Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet (23 page)

– Nora Gedgaudas

Remember, for the overwhelming majority of you who are reading this book, NK carries no known risks—it’s not the same thing as diabetic ketoacidosis. If you are truly concerned about an elevated blood ketone reading, then the best thing you can do is to test your blood sugar at the same time. If that reading is below 240 mg/dl, then you’re just fine. What you’ll probably see is that your blood sugar drops significantly (a very good thing!) when blood ketones rise. For example, it is not uncommon for me to see a blood sugar reading in the 60s and blood ketones in excess of 2.0 millimolar when I test in the morning, and I feel perfectly fine. This is just one of the many benefits that come from being in nutritional ketosis.

During my yearlong testing of NK, I was looking for quantifiable changes in body weight, blood sugar levels, and blood ketone levels. Additionally, I wanted to keep an eye on how I was feeling, my sleeping patterns, what my energy levels were like during exercise, and anything else that was happening to my body while in a state of ketosis. If changes were happening, then I was taking notice. And boy, did the changes happen!

I encourage my patients to follow Jimmy Moore’s example and do their own n=1 experiment. If eating in a certain way leads to health problems, then stop doing it! But if changing your diet leads to an improvement in your metabolic health and brain function, then you are on the right track. People vary somewhat in their response to any given type of diet, so you need to experiment to see what works best for you.

– Dr. Bill Wilson

I officially began my experiment on May 15, 2012, when I measured my blood ketones for the very first time. As someone who’d been eating a low-carb, high-fat diet for over eight years, I was utterly shocked by the results: 0.3 millimolar! According to Volek and Phinney, to get the benefits of being in a state of NK, ketones need to measure between 0.5 and 3.0 millimolar. I wasn’t even close to being in ketosis. I realized I had stumbled across something fascinating that could help not only me but potentially many other would-be low-carb dieters who experience frustratingly lackluster results:
Just because you’re eating low-carb doesn’t mean you’re ketogenic.

Because I was already eating a low-carb, high-fat diet, it didn’t take me long to enter into a state of NK once I slightly adjusted my intake of carbs, lowered my intake of protein considerably, and increased the amount of fat, especially saturated fat, in my diet. I was seeing blood ketones over 0.5 millimolar within four days, well over 1.0 millimolar by the end of one week, and as high as 5.0 millimolar within two weeks. It can take from two to six weeks to make the switch from being a sugar-burner to a fat-burner, so be patient with yourself during this transition period. Chapter 14 has some invaluable tips and strategies for improving ketone production if you are struggling.

The physiological acclimatization to a carbohydrate-restricted ketogenic diet, known as
keto-adaptation,
is not instantaneous, and this has led to a misunderstanding that it’s not a normal state.

– Dr. Bill Lagakos

For me, it worked to start with a diet with that was 85 percent fat, 12 percent protein, and 3 percent carbohydrate. Over time that shifted closer to 80 percent fat, 15 percent protein, and 5 percent carbohydrate, which I still eat to this day. I didn’t obsess about it being absolutely precise down to the percentage, but when I ran the numbers that’s where I ended up. Of course, choosing the best-quality whole foods will maximize the benefits of ketosis on your health. Please note that I did not count calories doing this, but my intake was probably close to 2300 to 2500 calories per day. When you nourish your body well and get into ketosis, the calories take care of themselves. More on that in a moment.

Remember, this is not necessarily what
you
need to do in order to produce ketones. I realize people like to follow precise percentages, macronutrient equations, and lists of foods to eat, but ketosis doesn’t work that way. You need to figure that out on your own by using the diet guidelines we shared in chapters 5 to 7. My wife, Christine, was so impressed by my results that she decided to try a ketogenic diet for four weeks herself, and she got into ketosis with a fat/protein/carbohydrate ratio of 57/29/14 and about 1500 calories a day—her average morning blood ketone level was 0.7 millimolar and average nighttime blood ketone level was 1.8 millimolar.

