Ketones when new vs fat adapted

(Diana) #1

Hi all! Sorry in advance if this has been answered, please just direct me to the post. I searched and I couldn’t quite find the exact answer.

So 2 questions.

  1. My friend who is just 3 weeks into keto got a KetoMojo to test glucose and ketones. He wanted to make sure he was in ketosis as he does eat about 50 total carbs. He is measuring between .3 - 2.5 mmol ketones. I think the higher level thought is post exercise sometimes. My question is how do we know if the higher readings are truly because he is burning his own body fat, or is it bc he is consuming too much fat in the food?

  2. Now there is me, I’ve been keto for several years without break (possibly at most had 40g of carb one day around Christmas, when normal levels are 17g for past few years). Just for fun since he has the testing device I want to test as well. From everything I’ve read since I’m fat adapted (or should be) my ketones should in theory be very low. But how do I know if they’re low because I’m truly fat adapted OR are they low because perhaps there were sneaky carbs in my spices or I consumed too much protein for my body’s needs?

In comparison if I test and they’re normal keto levels (ie 1-2.0 mmol) this mean then I’m consuming too much external fat?

(KM) #2

I’m a bit confused with your question. The whole idea of keto is to use ketones for fuel, which means you will have them in your bloodstream. A high reading is a good reading. Getting fat adapted would likely mean ketones in your breath or urine would decrease, because you wouldn’t be making more ketones than you need. The ones in your blood are going to be burned.

(You've tried everything else; why not try bacon?) #3

It doesn’t matter. The fact that his liver is producing ketones indicates that his insulin is low enough for the diet to work properly. He is metabolising both his dietary fat and his excess stored fat, if any. There is a limit to how much energy can be derived from stored fat, so fat in the diet is essential.

The body has two sources of energy, glucose and fat. When insulin is high we metabolise glucose, when it is low, we metabolise fat in place of glucose. And how high insulin is depends on how much glucose (carbohydrate) we are eating.

You don’t, really. But think about it: First, how much spice could you possibly be using, that it would push you over your carb threshold? It’s more likely that if there are hidden carbs in your diet, they are coming from some processed food that has been reformulated and now contains more carbohydrate than you thought. (This is a good reason to stick with real, whole foods.)

Also, while excessive protein can lower the rate of ketogenesis, it is not the case, as someone once speculated, that extra protein gets automatically turned in to glucose. (For one thing, about half the amino acids we need can only be turned into fats, so that’s a limiting factor, right there.) There are also researchers who believe we have an instinct for getting the amount of protein we need, so overeating protein is not likely unless you are taking a protein supplement (again, a reason to stick with real, whole foods).

And lastly, as we often have to tell people, our level of serum β-hydroxybutyrate is a measure of the gap between production and consumption, and once we are fat-adapted and the muscles are refusing ketones, the liver doesn’t need to make nearly so much. Also, there are three ketone bodies, and we typically measure only one. And which one depends on the existence of a cheap home test: hence, we measure acetoacetate in urine, acetone in breath, and β-hydroxybutyrate in blood, but all three are found in all three locations, and their levels are not in lock-step with one another.

(Diana) #4

But why is it then said that as you’re fat adapted you will have less ketones in your blood as you’ve become efficient at using them and thus your liver is only producing what you need? Thus if you test your blood your results will appear very low.

(Diana) #5

Thank you for the detail. Okay so my friend then is good to go, either way he’s burning some body fat.

As for me, I eat 0 processed foods, my vice is vegetables and I try and weigh them to be sure I’m not exceeding the carbs. I do season heavily, paprika, pepper, cumin etc. completely agree you’d have to eat a bucket full to truly have a spice throw off your carbs, but in my mind it all adds up. But that is less of a worry as protein is. As I lean heavily on protein and perhaps my fat grams are not enough that my body may be looking for energy and thus converting some of the protein? Just curious.

#7

IDK what your body does, of course but protein isn’t really good as energy source and anyway, a little extra protein can’t help much (and very much extra protein isn’t healthy and for most of us, not doable). Eat enough fat.
Do you know your macros?

#8

Realistically don’t even worry about them, they literally don’t matter other than that they’re there in the first place. The number doesn’t correlate to fat loss speed, and there is no way to tell (why) they’re there, only that they are.

