I’ve just wrapped up the fifth month in my current n=1 testing of the concept known as “nutritional ketosis” and the interest in this has not waned a bit. In fact, many of my readers have even decided to take the plunge for themselves and started testing their blood ketones to see where they stand, too. I think a lot of people are just as shocked as I was (with a .3 mmol/L reading the first time I tested) because they thought they were doing everything right on their high-fat, low-carb nutritional plan. But perhaps they’ve fallen prey to some of the most common low-carb mistakes that seek to sabotage your efforts at attaining the optimal weight and health you so desperately desire. I sure did and now I’m correcting those thanks to the information I’ve obtained from this handy dandy little ketone meter.
It’s not cheap to test your blood ketones on a daily basis (or TWICE daily as I have been), but the data you obtain about yourself is so invaluable. Even if you only test your blood once or twice a week, you’ll know more about how well you are doing on your healthy low-carb lifestyle from ascertaining the level of beta-hydroxybutyrate in millimolars than most of your fellow low-carbers. This is some pretty cool cutting-edge technology that’s available to us nowadays and it is opening the eyes of a lot of people right now. Knowledge is power and there are a lot more empowered people in the low-carb community these days. You don’t have to test necessarily to reach a state of nutritional ketosis. But it’s always good to know exactly where you stand so you can make appropriate changes to see the desired results.
I recently shared an evaluation of the differences between the two major blood ketone meters — Precision Xtra and NovaMax Plus — so you can decide which one is best for you if blood ketone testing is something you’d like to do. I’ve been pricking my fingers every single day now since May (it’s not as bad as you would think) and I have been sharing regular updates every 30 days on what’s happening with blood ketone levels, blood sugar levels and my weight. In case you missed them, you can read all of my previous updates here: Day 1-30, Day 31-60, Day 61-90 and Day 91-120. And if you haven’t yet picked up a copy of Dr. Jeff Volek and Dr. Stephen Phinney’s 2012 book release called The Art and Science of Low Carbohydrate Performance where they put forth the idea of testing your blood ketones to be in an optimal level of ketosis for proper fat-burning to happen, then you should get it immediately if you want to learn more about how to do it, find outstanding recipes and nutrition guidelines and more. There’s so much great information in that 172-page book that will educate and inspire you anew on your commitment to livin’ la vida low-carb.
For the first four months of my n=1 experiment of nutritional ketosis, I decided to back off on my exercise routine just a bit to let my nutrition be the primary factor in what level of blood ketones I would be producing. It’s not like I was a total slob and never did any movement at all. But I made myself NOT go to the gym (which was hard) for the first few months until I had become fully keto-adapted with regular blood ketone readings averaging 2.0 mmol/L or greater. It’s at this level of blood ketones that I have felt the best with incredible appetite and craving control, mental clarity like never before, boundless energy and so many benefits that I’ve already expressed in previous updates. But the Volek/Phinney book is about exercise Performance, so it was time to put that to the test in Day 121-150. I realized ahead of time that this was probably going to put a damper on the weight loss I’ve been seeing in the first four months. But I didn’t care because that number on the scale doesn’t tell the whole story. More on this in a moment.
Before I share how I did working out in a keto-adapted state these past 30 days, let me give you a brief history about how it used to be for me with exercise. Back in 2008, I participated in and documented on video a week-long summer fitness event created by former “Biggest Loser” contestant and friend Isabeau Miller called FitCamp. This simulated the kind of intense workout regimen that Isabeau and her fellow contestants from Season 4 of “The Biggest Loser” experienced as part of the Black Team led by trainer Jillian Michaels. I had been working out pretty hard at that point just a couple of years removed from my 180-pound weight loss on the Atkins diet. But little did I know what was in store for me through this experience. The first day of high-intensity training led to dizziness, blackouts, fatigue, hunger, body aches and nausea despite eating a solid low-carb meal before arriving at the gym. It wasn’t a pretty picture! Isabeau and the trainers encouraged me to eat some carbohydrates before a workout like a high-sugar fruit. And so I did. Yes, it helped in the short term with a lot of these symptoms but that was because I was still a sugar-burner despite eating what I thought was a good low-carb diet for several years at that point.
