A question about ketosis

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  • posted by Lucy1970
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    Hello everyone. I’m going to be starting the fast 800 diet later this week. I’ve been eating low carb for about a week in preparation and have two questions about ketosis please. 1) I’m currently eating about 1700 calories a day, with lots of healthy fats, a moderate amount of protein and plenty of veggies. I’m still having 1-2 portions of fruit a day including the odd banana. Out of curiosity, I tested using a keto stick yesterday and to my surprise, it indicated that I’m well into ketosis. I’m surprised because I’m still eating a fair amount of carbs in fruit, veg and things like yoghurt (I’ve cut out bread, pasta, rice, potatoes, pulses etc). Is it possible to go into ketosis while still eating about an average of 120g carbs a day? 2) Are there degrees of ketosis, and will eating the occasional piece of bread or oats (as Michael says in the book) kick you out of ketosis? I had thought that you had to be very low in carbs to reach a ketogenic state? Thank you. Lucy

  • posted by SunnyB
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    Hello Lucy and welcome – whilst there are broad guidelines re: reaching a state of ketosis, our bodies are all unique and what might kick one person out of ketosis, another can tolerate. That’s not to say the level of ketosis will not be affected, but that it might be a piece of bread will not kick you completely out of ketosis. It is a case of trial and error to find the level of carbs you can have without A) losing ketosis and B) stopping weight loss.

    Personally, I wouldn’t touch oats or bananas with a barge pole and only rarely eat fruit, sticking to veggies, but if you find you can lose weight whilst including small amounts of these, all well and good. It is worth remembering though, that carbs drive hunger making the body crave more carbs, especially sweet sugary carbs which spike BG, so better to avoid wherever possible.

    Best wishes to you and hopefully we’ll be seeing you on other forum threads reporting progress.

  • posted by alliecat
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    I’m so sorry Lucy! 120g of carbs per day is far above the parameters of this low carb, moderate
    protein and high (healthy) fat style of eating. Low carb is defined as <50g per day, and those of
    us who are insulin resistant often go as low as 20g to get into ketosis. If you’re using keto sticks,
    please know that they aren’t very reliable. Hopefully JGwen will be along to advise you on the
    breathilizer that uses to get more accurate readings. Sunny is quite right that carbs drive hunger.
    Best of luck to you with your reboot!

    Allie

  • posted by Lucy1970
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    Yes I realise its well above the parameters, thank you. I’m not intending to be eating the same level of carbs once I start the 800 diet later this week. My question was about whether you can be in ketosis whilst still eating some carbs.

  • posted by alliecat
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    I’m sorry, Lucy, if I didn’t interpret your question well. The short answer is that while on the Fast800, you will be eating
    above ground vegetables, so there will be carbs in all of them to calculate. Since you have been here before, I’m
    certain that you will very quickly resume counting them, as you have done in the past. Ketosis is interesting, as
    some of us can achieve it on <50g a day, and others of us have to drop as low as 20g to get the job done. How did
    you calculate this in the past? Did you have a level that worked for you in your diary?

  • posted by JGwen
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    Hi Lucy,
    From your description of your diet I think it is unlikely that you were in ketosis, most people have to be some where in the range of 20 to 50g of carbs for a period of time to get into fat burning mode. It may be worth looking for reasons for a false positive for ketosis. This article could possibly be helpful. https://patient.info/doctor/urine-ketones-meanings-and-false-positives-pro

    Allie is correct the pee sticks are a notoriously unreliable way of testing. I use one of the cheap breathalysers to test for the by product of ketosis. An AT6000. There is a knack to using a breathalyser, you have to get the last of your breath into the machine. But one is only around £10 and you can test as many times as you want during a day to work out your response to different foods.

    I strongly feel that everyone who needs to eat low carb for more than one round of the BSD should either be closely monitoring their carbs and keeping under 20g a day and taking other steps to ensure insulin is kept low, or monitoring to ensure they are in ketosis. – If you look into the consequence of calorie counting without having insulin under control – including if you research the outcome for participants in the greatest loser diet show, a period of low calorie without keeping insulin levels low enough to be in ketosis will result in a lowering in metabolic rate which makes it more likely that people will put on weight once they try to enter maintenance.

  • posted by sixturkeys
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    For myself, I am not sure what is meant by “one round” of BSD. Is that 8 weeks? But on unrelated matters, hope the new pup is getting on well – it really sounded as if you were his saviour!

  • posted by sixturkeys
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    I may be being a bit slow here… but…I understand about the 8 week fast 800 or Fast 5:2. I started off on 6 Jan with a rough 3 1/2 st ideally to discard (and I know that weight discard on its own is very different to managing blood sugars or T2) ; I have no doubt stalled this week with indulgence with family visiting, but, give or take a cple of pounds, I am abt 1 1/2 stone lighter and feeling great! I am very happy with that, and really do see this as a permanent WoE, I am not (as before) chasing a particular target by a particular date, so I am not thinking in terms of 8 week cycles, and I am eating lovely food and yes some wine occasionally as well. I am very happy with the rate of discard, which has been consistent, even if not mind blowing, so should I be concerned about looking at additional “rounds” and a serious review of what I am doing now? I must say my instinct says no. But I know that is just for me.

  • posted by JGwen
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    Hi sixturkeys.
    As a matter of interest how many turkeys is that now, if 3.5 stone = 6 turkeys then are you now 3.5 turkeys to go? – Or is there a subset of turkeys such as 3 turkeys, 4 pigeons and 2 humming birds to go?
    ——————
    Anyway I digress. – I think this is a very important topic to discuss. Fridays are my most hectic workday so it will not be until this evening until I can reply.

  • posted by sixturkeys
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    Thanks JGwen. To stress, this was just my personal take on me, and we are all different and also doing this for a variety of reasons, again all unique to each of us. I also get of course that this is not just a question of getting to point X and then thinking (and eating) as if that would always stay the same. It was just the concept of 8 week “rounds” – I knew from the off that all my hoped for discard would not happen in that timeframe, having said that, yes of course I might need to re-address carbs etc if matters do stall. Anyway, I might just have misunderstood your original post! I worked on basis of 1 turkey = 4 kgs. A smaller avian sub-set might also be handy (dishwasher salt = 3kgs has also been noted as a guide!)

  • posted by Pippilina
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    Hi Jgwen
    I can’t find any cheap keto breathalysers on Amazon. There is one for £170 and ton of alcohol breathalysers. I put I the AT6000 and only alcohol ones came up (this was on Amazon uk). Any ideas?

  • posted by Pippilina
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    Thanks, J Gwen. