large amount of fat burning can take place at intensities well above 80 percent maximum oxygen utilization (VO2 max) – allowing for very-high-intensity or long efforts with low calorie intake and also allowing for use of fat fuel stores during long steady-state exercise, even at a relatively fast pace (so much for the “fat burning zone” giving you the best bang for your buck). With high-fat, low-carb intake, you can go hard and still burn tons of fat. In addition, this means that more carbohydrate stores will be available when you really need them, such as for an all-out, 100%, maximum effort.
3) Cholesterol levels usually go up with inflammation, because inflammation causes damage to the tissues, and cholesterol is manufactured and released in circulation to patch things up. So, again, eating high fat is the best way to drop inflammation; not increase it. My hsCRP are always below 0.1, and most of the time, below detection level. Oxidation of cholesterol causes inflammation; not the other way around. So, your point about inflammation is a non-issue.
I just discovered your site and have been thoroughly enjoying many of the articles and appreciate that you get so in depth in your explanations. I’m in my late 40’s and, while not an extreme endurance athlete, I am moderately active with 18-20 mile rides 3x a week as well as some boxing and body weight resistance (push up, pull up, etc) mixed in. I’ve generally been paleo and stick to quality macros for the most part (grass fed meats/dairy, organic veg and oils) and zero supplements. I recently started following keto (after reading this article) about 10 days ago and things seem good thus far. I do, however, want to avoid any of the negative side effects you mention and also not lose any lean muscle. I’m currently about 174 lbs, 5’8″ and about 19% bodyfat – I’m taking in about 95g protein, 130g fat and <20g net carbs. I'm eating all quality – wild salmon, grass fed beef, pastured eggs, coconut oil, Brain Octane and Grass fed butter in coffee, sardines, etc. With a smattering of organic veg, but it seems real easy to bust through the carb barrier. *I'M ALSO TAKING KETOCANA PRE-WORKOUT* and I notice this is keeping me going throughout a ride or the gym.
Dr. Perlmutter is a pioneer in medicine. His approach to brain health offers us the opportunity to get to the underlying cause of some of the most challenging diseases. Dr. Perlmutter offers a holistic approach to neurology, treating the whole person body, mind and spirit. His approach is evidenced-based and cutting edge providing options and hope to individuals with significant neurologic challenges.
Conklin's fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist Henry Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin's success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite only having studied the patients for a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles P. Howland, the parent of one of Conklin's successful patients and a wealthy New York corporate lawyer, gave his brother John Elias Howland a gift of $5,000 to study "the ketosis of starvation". As professor of paediatrics at Johns Hopkins Hospital, John E. Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.[10]
Signs of diabetic ketoacidosis include a high blood glucose level, a high ketone level, dehydration, frequent urination, nausea, difficulty breathing, and dry skin. If you have poorly managed type 1 or type 2 diabetes, test your blood glucose level regularly before and after meals, and make sure you check your ketone level whenever your blood sugar is higher than 240 milligrams per deciliter (mg/dL). (11)
On the ketogenic diet, carbohydrates are restricted and so cannot provide for all the metabolic needs of the body. Instead, fatty acids are used as the major source of fuel. These are used through fatty-acid oxidation in the cell's mitochondria (the energy-producing parts of the cell). Humans can convert some amino acids into glucose by a process called gluconeogenesis, but cannot do this by using fatty acids.[57] Since amino acids are needed to make proteins, which are essential for growth and repair of body tissues, these cannot be used only to produce glucose. This could pose a problem for the brain, since it is normally fuelled solely by glucose, and most fatty acids do not cross the blood–brain barrier. However, the liver can use long-chain fatty acids to synthesise the three ketone bodies β-hydroxybutyrate, acetoacetate and acetone. These ketone bodies enter the brain and partially substitute for blood glucose as a source of energy.[56]
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