Ketones from a low carb diet or from supplementation: pros and cons

[PES]

Hi All.

I’m a biologist by training and currently works in the field of nutrition, wellness and sport/performance monitoring. I’m a long term keto dieter and I believe that I know relatively well the scientific literature on the pros & cons of ketosis.

The question I have is whether causing ketosis through a very low carb diet still presents some advantages over a LCHF diet with carbs still low but not low enough to induce ketosis together with a supplementation of C8 MCT to keep blood levels of ketones high (i.e. ketones from supplementation and not from ketosis). This question because ketosis is still viewed by many as a metabolic state that the human body developed to survive long fasting periods and despite what we can read and see, ketosis has never been the main metabolic state of our ancestors, because of the availability of fruits and vegetables over long periods of the year in most places on Earth.

Of course ketosis presents well known advantages for “unhealthy” people, I will not list them here. However, the more I study (and practice) keto the more I think that for healthy people who practice regular exercise a keto diet may have more cons than pros than a LCHF diet composed of an amount of fruits and vegetables high enough that doesn’t allow ketosis but supplemented with a product such as C8 MCT to still benefit from the ketones. Any comment/advice in that regard?

[Baytowvin]

I’m probably not going to explain it as well as others can, and hopefully will, but here it goes.

The benefits of ketosis come from the process of you getting there, not by simply “having” ketones register. If your system isn’t actually producing them, then it’s not in a state to benefit. You can take exogenous keytones and register on a test as being in a state of ketosis, but without the absense of carbs, you’re just pissing them out and not using them for fuel.

To answer more directly:

Pros: they’re profitable if you’re the one selling them.

Cons: they’re expensive if you’re the one buying them, and they don’t really do anything.

I know relatively well the scientific literature on the pros & cons of ketosis.

I’m curious what cons you have found?

[Shortstuff]

There’s an amazing search function on these forums…

[PES]

THank you for the feedback.

I’m surprised by your claim that ketones only work in the absence of carbs because some studies suggest the opposite. To cite a few: this study showed that ketones can be used as fuel on top of carbs (doi:10.1152/jappl.1996.80.6.2217). This one (doi: 10.1016/S0197-4580(03)00087-3) showed a direct relation between the blood levels of ketones (supplemented) and cognitive function. Re glucose, this study (doi:10.1186/s12986-016-0069-y) concluded “We demonstrated that therapeutic ketosis could be induced without dietary (calorie or carbohydrate) restriction and that this acute elevation in blood ketones was significantly correlated with a reduction in blood glucose”. Finally, this last review (doi: 10.3389/fphys.2017.00848) showed similar healthy effects between low-carb-induced ketosis and supplementation-induced ketosis.

Actually, my question was whether there are additional benefits in a low-carb keto diet. My search didn’t find any for healthy patients but I may have missed some.

Re the cons of a ketogenic diet on health, GI disturbance and an increase in infectious diseases are often mentioned. This study (doi: 10.1111/j.0013-9580.2005.48504.x) is often cited when talking about the side effects of a ketogenic diet.

Other cons I see are more associated to tolerance and compliance. The reason why I seriously think about moving to a less strict LCHF diet but with ketone supplementation.

[LeCheffre]

The main benefit of making your own ketones is that it doesn’t require constant supplementation. Or even regular supplementation with ketones. Even the cheaper ones.

You get most of the cognitive benefit, only it doesn’t wear off after a few hours without another dosing, as you are making them yourself.

The benefit of taking exogenous ketones is that you can hit ketone levels that are difficult to hit frequently on LCHF/ketogenic diet. Folks who go for therapeutic ketosis or full carnivore can get in the neighborhood of the ketone levels that say ketone esters might produce.

Quantified Bob has tried exogenous ketone esters and has reported on results, if you are curious. He talked about it on the Biohackers Lab podcast as well as his own website.

If you were to supplement with an affordablish version of ketones, and continue to eat standard western diet, or an otherwise non-ketogenic diet, your brain may use ketones for some processes, but you won’t get the full dietary benefit from them. And you won’t get the protective benefit from being in nutritional ketosis.

