Four weeks of a strict keto diet and ketone monitoring

Can ketone measurement help you lose weight and improve performance? That’s the main question I’ll be trying to answer with my four-week experiment.

See Report #1 for diet and experiment design.

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

Below are graphs of my weight and waistline over this first four-week period, as well as the results of blood and urine ketone measurements.

optimal-ketos-4veng

After two to three weeks of light nutritional ketosis, I’ve now spent 8 days in “optimal ketosis” – that is, between 1.5 – 3 mmol/L. Want to know what’s happened?

The effects of optimal ketosis

Weight

Although happy with my weight before this experiment, I’ve become noticeably leaner: -4kgs (9 pounds) and -6cm (2,5 inches) around the waist. This, of course, in complete absence of hunger – in fact, I’ve seldom felt so constantly sated. Food is tasty to eat at mealtimes, but I can skip a meal without even blinking.

My weight – initally 100kgs – was already well within normal range, considering I’m 202 cm tall – 6 feet 7 inches – and do strength training regularly. The other measurement I kept track of was my waistline. 94cm or less around the waist is considered excellent for men; I started out with 91cm, and am now around 85cm (33 inches). I need to punch a new hole in my belt, which means I’m leaner than I’ve been in a very long time. Not bad for a forty-year-old father who has limited time to work out and always eats his fill!

Mental effects

Being the father of a small child, I often get tired from lack of sleep, and during the first week of the experiment I sometimes felt even woozier than usual. This is natural while the brain adapts to running on ketones.

The last two weeks brought everything back to normal again. Or perhaps I even felt sharper and found it easier to focus for longer periods of time? Hard to tell. Perhaps it was just my imagination.

Some people have mentioned having more colourful, dramatic dreams when in ketosis – at least during the first period. I actually think this was the case for me during the first couple weeks, too.

Exercise

Due to a tight schedule, my exercise has been limited to one short weekly strength routine at the gym, in the style of “Body by Science”. I take note of the weights and times I manage though, which makes it easy to compare my weekly performance.

  • The first session, following one day of strict LCHF, was nothing out of the ordinary.
  • The second and third sessions, after 7 and 17 days respectively, showed a marked performance decrease. My muscles tired more quickly.
  • The fourth strength training session, 26 days in, showed a better result than when I started.

Just as I had expected, exercise was tougher the first weeks of strict LCHF. However, four weeks in I was back at my original strength level – despite losing weight.

The combined result of less body fat while keeping (or slightly improving) my strength level reminded me of the new study conducted on elite gymnasts. Being stronger with less body fat is certainly much coveted by athletes.

Other early effects of ketosis

Another thing I noticed during the last week, i.e. during the most pronounced ketosis, is the diuretic effect. I was copiously leaking ketones (as is evident from the urine ketone levels), which take a lot of water with them going out of the body. A few of the days I drank lots of water trying to quench a stubborn thirst, and consequently paid frequent visits to the bathroom. My mouth felt dry no matter how much I drank.

Today, this is much less noticeable. Perhaps my body is adapting. Many people seem to stop leaking ketones through urine in the longer term, coupled with still being in ketosis according to their blood ketones. I’m excited to see if the same will happen to me.

A similar trend can be noted with the breath issue. The first days or weeks of ketosis, many exhale small ketone bodies, acetone. Ketosis breath has an odour reminiscent of fruit (that’s putting in nicely – others put it right up there with rotten apples), and may also be reminiscent of nail polish removers (which often contain acetone). If you find yourself experiencing this, bear in mind that it generally disappears in a couple or several weeks*. I’ll just wait and see if that’s true for me too, as I’ve had that kind of breath once in a while.

Sense of taste

Another interesting thing I’ve heard people mention during ketosis is the way they experience sweet tastes. For my part, I never drink soda and almost never eat any kinds of sweets as it is. I do however tend to enjoy fruits and berries regularly. Of course, striving for optimal ketosis means completely abstaining from everything sweet, and after doing so for a couple weeks, I one day mindlessly ate a piece of banana my daughter gave me. It felt like an explosion of sweetness. The fewer sweet things you eat, it seems, the more your sense of taste adapts.

