Final report: two months of a strict keto diet and ketone monitoring

Note: This experiment was done six months ago and initially only reported on my Swedish blog. This is a somewhat delayed translation!


What happens if you hugely digress from a low-carbohydrate diet and suddenly eat a whole load of carbs?

Here is my final report following two months of a very strict LCHF diet, and daily measurements of four parameters:

  • Blood ketones (the red curve)
  • Urine ketones (yellow)
  • Weight (purple)
  • Waistline (purple)

To get familiar with the experiment design, I recommend reading my first report. For results from the first month, have a look at my second report. Here’s the third and final one, discussing the second month.

As you can see from the above graph, I took the opportunity to conduct a side experiment. The pink vertical column marks one weekend where I conciously completely deviated from the low-carbohydrate diet. I was on the Swedish archipelago “Koster” for the year’s lobster premiere, and simply had the same food as everyone else.

So, what happens if you totally veer off the low carb lifestyle after a long period of strict LCHF? Is complete havoc wrought in your body? Do you have to start from scratch again? Here’s the answer:

Lobster weekend

Here are the non-strict LCHF foodstuffs I consumed during the weekend of 28-30th September:

  • Three small helpings of pasta
  • One “Digestive” biscuit
  • A total of 7 slices of bread!
  • Some orange juice x 2
  • Some chocolate (70% cocoa content)
  • Liberal helpings of nuts
  • Liberal helpings of sorbet and honeymelon
  • Yoghurt with müsli and apple
  • An unspecified number of wine glasses (many)
  • A pizza!


After finishing off that pizza on my way back home on the Sunday, my ketone meter read “LOW” – that is, a negligible amount of ketones. The ketosis was gone.

I’m sure you’re curious as to how long it takes to return to ketosis after such a monumental digression. Some have claimed it can take up to two weeks, but for me, it didn’t:

  • The morning after, I was at 0.3 and one day after that I was at 0.5, which means I was back in ketosis. It took a week for me to get back to my previous “optimal” levels of over 1.5.
  • The scales immediately showed +2kgs (+4.5 lbs), but these vanished in a couple of days. In other words, it was all water and glycogen weight. My waistline saw little or no change at all.
  • I felt alright the whole time.

Summary: An entire weekend of cheating took me a few days to a week to bounce back from. That’s of course keeping in mind I was very keto-adapted going in. I can however imagine that some people may need more time.

Weight results after two months

As mentioned in my earlier accounts, weight loss was not my ambition when starting this experiment. I was happy with my weight and waistline, which I’ve kept for years with the more liberal LCHF diet I stick to. Interestingly, I still lost a total of 4.5kgs (almost 10 pounds) and a whopping 7cms (over 2.5 inches) around my waist. This happened without the slightest hunger pang.

I had to punch a new hole in my belt. My trousers were falling off – that’s how noticeable it was. I have however kept my original weights at the gym, so I’m assuming there hasn’t been significant muscle loss. This in spite of the fact that I’ve only found time to work out about once weekly.

Lessons learned

The biggest lesson I’ve learned during these two months is how much the effects of a strict LCHF diet can be intensified when taken to optimal ketosis. Also, I’ve seen that it takes more than just great care with carbohydrate to achieve deep ketosis; in fact, you need more fat and less protein than many believe. Too much protein tends to actually inhibit optimal ketosis (a ketone level of over 1.5), instead making it easy to stall at around 0.5.

A handy way to consume more fat and less protein is to drink your coffee with butter and coconut oil (mix with a blender!). One or two mugs of this kind of “fat coffee” gets you feeling so full you won’t be eating too much meat, fish or eggs. Perhaps this brings an environmental as well as monetary saving?

What are your thoughts on these results? Is there anything you’d like to ask? Go ahead and hit me with some comments below, and I’ll do my best to answer.


Previous posts on ketone measurement

A keto diet for beginners


I’ve conducted two more experiments during this time – reports are soon to come. One of them is the much awaited coffee experiment that’s been requested a lot since I posted the Pepsi Max experiment.

