Question about Keto, blood sugar and fasting

(Nicole Roper) #1

Confession: I am not the best ketoer. I probably do not get enough fat and many days I get more than 20 g of Net carbs.

Question: For many years now, I do not eat high carb foods on a regular basis. Maybe once per week, I will break down and each something that is higher carb. But generally speaking my diet consist of low carb foods. If I go over my 20 grams it is due to veggies.

I have been taking my blood sugar regular. I run between the Fasting blood sugar is 95-100+ range. My glucose runs this high even when doing intermittent fasting.
I have not graduated to long term fasting. I am just not mentally ready for that.
I wouldn’t be concerned if my blood sugar ran that high and I was a carb eater, but it concerns me that it is that high and I don’t eat many carbs.

I do have an appointment with an endro next month.

Of course, the real problem is I can’t lose weight.

(Bacon by any other name would taste just as great.) #2

Welcome to the forums!

The key to ketogenic eating is to limit carbohydrate intake. This helps reduce your insulin level, because you are not burdening your body with high levels of serum glucose. In the absence of a high carbohydrate intake, the body typically maintains around 4-5 grams of glucose in the blood serum to meet the needs of various cells. The serum glucose range you mention is perfectly fine. You seem to be doing well.

What your actual carbohydrate threshold is will depend on how insulin-resistant you happen to be. If you are very insulin-sensitive, you should be fine eating quite a lot of carbohydrate; if you are very insulin-resistant, you will probably need to eat almost no carbohydrate to have a healthy insulin level. We recommend an upper limit of 20 g/day, because that is a level at which everyone who is not extremely insulin-resistant can get into nutritional ketosis. So that is a good place to start. Once you are fat-adapted, you can experiment from there.

As far as losing weight is concerned, the questions are what your current weight is and what your goal is. I am presuming that when you use the word “weight,” you actually mean fat weight, not muscle weight. Losing fat is generally a good thing, losing muscle mass (or bone density) is not. The number on the scale is not always a useful indicator of progress on a ketogenic diet, because many people respond by adding muscle mass and bone density as they lose fat mass, and this confuses the scale. This is why we also suggest tracking your body dimensions (the fit of your clothing can be a rough guide) as well as weight. If your scale number doesn’t change, but your clothing starts to hang more loosely on you, that is a sign that keto is working for you.

Bear in mind that the stories of people who lost large amounts of fat in a very short time all concern people who had large amounts of excess fat to lose. As we get closer to a healthy body composition, fat loss slows. Losing the last ten pounds of excess fat can take longer than losing the first hundred pounds. This is normal.

(Susie) #3

Hello I found this topic interesting as I’m type 1 diabetic and just done a nearly 21 hour fast and my blood sugars are still within the normal range and my ketone is 0.6. I’m getting a little confused as the scales aren’t moving and this is the 3rd week and 2nd day of extreme fasting.
Seems we are all at this stage and it’s hard to see what’s happening under the skin to see any change. Possibly because I have long term insulin laboring around I’m now a little insulin resistant. I’ve stopped the 3 quick acting insulin doses too, as I just don’t need them any more.

(Nicole Roper) #4

Thank you for your reply. I know it is really hard to answer because I didn’t give me history.

I have been eating what I would call low carb for several years. Generally speaking, I do not eat anything white (rice, bread, pasta, potatoes, etc) Really don’t eat any types higher carb foods. Most veggies are low glycemic veggies. Sometimes I will eat eggplant and veggies that have a higher carb content. The problem I have with Keto is staying under 20 g of carbs due to veggies and ensure that I take in enough fat.

I try to do 16/8 intermittent fasting( not always).
I understand that my blood glucose is not in the high range (diabetes). I have read that optimal glucose ranges should be between 70-85. I would expect this considering I am doing low carb and intermittent fasting.

In addition, I am not losing any weight. Matter fact, if I am not doing intermittent fasting, I will gain weight. I am obese. But I am very active. I work behind a desk so I am not really moving around a lot during the day. But I get up and walk around every hour, I do exercise bans while on phone calls and I do at least an hour of structured exercise daily.

I feel like I am doing all the right things and I see no progress in my weight.