With the exception of verifying their existance, they’re a useless metric. The only real case for doing so is people doing Keto as a medical intervention for epilepsy or another medical condition that responds better to having a high ketone levels.

On consuming too much protein, you didn’t. Needing to fear protein is long debunked at this point. Gluconeogenesis is demand driven, not supply. If you actually pulled that off, and it’s hard to do, once you start burning protein off as a fuel source you feel like complete garbage, not something you’d miss. Every have the meat sweats? That’s the feeling!

It’s very easy to overconsume fat though as it adds up twice as fast as protein and carbs.

(Doug) #9

I think this is an important point. The old “excess protein turns into sugar” thing really does not apply on a ketogenic diet; it just does not happen.

“Too much protein” - what is actually going to happen, there? If we’re eating ketogenically, then insulin is relatively low, and glucagon is relatively high, and to generalize at that point it’s “No worries on protein, as long as you’re getting enough.”

Exceptions would be when there is a demonstrable reason why more protein will be a bad thing, and/or why “too much protein” can be a fact in the first place. Something like an immunological food protein allergy - that would really be a thing.

#10

Everyone has an upper protein limit. Most of us just can’t go beyond but some manage it. Protein toxicity is a thing.
And I understand (partially because I have it too but only mildly) that one doesn’t want to consume unnecessarily, wastefully much protein even if they feel okay. I try to avoid that level but I don’t worry much if it happens (it happens all the time so it wouldn’t be hedonistic at all). I never was able to eat enough protein to feel unwell, no matter how seriously I overeat, that was mostly fat. And maybe twice as much protein as I supposed to have (I suspect my need is a bit higher but I definitely need more for satiation so I don’t even try to eat less than what I experienced I work well with) so nothing serious.

(Diana) #11

Something is not making sense to me….sorry. If protein isn’t an issue, I could literally eat loads of protein and like 50g of fat a day and be stuffed. But then my macros would no longer truly fit the mold of keto macros. But I guess that doesn’t matter as you eat fat to satiety….so if the macros are no longer showing >65% fat it doesn’t matter? Ketones would be lower as you’re not bringing in as much external fat but you’re still in ketosis.

#12

The only keto macro is keeping carbs low enough to be in ketosis, percentages are actually a terrible way to go since people only follow them in one direction most of the time, and it leads to a weird macro breakdown vs need for many people. That whole idea of doing % based macros was stolen from the medical version of keto, where it mattered.

(Doug) #13

I would say that it can be a thing. If somebody has certain kidney problems, for example, and the by-products of protein metabolism build up enough in the body to cause problems, then yes. But unless something comparatively rare like that is present, then we’re back to the practical matters at hand - and I agree that most of us just don’t go beyond a meaningful “upper limit” on protein.

I don’t know where the limit would be, but from what I’ve read it looks like somewhere in the range of 2 to 3 grams of protein per day per kg of bodyweight, as an average, might cause problems over the long term. For me, that would be eating like 1 kg to 1.5 kg of meat, every day or averaging that. Pretty substantial; I wonder how many people really average that much or more.

(Diana) #14

Okay so truly then only worry about carb grams and keep to 20 or below and don’t worry about anything else. Eat protein and fat to satiety.

(You've tried everything else; why not try bacon?) #15

That’s the hypothesis recently advanced by Amber O’Hearn.

The problem is that some people need more protein, so finding a proportion of fat and protein that works for everyone is impossible.

What I go by is this: Suppose I cut 300 g of carbohydrate out of my diet when I went keto. That means I need to replace 1200 calories of missing energy. And I can safely do that by eating 133 g of fat. So it isn’t so much about the percentage of fat (whether a percentage of calories or by relative weights of protein and fat), it’s about eating enough fat to get enough energy, however that works out for my total diet.

To be honest, my opinion is that thinking of food in terms of its caloric value is not actually all that helpful. Not to mention the fact that the past sixty years have seen our thinking about nutrition get really messed up. Until Ancel Keys turned up on the scene, researchers and nutritionists used to believe that Americans were the healthiest people on the planet because of the large amount of meat we ate. Looking at the result of our high-carb, low-fat diet recommendations, I’d say that might have been right. We’re certainly not healthier now!

