Ever since I first began my n=1 experiment examining nutritional ketosis on May 15, 2012, it’s been quite the time measuring my blood ketone levels on a daily basis. Using the Precision Extra Ketone Meter (pictured to the left), I’ve pricked my finger every single morning when I wake up to see where my blood ketones stand. You’ll recall I was inspired to start testing my blood ketone levels after reading Dr. Jeff Volek and Dr. Stephen Phinney’s latest book The Art and Science of Low Carbohydrate Performance and realizing that I’ve probably been making some mistakes in my low-carb lifestyle despite eating this way for years. Although the book was written specifically to show how athletes can maximize their performance in a ketogenic state, the section in there about nutritional ketosis is invaluable to anyone who thinks they are already eating a well-formulated low-carb diet–but like me, they’re not. What I’ve discovered in the midst of this experiment is that I wasn’t nearly as zoned in on my high-fat, low-carb diet as I should have been. And this blood ketone meter has helped me correct that.
It’s been rather humorous to me reading some of the comments from people on forums and blogs about my experiment. Some say, “it’s about time he started eating high-fat, low-carb” or “of course your hunger will go away eating ketogenic.” Still others believe I’m simply doing the Fat Fast (a calorie-restricted very high-fat, very low-carb diet), Atkins Induction, or some other quick weight loss strategy. But these people totally miss the point. While I’m not yet revealing my menus during this experiment (and I won’t be for a while until the experiment is completed), I can tell you it all boils down to three things:
1. Consuming MORE fat, especially saturated fat (85% of calories)
2. Eating LESS protein overall (12% of calories)
3. Keeping carbohydrates significantly reduced (3% of calories)
That’s pretty much it! I’m not counting calories at all and I’m eating once or twice a day depending on my hunger. And lemme tell you–getting into a true ketogenic state has revealed to me precisely what satiety on a low-carb diet is supposed to feel like. Perhaps other people can get away with consuming more carbohydrates and protein and maybe less fat in their diet to feel this same kind of hunger satisfaction. But for me, this is what is working to give me the satiation, energy, and mental clarity that has been quite evident over the past 60 days of this experiment.
Interestingly enough, on the day we left on our trip to see my buddy Tom Naughton in the Nashville, Tennessee area on July 1, 2012, I decided I’d do a little bit of intermittent fasting during the 5-hour drive and eat when we got there. So I hadn’t consumed any food since the afternoon before and when we get closer to Naughton manor Christine tells me she has a sharp pain in her stomach. It kept getting worse and worse to the point that I asked her if she needed to go to the emergency room (yes, we’ve been seeing a lot of the ER lately!). So we got to Tom’s house and asked where the closest emergency clinic was–then bolted there to take care of the issue. Tom had a fabulous brats and peppers meal for us…but we got stuck at the clinic for three more hours with x-rays and MRIs (turns out it was a urinary tract infection which will be funny when you read what happened to me about a week prior to this below). By the time we ate around 9:30PM, I hadn’t eaten in 29 hours–and yet I was still fine without any hunger. AMAZING!
And if how I feel right now eating this way is how it will always feel, then you bet your sweet bippy I’ll be eating this way for life. Although my Paleo blogging friend Sarah Ballantyne shared in Episode 589 of “The Livin’ La Vida Low-Carb Show” podcast that consuming less than 100g carbohydrates daily is “not sustainable or even necessary” (presumably over the long-term), perhaps for some of us it’s EXACTLY what we need to do in order to overcome the damage that has been done. I guess I’ll have to be the guinea pig for this in the months and years to come if (and when!) I continue pursuing nutritional ketosis and making this a truly sustainable plan for me while reaping the benefits to my weight and health it is giving me. More on this in a moment.
After I blogged about my first 30 days testing nutritional ketosis last month, there’s been an explosion of interest in testing blood ketones, increasing fat consumption, moderating protein intake and more across the health forums and blogosphere. Here are just a few examples:
I’m happy to hear others are seeing results when they’ve been stuck in their low-carb plan and that getting into nutritional ketosis has been the key to making that happen. Naturally there are a LOT of questions people have about blood ketone testing since it is a newer way to measure ketone levels in the body. When I sent a few commonly-asked questions over to Dr. Volek to share his answers with you in this post, he said that he and Dr. Phinney are in the midst of writing a new book that will address these questions and more in much greater detail. I’ll be sure to tell you more about that book when it is released later this year.
In the meantime, I’m still plugging away at my experiment and it was a challenging past 30 days for me. Nine days into this 30-day period I had to go to the emergency room (MY TURN!) with a 102-degree fever which turned out to be a urinary tract infection (ironic that Christine would get one just a week later) requiring me to be on an antibiotic for a month. UGH! The doctor said I needed to drink cranberry juice to help with it and she recommended the diet version of it since I don’t consume sugar. But it still had enough sugar in it that it negatively impacted my ketone levels for a few days. ARG! The fever continued for four days before it broke. Of course, I couldn’t go to the gym while I was sick and the antibiotics were giving me some bad diarrhea. Then I went on vacation to Tennessee and then Indiana and caught a nasty cold that required Sudafed and Mucinex and got poison oak (while playing frisbee golf with Tom Naughton on his farm) treating it with calamine lotion and Benadryl. This was one big comedy of errors that would have been hilariously funny if I didn’t actually live through it. It’d be a miracle if I could salvage anything out of this 30 days. But, surprisingly, I still managed to do remarkably well despite these obstacles.