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  1. tina
    i tried strict lchf during 2 months, but i was drinking lot of wine during this period. nearly every day, but i was counting my carbs and i wasn't gaining 50 g. per day. i was taking around 40 g. per day, well it means i was eating less and taking most of the carbs from wine. now i decide to drink only ones or twice a week, but decide not to drink wine. i choose whisky or vodka. i understand alcohol is slowing down the fat burning, but this regime will make my diet longer. i need to loose around 30 kg - so i decided to be on this diet for maybe a year, so i need the products that i need for my lifestyle. but i avoided the carbs from food a lot... so, despite i was taking alcohol (wine) i lost 7 kg -s in nearly two months. now i am eating only 500 grams of sour cream a day (only for three days). i decided to input something strict into this diet, to loose more quickly and then to be more free with alcohol on weekends. so, i decided to do this kind of strict several days, maybe ones in a month. so can you tell me what you think about that? and also, i wander if the sour cream is the best choice for this unloading? or yogurt is better? but i thought on greek yogurt i will be starving seriously. thanks
  2. Claudio
    That debate has no impact on LCHF for the average person to lose weight and be healthy. That debate was about high level athletes that need short bursts of energy. Both Volek & Aragon are experts and well respected. No need to pit the 2 camps against each other. High level athletes are very active, usually in their prime, and generally healthy people. Although high carb levels do often catch up with those individuals as they get older. There are lots of other benefits of LCHF outside of just body composition and elite performance. By keeping mTOR low and glutathione high, a well formulated LCHF diet is also a great way to prevent cancer, heart disease, degenerative brain conditions, and diabetes (how much are those diseases costing society? A LOT!).
  3. Amanda
    Hi! I am wondering about optimal ketosis when you are extended fasting. If your ketones aren't high enough because you are eating enough, how do you fix that with long-term fasting? Are you still surely in ketosis and burning fat? Thanks!! Loving this site.
  4. dave
    we are all gonna die

    @Galina L.
    Low-carbohydrate diets and all-cause and cause-specific mortality: Two cohort Studies
    Data on the long-term association between low-carbohydrate diets and mortality are sparse.
    To examine the association of low-carbohydrate diets with mortality during 26 years of follow-up in women and 20 years in men.
    A prospective cohort study of women and men, followed from 1980 (women) or 1986 (men) until 2006. Low-carbohydrate diets, either animal-based (emphasizing animal sources of fat and protein), or vegetable-based (emphasizing vegetable sources of fat and protein) were computed from multiple validated food frequency questionnaire assessed during follow-up.
    Nurses' Health Study and Health Professionals' Follow-up Study
    85,168 women (aged 34-59 years at baseline) and 44,548 men (aged 40-75 years at baseline) without heart disease, cancer, or diabetes.
    Investigator documented 12,555 deaths (2,458 cardiovascular, 5,780 cancer) in women and 8,678 deaths (2,746 cardiovascular, 2,960 cancer) in men.
    The overall low-carbohydrate score was associated with a modest increase in overall mortality in pooled analysis (Hazard Ratio, HR, comparing extreme deciles=1.12 (95% CI=1.01-1.24, p-trend=0.14). The animal low-carbohydrate score was associated with a higher all-cause mortality (pooled HR comparing extreme deciles=1.23, 95% CI=1.11-1.37, p-trend=0.05), cardiovascular mortality (corresponding HR=1.14, 95% CI=1.01-1.29, p-trend=0.029), and cancer mortality (corresponding HR=1.28, 95% CI 1.02-1.60, p for trend = 0.09). In contrast, a higher vegetable low-carbohydrate score was associated with lower all-cause (HR=0.80, 95% CI=0.75-0.85, p-trend<0.001) and cardiovascular mortality (HR=0.77, 95% CI=0.68-0.87, p-trend<0.001).
    Diet and lifestyle characteristics were assessed with some degree of error, however, sensitivity analyses indicated that results were not unlikely to be substantially affected by residual or confounding or an unmeasured confounder. In addition, participants were not a representative sample of the U.S. population.
    A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates.
    Primary funding source
    NIH grants CA87969, HL60712, and CA95589"

    Replies: #113, #126
  5. Matesbk
    I'm measuring my blood Ketones the last few days. I'm always over 4,0mmol. The next morning after my 4hrs cycling with 130g of carbs,I had 6,4mmol. I have a race last weekend during which I have ful dose of carbs and after a race 1liter of wine with lots of nuts and I meen lots... In the morning I was still at 2,2 which is the lowest I saw after I have purchased blood ketone test strips.
    ........But my weight stopped going down. I am now at 73kgs, on high carb diet previous years I came to 66kgs.
    Should I target 1,5-3,0 with higher carb intake? Oh and I'n doing intermittent fasting too.
  6. Mary
    Hello Doc,
    I know this is an old topic, but you mention coconut oil in your coffee. I wondered.. If fasting is a problem, would you recommend using coconut oil a few times a day (in coffee, or just as is) and nothing else? This would provide energy with the least possible raise in insuline. What is your view ... would it be healthy?
    I wonder too if you could keep this up for days on end. That would put the body in ketosis!
    Thank you for your reply.
  7. Alana
    ****For everyone asking about the coffee recipe****
    8 oz coffee
    1 tablespoon butter
    1 tablespoon coconut oil

    Put in blender and blend until frothy (emulsified). It will look like you put cream in it (cafe au lait colored) and it tastes delicious.