(You've tried everything else; why not try bacon?) #16

For heaven’s sake, Michael! That is absolute buncombe. Ketogenesis and gluconeogenesis are stimulated in the liver by glucagon, which rises as carbohydrate intake drops. Elevated glucagon is accompanied by lowered insulin, and the low ratio of insulin to glucagon is what throws the body into fat-burning mode.

The purpose of these twin processes is to see that the brain continues to be fed in the absence of dietary glucose (there are indications that the brain actually prefers ketones, when it can get them) and that our red blood corpuscles get the glucose they need (since they lack the mitochondria to metabolise fatty acids or ketones). Watch any number of Benjamin Bikman’s lectures, because he explains in detail how glucagon and insulin work with each other, and their joint effect on our metabolism. He even provides links to the data, so you can judge for yourself.

Given that ketones are partially metabolised fatty acids, how would you expect a liver that can’t metabolise any more fat to continue metabolising fat to make ketones? That’s like saying that when you overload your stove with more wood than it can handle, it can make charcoal out of the excess.

And anyway, every cell in the body that contains mitochondria can metabolise fatty acids and ketones, and the skeletal muscles actually prefer fatty acids, so if your liver ever threw up its hands and said, “I can’t deal with all this fat!” all it would have to do is let the muscles use it. The only reason that fatty acids can’t fuel the brain is simply that they are too large to get through the blood-brain barrier, which is one of the reasons the liver makes ketones in the first place.

(You've tried everything else; why not try bacon?) #17

Fat adaptation is a process that occurs in skeletal muscles, as they heal their mitochondria and reactivate several pathways inactivated after years on a high-carbohydrate diet. It has nothing to do with the liver. Muscle cells, once they are well enough, actually prefer metabolising fatty acids over ketone bodies and glucose. This is called, variously, “physiological insulin-resistance” and “adaptative glucose sparing.” Any number of Dr. Phinney’s lectures on YouTube discuss how this works.

I don’t know where you got the idea that the liver metabolises all the fat we eat, but it is simply wrong. On a low-carb diet, the liver makes ketones for cells and organs that need and can use them. It makes glucose, likewise. On a high-carb diet, the pancreas is so busy telling every one to switch to metabolising or storing glucose in order to get it out of the blood stream, that they have to shut down fatty-acid metabolism and help out in the emergency.

Come on, Michael, get it right. If this is a belated April Fool’s joke, it’s not funny.

(You've tried everything else; why not try bacon?) #18

A more accurate way of putting this would read, "The important thing is to eat a sufficiently small amount of carbohydrate to allow your insulin level to drop below 25 μU/mL. Below this level of insulin, the body switches from glucose metabolism to fatty acid metabolism, and the liver begins producing ketone bodies. The actual amount of carbohydrate people can safely eat, and remain in ketosis, is highly individual and depends on the person’s degree of sensitivity or resistance to insulin. The 2 Keto Dudes picked 20 g/day as a limit that is guaranteed to work for almost everyone, except for people who are highly insulin resistant, and who will have to restrict their carbohydrate intake even further."

Your statement may take less effort to type, but it leaves out all of the nuance, which is critical for properly understanding how a ketogenic diet works.

(You've tried everything else; why not try bacon?) #19

The determining factor in a low-carb/ketogenic diet is the carbohydrate restriction, not the fat percentage. The idea is to lower insulin by reducing the glucose burden on the body. All carbohydrates are, except for certain sugars, is glucose molecules linked together in various ways. The fact of noticing circulating ketones tells you that your insulin is low enough for metabolic healing to occur. Fat loss is one of the delightful side effects of said metabolic healing.

Of course, when we cut carbohydrates, the body still needs energy, which, in the absence of carbohydrate is going to be coming from fat. So, yes, if carbohydrates were 65% of your caloric intake, then you’d need 65% of your calories to start coming from dietary fat (less, though, if you have excess stored fat to shed).

So let’s say you used to eat 1600 calories’ worth of carbohydrate. That’s 400 g/day. But you can get1600 calories from only 178 g of fat.

And as far as protein is concerned, the amount of protein you were eating pre-keto is probably not going to need to change once you start keto.

(Robin) #20

My exact belief.

#21

Definitely worry about your carbs, your protein to your needs to maintain or gain muscle at a minimum, and fat to fuel yourself at minimum. The excess beyond that to meet your caloric needs can be however you want them.