Lose weight by achieving higher ketone levels
Before we get started, here’s a short recap of the tips so far: The first and most crucial piece of advice was to choose a low-carb diet. The next were eating when hungry, eating real food, eating only when hungry, measuring progress wisely, being persistent, avoiding fruit, beer and artificial sweeteners, review your medications, stressing less and sleeping more, eating less dairy and nut products, stocking up on vitamins and minerals, using intermittent fasting and finally, exercising smart.
This is number sixteen:
16. Achieve higher ketone levels
Warning: Not recommended for type 1 diabetics, see below.
We’ve now arrived at tip number 16. If you’re still having trouble losing weight, despite following the 15 pieces of advice listed above, it might be a good idea to bring out a controversial option: higher ketone levels. Why is it controversial? For most people, “low” or “higher” ketone levels don’t make a difference for health and weight loss, and in general we do not recommend shooting for a specific ketone level. However, for some people stalling at weight plateaus while on a low carb diet, trying to raise ketone levels may be of benefit.
So how does this work? A quick run-through: The first tip was to eat low carb. This is because a low-carb diet lowers your levels of the fat-storing hormone insulin, allowing your fat deposits to shrink and release their stored energy.1 This tends to cause you to want to consume less calories than you expend – without hunger – and lose weight.2 Several of the tips mentioned above are about fine-tuning your diet to better this effect.
Video course
Do you know exactly how to eat a low-carb and high fat diet (LCHF)? This is required for ketosis. If not the easiest way is watching this high quality 11-minute video course on how to eat LCHF, and the most important things to think about.
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Ketosis
Ketosis is a state at which the body has an extremely high fat-burning rate. Even the brain indirectly runs on fat, via ketone bodies. These are energy molecules in the blood (like blood sugar) which become fuel for our brains after being converted from fat by the liver.
To encourage ketone production, the amount of insulin in your bloodstream must be low. The lower your insulin, the higher your ketone production. And when you have a well-controlled, sufficiently large amount of ketones in your blood, it’s basically proof that your insulin is very low – and therefore, that you’re enjoying the maximum effect of your low-carbohydrate diet.3
Measuring ketones
Today, there are reasonably-priced gadgets available for measuring ketone levels at home. One needle prick of the finger, and in just a few seconds you’ll know your blood ketone level.
Blood ketones are best measured on a fasted stomach in the morning (before breakfast, that is). Here are a few pointers on how to interpret the result:
- Below 0.5 mmol/L is not considered “ketosis”. At this level, you’re likely not in your fat-burning zone.4
- Between 0.5-3.0 mmol/L is nutritional ketosis. This is where you see the beneficial effects on weight and metabolic health. For most people, it won’t matter where in this range you fall
- Around 1.5 – 3 mmol/L is the upper end of nutritional ketosis. If you have hit a weight loss stall without a clear reason, one possible intervention is to increase your ketone levels. Although there is no scientific support for this intervention, rare cases may see benefit.
- Values of over 3 mmol/L aren’t necessary. That is, they will achieve neither better nor worse results than being at the 0.5-3 level. Higher values can also sometimes mean that you’re not getting enough food. For type 1 diabetics, it can be caused by a severe lack of insulin, see below.
Ketones in urine
Ketone levels can also be measured in a more old-fashioned way, with urine test sticks (sold prescription-free in pharmacies or on Amazon). Ketone sticks give less reliable results for several reasons, and the above recommendations can’t be straightforwardly applied to them. They are, however, much cheaper.
My personal experience
Feel free to read my accounts of a two-month personal trial:
- Experiment: Higher ketone levels for weight loss and increased performance
- Four weeks of strict LCHF and ketone monitoring
- Final report: Two months of strict LCHF and ketone monitoring
Although I was quite happy with my weight before these trials, they resulted in a further loss of 4.5kgs (10 pounds) and 7cm (3 inches) around my waist – without additional exercise or even the slightest resemblance of hunger.
How to achieve higher ketone levels
Many who firmly believe they are eating a strict low-carb diet are surprised when they measure their blood ketones. They may be at around only 0.2 or 0.4. Why?