(Nicole Roper) #5

I fear that if I ate a normal diet, I would be a full blown diabetic.

(Susie) #6

Yes same here with my lack of losing weight. This is the second time of trying Keto for me. Its suits me health wise but my initial aim is to also lost weight?? I’m not sure why I’m not as I follow macros. In fact strict keto, so surely my weight should now be shifting. I will stick it out and see what happens over time.

(Bacon by any other name would taste just as great.) #7

Fat is not a magic food in a ketogenic diet, it is merely the macronutrient that stimulates the smallest secretion of insulin, the primary fat storage hormone. Chronically elevated insulin, typically resulting from a high-carbohydrate diet, has a number of deleterious effects on the human body, as well as stimulating the storage of excess quantities of fat in adipose tissue. It therefore prevents stored fat from leaving the adipose tissue, which is not what we want if we have a lot of excess stored fat to shed. The effect on insulin is highest from eating carbohydrate. Protein has about half the effect, but if eaten in the absence of carbohydrate it also stimulates a compensatory release of glucagon, which helps keep us in nutritional ketosis. Fat has very little effect on insulin—just enough to keep us alive—which therefore makes it the best source of calories to replace the calories no longer being consumed in the form of carbohydrate.

So to lower insulin, we recommend a maximum carbohydrate intake of 20 g/day. Protein is essential to the diet, so we recommend a reasonable amount, between 1.0 and 1.5 g/day per kilogram of lean body mass. There is no target for fat consumption, we simply recommend eating enough fat to satisfy hunger. Most people eating this way find that without the inhibitory effect of excessive insulin, their hunger and satiety hormones start working properly again, and appetite becomes a reliable guide to how much food to eat. The actual amount of calories consumed can be safely controlled by eating to satiety.

The first thing to check is your carbohydrate consumption. Our fat tissue cannot release fat to be metabolised unless insulin drops below a certain level, which varies by individual. Some people who are more highly insulin-resistant than usual might have to eat even less carbohydrate than 20 g/day in order to get their insulin to drop. Another obstacle to losing excess fat is failing to eat enough food. In conditions of restricted calories, the body responds as to a famine, dropping the basal metabolic rate, and cutting back on non-essential processes such as hair and nail growth, in order to get us through the famine. So paradoxically, we recommend eating food in quantity in order to lose weight. If we get enough protein and fat, and keep our carbohydrate intake low enough, we will automatically find ourselves eating at a level that allows the body to metabolise both the food we eat and some of our excess stored fat. In the context of limited carbohydrate intake, the quantity of calories consumed is not as important as the body’s hormonal response to the types of food eaten. We are not what we eat, but are rather what our body does with what we eat.


No rule saying you have to get a specific amount of fat in, ketosis if from low carbs, not high fat.

Wouldn’t worry about it.

Up to 100 is considered normal, many charts are now using 115, I’d be more concerned with A1C than a snapshot reading at any one time.

Nothing to graduate to, 100% optional and not for many people.

Are you tracking what you’re eating? Are you exercising/working out? Physically active otherwise?

(John Drewett) #9

Hi Paul ,

Regarding Protein , may I inquire if using ISO Whey with one carb per 27 grams of protein is problematic , I bought a big bucket of it and now I read to avoid from the Fung people , do you have an opinion or information if it is ok to use this , it is an easy way to add protein is the thing . I had a Dexa Scan and I’m 35% fat and weigh 253 lbs . That is about 157lbs of lean tissue , well they didn’t tell me that but I tried to figure it out using the 35% , but I’m getting something like 196 grams of protein and so that is a lot of protein to eat, I’m John thanks in advance , I enjoy and learn from your post

(Bacon by any other name would taste just as great.) #10

Sorry I missed the post when you posted it. If you weigh 253 lbs. and are 35% fat, then 253 × 65% is 164.45 lbs. or 74.75 kg. So the range of protein we recommend would work out, for you, to 74.75-112.125 g, which would mean eating 299-448.5 kg (10.5-16 oz.) of meat. So the quantity you mention in your post is well within the recommended range.

If you are trying to build muscle, you could conceivably go as high as 2.0 g/kg, which would mean 149.5 g of protein, or 598 g (21 oz.) of meat.