The same principle appears to work the other way as well. Those addicted to sugar and used to consuming large amounts of sweets/artifical sweeteners daily, will have a hard time registering the sweetness of something only fairly sweet.

Transition troubles

From what I’ve read and heard, the first week of strict LCHF seems to commonly bring headaches, dizziness, tiredness, palpitations and irritability. I felt none of these things, save for a slight “woozy” feeling on some of the first days. This is probably because my everyday liberal LCHF diet should mean already I’m partly ketone-adapted. The lack of heavy transition troubles can also be because I took care to stay hydrated and get enough salt, which usually keeps the worst symptoms at bay.

Summary

This is going well so far.

  • Weight loss without hunger, even down to being very lean. It’ll be interesting to see where my weight stabilises; I’m guessing, pretty soon.
  • An overwhelming sense of satiety, which is quite practical if you don’t have time to constantly be eating.
  • The exercise routine seems to be running smoothly now that I’m a few weeks in.
  • My mental focus feels at least as sharp as before.
  • On the downside, there’s sometimes been a pronounced diuretic effect, and ketosis breath once in a while. Hopefully, these will disappear with time.

I’m going to keep this going for a while more, to try and experience the full effects of ketosis, and also to be able to perform some interesting and accurate experiments with different types of food and ketosis. More reports to come!

Previous related posts:

Lose weight by achieving optimal ketosis

A new toy measuring blood ketones

The ketone master has arrived

A keto diet for beginners

Experiment: Optimal ketosis for weight loss and improved performance

*/ For some individuals, this might not even disappear in the long term. If you’re one of those, and decide you don’t want to go around constantly smelling of ketosis, or rely on a constant supply of breath mints, you’ll probably have to settle for a more liberal LCHF diet. That is, eat some carbohydrate; around fifty grams or more a day will keep ketosis away. Unfortunately, this is a compromise, meaning you won’t be getting the maximal effect of your LCHF diet.

61 comments

Top comment

  1. it's really cool that counting ketones in your blood isn't an eating disorder, unlike counting calories in your food. that's really cool.

    Counting calories, staying hungry and desperately trying to ignore your body's natural hunger signals forever = first step on path to anorexia and/or bulimia.

    Checking your ketone levels while eating as much delicious food as you want = path to becoming a low-carb nerd.

    Reply: #62
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  1. mlaz
    I would like to know if any one has a easy to follow sample menu. I don't know what I'm doing wrong I have not lost any weight , please help. I avoid milk and milk products except cream cheese, I'll snack on almond butter,any ideas?
    Reply: #63
  2. 1 comment removed
  3. Walter
    I have been on an LCHF diet for about 3 weeks now. The beginning was admittedly somewhat tricky and I had some of the mentioned symptoms (Keto flu as it's called) but only fairly slight, mostly this was probably because I pre-emptively mitigated them by following the typical advice (started making/drinking bouillon pretty much on a daily basis, started taking a moderate multi-vitamin, drank lots of water, all the while keeping carb count way down as much as possible though otherwise eating as much as I wanted, keeping protein moderate as well.)

    Anyway, generally I feel fantastic and what I've noticed is that my energy levels are far more stable, including my mental acuity and ability to focus. I seem to be able to concentrate and focus for hours on end which was not nearly the case before I started this.

    @mlaz: What I've done for diet:

    Breakfast:
    Mostly eggs [typically 2 or 3] and a few generous slices of cheese [mild cheddar but you could use any high-ish fat one], some days bacon as well. Eggs are made with a generous helping of butter [no oil] and I add a pinch of salt. Also I have pouring double cream in my coffee (and sometimes butter or coconut oil)

    Lunch:
    I found lunches very hard in the beginning as there's such a lot of food that contains carbs. Even the high-fat wraps that would be good in terms of fat/proteien content at my local supermarket *also* contained enough carbs to blow through the entire allowance for the day. Not an option.

