The goal is not to make the keto meter read 3+. - *The Scribble Pad*:

*The Scribble Pad*: The goal is not to make the keto meter read 3+.

I more or less wrote this blog entry a few days ago, but I'm writing it again for emphasis.

First, let me ask you why you are reading this blog? Because you are on a low carb diet probably. Also, because you like teh lulz.

Why are you on a low carb diet? To control your blood sugar, perhaps? To
control an endocrine problem related to blood sugar disorders like
PCOS? To control obesity? To help a neurological problem like migraines
or depression ? I can reliably bet your response isn't "I'm on a low
carb diet to get my keto meter to say 4" .

The ketosis blood monitoring experiment has been very helpful for me.
First, I've learned that I feel much better emotionally when eating an
even lower carb high fat diet. There seems to be clear mood benefits
when I am more specifically ketotic. I also seem to lose body fat eating
a ton of food calories if I am more ketotic. You have seen my CICO
counts, and I tweet photos every day. This was taken yesterday. Here's another photo.
I've lost a lot of body fat in a short period of time. I'm not even
weighing myself but my pictures make it obvious I am way thinner than I
was just a few wks ago. I gained a lot of fat during fall crap out, and I
am almost as thin as I was in November.

If your keto meter is telling you that your blood ketones are >0.1 or
so, YOU ARE IN KETOSIS. Normal people do not have ketosis readings much
greater than that.  Maybe after exercising while on a diet they will be
slightly higher than .1 , but only on ketotic diets will you see BOHB levels of 0.5, 0.6, 0.7, 0.8 etc.
For people eating relatively normal mildly ketogenic diets typical BOHB
levels are going to be like 0.6 to 1.5 range like the kind of readings I
am getting. That would represent very low carbs, very high fat atkins type eating.

A person who is sick, with diabetes, with life threatening insulin
deficiency will have BOHB levels of like >8. This is ketoacidosis.
Starving people eating nothing at all get to like ~4 or ~5. Starvation
involves pathologically low insulin, just like diabetes. With this in mind think about what it must take to 4 while eating food? Assuming
the person is eating enough calories (vs simply eating 500 cal per day
and starving self on a "keto diet"), the only way to get ketones this
high is to more or less pare down your diet to oil/butter, and fast. If
you think this kind of diet is without consequences you are insane.
People are not meant to live on butter and isolated fat. Basing your
diet on butter like substances sounds like a horrible idea to me unless
there is a really strong medical reason like disease.

The ketotic diet can become very cult like, it's amazing how one is made
to feel like a failure if their keto meter isn't high enough. It's
not enough to be IN KETOSIS these days; no, you need to be "winning" the
ketosis video game by reading 3.5 ketones or whatever.
The fact I have maintained massive wt loss for over a decade isn't enough, nope, ketones only 1.5 when exercising!

This is success, not a keto meter number.

As I've written before, it is also going to be *easier* for people who
are obesity resistant to get very high keto numbers simply because of
nervous system dynamics. Not only do they fail to store much fat eating
cookies and cakes (relative to the constitutionally obese) but the same
rules apply to ketotic diets, and they easily tear apart their fat
tissue/ resist storing it for energy. This produces those super high
keto numbers. Hyposympathetic types who are highly predisposed to obesity like wooo are just not going to be able to score ketones of 3. I
would literally probably have to be starving to ever see ketones that
high. I think even if I were eating pure fat and exercising an hour a
day it wouldn't get much above 2.

It's important to remember the ketones don't really make you lose
weight, they are only a sign of very low insulin signalling in adipose
and imply lack of weight gain/active weight loss. There is evidence
ketones themselves help promote leptin signalling and may be useful for
wt control, but definitely mostly it is true that cause and effect are
reversed WRT the importance of ketones. Jimmy Moore is not maintaining
weight because his ketones are 4. It's more accurate to say because
Jimmy Moore is eating/fasting/exercising to have ketones of 4, he is
therefore maintaining weight.

The thing is, the reverse isn't true and super intense keto is
not really *necessary* to lose or maintain weight. Just because it is
true being in major ketosis makes it difficult to gain weight doesn't
mean you HAVE TO be in super ketosis or else yr DOOOOMED to get fat. I
haven't had a ketone reading greater than 1.4, and I am still losing
weight. There is no linear relationship between adipocyte energy balance over time and ketone numbers. Merely, the ketones function as a yardstick estimating the current insulin signalling of fat tissue.

