" "

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]
Once inside the mitochondrion, the dominant way that the bound fatty acids are used as fuel in cells is through β-oxidation, which cleaves two carbons off of the acyl-CoA molecule in every cycle to form acetyl-CoA.[24] Acetyl-CoA enters the citric acid cycle, where it undergoes an aldol condensation with oxaloacetate to form citric acid; citric acid then enters the tricarboxylic acid cycle (TCA), which harvests a very high energy yield per carbon in the original fatty acid.[25][26]
"If you're going to do keto, there's a better and a worse way to do it," registered dietician Kim Yawitz told Everyday Health. "Loading your plate with meats, and especially processed meats, may increase your risk for kidney stones and gout... High intake of animal proteins makes your urine more acidic and increases calcium and uric acid levels. This combination makes you more susceptible to kidney stones, while high uric acid can increase your risk for gout."

In theory, all of this is possible. A study published in the Journal of Nutrition did find an association between having more severe bacterial vaginosis and consuming diets higher in total fat and saturated fat. But the keto diet is still a relatively new rage, and not enough scientific studies have been done to determine whether "keto crotch" is really a risk of the keto diet.


Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often, no initial fast is used (fasting increases the risk of acidosis, hypoglycaemia, and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size, but alter the ketogenic ratio from 2:1 to 4:1.[9]


The low glycaemic index treatment (LGIT)[49] is an attempt to achieve the stable blood glucose levels seen in children on the classic ketogenic diet while using a much less restrictive regimen. The hypothesis is that stable blood glucose may be one of the mechanisms of action involved in the ketogenic diet,[9] which occurs because the absorption of the limited carbohydrates is slowed by the high fat content.[5] Although it is also a high-fat diet (with approximately 60% calories from fat),[5] the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40–60 g per day.[18] However, the types of carbohydrates consumed are restricted to those that have a glycaemic index lower than 50. Like the modified Atkins diet, the LGIT is initiated and maintained at outpatient clinics and does not require precise weighing of food or intensive dietitian support. Both are offered at most centres that run ketogenic diet programmes, and in some centres they are often the primary dietary therapy for adolescents.[9]
I’ve been experimenting with MCT Oil Brain Octane. I have one questions. I’ve been eating about 20 – 25 gr. of carbs per day on a high fat, medium protein diet. I’m measuring ketones in the morning before taking the MCT and after. I’ve been taking btw. 1-2 tbsp of MCT Brain Octane with butter (Bulletproof coffee) – I measure again after 30 min., 1hr, 2 hrs. and don’t see a raise in my blood ketones. Anything I’m missing, would love to hear your thoughts, Ben. – Thx I’m measuring with Precision Xtra and Ketonix Red.

I am not a doctor and this is not to be taken, interpreted or construed as medical advice. If you have poor liver or gallbladder function, it can be a good idea to take care of that prior to a high fat diet, yes. But a healthy high fat diet would not cause liver issues per se. These are just my own personal thoughts and not a prescription or a diagnosis or any form of health care whatsoever.


“Given that there is no known detriment to consumption of a high-carbohydrate diet (other than body weight gain due to water retention) and some research reports a benefit, it is recommended that all athletes consume a high-carbohydrate training diet, i.e., at least 60-70% of energy as carbohydrate (7-10 g/kg), and increase this to 65-85% for the few days before competition. Use of a carbohydrate supplement before and during exercise will likely improve performance of intermittent, high-intensity sprints.”


Whether ketosis is taking place can be checked by using special urine test strips such as Ketostix. The strips have a small pad on the end, which the user dips in a fresh urine specimen. Within seconds, the strip changes color to indicate the level of acetoacetate ketone bodies, which reflects the degree of ketonuria, which, in turn, gives a rough estimate of the level of hyperketonemia in the body (see table below). Alternatively, some products targeted to diabetics such as the Abbott Precision Xtra or the Nova Max can be used to take a blood sample and measure the β-hydroxybutyrate ketone levels directly. Normal serum reference ranges for ketone bodies are 0.5–3.0 mg/dL, equivalent to 0.05–0.29 mmol/L.[29]

