How to maintain optimal ketosis? Learnings from my blood ketone levels chart?

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When I started ketogenic diet, I wanted to be sure to gain maximum benefits from this diet. So I started testing my blood ketones. Sounds like a chemistry term, right? Let us first find out what ketones really are.

What is ketones in blood test?

You must be wondering where do ketones come from?

They are are fuel source coming from fatty acids. These are by products of fat metabolism.

Ketones are produced from fat when we have limited energy from glucose or glycogen.

Lipase (an enzyme) break down fatty acids into beta-hydroxy butyrate (BHB). This molecule of BHB is popularly known as ketones. They are found in human blood and our body uses them as a fuel source. More details about fat metabolism can be found here.

How to check ketone levels at home?

Have you just started keto diet and still wondering whether my body is in ketosis or not (what is ketosis)? Not to worry, there are multiple ways to find that out. First, you may have some symptoms. At the same time, your blood ketone levels will go up. Symptoms can vary greatly from person to person. So, let us not focus on symptoms and try to work with real ketone data.

I mentioned in my previous post that blood ketone levels can be measured using three methods 1. keto sticks or keto stripes (measures the amount of acetoacetate) 2. ketone breathe meter (measures volatile ketones) and 3. blood ketone meter (measure beta-hydroxybutyrate).

Blood ketone meter is the best way to accurately know if your body is breaking down fat into ketones.

Lets get started with some background on this before we jump to the collecting and analyzing the data. At the end of this article, i will answer some of the frequently asked questions.

Background

I failed miserably in my first 100k road race. Therefore, i decided to change my diet. I had heard a lot about ketogenic diet or High Fat Low Carb diet in past. But never had courage to control what i love to eat. The failure sometimes is necessary in life. Thanks to my poor performance in that race, i made a decision to change. So, i decided to give keto diet a try.

A number of ultra-runners have benefited from ketogenic lifestyle. Since Anthony Kunkel (my coach now) won the race and I found out that he is also a big fan of low carb diet. It did not take me long to jump into keto pool. I precisely started on May 23, 2018 with firm determination to stay on course. This was mainly because of these two reasons

  • Test ketogenic diet to see if this has any impact on my athletic performance.
  • I wanted to lose weight that would eventually help me run faster.
  • To answer some of the questions like
  1. How does one feel in the first week on the ketogenic diet?
  2. Is High Fat Low Carb (HFLC) diet sustainable?
  3. Did ketosis affect endurance performance?
  4. Can one loose weight on the high fat low carb diet?
  5. Is it ok to cheat on ketogenic diet?

The ketone experiments

So, i decided to work on my diet and ketosis data using blood ketone meter. I have compiled my data here along with the food and drinks consumed as a part of this diet. This data was collected for around 50 days. Since, I used up all the test stripe when i began, there is some gap in the experiment. I am a tea addict and usually take tea (with milk) in early mornings. Beginners on ketogenic diet must avoid milk because it contains lactose. Lactose is a type of sugar that needs to be avoided if you want to kick start ketosis. I got away with this because of my regular physical activity. However, if you keep your daily carbs within a specified range (30-50g net carb). You should be ok.


What level of ketones indicates ketosis and what is optimal ketone level?

Dr. Volek and Dr. Phinney are pioneer in the field of high fat low carb diet. They have published some outstanding research papers on the benefit of keto lifestyle. They found out that optimal ketone level in human blood is 1.5mmol-3 mmol. One can benefit greatly if they maintain this level of ketones in blood. Here is an image that shows the range. This is the normal blood ketone levels for weight loss. I have explained all three types of ketosis here.

Graph taken from the book of Dr. Volek and Dr. Phinney’s book, “The art and science of low carb”

Let now focus on the blood ketone data obtained in 5 days at the end of May, 2018. Here is the summary

  • May 23, 2018: At 5 pm: 2.4 mmol

Post dinner: 1.1 mmol (What i ate)

  • May 24: Morning after 6 mile run: 1.1 mmol

At 5 pm:1.8 mmol (What i ate)

  • May 25: Morning after 16 mile run: 1.0 mmol

At 5 pm:1.7 mmol (What i ate)

May 26: Fasting (no chai) after 12 mile run: 0.8 mmol

Before lunch: 1.3 mmol

At 5 pm: 2.8 mmol (What i ate)

May 27: Fasting after 12 mile run: Did not check

At 5 pm: 2.8 mmol (What i ate)

Key take away from blood ketone data (May 23-May 27):

  • No matter how much exercise you do, ketone level in the morning time is low (ranging from 0.8-1.1 mmol). Even fasting ketone levels were found to be less than 1 mmol
    why are my blood ketones low in the morning? I dont know but i am recently reading more about this. One of reason might be that glycogen is preferred source of energy and body will tap that first and then switch to fat as a fuel source. Since it was just a beginning, i should not expect any fat adaption immediately? But it should improve over time.
  • Blood ketone level is the highest around 4-5 pm and drops again in the night. This data match very well with Mark’s data, read his wonderful article on the Ketosis here.

Round 2 of ketone experiment:

I used my all ketone test stripes in the first 5 days and did not bother to buy a new set till mid June, 2018. I found it very expensive and so hold on to that till June 20. Then, i ordered a set of 50 test stripes. I decided to use that twice initially and once a day later in the experiment. Here is June-July blood ketone chart.