Ketones just really aren't even that important even for energy. With
long enough time of a VLC diet the mitochondria rely less on ketones and
oxidize FFA more directly for energy directly. If so, it stands to
reason with prolonged adherence to an extreme low carb diet blood
ketones eventually decline naturally anyway; or, at least, aren't all
that important as a measure of energy. Intuitively I feel as if ketones themselves, the number the ketometer is reading, have very little to do with my energy.
I have been on a VLC for *years* and most evidence suggests ketones are
a short term adaption to glucose deprivation. With extended/prolonged
VLC intakes, the body adapts to using FFA for energy.

The main benefit of tracking ketones is forced adherence to an insulin
inhibiting lifestyle. It isn't enough to just "low carb"; it only works
if your fat cells are not getting an insulin signal. Ketone tracking
helps accomplish this most specifically.

  • Eating tons of food? Binging out on cheese?
  • Not exercising? Sitting fat ass in chair?
  • That keto meter is going to tell you about it in the morning. 
 It doesn't lie. If your basal insulin is high from eating too
much energy (this includes FAT), and not moving at all, your ketones in
the morning are going to laugh at you. The keto meter is like this bossy fitness coach telling you to fast , eat less, and exercise more. While
CICO is a hilarious failure and a joke, it is a biological fact all
energy is insulinogenic, all energy positively influences adipocyte
growth dynamics (although to what extent is HIGHLY variable; e.g. very
obesity resistant people can't even fatten on junk food, whereas
extremely obesity prone people like wooo will fatten even eating too
many calories of a ketogenic diet).  The reason CICO kinda sorta works
is because eating less and exercising more, even of a cheetos diet, will
typically reduce insulin. Ketogenic diets are simply a much more
intelligent and arguably healthier way to do that . Although, if you get
into the "100% butter diet" form of ketogenic, as far as I'm concerned
you might as well CICO on doritos because the health impact is the same
for most people, grossly nutrient deficient.

Proneness to weight gain , as I stated, is very individually variable.
What I am calling "obesity proneness" is the sum of a myriad of
neuroendocrine dynamics influencing the adipocyte.  Type as well as
amount of dietary energy is just another factor , although obviously a
critical one as no obesity can occur without food energy just as a boat
full of holes can only sink if you try to sail it.  Blaming food
calories for obesity is like blaming the ocean for making a boat full of
holes sink. Proper boats are meant to float and proper bodies use fat
tissue for energy vs storing it escalating fashion. The following is a
broad list of the main factors determining obesity proneness. These
factors control insulin signalling int he adipose.

  • sympathetic nervous system: adrenergic receptors on adipocyte
    , thyroid hormone, influence rate of lipolysis and fat oxidation. This
    also doubly influences insulin sensitivity  (less SNS, more insulin
  • parasympathetic tone: actively antagonizing and suppressing
    the action of the SNS,  also directly contributes to gastric motility
    and digestive function which means higher insulin levels with feeding,
    inhibited use of fat for energy. If it is excessive a person experiences
    frequent hypoglycemic excursions and sluggishness. The obese may be
    parasympathetic dominant if they have hypothalamic obesity. The post
    obese are all without exception  parasympathetic dominant as a normal
    function of leptin deficiency in the CNS.
  • "Carbs make insulin" is an extremely one dimensional way of
    viewing the problem of obesity. Actually, all food makes insulin (even
    butter), and insulin level is just a tiny fraction of the story. While
    all adipocyte growth occurs and inhibition of lipolysis relates to
    insulin , insulin isn't some free agent; it is a slave of the nervous system. If
    you have a low SNS and a high PNS you might have very low insulin but
    guess what? Insulin signalling in adipocytes is going to be super duper
    and you are going to get fat even on trivial intakes. You are
    also going to have functional hypothyroidism and feel like crap with no
    energy 24/7. The thyroid and SNS have reciprocal relationships, and both
    stop insulin action in fat tissue while raising fat oxidation.

You know what? After doing this ketometer experiment for a few days, I
can honestly say being in deeper ketosis does not help with weight
control. It does, but the causation is reversed. My ketones are >1
when I have done exercise and consolidated eating via semifasting.  It is active insulin inhibiting behaviors truly causing the resistance to weight gain even eating tons of calories.
The ketones are just a useful yardstick to estimate effectiveness, but
by no means is it required that ketones be elevated to lose weight
effectively. Also, there is much more involved to a proper keto diet
(just like a proper weight loss diet) than simply eating fat and not
eating carbs. Eating a bag of macadamia nuts sitting in a chair is not
making me feel energetic and lose weight. In fact, being sedentary while
pigging out on ketogenic food is a great way to have low fasting
ketones and to gain body fat (at least for me, given how prone to
obesity I am).

