I'm curious if anyone following Dr. Bernstein's way of eating have ever done a random check of their blood keytone levels.

I follow a low carb plan, but generally find myself between 75-100g of carbs per day.
(Yes, this is over double what Dr. Bernstein recommends - but I stay within the bg targets that I set for myself.)

I've recently read The Art and Science of Low Carbohydrate Living by Stephen Phinney & Jeff Volek.
In that they discuss about nutritional ketosis, and any diet with <50g of carbs/day should put you there. They defined a range of blood keytone levels between 0.5 and 5.0 mmol for those in nutritional ketosis A random test of my own blood keytone levels was 0.2 mmol - short of the range that they identifed. They also had a statement about lc/hf diets, and differentiated about he long term effects those w.o.e that put an individual into nutritional ketosis and those that don't - implying that those that did not wouldn't have the same long term benefits. At the very least, this has caused me to start to rethink where I'm at...
I'm reminded of Mr. Miyagi in Karate Kid:

Walk on road, hm? Walk left side, safe. Walk right side, safe.
Walk middle, sooner or later get squish just like grape.

I'm wondering if the same holds true for lc/hf way's of eating.
I'm curious if others have tested their keytone levels, and where they fall...

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I have never tested my blood ketone levels, but I did partake in the Atkins diet a few years ago, where I ate nothing but protein and fat (it didn't work out for me, and I'm on a more sensible low-card diet now, where I eat about 5-10g carbs/meal).

The Atkins Diet was really excited about ketones, and wanted you to test your urine ketones constantly. I bought the little ketone strips, but never once did I get a result that showed ketones in my urine. Mind you, I was only on the diet for a couple of weeks before I lost it and ate a bowl of pasta.

I have a bottle of ketostix right there in my bathroom, right next to a bottle of glucostix. I used to test for ketones to monitor compliance to my diet. I never had very high ketones, generally marginal or trace. And I don't think I will have high ketones, it just doesn't make sense for my body to generate large amounts of ketones, just to pee them out. The only exception is after exercise when I could turn the strip dark very easily.

Sounds similar to me.

I rarely test (for keytones), and when I do it is mostly out of curiosity.
Aside from rare cases, I usually show "trace" or "small".
In part I believe that this is driven by my level of hydration.
(I typically drink at least 96 fl oz a day, often more.)

It was also my impression that it wasn't unusual for urine keytone levels to stay low once you are keto-adapted...
so there isn't a direct mapping from urine keytone levels to blood keytone levels.

(I typically drink at least 96 fl oz a day, often more.)

I think I drink that much coffee a day. =^)

I'm in the same boat, testing keytones maybe bi-monthly for curiosity sake. I end up with trace to none sometimes.

I never seem to make +k

I'm curious about this as well (and a few other questions I'm going to tag on!).

1: How do you determine that you have keto-adapted? Since the high-fat/low-carb diet is really only healthy if keto-adapted, it seems important to know.

2: What happens metabolically if you over-carb for a single meal? A week straight? How fast does your body return to glucose as a primary fuel? Does it just use insulin to store the glucose as triglycerides? IF it does, do those triglycerides then become available fuel? Would that impact liver function?

3: If urine tests for ketones aren't showing much of note, do you use blood tests? What ranges do you deem acceptable/problematic?

I have adapted to a pretty low carb life these days, and am thinking of taking the leap to try to go ketogenic, but want to make sure I understand it. I've read through
The Art and Science of Low Carbohydrate Living which was a great book, and have Dr. Bernstein's on the way, so there may be many more answers in there. If so I apologize!

My pump reports that I currently average 46g of carbs per day which is probably slightly under-calculating as I'll snack on nuts between meals and not bolus for it. Last A1c was 5.3. SO I figure I am close enough to make it a fairly easy transition. Just want to do it right!

Hope I'm not redirecting your thread, Knightshade. I think my questions are likely ones you may have as well, so it seemed better to tag it on here than start another thread.

Edit: I did just watch the interview with him that is posted in this thread, which did discuss some of #2 above. He noted that breaking from the diet "for a weekend" could result in a week or more of re-adaptation. It wasn't specified the impact of the metabolic shift though.

I wonder how that would change insulin needs (both basal and bolus).

I saw that interview as well.
I also listened to a podcast with Mark Sisson who argued against that interpretation of the data...

At this point, I'm not sure who is correct....
In part, that is where my question stemmed from.

Where is the dividing line between being keto-adapted vs glucose-adapted?
Is it a line, or are there shades of grey as you approach it?

My personal impressions are that there are shades of grey between 50g of carbs per day and 100g of carbs/day

My understanding, from Stephan Phinney's perspective as a low-carb athlete anyway, is that you need to be in ketosis to get the full benefit of a low-carb diet. In order to do this, you have to drop your carb intake to the point where you are storing extremely small amounts of muscle and liver glycogen.

I imagine that the amount of carbs required to induce ketosis probably varies. Stephen Phinney strongly advises against even the smallest deviation from the amount of carbs that put you into ketosis.

Phinney does have some experiemtal evidence from animal models as support. For humans, it's a mix, but, from what I can see, the strongest results seem to depend on how much you engage in endurance activities. This makes complete sense to me.

Second this thought process. Exercise, even in small amounts really goes after the glucose stores you have and once depleted the Bernstein process seems to really kick in (fat for carbs, etc.).

The problem I find is that days when I am ketogenic my insulin requirements plummet and control becomes rather difficult to the point that I end up eatting more carbs to correct for LBS.

I think that this is one of those phrases that I've been having difficulties with: "full benefit of a low-carb diet"

Is there an itemized list of what this entails?

Perhaps with that, we could judge at what levels those benefits became apparent.

So far, I've been able to accomplish everything that I wanted a low carb diet to accomplish by hovering at the 100g of net carbs/day....
The mindset above implies that there are other benefits to be realized with further restriction....

More efficient use of fat and, apparently, an increased aerobic capacity along with, what Phinney claims, is more efficient glycogen use (I'm skeptical on this point).

Ketosis, basically, turns you into a fat burning machine.

I imagine that there is some gradient to these effects according to how many carbs you are taking in. In ketosis, however, these are maximized because your body doesn't really have a choice.

If your carb level puts you where you want to be otherwise then, yeah, why bother?




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