More good news: Snacks are totally allowed (and I'm not just talking about carrot sticks). There are plenty of packaged options out there designed for keto fans. FATBAR is one of them. These snack bars have 200 calories, 16 grams of fat, and four grams of net carbs. They're also plant-based and are made with almond or cashew butter, cocoa butter, coconut, pea protein, sunflower seeds, and chia seeds.
What would your advice be to a high raw vegan who wants to try an HRV keto diet? The supps you recommended above look vegan, but aren’t the results based on those of omnis? Would they work the same way on vegans? Also I heard you mention in the recent Keto Summit that SE Asians need a little more carb and I happen to be one. I’m a petite 39-YO female and I’ve been raw for the past 11 years. I have been practicing intermittent fasting in the last 7 years and try to eat only twice a day. Up to how many grams of carbs can I consume to get into ketosis?
If you remain under your optimal net carbs limit, then you should enter ketosis within 2 to 3 days. But it can take up to 7 days. The fastest way to get into ketosis is to exercise on an empty stomach, in order to accelerate the depletion of glycogen in your body. You can also do a Fat Fast for a few days (eating more fat) to speed up the rate at which you enter ketosis AND start to cut out refined carbs (like sugar) before you go for full ketosis. Another option is to do a water fast, (only drinking water) which also speeds up getting into ketosis.

To encourage ketone production, the amount of insulin in your bloodstream must be low. The lower your insulin, the higher your ketone production. And when you have a well-controlled, sufficiently large amount of ketones in your blood, it’s basically proof that your insulin is very low – and therefore, that you’re enjoying the maximum effect of your low-carbohydrate diet. That’s what’s called optimal ketosis.


And it all culminated with me stepping into Dr. Jeff Volek’s world famous laboratory at University of Connecitut to subject myself to extensive blood testing, chunks of muscle removed from my legs, fat sucked out of my butt-cheeks, urine, stool and gut microbiome testing, oxygen and carbon dioxide testing and countless hours of treadmill running to discover what a full twelve months of eating a ketotic diet had actually done to my body.
The first cellular fuel is glucose, which is commonly known as blood sugar. Glucose is a product of the starches and sugars (carbohydrates) and protein in our diet. This fuel system is necessary, but it has a limitation.  The human body can only store about 1000-1600 calories of glucose in the form of glycogen in our muscles and liver. The amounts stored depend on how much muscle mass is available.  Men will be able to store more because they have a greater muscle mass.  Since most people use up about 2000 calories a day just being and doing normal stuff, you can see that if the human body depended on only sugar to fuel itself, and food weren’t available for more than a day, the body would run out of energy. Not good for continuing life.
A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).

The trick here is not only to avoid all obvious sourced of carbohydrate (sweets, bread, spaghetti, rice, potatoes), but also to be careful with your protein intake. If you eat large amounts of meat, eggs and the like, the excess protein will converted into glucose in the body. Large amounts of protein can also raise your insulin levels somewhat. This compromises optimal ketosis.
Hi Ben…first, I have learned so much from you, thank you! I’m interested in using exogenous ketone supplements and I have a question for you. I just read the transcript of an interview Dave Asprey did with Dr. Richard Veech (episode 299). He advises against them, and says they can even be harmful. I was disappointed to read this, and wanted to ask you about it, since I respect your opinion greatly….thank you.
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.
The question then is whether your crotch is like your mouth. Not in general, but in the specific case of ketones. That is, when you are on the keto diet, can ketones also accumulate in your crotch area and then subsequently lead to a new smell? Moreover, if you are woman, could ketones be changing the acidity of your vagina, which then may produce an environment more favorable to certain types of microorganisms? Indeed, the smell of your vagina can depend on the composition of microorganisms there. Some odors, like a strong fishy one, can be the result of an overgrowth of certain microorganisms like bacteria, which is the case in bacterial vaginosis.