To cut to the chase I would probably say, for simplicity sake, yes, I
lose weight when my ketones are over 1. However, this is a gross
misrepresentation of what is really going on. In reality it is most
proper to say BECAUSE I have  been consolidating eating (semi-fasting)
and exercising, my insulin levels are significantly lower, which is
provoking fat loss and symptomatically my fasting ketones are higher. Do
you see the difference between these two concepts, because it is a HUGE
one. In the latter framework, ketones are merely a passive symptom
of insulin levels for the obese person, much in the way blood sugar is a
symptom of insulin for the type 1 diabetic. 

 When obese people see rising ketones as part of a ketogenic diet
this is a redundancy with insulin signalling being inhibited in the
adipocyte. This may be achieved by serum insulin reduction, or it may be
achieved with sympathetic stimulants / catecholaminergic drugs that
provoke increases of SNS acting on the adipocyte. Both will raise
ketones because they inhibit insulin from talking to fat tissue. The
reason meth users (or wellbutrin users, or phen/fen users) become  thin
is sympathetic stimulants prevent insulin signalling of fat tissue, via
very high fat oxidation from the stimulant.  Stimulant drugs and the SNS
produces a condition which is polar opposite of normal weight loss...
however, whenever ketones appear it is only a symptom, not a cause of
fat loss. It is not required either.

Functionally this is no different than a type 1 diabetic being able to
predict their insulin levels by their blood sugar. If their blood sugar
is 250 they didn't take enough insulin. Other things may lead to high
blood sugar (as expected, all drugs that disrupt insulin signalling of
the fat tissue will typically worsen diabetes, but make obesity way
better e.g. stimulants and thyroid). Generally speaking rising sugar
reflects lower insulin/not injecting insulin. Diabetics will say for
simplicity sake that high blood sugar causes diabetes, but
pathophysiology wise this really isn't true; the high sugar is a symptom
. In weight loss, ketones are a symptom of losing weight, and only
SOMETIMES is this true.

In typical wooo fashion I am going into excessive needless detail and
escaping the main point I am trying to make. Summary of ideas:

  • Ketones are a symptom of insulin inhibiting behaviors. Ketones do
    not cause weight loss, although it may be true they help inhibit weight
    via central effects; it is still overwhelmingly true ketones are at best
    a placeholder for insulin levels/signalling activity in the adipocyte.
  • For most of us the goal is simply to lose weight, have
    energy...doing everything you can to raise that keto number may be very
    counter intuitive indeed. 
  • Eating more fat in obese prone people will often lead to elevations
    of insulin/ insulin signalling in adipose and ironically lower fasting
    ketones. The best way to get a high ketone number, which means to say, a
    low insulin level, is to EXERCISE, ENERGY RESTRICT and/or FAST. Eating
    nothing at all is ideal, and also leads to the fastest weight loss.
  • People who are generally obesity resistant with really great SNS
    tone are going to have high fasting sugar and high ketone levels very
    easily. They also feel really great on these diets because of how well
    their body can make energy from fat tissue and how reluctant it is to
    store food in adipocytes. They may shame and guilt you for not being
    "keto enough" but they do not understand these things are regulated by
    the nervous system. I have been trying to explain to DLS pablo that his
    body works differently from mine for like weeks now and he still tells
    me how great he feels eating one meal a day and I'm doing it wrong.
  • Remember above all else, THE GOAL IS NOT KETONES. I am guilty of it,
    falling into the trap of feeling "bad" I'm not ketogenic enough, but
    take a step back and look at big picture and remember the real goals.

For me personally , the biggest benefit of specific keto is for my depression and emotional state. I
am open to idea it is helping me lose weight but the improvement is
mood is much more specific / obvious. If my only concern was weight I
would not be doing keto at all. I would be pigging out on protein ,
eating lean protein and lower fat things.

Keto is great for wt control but the very high fat moderate protein diet
makes it EASY to get fat relative to high protein, lower fat & carb
diet. OTOH, the high protein/low fat diet is horrific for mood
(probably seizure too lol) so keto is what wooo needs. But if you are
big fatty who only care about not being fat, base meals on protein and
don't worry too much about keto. 99% of normal people feel really
stuffed eating meat and  get super skinny following basic meat based
atkins. Oh, and stop worrying about your keto meters.