    So, what I've finally settled on for most lunches, that works well, is cheap, and is amazingly satisfying is the following:
    1) Buy a simple salad bowl (approx 100g of salad -- this is quite a large bowl!), basically lettuce and a few other leafy things, perhaps a *small* amount of carrots, some cherry tomatoes etc. Check the carb content, if it's about 5g or less of total carbs then this is fine. Where I live you can buy that for £1.
    2) Buy a bottle of virgin olive oil and a bottle of white wine vinegar (preferably) or perhaps a bottle of balsamic vineger. Note: There's nearly no carbs in the white wine vinegar so this is preferred, but the balsamic should be fine provided you limit your use: I stick to one desert spoon balsamic max. in one salad bowl. This is enough for a tasty salad and adds perhaps [off the top of my head] 2-3g of carbs max. Quite acceptable.
    3) Go to the cold meats section of your supermarket and buy (to your taste) a pack of about 90-120g of :
    - Chorizo
    - Pepperoni
    - Salami (especially pizza salami which seems to contain a higher proportion of fat)
    4) Go to the dairy section of your supermarket and buy some cheese sticks, perhaps a pack of 5 (total weight about 100g or so.) Make sure it's real cheese e.g. cheddar or something (not processed cheese).
    5) Optional: Buy some nuts, I buy Macadamia, Brazil and Walnuts typically.

    So aside from the olive oil and vinegar which will last a long time, and the nuts (if you elect to buy these) and will also last multiple meals unless you overdo it), this costs only about £3 per visit and as you won't typically use all the ingredients every time it works out to be quite cheap (though you can, and I have on occasion!..)

    To prepare your salad:
    1) Add a generous helping of olive oil to the salad
    2) Add a small amount of vinegar
    3) Add some of the salami/chorizo/pepperoni, cut it into bits if you like. I usually use about half a pack. I have on occasion used the entire (90g) pack...
    4) Add some cheese, sliced into cubes or so. Again I usually use about half the pack (but have used the entire pack on occasion.)
    5) Sprinkle in a few nuts to taste (4 or 5 from 1 or 2 packets).
    6) Mix it all up properly
    7) Enjoy a very satisfying meal.

    I've found this to be very effective at keeping me fed while keeping me in ketosis for lunches.

    Dinner:
    Typically some proteien (steak, Salmon, or chicken) with some stir fried something (in a generous helping of olive oil typically): Typically leafy green things etc, like spinach, kale, lettuce, asparagus, celery, cucumber etc. Check the carb contents and don't be afraid to experiment. Often when stir frying the veggies I'd toss in a few more nuts to taste. For the meats err on the side of being generous in respect of fats/butter rather than not. Occasionally I'd add some cheese here as well, or some cream cheese (check the carb content, you want the high-fat low carb sort).

    I found these meals relatively easy to prepare and wonderfully satisfying without having to eat a massive meal, and again keeps me in ketosis very effectively.

    I hope these suggestions give you some inspiration.

    (Just to be clear, I'm also fairly active as I'm also training for a marathon, hence I run about 20 miles a week at present. I mention this as just for your information as it might play into your meal sizes -- obviously I'll eat more than the typical person thanks to the amount of additional calories I burn through excercise.)

    Aside, I also bough a Freestyle Optium Neo blood glucose and Beta-Ketone monitor. This is not exactly cheap but especially in the beginning I've found this highly useful to get an objective reading as to whether I'm either a) in or b) remaining in ketosis after a meal. Over time you'll also learn how your body reacts to various meals, and of course it also helps monitor how your body adapts etc. It is just very useful to remove some of the guesswork so is highly recommended to give yourself the best chance of success. I've also tried uranalysis strips but I've found them problematic as it's hard to tell how your body reacts to a meal from them. Still, they're better than nothing and cheap so you might also want to get them as a low cost stopgap occasionally.

    Good luck.

  4. Miguel
    I've started ketosis on August 12th 2016 and I had some full blown cheat days (Aug 20 & 21) but for the major part I stick to it. I am not diabetic so I don't think I ever produced ketones in my life.

    I believe I am now keto adapted and I really really really REALLY have a hard time adapting to ketones. I feel like I am potty training again. I can never tell if I will pee 1 teaspoon or pee a normal amount, it's REALLY annoying and frustrating because the URGE TO PEE is present constantly throughout the day!