What are the ideal levels of blood sugar? A blood sugar or blood glucose chart identifies ideal levels throughout the day, especially before and after meals. The charts allow doctors to set targets and monitor diabetes treatment, and they help people with diabetes to self-assess. Learn more about guidelines, interpreting results, and monitoring levels here. Read now
Wow! Such an informative article! A lot to take in! Loving that you mentioned the KETO//OS! I’ve actually lost 10 lbs in 3 weeks! Kinda cool. I haven’t heard of the other products but I’m excited the check them out! Also, the breath tool is new to me. Thank you! If anyone wants to checkout my testimonial with epilepsy, weight loss on the KETO//OS you can read it here: http://bit.ly/keto-os
3 years ago I was 500 pounds at my absolute worst. Went through a traumatic experience when I was 17 and afterwards the weight just seemed to add on over the years. I'd always been a big guy but it got really bad. Decided to start the keto diet after looking into healthier lifestyles and fast forward two years later (with intermittent fasting and gym training) I had lost 260 pounds. I kept under 1200 calories a day and the best feeling was not constantly being hungry. The last year has been more of a maintenance but with keto cycling.

Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.[42]


I am not a doctor and this is not to be taken, interpreted or construed as medical advice. If you have poor liver or gallbladder function, it can be a good idea to take care of that prior to a high fat diet, yes. But a healthy high fat diet would not cause liver issues per se. These are just my own personal thoughts and not a prescription or a diagnosis or any form of health care whatsoever.
^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.
Can’t get enough of avocados? You now have a great excuse to eat more of them. A ½-cup serving of the creamy fruit has almost 12 g of fat and only 2.6 g of net carbs. Avocados are also low in calories (about 138 for the same serving), making them an ideal snack in between meals. One serving also has about 6.4 g of dietary fiber (25.6 percent daily value, or DV), 404 milligrams (mg) of potassium (8.6 percent DV), and only 2.8 g of sugar. Try topping your salad with cubed avocado for a keto-friendly lunch.

I talk about that quite a bit here :https://bengreenfieldfitness.com/2015/09/things-your-pee-can-tell-you-about-your-body/
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.
As a matter of fact, it’s more dangerous to have high levels of cholesterol and high levels of CRP than low levels of cholesterol and high levels of CRP – even if your high levels of cholesterol are “healthy”, big fluffy LDL particles, and not small, dense vLDL particles. In other words, no matter how many healthy fats you’re eating, these fats may actually come back to bite you if you’re creating high inflammation from too much exercise, not enough sleep, exposure to toxins and pollutants, or a high-stress lifestyle.

Fuels and feeds your brain: Ketones provide an immediate hit of energy for your brain, and up to 70% of your brain’s energy needs when you limit carbs.[6] Fat also feeds your brain and keeps it strong. Your brain is at least 60% fat, so it needs loads of good fats to keep it running.[7] Essential fatty acids such as omega-3s help grow and develop the brain, while saturated fat keeps myelin — the layer of insulation around the brain — strong so your neurons can communicate with each other.
So how does this work? A quick run-through: The first tip was to eat low carb. This is because a low-carb diet lowers your levels of the fat-storing hormone insulin, allowing your fat deposits to shrink and release their stored energy. This tends to cause you to want to consume less calories than you expend – without hunger – and lose weight. Several of the tips mentioned above are about fine-tuning your diet to better this effect.
Some research suggests that ketogenic diets might help lower your risk of heart disease. Other studies show specific very-low-carb diets help people with metabolic syndrome, insulin resistance, and type 2 diabetes. Researchers are also studying the effects of these diets on acne, cancer, polycystic ovary syndrome (PCOS), and nervous system diseases like Alzheimer's, Parkinson's, and Lou Gehrig's disease.
Short-term results for the LGIT indicate that at one month approximately half of the patients experience a greater than 50% reduction in seizure frequency, with overall figures approaching that of the ketogenic diet. The data (coming from one centre's experience with 76 children up to the year 2009) also indicate fewer side effects than the ketogenic diet and that it is better tolerated, with more palatable meals.[18][50]
To prove this point, they knew full well they had to have a lower osmolarity than their competition. So, Gaspari spent the money and had their competitors’ products tested at a 3rd party laboratory to see where they stood. With some fine tuning using Osm Technology, Glycofuse is proven to have outstanding osmolality compared to just about every product on the market, including the biggest brands out there.
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