Fast forward to the past year or so. I had read posts from highly-respected people in the Paleo/primal/low-carb community like Mark Sisson, Brad Pilon and others who claimed there was an added benefit to engaging in exercise while in a fasted state and that it’s the most incredible feeling in the world producing superior fat loss and muscle recovery results. Ummmm, try telling that to someone who suddenly becomes hypoglycemic at the mere thought of working out without eating anything! And as of earlier this year, I was STILL experiencing this kind of poor performance at the gym whenever I’ve attempted to do it after even an overnight fast of less than 12 hours. And don’t even ask me about how well my recovery after workouts went–sometimes upwards of 7-10 days between workouts because I was still so sore. Needless to say, I was quite skittish about mixing the words “fasting” and “exercise” together in the same sentence ever again.
But what about what Volek/Phinney wrote about in their Performance book? They claim that once you are in nutritional ketosis and are fully keto-adapted burning ketone bodies instead of glucose (sugar) for energy, you tap into a virtually unlimited (40,000+ calories) energy source (body fat) compared to those who limit their energy calories to a glycogen tank of only around 2,000 calories as a sugar-burner. This even applies to very lean athletes with 10% body fat as well as the rest of us who have even more stored body fat just waiting to be tapped into. While much of Dr. Phinney’s research has been on endurance athletes in a carbohydrate-restricted state, keto-adaptation extends to virtually any form of exercise that needs to be fueled. As someone who has grown to love weight lifting (yes, I said LOVE it!) over the past year and a half, I decided to put this keto-adapted thing to the test for myself (GULP!) to see how I’d do. What I experienced in those eight weight-lifting sessions at the gym over the past month was nothing short of miraculous!
I committed to doing 30-minute sessions lifting very heavy weights which have traditionally had me seeing stars within minutes of my time at the gym even after eating a solid low-carb meal. And, I’ll be honest: I was completely skeptical that being in a strong level of nutritional ketosis was going to make a difference in the negative side effects I had grown accustomed to seeing when lifting weights or engaging in physical activity. But to add one more element to these workouts and putting the keto-adaptation to the ultimate test, every visit to the gym was done in a fasted state of at least 18 and as much as 24 hours since my last meal. AM I CRAZY?! Yes, but with a purpose in mind I had to do this to see what’s going on with my body now that blood ketones are where they need to be for me.
Here’s what happened:
You might think these benefits I’m seeing make me an outlier and not what happens for most people. But as you’ll see in the testimonial from one of my readers below, I’m not the only one seeing great results in the gym on nutritional ketosis. See what his experience has been like exercising in a proper level of ketosis at the gym:
I’ve found that if my ketone levels are below 1.1 mmol/L it is impossible to get quality training in. Once my blood ketones rise above 1.5 mmol/L, I don’t notice a difference between a carb-loaded workout and ketosis workout. Therefore I have determined that carbs are not necessary for even the most intensive training as long as ketone levels are sufficiently high. This is confirmed by the chart in the Performance book. I only eat 30g total carbohydrates per day and can maintain my training schedule.
I could probably go on and on about how utterly amazing I feel engaging in resistance training in a keto-adapted state. But suffice it to say I was floored by how my body performed now that my blood ketones are where they need to be for me to tap into my fat stores for fuel. I wish I could let everyone have a taste of what this feels like because I don’t think I’ll ever go back to being a sugar-burner again. The muscle gains I’ve seen just in one month of heavy lifting while in nutritional ketosis are motivating me to keep this going for a very long time. I can’t wait to see how much stronger I’ll be over the next few months.
I turn 41 in December and have never felt so healthy, strong and full of life as I do right now. And I know that will only continue to get better and better as I keep doing this in the months and years to come. While this started out as a simple n=1 experiment of a concept, it’s obviously become much more than that for me. I am excited to see this thing play out in the months to come, so I will be continuing to provide updates every 30 days for the time being on my progress with nutritional ketosis. This is one of the most exciting breakthroughs in low-carb living that has happened in a very long time and I’ll keep sharing everything I’m learning with you as it happens.