    You cannot emulsify it with a spoon- you must use a blender, any type is fine. You can make as much as you want and refrigerate it to drink later. You can use less oil and butter (i.e. one teaspoon each). Google "bulletproof coffee" for more information. Hope this helps.

  8. Pat H
    I have just bought a blood monitor and been doing this LCHF since January, when I checked my blood it was 6.0mmol. I have lost 6kgs and having read all the comments think I may be eating too much protein is this possible. I have not eaten potatoes, pasta, rice or bread since I started and also gave up the sugar.
  9. Owen
    You should look into Dr D'agostino who researchers for the military on a ketogenic diet and has been on it for 7-8 years himself. He went on the diet himself because of all the amazing things he was seeing in not just military subjects but people with cancer and neurogenic disorders. The study with the participants you mentioned earlier was from pooled data that was taken subjectively from voluntary participants (high amount of statistical error). This D'agastino has nothing to gain from publicly endorsing this diet and has plethora of videos on youtube and knowledge on the subject. Do yourself a favor and watch his videos.
    Reply: #114
  10. Pooh bear
    So what sort of ratio/ percentage should my macros be for optimal ketosis? Is this ok..?
    Carbs 10%
    Protein 30%
    Fat 60%
    Or should I adjust?
    Reply: #111
  11. Peter Biörck Team Diet Doctor
    Hi Pooh!

    I guess that you mean E%. It should be more fat and less carbs and protein.

    But it's often better to talk about gram instead of percent when you try to eat ketogenic. I would say:
    < 10-20 gram carbs
    < 50 - 100 gram protein (a bit depending on your weight)
    Fat as much as needed to not feel hungry.

    So what sort of ratio/ percentage should my macros be for optimal ketosis? Is this ok..?
    Carbs 10%
    Protein 30%
    Fat 60%
    Or should I adjust?

