The day has finally arrived at long last and I’ve been chomping at the bit to give you the latest update on my n=1 experiment of what is being commonly referred to as “nutritional ketosis.” Every single day on Twitter and Facebook, I get people asking me, “When are you going to update us on your nutritional ketosis experiment?” Well, I’ve been doing it every 30 days since beginning this project right after the Low-Carb Cruise in May 2012 and there’s not much more to say in between those times. Allowing for this time to pass gives me enough information about my weight loss, blood ketone levels and blood sugar to see patterns and correlations that might be of use. In case you’ve missed my three previous updates on this, check out Day 1-30, Day 31-60 and Day 61-90 to see my progress. It’s been an amazing journey so far and today’s update continues some truly remarkable changes that I’ve seen in various aspects of my weight and health since beginning this. I’m now four months into this six-month experiment and I saw some of the most impressive results of this over the past thirty days. I’ll share more on those numbers with you coming up.
First I wanted to address a question that has come up many times since I started blogging about getting into “nutritional ketosis.” It’s goes something along the lines of this: “What’s the difference between ‘nutritional ketosis’ and the ketosis you get on Atkins?” In fact, one lady on Facebook took me to task for basically doing Atkins but trying to re-brand it as something “new” calling it “nutritional ketosis.” Apparently she hasn’t been reading my blog posts about this because I’ve made it perfectly clear that this is something I read in Dr. Jeff Volek and Dr. Stephen Phinney’s 2012 book release called The Art and Science of Low Carbohydrate Performance. But actually the concept of “nutritional ketosis” even extends back to their 2010 New York Times bestselling book The New Atkins For A New You where they use this phrase very clearly on page 287:
Ketones have gotten a bad name because they can rise to very high levels in individuals with uncontrolled type 1 diabetes, a state known as diabetic ketoacidosis. However, there is more than a tenfold difference between the ketone levels seen in ketoacidosis and those achieved with a carbohydrate-restricted diet, which we call nutritional ketosis. (emphasis mine)
As you can see, this is neither my term nor is it particularly new. But I do see a line of delineation between the state of ketosis you achieve on the Atkins diet and the nutritional ketosis I am actively pursuing now. The most important difference is that Atkins does not explicitly call for moderating protein intake, just carbohydrate. Traditionally, ketosis has been measured by using a Ketostix urine pee stick test and the will change to shades of pink and purple when ample amounts of the ketone body acetoacetate is present in the urine. Dr. Stephen Phinney, who co-authored with Dr. Jeff Volek another book that discusses nutritional ketosis called The Art And Science of Low Carbohydrate Living, shared in Episode 23 of the “Ask The Low-Carb Experts” podcast recently that he used to have a breath ketone acetone meter. However, these aren’t manufactured commercially because the demand has been so minimal.
That’s why when Drs. Volek and Phinney shared about testing blood ketones in their Performance book (by the way, if you can find several people to go in with you on the purchase, I found a company that has the Precision Xtra blood ketone testing strips for a much more affordable $1/strip…but the catch is you have to buy 1200 of them!), it was seen as a more accurate measurement of whether or not you have achieved the proper level of nutritional ketosis where you are keto-adapted, fat-adapted and using these as an alternative fuel source to glucose. The ketone body measured in the blood is beta-hydroxybutyrate and attaining a measured level between 0.5-3.0 is what the dynamic low-carb research duo have concluded is optimal for fat loss and keto-adapted performance. More on these ranges in a moment. But here’s the bottom line distinction I make between the nutritional ketosis I am experimenting with now and the traditional ketosis seen on low-carb plans like the Atkins diet: Nutritional ketosis (measured by blood ketones) is ketosis, but ketosis (measured by urine ketones traditionally by low-carb dieters) may not be nutritional ketosis. If being in nutritional ketosis was merely about cutting carbs, then I would have been in nutritional ketosis for much of the past nearly nine years. Unfortunately, as I’ve been sharing in these n=1 update, there’s more to it than that.
With carbohydrates reigned in to the bare minimum for my carb tolerance and protein moderated to the level that’s right for me, I’ve been reaping the abundant benefits of nutritional ketosis for most of the past four months. Some new improvements to my health that I’ve noticed over the past 30 days include the disappearance of a bad case of painful hemorrhoids that I’ve had for three years, the continued disappearing act played my skin tags, the clearest skin I’ve had (and I had frequent outbreaks on my face prior to this experiment) without the use of any skin care products, sound sleep throughout the nite waking up refreshed, impeccable hunger and craving control over the course of the entire day even after hours without eating, boundless energy and vitality with a pep in my step, mental clarity and sharpness that has helped me in my work (especially during podcast interviews) and an even-keeled mood and confidence that hasn’t been present in many years.
These are all very tangible physiological and psychological improvements that cannot be explained beyond the now-obvious benefits of being in a constant state of nutritional ketosis. Don’t let anyone convince you that being on a very low-carb, very high-fat diet with adequate protein is somehow harming your health. Once you’re keto-adapted like I am right now, nothing’s gonna stop you from experiencing a literal health nirvana! Just ask the Swedish “Diet Doctor” Andreas Eenfeldt (who recently started measuring his blood ketones as well) about that.
Alright, the wait is over, let’s take a look at my numbers for Day 91-120. Thankfully I wasn’t sick nor did I have to travel during this 30-day cycle, so there were no excuses for me to blame for any poor performance in my blood ketones, weight loss or blood sugar levels. There’s something to be said about being in a regular routine and schedule to keep you on the straight and narrow. I threw in a couple of curve balls this month to see how they would impact my numbers. Over these past 30 days, I deliberately did not engage in ANY exercise at all other than the normal day-to-day movement and occasional frisbee golf practice so I can kick my buddy Tom Naughton‘s fanny when I go back to visit him and his family on his farm in Nashville again in a couple of months. I may step up my exercise in the next 30 days to see how I perform in a keto-adapted state since I’m fully there now. We’ll see. The other thing I did differently this month was I deliberately ate dark chocolate every single day just to see what would happen. No, it wasn’t a sugar-free brand, but it was a high-quality, dark chocolate that I savor and enjoy sometimes several times daily. I probably consumed an average of 3 ounces of this stuff without guilt and if it impacted me negatively then I certainly would have stopped (but as you’ll see below, it didn’t).
For Day 91-120, I tested my blood ketones and blood sugar levels both in the morning and at night for the first time to show you the difference between the two times of the day. Generally, your lowest blood ketone levels will be in the morning and your highest levels will be in the evening. We’ll see how well this trend held up for me by first looking at my AM blood ketone levels in Day 91-120:

Blood ketones in the morning this past month were the strongest and most consistent they have been since I started doing this. I stayed well above my 2.0 average from the first 90 days, getting closer to an average of around 2.6. And while Volek/Phinney note that nutritional ketosis begins at 0.5, I can’t help but wonder if some of us might perhaps be even more optimal at a higher level of blood ketones. I can tell you I felt fantastic at these levels and would prefer to be at this level than trying to fight to keep blood ketones above 1.0. So what about my PM blood ketone levels in Day 91-120:

Now that’s what you call a hunka hunka burnin’ ketones, baby! I probably averaged for my PM blood ketones around 4.6, a full 2.0 millimolar HIGHER than the AM readings. Again, this is not unexpected nor is it cause for any concern. These levels of ketones are above the 3.0 level that Volek/Phinney talk about and they say that there is no added benefit to being above 3.0. But this is an n=1 experiment for me and from an anecdotal perspective I seemed to experience all the previous benefits I shared above that much more. Perhaps these greater ketone levels at night are producing results on other areas of my healthy lifestyle that I might not even realize–like with weight loss, for example. The past couple of months I’ve seen decent weight loss numbers of 6.2 pounds and 8.0 pounds respectively for Day 31-60 and Day 61-90. Honestly, these were a bit lackluster compared with the 20.2 pounds I had shed in Day 1-30. Don’t get me wrong, I’m happy with the progress in the RIGHT direction–but what would happen in Day 91-120? Let’s take a look:

BOOM! Bada-bing! Suh-weeeeet! Can you tell I’m just a wee bit excited about these results? After ending the last 30-day cycle at 274.8, I chalked up a cool 15-pound weight loss in Day 91-120 for a grand total of 46.4 POUNDS LOST…and counting! I can hardly believe I’m in the 250s again and it’s been five years since I’ve been below 250. Day 121-150 will be a watershed moment in this n=1 experiment of nutritional ketosis if I’m able to get past that physical and psychological barrier in my mind that I’m really doing this. And after all this weight loss, it was only this week that I actually “felt” lighter despite the fact that my rings have been getting loose, my underwear is drooping (TMI, but it’s true!), and I’m on the last notch of my belt going in the RIGHT direction. Good things are indeed happening and I’m so very grateful that it is. I can’t imagine this would somehow stop working when it’s been firing on every cylinder for me since I started! We’ll see what happens.
Last but not least let’s see what happened to those pesky fasting blood glucose levels during the morning in Day 91-120:

Did you notice that something miraculous happened with my morning fasting blood sugar readings this month? THEY NORMALIZED!!! My average reading was probably around 83 which I’ll take every day of the week. This month I also measured my blood sugar levels at night, so here were the results of those tests:

Oh yeah! As good as my blood glucose numbers were in the morning, they were that much better at night averaging around 82 each evening. Consistency with blood sugar is likely a benefit from keep carbohydrates and protein in check and allowing my body to use ketone bodies for fuel. As I shared with you in last month’s update, I started taking a blood glucose stabilizing supplement called Glycosolve 2-3 times a day which I am sure is contributing to these rockin’ blood sugar numbers. Wanna see something pretty awesome that just happened this past Saturday? Christine and I went to our local Sam’s Club (despite their idiotic dietary advice for diabetics) to get a free health screening that would reveal our latest A1c levels. They do this about once a year there, so we always try to take advantage of it. Imagine my shock and surprise when my results were this:

WHOA! When I posted my 4.5 A1c number on Twitter, several medical practitioners said they had NEVER seen a level that low before. WOO HOO! It’s yet another one of the many benefits I’m seeing with this nutritional ketosis experiment. And I’ve still got two more months left officially on it. But honestly, if I’m still seeing results, why would I EVER stop doing this? Some have questioned the sustainability of a diet that is 85% fat, 12% protein and 3% carbohydrate. It’s certainly what I’m doing now but maybe I won’t have to stay there forever. And although many people are begging me to release my menus during this n=1, I don’t really see the relevance of what Jimmy Moore is doing on anyone besides Jimmy Moore. You have to customize your plan to what works for you and that maybe be radically different from what I’m doing. Experiment, tweak and make the appropriate changes to see the positive effects you desire. That’s the beauty of doing tests like this so you know where you stand and what you need to do to reach your health goals.
By special request from several readers, here is a cumulative look at all of my blood ketones, weight loss and blood sugar readings for Day 1-120 so you can see just how far I’ve come:



Man, I hate to be too overly optimistic, but this sure feels like VICTORY to me. I haven’t had this feeling of accomplishment since my original 180-pound weight loss on the Atkins diet in 2004. There’s excitement about this because it is giving me hope that I’m not going crazy spinning my wheels on something that is not producing results. Nutritional ketosis IS when just plain ole low-carb living was not. I’m not saying it is the grand panacea for all of your weight and health woes, but it is certainly working for me. I still can’t believe how good I feel doing this and look forward to many more outstanding reports in the final two months of my n=1. THANK YOU so much to those of you who have encouraged me through this and have been inspired to start your own nutritional ketosis experiments, testing your blood ketones and blood sugar and tracking your progress. YOU inspire me too and we are all in this together to prove to the world that healthy high-fat, low-carb living is an excellent option for losing weight and attaining optimal health. Be well my friends and I welcome your feedback in the comments section below.
Listen to my one-hour interview on “The Dr. Lo Radio Show” with Dr. Lauren Noel where we discussed “Nutritional Ketosis & Weight Loss” at BlogTalkRadio or on iTunes. For crystal clear audio quality, you can listen to the entire interview on YouTube below:
http://www.youtube.com/watch?v=Z8gHK6T4j68
I provide details about my n=1 experiment through the first 120 days! ENJOY!
















