Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet (22 page)

DOCTOR’S NOTE FROM DR. ERIC WESTMAN: Dr. Lubna Ahmad, president of Invoy Technologies, which is developing a breath ketone analyzer, did a small study comparing breath ketones, blood ketones, and urine ketones in about forty people, some of whom were following a low-carb, high-fat, ketogenic diet and some of whom were not. Two important findings are clear: 1) occasionally the urine ketones are absent but the blood ketones are present; and 2) morning ketone levels are lower than evening ketone levels. What this means is that if you only check ketones in the morning urine, you might be in ketosis even if the tests are negative.

We are living in exciting times when patients like us have access to equipment that you used to see only in a doctor’s office. And now that we have these at-home technologies to determine how well we are doing in our pursuit of health, the power is in our own hands. I envision ketone testing to be part of the wave of the future for those who are interested in being in a state of ketosis.

A ketogenic diet is a great opportunity for self-experimentation. Start with a set of simple generic guidelines, such as Atkins Induction, and manipulate the variables to see how your body responds by measuring blood or breath ketones. I think this is probably the best way to know what works for you.

– Bryan Barksdale

Self-testing is a powerful thing, and I highly encourage you to give it a go for yourself. If you cannot afford to do any of the ketone testing discussed in this chapter, then you might be interested to know that there is a fantastic free website, The Low Carb Flexi Diet (www.flexibleketogenic.com), that provides a ketogenic ratio calculator. All you do is plug in how many grams of carbohydrates, protein, and fat you are consuming, and it tells you how ketotic you are. Give it a try and see for yourself!

Coming up in the next chapter, I want to share with you what happened to me over the course of one year when I decided to put the idea of being in a constant state of nutritional ketosis to the test. The results and lessons of that experiment were what really propelled me to write this book. Get ready to be blown away by what I discovered!

Key Keto Clarity Concepts

• New technology is being invented to test for ketones in the urine, blood, and breath.
  
• There are three types of ketones—acetoacetate, beta-hydroxybutyrate, and acetone.
  
• Urine testing is the cheapest, easiest way to test for ketosis.
  
• Blood ketone testing is much more accurate than urine ketone testing.
  
• The high cost of blood ketone testing make it too expensive to test daily.
  
• Blood ketone monitor companies are uninterested in marketing to people pursuing nutritional ketosis.
  
• Breath ketones correlate very closely to blood ketone levels.
  
• Several companies are working on breath ketone meters for consumers.
  
• There are pros and cons for each way of testing the presence of ketones.
  
• At-home ketone testing is the wave of the future for people seeking to be healthy.
  
• Self-testing is the only way you can know for sure if you’re in ketosis.
  

Because each person is different, I think it pays to do a little experimenting. Measure your ketones and manipulate your ratio of fat to protein and carbohydrate to see what it takes to keep you in ketosis.

– Dr. Bill Wilson

What exactly does ketosis look and feel like in the real world? I wanted to know the answer, so I embarked on my own one-year ketosis experiment in May 2012. In the language of scientific research, it was an “n=1” experiment—“n” stands for the sample size, and in this case, it was just one: me. So let me be very clear up-front that this experiment only reflects my own experiences, no one else’s, and it does not take the place of any objective scientific research that has or will take place on ketogenic diets. This is merely what happened to me during my year of testing the impact of nutritional ketosis on my body.

In the spring of 2012, I read
The Art and Science of Low Carbohydrate Performance,
a book by two fabulous low-carb and ketogenic diet researchers named Dr. Jeff Volek and Dr. Stephen Phinney. In it, they explained the science behind ketogenic diets for athletes who are keenly interested in optimizing their exercise performance and argued that burning fat and using ketones as the body’s primary fuel source provides better, longer-lasting energy for exercise performance than carbohydrates.

It was in this book that I first learned about blood ketone testing and the concept they called “nutritional ketosis,” which I’ll refer to as “NK” from here on. While Volek and Phinney admit that blood ketone testing strips are “relatively expensive”, they make a compelling case for giving it a go: “Is this (hassle/expense) worth . . . pricking your finger once per day for a month or two? Based upon our experience working with many people, we think that the answer is ‘yes.’” On the annual Low-Carb Cruise I helped organize and lead in 2012, I announced to a crowd of over 250 people that I would be testing NK for ninety days to see what would happen. In fact, Dr. Volek himself was in attendance as one of the special guest speakers that year, and he presented an awesome lecture outlining the benefits of NK.

People need to do considerable self-experimentation to assess their response to the ketogenic diet, and in particular how much carbohydrate and protein they require to sustain ketosis.

– Dr. Dominic D’Agostino

At the time, I was struggling with a bit of weight regain, lackluster sleep, and constant fatigue, despite eating what I thought was a pretty good low-carb, high-fat diet. So when I decided to begin this n=1 test, I was hoping to figure out what I was doing wrong. During the experiment, I always checked my blood ketones using the Precision Xtra blood ketone meter in the morning after I woke up and while in a fasted state; at the same time, I also checked my weight and blood sugar levels. I repeated the blood ketone and blood sugar tests at night at least four hours after my last meal. This ritual became part of my daily routine for an entire year.

Keep in mind that I wanted to examine the results of NK as scientifically as possible, which explains why I did so much testing. But for the average person, testing blood ketones once in the morning and once at night during the week will allow you to track your progress without breaking the bank on blood ketone test strips by testing more often. However, since blood sugar testing is much more affordable than blood ketone testing, checking that daily in a fasted state as well as after meals is probably not a bad idea. In fact, Google announced in January 2014 that they are working on developing a contact lens that will be able to keep a constant check on your blood sugar levels. I’ve got to get me a pair when they come out with that!

When it comes to adapting to the ketogenic lifestyle, a lot depends upon exactly who is embarking on this path and what their underlying issues might happen to be. I generally find that jumping right in with both feet is the least painful and often the most effective and compliance-friendly way to go about it.