    I even went through I'm pretty sure Adrenal Fatigue just a couple days ago and MY HORMONES WENT OUT OF WHACK LITTERALLY!! I am 29 yrs old, 5' 11'' & now 155-160 lbs. I started eating more veggies & eating limited amount of fruits which I didn't eat before (strawberries, blackberries, blackberries) and also drinking warm water with lemons squeezed in to bring my pH more to neutral as I had a urine test and was high in acetone which is normal on ketosis but I felt like this acid pH may have been causing some issues.

    I'm wondering after being long term keto adapted if this feeling of constant urge to pee even after JUST peeing will go away ? I feel like I could go 20+ times to pee if I didn't control myself and it would most likely be 1 teaspoon of pee which is nothing on most occasions. I feel like I'm potty training all over again! ^_^

    Thanks for your time!

  5. Tracey
    Hi Miguel, regarding your urinary problem. Having hardly any come out means you're dehydrated and need to drink ALOT more! Peeing a lot is good! The urges that you have to pee make me highly, highly suspicious that you have a urinary tract infection or bladder. Men don't get these as often as women do, as your urethra is longer and so puts up a bit of a barrier between the outside and inside world. Mannatose is a natural supplement (a sub-type of sugar) that could help. When passing through the bladder the molecules attach to the sticky sugars on the walls inside, and then get flushed out. That will alleviate the irritiation, but it depends on how bad your case is. If it hasn't healed itself by now, you need to see a physician and they will test your urine for bacteria. If that isn't the cause then you just aren't drinking enough. I suggest when you're at the doctor to talk to him about the diet, it is a very strict and worthwhile diet, but we all need to share with the doctor so he can do proper tests for cholesterol levels, blood pressure, weight, vitamin deficiencies, etc. so that you don't harm your body doing the diet. You should READ ALOT of articles and advice from technical sources off the internet and get yourself a few cookbooks. You need to eat as well as you can (avocadoes, MCT oil or olive oil, fish, chicken, the three nuts: macadamias, walnuts, brazil, take your vitamins!, lots of dark green veg and salads, and don't forget your salt intake has to be high, with magnesium and potassium rich foods. All the best!
  6. Becka
    What does a Keytone meal plan look like? I get conflicting reports from trainers and nutritionists that you need to eat this many or that many meals even if not hungry because if you get hungry your already starving. I don't always wake up hungry and would workout without food I figured I would burn fat instead. I have also been told that you have to drink a protein drink after working out to fuel your muscles. I can typically do 2 - 4 weight or cardio & yoga classes a day at the gym. How do you refuel?
    Reply: #57
  7. Apicius
    Becka, don't eat when not hungry. Let your body go through a fasting period and you will burn more fat. You won't starve because your body is eating (your fat). Look up information on "intermittent fasting" on this site. Especially the entries written by Dr Jason Fung.
  8. Wangai
    I would like to warn people who stay too long in ketosis, mucus membranes in your body rely on glucose to produce mucus, most people on a ketosis diet die prematurely from gastro-intestinal cancers. This (Ketosis) is why people have dry eyes, mouth (lips) and this extends to lungs and intestines. Just have little carbs, but dont stay too long in ketosis.
    Reply: #59
  9. Apicius
    Wangai,
    Where are you coming up with this BS? This is simply untrue. Where are your scientific resources to back up your false claims?
    People on this website have been in ketosis for months and years, including me, and have never experienced the BS symptoms you mention.
  10. Inga
    Hi there.I am 23 days on keto. I'm 66kg at 166cm a would like to lose about 10kg of weight. I am very strict with carbs and in fact don't consume more than 10/day. Is there an estimation of how much I should be losing. I have lost 2kg in the first week (perhaps water weight) and have not lost a gram in the past 2 weeks and am very frustrated.
  11. 1 comment removed
  12. Samantha
    Dr. Andreas thank you for your input. I would like to know what menu plan you used for the 4 weeks. I think I have reached a plateu. I want to lose more weight. Can you point me in the right direction? Maybe you have already posted menu meal plans already / what worked for you.
    Also it would be cool if there was a way to track the posts / reply's I write because I forget where I wrote something and if someone reply's I can't see the reply :(

    Thank you!

  13. Fatman300
    Probably too much protein
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