Any condition in which there is decreased glucose uptake in the brain or nerves, or mitochondrial dysfunction, could possibly respond to a ketogenic diet. My feeling is, what do you have to lose by trying this strategy?

– Dr. Mary Newport

So what kind of results did I see in NK? One interesting thing that I noticed right away was my hunger simply dissipated. Zapped. Poof . . . gone! There are some powerful prescription drugs out there that people pay good money for to curb their appetite. And yet ketosis did the exact same thing naturally, allowing me to spontaneously begin fasting for twelve, sixteen, even twenty-four hours at a time. I know it probably sounds absolutely crazy to think you could go that long without eating, but your body is designed to feast on ketones and stored body fat during fasts. We’ll expand more on the subject of fasting in chapter 11, but for now, know that one of the biggest benefits you’ll receive from ketosis is hunger control like you’ve never experienced before.

My blood sugar levels, which began in the upper 90s and low 100s at the start of the experiment, dropped down into the upper 70s and low 80s within just a few months. Although I took a blood sugar–stabilizing supplement called Glycosolve, I eventually stopped taking it when my blood sugar remained in the healthy range through ketosis alone. In fact, I tested my blood sugar levels hourly for a week just to see what happened to it after meals. What I discovered was that ketosis helped me maintain a pretty tight rein on blood sugar, keeping it within a twenty- to thirty-point range. There are no huge spikes in blood sugar when you are producing ketones through nutrition.

In my opinion, controlling both the quality and quantity of carbohydrate foods allows for a more normal insulin and blood sugar response and fluctuations in these values. This is what we saw in clinical practice at the Atkins Center. Since a disturbed insulin and blood sugar response has a negative impact on every cell in the body, maintaining normal function of this metabolic system is vital to long-term health.

– Jackie Eberstein

When I tested my HgA1c level (a key marker in blood sugar regulation that shows the average blood glucose over the previous three months) at the beginning of this experiment, it registered at 5.4. That’s not horrible, but it could definitely have been better. When I retested after six months in nutritional ketosis, it had dropped to 4.7, or an average daily blood sugar reading of 88 mg/dl.

My heart health indicators changed as well: HDL cholesterol went up, triglycerides went down, LDL particles shifted to more of the healthier large, fluffy kind, my C-reactive protein (a key inflammatory marker) fell into the optimal range, and a CT scan of my heart revealed zero calcium plaque build-up in my coronary arteries. Remember, all these positive changes happened while eating a diet composed of more than 80 percent fat, mostly saturated fat. Although my LDL and total cholesterol levels remained elevated, as they had been before ketosis (indicating an increased risk factor for heart disease according to conventional medical standards), every other relevant marker on my cholesterol panel improved dramatically. More important, the CT scan found no sign of actual disease taking place in my arteries.

As a cardiologist, I often view life from the perspective of heart health since heart disease is the number-one cause of death in Americans. Achieving ketosis leads to dramatic improvements in lipoproteins, even in crude cholesterol values. Many doctors rely too much on LDL-C, which is calculated—yes, calculated, not measured directly. It’s based on an outdated equation developed in the 1960s that makes crude assumptions about diet composition, not factoring in such things as carbohydrate reduction. Genuine risk is much more accurately revealed via advanced lipoprotein testing, which readily identifies carbohydrates as the culprit in creating the most common causes of heart disease, including excess small, oxidation-prone LDL particles, and exaggerations in postprandial lipoproteins. Fat makes little to no change in lipoproteins.

– Dr. William Davis

One of the more curious results of my n=1 NK experiment was its effect on my exercise performance. We haven’t discussed the relationship between ketones and exercise much yet, but there are tremendous benefits in this realm. I held off on doing any intensive exercise program for the first few months of my experiment because I wanted to make sure I was fully keto-adapted first. I noticed that my energy began to increase within the first couple of months of the experiment, so that gave me a sneak peek at how I would do in the gym once the ketones were my primary fuel. But I was still skeptical, since all my other attempts at high-intensity training had led to bad bouts with hypoglycemia (in other words, significant drops in blood sugar).