Ketosis VII: Practical recommendations

Well, here we are at our final Ketosis post!  It has been a long ride for all of us, and I hope you have learned as much as I have while researching the topic.

We have seen a lot of benefits of ketosis from helping lower triglycerides to helping with certain neurological conditions.  Now while all of these things sound great, how do we appropriately approach ketosis?  While many of us may want to try and be in ketosis at all times after seeing these benefits, and that it is a normal, physiologic process, I do think there are some reasons to not be in ketosis all the time, but I will cover those in a separate, later post, since I think they relate better to a different topic I have been thinking about lately.

So we know we have three main ways to get into ketosis: fasting, low-grade exercise, and high fat diets.  I think an appropriate ketosis-style diet is one that will combine all three of these into a cyclic approach, that way we make sure to leave ketosis for a little bit every now and then.  Also, as you will remember from my cornerstones of health posts I believe a system of HOW you eat it is very important to overall health, and we will also incorporate this system into our ketogenic protocol.

To start off our ketogenic protocol (KP), we will begin with fasting!  We have seen the benefits of fasting from this post, and we also talked about its role in ketogenesis in part I.  We can see here that a 12 hour fast is enough to induce about a 5-fold increase in ketones (1).  Now, many of you may be thinking a 12 hour fast is quite a lot, but if you think about it, if you stopped eating after dinner at say 7pm that would only be fasting until 7am the next morning.  This type of eating simply reflects the cornerstones to only eat when hungry and to satiety.  After you do those two things I think the fast portion should be taken care of!

Now in these mornings in your fasted state a little walk would be a great way to further induce ketosis, especially if you were trying to lose some weight!  This is exactly the type of prolonged light exercise that had been shown to increase ketogenesis.  However, if you are not trying to lose weight, I don’t think exercising at this time will give you the greatest returns, so I would save that for later in the day.

When it is time to eat, what should you pick out?  It is time to add in our third way to induce ketogenesis, high-fat meals! I am currently enjoying some coffee with heavy cream in it, and this type of high fat drink is a great way to keep ketogenesis going.  With it, I would say a nice high-fat breakfast is a great way to start your morning and will keep your ketone generators burning well into the afternoon!  It is important here to limit carbohydrate intake, so something like a few eggs and bacon or sausage should keep you going for a while and maintain ketogenesis.

So if we ate our dinner at 7pm and fasted until 7 am, at which point we had a high-fat breakfast we could conceivably stay in ketosis until we ate our next meal, which might be around noon or so. That would be 17 hours where we are sure to be in ketosis!  At this point I would say we could add in some carbohydrate, and begin our cyclic approach to ketogenesis.  We can curtail it here, and eat what we feel like for the remainder of our eating window.  However, we must keep cornerstone #1 in mind, and be sure to stick to whole food carbohydrate sources, like potatoes or, since it is winter, some squash would be tasty!  We have gotten a lot of the benefits of ketosis during our 17 hours.

Another thing to keep in mind is at any point during the 17 hours you should be sure to consume some type of MCT!  I like to eat a couple spoonfuls of coconut oil with my breakfast, but you can do this at any point throughout the 17 hour window.  This will be sure to give you a nice jump up in ketosis.  I like to do it towards the end of my fast, to help keep it going farther into the day, but it could easily be done right away to jump start it!

Also, note that the 17 hours is not a be all end all, it just seems to be an easy plan to keep up ketosis for the majority of the day, while still leaving time to return to a normal state.  If you would like to try staying ketosis for longer by all means eat some more MCTs during the day, or eat a high-fat lunch and save almost all of your carbohydrate for dinner.  I do think that it is important to get out of ketosis at some point, though.

Another thing to consider is a longer term KP.  If you don’t exercise too much, or not very intensely, you might want to try eating high-fat for a day or more, then high-carb for a day, and rotate this daily regime, rather than cycling during the course of a single day.  These are all things to try, and finding what is easy for you to maintain and makes you feel the best is the best strategy, there is no one-size fits all to this kind of stuff!  I think sustainability is the key to any type of eating regime, so what ever you can sustain is your optimal diet.

Finally, I’d like to take just a moment to discuss measuring ketosis.  I know some of you may have heard about the test strips, such as ketostix, but these are not a very good indicator of ketosis.  These strips work by measuring the acetoacetate levels in your urine, and as we saw before it is actually BHB that is the main ketone body in our bodies, not acetoacetate (2).  So these test strips are really a waste of money for trying to measure ketosis.  Another way would be blood levels, which would accurately reflect true ketone levels.  You could try to get a test done at your doctor, but that would be something you could only do sporadically. There are few meters out there for diabetics that will test both glucose and ketones, and these are probably your best bet if you want to try and measure ketosis.  I don’t think measuring it is that important, but I do know that some people like to track this kind of stuff, so if you are one of them I would recommend these meters.

Well, there you have it folks!  This is the KP I would recommend to someone who would like to see if a ketogenic diet would benefit them.  It is relatively easy to perform for anyone out there, and shouldn’t require too much variation from a normal diet.  If you are already eating in a system similar to the cornerstones I outlined earlier, the only changes you are likely to make is adding in some MCTs from either coconut oil or straight MCT oil, and not eating carbohydrates with breakfast.  In fact, I would say just the addition of MCTs is probably enough for the majority of people out there.  As I said earlier it is important for you to play around with this stuff, and see what works best for you, but I think this is a good starting point for most people want to try a ketogenic approach.

I hope you learned a lot throughout this series, I know I did.  And for those of you who were just looking for these practical recommendations sorry you had to wait so long!  There was just too much interesting research out there for me to go over that I couldn’t get to this one as quickly as I had hoped! If you have any questions please leave them in the comments.