[Baytowvin]

You said:

I’m a long term keto dieter

So what has your experience been that is causing you to now think there might be a benefit to supplementing with ketones? What are your goals for following a ketogenic way of eating?

As far as benefits, feel free to search the forum. There are plenty of n=1 examples of benefits people have found following a ketogenic way of eating.

Personally I started keto to reverse my type 2 diabetes, and I have done so. I’m also losing a significant amount of weight, although that wasn’t my primary goal.

Your links don’t seem to link. This forum generally has the opinion of “you do what you think works best for you”. If you want to supplement ketones, go for it. I’m sure the forum would appreciate learning about your experience.

I think you’ll be hard pressed to find actual science that demonstrates any significant benefits of exogenous ketones that can’t be linked back to a company that manufactures and/or sells them.

[LeCheffre]

If anyone is interested in the studies:

MCTs and performance:
https://www.physiology.org/doi/abs/10.1152/jappl.1996.80.6.2217

Beta hydroxybutarate and cognitive impairment:

Effects of β-hydroxybutyrate on cognition in memory-impaired adults

And the other one:

Effects of exogenous ketone supplementation on blood ketone, glucose,...

Supplement manufacturers would love to offer the keto diet in a pill.

[In2steam]

“We demonstrated that therapeutic ketosis could be induced without dietary (calorie or carbohydrate) restriction and that this acute elevation in blood ketones was significantly correlated with a reduction in blood glucose”

I am not a study reader but my brief skimming of this study concluded to me two things, I am not a rat, and that yes you will have lower blood glucose if you are taking exo ketones if your diet is very high in carbs(62%)

This is not really rocket surgery, if you supply enough glucose to raise insulin your BG will drop over time, and then you will use the exo ketones as energy to a limited extend as they are prefered energy source. So you are storing fat and burning exo ketones and telling your fat burning system to be ready to go.
Sounds like a metabolic train wreck in the making, telling your body to store fat, make it think its burning fat, and make fat all once.

I honestly don’t believe this belongs in the newbie area.

[LeCheffre]

I honestly don’t believe this belongs in the newbie area.

I’ve moved it to Show Me the Science. If you have a better idea, I’ll be happy to move it somewhere else.

[In2steam]

agreed TY.

[PES]

Quantified Bob has tried exogenous ketone esters and has reported on results, if you are curious. He talked about it on the Biohackers Lab podcast as well as his own website.

That’s very helpful, thank you.

If you were to supplement with an affordablish version of ketones, and continue to eat standard western diet, or an otherwise non-ketogenic diet, your brain may use ketones for some processes, but you won’t get the full dietary benefit from them. And you won’t get the protective benefit from being in nutritional ketosis.

I probably didn’t make myself clear, sorry for that. The idea is still to keep a LCHF diet but with less restriction on the carbs, especially on the fruits and some types of vegetables. I know by experience that I may leave the keto zone if I introduce too many fruits/vegetables, at least at some occasions. I fully acknowledge that constant supplementation is expensive. I will probably cycle.

[PES]

So what has your experience been that is causing you to now think there might be a benefit to supplementing with ketones? What are your goals for following a ketogenic way of eating?

Simply because I’m weak. Keto is restrictive. After a few years of keto, I would like to ease the restrictions through supplementation however I don’t want to loose the important benefits of a ketogenic diet.

As far as benefits, feel free to search the forum. There are plenty of n=1 examples of benefits people have found following a ketogenic way of eating.

Oh I know them well. My question precisely because I don’t want to lose them.

Your links don’t seem to link. This forum generally has the opinion of “you do what you think works best for you”. If you want to supplement ketones, go for it. I’m sure the forum would appreciate learning about your experience.

I think you’ll be hard pressed to find actual science that demonstrates any significant benefits of exogenous ketones that can’t be linked back to a company that manufactures and/or sells them.

Thank you for the advice. I already ordered the equivalent of 3 months of supplementation. Will start soon.

[LeCheffre]

If you’re interested in it as a nootropic, Quantified Bob and the biohacking community is your resources.