The trick here is to avoid all obvious sourced of carbohydrate (sweets, bread, spaghetti, rice, potatoes), consider time restricted eating, and use fat as a lever for taste and satiety.
Sometimes adding MCT oil to your coffee or tea can help increase your ketone levels which may or may not resolve your stall. It may not be “magic” for everyone, but for some it may just do the trick.
If it doesn’t work
Having higher ketone levels for a prolonged period of time (say, a month) will ensure that you experience the maximal hormonal effect from eating a low-carb diet. If this doesn’t result in noticeable weight loss, you can be certain that too many carbs are likely not part of your weight issue and not the obstacle to your weight loss. There are, in fact, other causes of obesity and being overweight. The next three tips in this series might help you.
Also, consider signing up for our Weight loss for good program, free for Diet Doctor members!
Try it
Order a ketone meter online and start measuring. There are a few different models, the most popular one is probably the Precision Xtra ketone meter. Unfortunately these meters are all quite expensive to use, as the test strips can cost about $5 per test.
Here’s a complete package with everything you need to check your blood ketone levels.
More
Learn much more about ketogenic diets here:
A ketogenic diet for beginners
Watch my video interview with Dr. Peter Attia, on a strictly ketogenic low-carbohydrate diet: Very Low Carb Performance
Read all the tips on the How to lose weight page.
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A word of warning
If you have type 1 diabetes, you should not follow the above advice to purposefully increase your ketone levels – it may be risky. If you have ketones in your blood at all, you must be sure that your blood sugar levels are normal. If they are, you’re in normal ketosis – just like the ketosis of healthy people who stick to a strict low carb diet.
High blood sugar levels coupled with high blood ketones, on the other hand, will mean that you have a pathologically low level of insulin – something non-diabetics do not suffer from. This can lead to ketoacidosis – a potentially life-threatening condition. If this happens, you’ll need to inject more insulin; if you’re at all unsure of what to do, contact a medical professional. Coveting really high blood ketones for weight control is not worth the risk for type 1 diabetics.
The Journal of Nutrition 2015: A lower-carbohydrate, higher-fat diet reduces abdominal and intermuscular fat and increases insulin sensitivity in adults at risk of type 2 diabetes [randomized trial; moderate evidence]
Annals of Internal Medicine 2005: Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes [non-controlled study; weak evidence] ↩
Journal of the American Dietetic Association 2005: Perceived hunger is lower and weight loss is greater in overweight premenopausal women consuming a low-carbohydrate/high-protein vs high-carbohydrate/low-fat diet [randomized trial; moderate evidence] ↩
Current Nutrition Reports 2018: Nutritional ketosis for weight management and reversal of metabolic syndrome [overview article; ungraded] ↩
Some controversy exists for this cut off level as few head-to-head trials exist comparing low levels of ketone production. Some studies have shown benefit of a ketogenic diet with ketone levels as low as 0.3mmol/L. ↩
468 comments
Beware of the dangerous side effects.
Keto diets should only be followed as a last resort and under clinical supervision.
Anyone pushing it otherwise should be subject to prosecution
I know I'm replying to an old post, but wrong is wrong. Net carbs isn't an "idea".
Net carbs = total carbs grams - fiber grams
By definition, your body doesn't metabolize/digest fiber, therefore they should not be counted in the carb total for that food item. It has nothing to do with "binding up" digestible sugar/starch in fiber.
THanks!!
I'm not convinced that those products will lead to weight-loss. What is your experience?
I'm losing weight but very slowly, only one pound or so per week. I was on a two month long plateau but finally broke it by doing more detailed tracking and keeping to under 1,000 calories per day.
How can I stay in Optimal Ketosis all day? How can I accelerate my weight loss? Thank you
First cut out all sugars, then all flour, reduce tubers.
Buy only real high fat food and veggies, frye in butter.. eat a lot of eggs.
Its when your foods look like this you can eat ad libitum.
http://www.dietdoctor.com/low-carb
The magical trick is to only eat real food!
Today is my 4th on an egg fast. I've been on LCHF for about 3 months.