Summary of blood ketones level data

As you can see in the bar graph my blood ketone level was towards lower end in the morning time (even till noon). This effect is very normal and usually referred as “Dawn Phenomena“. Between 4am-8m the release of some hormones such as adrenaline and cortisol promote release of glucose in blood. This eventually lower the amount of fat that needs to be used as fuel.

It reaches a maximum around 4-6pm. Another thing that we observed in this chart is that my ketone level was more than 2mmol around the peak time. Except few days, i mostly stayed in the optimal ketone range. This is shown by shaded area (indicated by an arrow) in the chart. Now, we have some solid data at place. Here, I will be answering some of the basic questions that readers may be have.

How to maintain optimal ketosis and how often should you check ketones?

According to my data, i was in ketosis on almost all days. A few days, i was on the light ketosis when my ketone level was less than 1. That level was still very good. Any level between 0.5-1 mmol is considered light ketosis and this is certainly not low ketone level. Just by limiting the carb intake, i was able to maintain the optimum level of blood ketones.

Since test stripes are expensive, once you know which food items work for you. You may check it may be once a week.

How did I feel in the first week on the ketogenic diet?

The very first week was difficult. I got keto flu. I had body ache for the first two days. The keto flu went away in couple of days. I felt great within 7 days. One of thing that i am very pleased about is that my energy level stayed constant. There was no more sugar spikes or crash when i used to be on a high carb diet. For example, i used to run during lunch time and even after 4-5 miles, i felt tired and sleepy. After switching to high fat low carb diet, i never experienced that tiredness after a run.

Is High Fat Low Carb (HFLC) diet sustainable?

Let me be very honest, it is certainly sustainable with some tweaks. This means that we all love carbs because they taste good. Living without them is sometimes challenging. So, i increased my carb intake during my peak training session. However, i kept it below 100g per day. This will not apply to someone who does not engage himself/herself in physical activities.

Since I was running mileage in excess of 70 miles/week, i found 100g carbs/day very reasonable.

Did ketosis affect endurance performance?

The answer to this question is yes. I have mentioned this at my homepage too. I ran 100 kilometer race in the first week of April, 2018 in 9 hours 22 minutes. Then i switched to high fat low carb diet in may. I ran 100 kilometers again in the first week of September in 8 hours and 27 minutes. That was a PR by an hour. I felt just wonderful in that race. I am pretty sure along with my high mileage training ketogenic diet played a huge role. There some research that shows that fat oxidation (energy production by burning fat) in endurance athletes on ketogenic diet is higher than the athletes who are on normal high carb diet (2)

Did I loose weight on the high fat low carb diet?

Yes, i lost 20 pounds (10kg) and thanks to this diet i still maintain my weight around 155 lbs (70kg). There is still chance to lose some more weight but my friends are already calling me skinny. The ketogenic diet will do wonders if you stay on course atleast for a month. Like in any other activity, consistency is the key. Stay consist even if you ate something high in carb on the 3rd or 4th day. That is totally ok, bounce back cut the carb again.

Is it ok to cheat on ketogenic diet?

Since it has already been a year on the keto diet, i do cheat once every two weeks. Sometimes, i do cheat very badly and it is not recommended for beginners. Last time, i ate 2 naans 4 muffins, tons of crackers, candies and everything else that was pure high carb. But that was only one day in several weeks. If you are beginner on keto diet, i recommend to cheat once every two weeks and bounce back the very next day. This way you wont feel the burden of giving up everything. Important point here is that even if you cheat some days, it is ok. Next day, come back to keto diet again and within a month you will see significant improvement.

Key take away from the experiments

If you believe in data more than you do in symptoms, i think tracking blood ketone levels is the best way to go. Here are some key take away from my experimental data.

  • Food and exercise affects the level of blood ketones
  • Since glucose is the preferred source of energy, your ketone level may fall after any type of physical activity.
  • Ketone level will also fall after meals even when you are consuming low carb diet. Even low carb and moderate protein will provide instant energy.
  • It is after 2-3 hours of meal or physical activity when you can expect a rise in your ketone level. At that point your body is using fat as a fuel source and conserving the glycogen level.
  • Blood ketone level was found to be maximum around 4-6 pm. This can be explained because body has used all the little carb that you consumed during lunch time. It is now tapping into fat as a fuel source.

I still plan to do some more keto tests

In future, i plan to do some more tests that will answer some of the following questions.

  • What is the effect of tea/coffee on the blood ketone level?
  • How many miles I need to run in the morning before i see a rise in ketone bodies even before the peak time of 4-6pm?
  • What other high fat foods affect the level of ketones?
  • How does fasting along with intense exercise change the usage of fat for energ?.
  • What is the effect of exogenous ketones (ketone supplements) on the blood ketone levels?
  • What is the effect of MCT oil on the blood ketone levels?
  • Can we replace MCT oil with coconut oil and get similar benefits?

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6 comments on “How to maintain optimal ketosis? Learnings from my blood ketone levels chart?

  1. Manoj Bhat

    Good follow up article… will look forward for the other results

  2. Thanks for reading the article, Manoj

  3. Nice work!

  4. Malik Sahab!!!
    Superb…

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