I’ve been in and out of Nutritional Ketosis during the past 3 years and both my health and weight have fluctuated. In that time, I’ve purchased a myriad of ketone & blood measuring tools, including a Precision Neo, a Ketonix Breath Analyzer, and a Dexcom G6 Continuous Glucose Monitor. I am currently using all of these devices, in tandem, to help paint a picture of what it actually takes to achieve consistent Nutritional Ketosis. This experiment has taught me that a constant ketogenic state is much more challenging to accomplish than I first realized.
Based on the work by Stephen Phinney and Jeff Volek, nutritional ketosis is achieved by eating a high- fat, moderate protein, and very low carbohydrate diet. A person is considered to be in this state when they measure between 0.5 and 3.0 mmol/L of Beta-hydroxybutyrate (BHB) in their blood. This can be measured directly by using the Precision Neo, which tests blood levels through a pinprick to the finger. You can increase BHB in your blood, by adjusting the levers of dietary, caloric, and time restrictions.
When I first started eating a ketogenic diet I was very strict, using my breathalyzer multiple times in 24 hours, eating once a day, exercising often, and consuming moderate protein levels. This method yielded great results– I was back down to the weight I had once been in high school! I was tracking everything. The only vegetables I was eating consisted of basic fibrous salads with olive oil and vinegar. I limited alcohol, chocolate, and nuts and was consuming under 20 grams of carbs a day. I was extremely lean. (Almost too lean). I found it easy to fast, given the amount of fat I was consuming. This all changed when I decided to put on lean body mass and gain muscle.
Once I decided to put more of an emphasis on training at the gym to garner lean muscle and fill out my frame, I adjusted my macros to become more protein-heavy. I even went so far as to limit my fat intake, increase my protein, and continue eating a low carb diet. At 155 pounds, I was eating close to 200g of protein per day, 50g of fat, and 50g of carbohydrates. Based on some of the work by Ted Naiman and other protein advocates, I was also inspired to give a “Protein Sparing Modified Fast” a try. Basically, I was eating nothing but chicken breasts all day.
When you eat that much protein and nothing else for a week, you lose fat and don’t feel very well. Protein is not a macronutrient you can use directly for energy, so instead, you use your own body fat. This is especially true when your body is at a calorie deficit. The problem is, if you’re already lean, you only have so much body fat that can be utilized for energy, and your rate of usage is not as high as someone who is obese or overweight. Most bodybuilders that cut weight for competition have low energy and feel like garbage in the lead up to the event because of this.
When you consume high levels of protein and not much else, your body needs to release insulin to shuttle the amino acids into your cells. To avoid causing your blood sugars crashing, your body releases glucagon, which increases your blood sugars. Increased levels of blood sugars = increased level of insulin = decreased level of ketone generation by the liver. You end up in a no-mans land from an energy perspective, especially if you’re insulin resistant. You neither have enough glucose, fatty acids, OR ketones to run your metabolism. This is why people do not (or rather, SHOULD not) live on a Protein Sparing Modified Fast and only use it temporarily to cut weight.
While I was doing my high protein, low carb, low-fat experiment, there were definitely points during the day when I was generating ketones. As an individual with some level of metabolic syndrome, my body, however still finds it difficult to run off of a glucose-based metabolism. Meaning? A three-beer night out with the boys can completely throw me out of ketosis. Metabolic syndrome is multi-factorial. As I have already significantly decreased my visceral fat and liver fat, the research I have done now points to this being mainly due to the insulin resistance of my skeletal muscle tissue. These findings led me back to my original strict ketogenic diet.
With a “Strict” Ketogenic Diet (under 20g of TOTAL carbs a day), I feel my best. I’m just as lean as I was when I was doing my protein-sparing modified fast and have significantly more energy – this means I have more vitality to train at the gym. The only way I’m going to increase my insulin sensitivity, and carbohydrate tolerance at this point is to gain lean body mass and retrain my mitochondria. Translation? I need to focus more on weight training and “Zone 2” cardio.
I hate cardio. I’ve always hated cardio. I believe for fat loss– nutrition and diet are significantly more critical than exercise. Although, at Zone 2 (cardio training at 60 – 70% of your maximum heart-rate) Type 1 muscle fibers will activate, which stimulates mitochondrial growth, increases their function and improves their ability to utilize fat. Ultimately metabolic syndrome is a disease of the mitochondria and their ability to function optimally. So… let’s see what happens when I put them on a work out regiment.