If you’re interested in it as a supplement to allow a broader ketogenic diet, I’m afraid there hasn’t been much research in that direction that isn’t confounded by funding issues… I think the move would be to do some N=1 experiments with the fruits and vegs you’re looking to incorporate them, as you might in something like Whole 30 protocol, to see what works and keeps you keto. As a daily supplement, it’s pretty expensive at sth 5-7 a dose at the bottom end. If you were suffering from something like cancer or Alzheimer's disease, and needed to be in nutritional ketosis, absolutely. If you're looking for a performance edge or a protective effect, I'd try to get there with diet and testing of boundaries before I went to a supplement that cost more than say .25 a dose.

[PES]

If anyone is interested in the studies:

Thank you. For something more recent, see the articles mentioned here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5880954/

Personally I have no doubt of the benefits of both a keto diet and ketones supplementation. It is possible that little or no difference exists on health/well-being between a keto diet and a less restrictive LCHF+ketones supplementation. If the case I will go for the latter despite the additional costs.

[LeCheffre]

Whatever works… I’ll be interested to hear your results.

[PES]

“We demonstrated that therapeutic ketosis could be induced without dietary (calorie or carbohydrate) restriction and that this acute elevation in blood ketones was significantly correlated with a reduction in blood glucose”

I am not a study reader but my brief skimming of this study concluded to me two things, I am not a rat, and that yes you will have lower blood glucose if you are taking exo ketones if your diet is very high in carbs(62%)

This is not really rocket surgery, if you supply enough glucose to raise insulin your BG will drop over time, and then you will use the exo ketones as energy to a limited extend as they are prefered energy source. So you are storing fat and burning exo ketones and telling your fat burning system to be ready to go.

Agreed. But now change high-carb to low-carb (eg 15-30-55 for a 2.5Kcal diet), and perhaps you may keep the benefits of a ketogenic diet but with less restrictions.

[PES]

If you’re interested in it as a nootropic, Quantified Bob and the biohacking community is your resources.

If you’re interested in it as a supplement to allow a broader ketogenic diet, I’m afraid there hasn’t been much research in that direction that isn’t confounded by funding issues… I think the move would be to do some N=1 experiments with the fruits and vegs you’re looking to incorporate them, as you might in something like Whole 30 protocol, to see what works and keeps you keto. As a daily supplement, it’s pretty expensive at sth 5-7 a dose at the bottom end. If you were suffering from something like cancer or Alzheimer’s disease, and needed to be in nutritional ketosis, absolutely. If you’re looking for a performance edge or a protective effect, I’d try to get there with diet and testing of boundaries before I went to a supplement that cost more than say .25 a dose.

More the latter, a performance/protective/well-being effect. I’m currently on keto with no more than 20g carbs a day, some days up to 50g with some fruits after exercise. I feel great but I’m bored with the restrictions. I will post here the results of my “semi-keto-diet”.

[Karim_Wassef]

I’m new to the forum so thought I’d add my two cents and revive the topic…

Ketones are not about losing weight. All people globally have intrinsically sought out activities that increase ketones and reduce glucose and insulin for health. They didn’t know the biochemistry but they understood that it kept people healthy and slowed aging and increased cognitive/spiritual focus.

Exercise and fasting are key to this search. Even calorie restriction that results in weight loss triggers ketosis (or else it wouldn’t work). Fasting has been a therapeutic path for serious illness in many cultures. Both are also paths to longevity - slowing down aging and age related illness.

The damaging effects of insulin and glucose on arterial and organ health as well as the oxidative stress of glucose oxidation vs ketones means that tipping the balance to ketones keeps you younger, healthier and more mentally focused and clear.

There’s research in telemeres that I’m just getting into now.

My interest is driven by my age. I’m 45 and most age related illnesses begin to build up in the 40s showing symptoms in the 60s and disease/death in the 80s. I was 255 about 18months ago with a 44” waist at 5’10”… doctor gave me statins and a bundle of other pills with side effects that were insane… I discovered ketones and it’s been a whole different world since. At 165 and 32” waist, I don’t need weight loss but the heath, longevity and mental clarity are indispensable.

Whether I get them from what I eat or what I don’t eat or how much I exercise doesn’t seem to matter… as long as my ketones are over 1, I feel strong and clear. My path isn’t through chemicals though- it’s either fatty foods, fasting or lifting.

The only side impact is PUFAs causing inflammation… it’s a fat but doesn’t work for me.