Test 1st thing this morning no food. 1.0
Test 25 mins after break fast. 1.2 (2eggs 2tbs mayo)
Test after 25 mins after lunch. 0.8 (2eggs 2tbs mayo 1oz cheddar cheese)
Surprised I'm only in nutritional ketosis and not optimal ketosis.
So far that is only 16g of protein per meal. Thoughts?
Ketosis and ketoacidosis are two very different things. Ketoacidosis is a state in which you have blood glucose above 600 and a low pH (blood. Not urine) don't be a moron
have you seen the drink that puts your body into Ketosis with in an hour. go to showmetheketos.com
I check my Keto blood level first thing in the morning after not eating for approx 12 hours. Lately I've gone from being in nutritional ketosis to optimal ketosis. I write down everything I eat and admit I never exercise (and I know I need to start). For breakfast, I have several pieces of thick fatty bacon or breakfast sausage links with cream cheese. I slather the Cream cheese right on the bacon strips. That keeps me really full for the morning. I snack on Keto bars (www.keyobars.com) in the afternoon. For dinner I have a small chicken breast with cheese or a few beef jerky sticks.
I found a Great recipe for a no bake Chocolate peanut butter fat bomb. One net carb per serving. Super easy Recipe: 4 TB butter, 8 TB coconut oil, 4 TB peanut butter stir it up, microwave for 1-2 min, stir again, mix in 4TB chocolate cocoa powder and 1 packet of Stevia, stir very well. Pour into 24 cup cake tins and freeze. Delicious!! Be careful to watch the sugar and carbs in your peanut butter. I try to stick to under 4 net carbs for 2TB of peanut butter.
Try to eat 70% fat in every meal or snack then you don't need to worry about distributing the fat. Be careful too much protein can kick you out of ketosis and it can take me days to get back to nutritional ketosis.
There are several Kindle Keto Cook books and free recipes online. I've found that not all Keto cookbooks include the nutritional breakdown of calories, carbs, protein per recipe, which is very annoying. Try Pinterest for some good free Keto recipes.Good luck !!
You should keep proteins to 20 grams per meal.
I gave an opinion on another comment so I'm not sure exactly which procuct he meant. :)
But google on: "exogenous ketones" and you will for example find this product:
https://www.amazon.com/KetoSports-KetoCaNa-Original-Exogenous-Supplem...
Please advise, ANYone~
Brody
You want a 70 20 5 diet. 70% fat 20 protein 5 carbs.
To answer your question is you want to eat 20 percent of your daily caloric burn. If you are burning 1500 calories a day you need to meet the protein calorie requirements of .20x1500=300 a day, .75x1500=1150 calories in fat and .05x1500= 75 calories in carbs
Lastly sometimes it is hard to do percents and counting daily grams works
To Convert calories to grams divide 1150 by 9 for fat, 300 by 4 for protein and 75 by 4 for carbs.
So the most carb you can eat daily is 75/4= about 15 grams of carbs
Good luck hope you read this.
Read the post I just posted above
Your body goes into starvation mode.
Try coming off this diet and maintaining.... Good luck! You will pack back on the pounds quickly.
Also, your body does not have the metabolic capability to turn protein into glucose.... Completely different formula makeup.
Gluconeogenesis...look it up...
Supplement your fats with coconut oils.
I wake up work out then eat around noon and this is what I eat on the daily.
1st meal- 20 grams protein powder mixed with 4 tsb heavy cream and ice, 4 eggs, cup of broth w/ 2 tbs of coconut oil.
2nd meal- 4 eggs, 1/2 avacodo, 4oz. Chicken, broth w/2tbs of coconut oil
3rd- 6 oz salmon or 6 oz. of strip steak, 1/2 avacodo and or mushrooms and or kale.
Late night snack- handful of almonds or celery with 2 tbs of peanut butter.
Lastly, remember to take sublime to for magnesium and to refeed one day a week with nothing but carbs after you have become ketogenic. The carbs raise ur lepton hormone that ramps up metabolism each week.
But good carb lots of fruits, good luck
Not sure I agree with your leptin statement and needing to eat carbs...not true at all.