So let’s examine my daily numbers for Day 121-150. Again I tested both blood ketones and blood sugar levels in the morning and at night. For those of you new to blood ketone testing, you’ll generally see lower levels in the morning and higher levels at night. So if you decide to test, keep that in mind so you’re not discouraged by what you see. I’ve been fortunate enough to have ketone levels that have remained consistently high for the previous couple of months and this past month was no exception. Here’s how my AM blood ketone levels were in Day 121-150:

As you can see, they averaged right around 2.5 mmol/L when I measured first thing after waking up. I asked my low-carb expert friend Dr. Ron Rosedale about why blood ketones tend to be lowest in the morning and he said that the body is utilizing those ketones for fuel while you are sleeping to help repair and restore. The goal isn’t to see how high you can get your blood ketones in the morning hours but to have your body running efficiently on them as the preferred fuel source. It’s a good lesson and reminder for us all. So what about my PM blood ketone levels for Day 121-150? Let’s take a look at those numbers:

As it has been for the past few months, blood ketones when I tested them at night about an hour or so before bedtime tend to be around 2.0 mmol/L higher than the mornings readings. As you can see in the chart above, my average PM blood ketones for Day 121-150 came in right around 4.5 mmol/L with my highest reading ever happening on September 18, 2012 at 10:00PM when it registered at 6.3 mmol/L. Some people have asked if you can “feel” when your ketone levels are that high. No, not really. But you can sense based on how your body is operating that you are putting yourself in the best position for running optimally powered by ketones. It’s a beautiful thing! In my next column for CarbSmart coming later this month, I’ll share some specific foods you can consume to help you increase your blood ketone levels. It has been fairly easy to see higher blood ketones by doing a few simple things I’ll share with you now:
- Ketogenic level of carbs, below 20g daily for me
- Significant reduction in absolute value of protein to 75-80g daily (biggest key IMHO)
- A purposeful increase in dietary fat, primarily from butter, coconut oil, high-fat foods
You’d be surprised what making those simple changes above will do for your blood ketones enabling you to get into nutritional ketosis and experience the same success that I have. So what about the weight loss that happened in Day 121-150? This was a funny one to watch this month in light of the purposeful increase in weight lifting and I’ll explain more about this after sharing the results with you:

Did you see what happened during those first two weeks after I started some hot and heavy weight lifting in the gym? I GAINED NEARLY SIX POUNDS! But I didn’t really change anything about my diet. In fact, the only change I made was in the commitment to be at the gym twice a week lifting weights in a keto-adapted, fasted state. So it’s probably safe to say that the “weight gain” I experienced through September 23, 2012 was mostly lean muscle mass that I was putting on very quickly. And I’m sure stored body fat (and maybe some water) was still coming off my body, so the muscle gain was very likely greater than 6 pounds.
This is not surprising as Finnish exercise physiologist Anssi Manninen shared regarding very-low-carbohydrate diets and preservation of muscle mass. He noted that “ketone bodies exert a restraining influence on muscle protein breakdown. If the muscle is plentifully supplied with other substrates for oxidation (such as fatty acids and ketone bodies, in this case), then the oxidation of muscle protein-derived amino acids is suppressed.” He added that “beta-hydroxybutyrate (the ketone measured in the blood) decreases leucine oxidation and promotes protein synthesis in humans.” Manninen concludes that a very low-carb, adequate protein (and by default high-fat) diet is “protective against muscle protein catabolism.” I’m certainly seeing this happen for myself right now.
I had a DXA (dual-energy x-ray absorptiometry) scan conducted on September 13, 2012 at the Vitality Medical Wellness Institute up the road from me in Concord, North Carolina. A very special thanks to Dr. Jeffrey Galvin and his wonderful staff for providing such an outstanding service to the people in your area. I HIGHLY encourage you my readers to see if there is a medical facility in your area that will let you have a DXA scan done. I’ll be returning to Dr. Galvin’s office on November 12, 2012 to have another DXA scan conducted to see what kind of changes have happened in my body fat and muscle composition over a two-month period (wish I had one done before I started this experiment, but oh well). Stay tuned!