Let’s first take a look at blood ketones which have been in a good range (ideal is between 0.5-3.0) since Day 4 of my nutritional ketosis experiment. In Day 1-30 they reached as high as 5.0 with an average close to 2.0. How did my blood ketones fare in the midst of the sickness and vacation time in Day 31-60? Let’s see:
Overall, it wasn’t too bad all things considered. I still averaged around 2.0 blood ketone levels despite the precipitous drop in blood ketone levels about the time I was consuming the cranberry juice when it dipped to a low of .6 on July 1, 2012–just barely above the .5 minimum level of nutritional ketosis. After I stopped drinking the cranberry juice and Christine and I went to visit Tom Naughton and his family in Nashville, you’ll see the blood ketones spiked up there again (henceforth known as the “FAT HEAD effect”) thanks to some really nice high-fat, moderate protein, low-carb meals and lots of frisbee golf. One of the things Volek/Phinney discuss in their book that raises blood ketones is exercise and we got in our fair share that week (and yes, I’m a full-fledged frisbee golf addict now!):
I was seriously concerned about how I was going to eat while on vacation, but I came prepared with my own food we brought in a cooler that helped significantly. The final day we were in Indiana (which will be reflected on the first day of Day 61-90 when I update next month) was the only “mess up” that happened when we visited a Chinese buffet restaurant with family and they didn’t have any real butter. So I KNOW I overconsumed protein that meal which messed up my blood ketones and weight. I’ll share my weight change in a moment, but for this 30-day cycle I decided to also test urine ketones to see if there was a correlation between them and the blood ketones. Here are those results (I used the numbers correlating with the color changes on the Ketostix package):
While measuring urine ketones is significantly cheaper than blood ketones, the problem is there are subtle discrepancies that could deceive you into thinking your ketone levels are good when they are not and vice versa. For example, on July 4, 2012, my blood ketones were 2.3, but my urine ketones were moderately small at just 25. Compare that with my June 18, 2012 urine ketone reading of a moderately large level of 60 and yet my blood ketones were 1.5. A lot of things can impact urine ketone levels from the amount of fluid you drink (or don’t drink) to the time of day you measure. I measured first thing in the morning everyday, so there was consistency there. And blood ketones were tested shortly thereafter. My conclusion is that urine ketones are somewhat useful but not as reliable as blood ketones. So what about weight loss during this second thirty days of nutritional ketosis testing? With all the travel and sickness, did I manage to lose even a pound? Why don’t we take a look at that now:
It was ugly with a lot of ups and downs, but I stuck with it despite the struggles early on fighting that UTI. You’ll notice the “FAT HEAD effect” kicked in during the first part of July when we were with Tom’s family and I lost most of my weight this past month in that week alone. I started at 286.0 pounds on Day 30 and ended at 279.8 pounds on Day 60 for a 6.2-pound weight loss and a cumulative 60-day weight loss so far of 26.4 pounds. I’m pretty thrilled with this progress and fully expect the next 30 days to be even better! I can tell I’ve lost weight in my face but it’s hard to tell I’ve shed much weight in my midsection except that my shirts fit looser. My legs and arms are muscular, so it seems most of this added weight is smack dab in the middle of my body. I’m going to be aggressively attacking this in the coming months and I’ve already decided to extend my nutritional ketosis n=1 experiment to 180 days (6 months) to see if I can maximize the effects not just to my weight but also my blood sugar control which has still been a challenge to get stabilized. Like last month, my fasting blood glucose levels were all over the place from highs to lows seemingly at random despite eating a consistent high-fat, moderate protein, low-carb diet:
Once more, the “FAT HEAD effect” was in full force the week I was with the Naughton’s and my readings were the lowest they were all month. Perhaps I need to implore the principles I applied there that week (or I just need to move in with Tom!) into my normal schedule. Of course, I’m not underestimating the power of relaxation while on vacation helping to lower cortisol levels and give my body the relief it needed to be healthy. Trust me, I’m working on that part of all of this too by taking deliberate breaks from my regular schedule. I hate being away from my blog and podcasts, but I’ve learned I need that to help keep my health in order. In the end, that’s what is most important to me.
I’ll continue to test this nutritional ketosis concept over the next 30 days and give you my 90-day update after the Ancestral Health Symposium. If no more surprises happen in the next month, then I should see a 10-12 pound weight loss happen which would put me into the 260s for the first time in a VERY long time. THANK YOU to everyone who has wished me well in this exciting next journey of my healthy low-carb lifestyle and I’m grateful to each and every one of you for your incredible kindness and support. Lemme know what you think about what happened in Day 31-60 for me and please feel free to share any updates from you about how your own blood ketone testing is going in the comment section below. Be well!