  12. Jake
    Hi I'm 100 pounds and would like to get into ketosis how much protein and fats should I have a day
  13. Hatch
    Food questionnaire studies shouldn't be taken seriously. There are so many positive N=1 stories from keto and enough small scale short term studies of people where food was properly tracked that LCHF is clearly the healthiest way to go.
  14. Sade
    Yes he dose, he owns the patent for keto products. Ketones production supplements. No one those anything for free these days...
  15. Nadine
    Hello I'm starting keto and cannot figure out my macros? I have tried for 5 wks and lost 3 lbs . Very discouraging . I have hashimotos which having is impossible to lose. :(
    I am 180 5'8" and not very active at this time. Weight around mid section mostly. Would like to lose 25lbs. I have put a hold on doing my regular boot camp until I get this way of eating underway.
    Can anyone calculate for me?
    Thank you
    Reply: #118
  16. 1 comment removed
  17. Kevin
    Can you share your daily grams fat, protein, carb that you found optimal for deep nutritional ketosis????
  18. Nadine C.
    Hi Nadine! My name is Nadine too! I hope I can help! I started LCHF about 7.5 weeks ago, and to date have lost over 20 lbs. On day one I downloaded an app (Carbmanager) on my phone to help me track my macros. I honestly don't think I could do this without the aid of this app. Food can be very confusing sometimes. Mostly because of the bad information that is out there, what is healthy and what is considered not healthy. Previously I mostly ate fruits and veggies with hardly any protein or fat, and gained so much weight I couldn't stand it. So I did a lot of reading and found this website ( It really helped me understand what LCHF was all about, and what I need to consume to lose weight. And all I can say is, it really works. I haven't introduced any real exercise, but have increased my activity, I force myself to use the bathroom on the bottom floor of the building I work in, and take the stairs, and more steps throughout the day. I do plan on incorporating some exercising (pilates), soon. But in the meantime, I just keep reading information and flipping through my carbmanager app, to see which weeks were more successful then others and try to repeat what I did. I'm averaging about 2.60 lbs. per week, lost. Hope this information helps! Don't get discouraged, stay focused! :)
  19. LaurieLPhoto
    I’ve been sticking to a Keto diet for 7 weeks now... using Carb Manager as my app to stay on it very strictly. I lost most of my weight in the first 2 weeks, but for the last 4 weeks... my loss is incredibly slow and I don’t understand Y. In the past two weeks I’ve started 3 mile walks (sometimes twice a day... 1 for fat burn through my neighborhood keeping my heart rate in fat burning mode, and 1 through a park that has lots of up and down areas for keeping my heart rate in cardio mode. Plus, I’m working out on our Total Gym. I space everything out so I’m not over doing it. I stick to my keto 5% 25% 70% - and yet my weight loss is still crawling. I’m lucky if I loose a pound a week. It’s truly not hard for me to stick to this lifestyle- so I don’t feel like I’m struggling. I drink 80 oz of water a day as well. I stop eating by 9pm and normally don’t start eating until noon or later. I started at 162.5, on June 18, 2018. It’s now Aug 5th, and I weigh 148.3. That’s 14.2 lbs in 7 weeks. And like I said... the majority of that was in the first 2 weeks. Do U have ANY suggestions for me?! This is going painfully slow for all the effort I’m putting in! BYW, I’m a 5’4” woman who is 58 yo
    Replies: #120, #128
  20. LaurieLPhoto
    Forgot to mention that I ck my ketones w a blood meter about twice a week and am always in the 1.5 - 3 area... so I know I’m in Ketosis.
  21. Nan
    LaurieLPhoto...females are different. Research Anne Mullens article 'Top 10 tips to lose weight on low carb for women 40+' recommending intermittent fasting to get past a stall. She references Dr's Fung, Hallberg, among others re post-menopausal women.
  22. Randall
    My ketone meter is runing about .5 to .9, what should i do to get it higher?
  23. Joe
    Hi . What happened after your experiment? Did you return to your previous weight and waist size or did you maintain your new measurements?
  24. Davina
    I am so so scared to try optimal keto. I am worried about the lethargy/switch to a completely new way of burning fat. What if I'm too tired on a day to day basis? What if I mess up my metabolism by trying this? Is this healthy? I've done a lot of research but I am still a little worried.
    Reply: #125
  25. Kristin Parker Team Diet Doctor

    I am so so scared to try optimal keto. I am worried about the lethargy/switch to a completely new way of burning fat. What if I'm too tired on a day to day basis? What if I mess up my metabolism by trying this? Is this healthy? I've done a lot of research but I am still a little worried.

    The "keto flu" does not hit everyone and usually only lasts for a few days. You can ward it off by keeping your fat intake high and keeping up with electrolytes!

  26. Stephen
    Why hast the doc commented on this?
    Reply: #127
  27. Kristin Parker Team Diet Doctor

    Why hast the doc commented on this?

    We have refuted that study in a few different articles on our website. Basically, they were using peoples' self reported food intake over 20 years. Hardly scientific.

  28. Kris
    Hi Laurie!

    Did you ever break that plateau? It seemed like you were doing everything right and working so hard to not be losing quicker than you were! I was thinking you should have upped your fat to 80% or higher & lowered your protein to see if that helped or even eat before noon a few times a week not to be fasting 15 hours every day.

    Would be interested in hearing how you're doing now!

  29. SD
    Can someone explain lowered Glutathione levels on a strict keto diet? All plant fats, high daily exerciser, excellent shape, NO alocohol (which lowers GSH). From what I've read in the literature, it should be upregulated?
    Reply: #130
  30. Kristin Parker Team Diet Doctor

    Can someone explain lowered Glutathione levels on a strict keto diet? All plant fats, high daily exerciser, excellent shape, NO alocohol (which lowers GSH). From what I've read in the literature, it should be upregulated?

    I am sorry I don't have any research to point you to. Make sure you're eating plenty of sulfur rich cruciferous vegetables like bok choy, broccoli, brussels sprouts and cabbage!

  31. 1 comment removed
  32. jennisurf
    Do i need to be concerned about how many calories i have in a day or is it only sticking to max 20g carbs per day is all that matters??
    Reply: #133
  33. Kerry Merritt Team Diet Doctor

    Do i need to be concerned about how many calories i have in a day or is it only sticking to max 20g carbs per day is all that matters??

    We don't recommend counting calories. Here's a great article that explains why!

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