While my weight loss for Day 121-150 was just 4.6 pounds (as compared with the 15-pound weight loss in Day 91-120), this marks a pretty significant achievement in my overall weight loss since beginning on nutritional ketosis: I have now lost a total of 51 POUNDS IN FIVE MONTHS! For those of you who have been with me as I’ve shared about all the struggles I’ve experienced in recent years trying to figure out why my body had seemingly rebelled against every effort to get my weight under control again, you know just how monumental this is. Although there have been ups and downs during these first 150 days, the “big picture” look says it all in this graph of my weight loss in Day 0-150:

It’s great to see the progress, but I’m far from finished and there’s still plenty of work left to be done. I now weigh in at 255.2 pounds after being at 300+ pounds in May 2012. The next big step for me will be to get over that psychological obstacle that has been my albatross since the weight first started coming back on me beginning in 2006: Getting back below the 250-pound mark again! And I’m so close to it now I can taste it at this point. Short of a catastrophe happening, I should be below this by the next update in 30 days. People have asked me what my goal weight is. The answer is simple: whatever weight I end up getting to while still in a keto-adapted state. Obviously the 230-pound mark will be huge because that’s where I was after my original Atkins diet weight loss in 2004. But I’m not putting any limitations on where my weight will end up because I’m more concerned about being healthy, feeling well and performing at the optimal level for me. If that’s at 230, 220, or even 200 pounds, then so be it. What happens will happen and I’ll be happy to go along for the ride in the process of it all!
And finally, let’s look at what’s going on with my blood sugar levels. After reporting my spectacular 4.5 A1c number last month (which works out to an average blood sugar reading of around 83), these numbers should come as no surprise for the morning fasting readings for Day 121-150:

If you look at the average, it’s right there at 83…HO HUM! That’s my little inside joke with my wife Christine now when she asks me what my n=1 testing numbers were like for that particular day. If I say “ho hum” then she knows it’s what I’ve typically been seeing. The range of AM blood sugar readings was from 71-91 and I’m perfectly happy with that. Interestingly, the day I hit 71 also happened to be a weight lifting day and I felt completely fine pumping the iron with that seemingly low blood sugar reading. How about the PM levels in Day 121-150? Check ‘em out:

Again, HO HUM! My nighttime blood sugar readings taken at the same time as my PM blood ketones averaged around 83 as well ranging from 70-93 in the past 30 days. I asked Dr. Rosedale about whether blood sugar readings in the lower 70s is something to be concerned about and he said that readings even as low as in the 60s can be completely normal for someone consuming a minimal carbohydrate, moderate protein, high-fat diet. It’s not something to freak out about thinking you need to eat some carbs to get your blood sugar up or you’ll pass out. That’s nonsense! Get into a fully keto-adapted state and the days of needing to consume more than a cursory level of carbohydrates become ancient history. This is DEFINITELY the place you want to be.
One more thing I wanted to share with you is something that spontaneously happened in just the past week. Now that I’m over 50 pounds lighter than I was just a few months ago, I’ve noticed my energy requirements are not as high as they once were. In the middle of one of my meals last week, I noticed I was getting fuller faster despite having the same amount of food as I’ve been eating all along. But the 255-pound Jimmy doesn’t have the same caloric requirements as the 306-pound Jimmy did back in May. So I cut down on the volume of food just a bit and haven’t felt any ill effects in hunger, energy or anything else since ostensibly cutting out around 300 calories from my daily diet. Adjusting your food intake to your new, smaller body is a critical key to continuing the success moving forward.
Some would argue that this proves that the weight loss I’ve experienced is merely a result of a simple reduction in calories. But without the sustained satiety, craving suppression, robust energy and other key benefits of being in nutritional ketosis, the reduction in calories would never happen without forcing the issue and arbitrarily cutting them while suffering through hunger, irritability and overall weakness. NO THANKS! I’ll take my high-fat, moderate protein, low-carb approach every day of the week and give credit where credit is due–nutritional ketosis rocks, baby!
I invite you to share your comments about my latest n=1 update of nutritional ketosis in the comments section below. Here’s some feedback I recently received from someone who used to be critical of my advocacy of low-carb living until he realized the value of the information I’m providing my readers through sharing about my own ups and downs:
You know Jimmy, I was one of those people who was critical of your advocacy of low-carb diets while still being overweight. I never flamed you or wrote anything critical publicly, but in the back of my mind I was always thinking, “What does this guy know? He is not getting great results.” In retrospect I think you actually deserve an “atta boy” for keep-on-keeping-on continuing to learn and sharing your life experience. I know I would have disappeared from the Internet the first time someone wrote something critical of me. Keep up the great work you are doing!
Oh, I’m not going anywhere. There’s a world full of people who desperately need to hear nutritional truth. THANK YOU for your support and I’m so very grateful to my readers who have stuck with me through thick (literally!) and thin. How have your results been testing your blood ketones and getting into nutritional ketosis? I’d love to hear your stories, so please share.
















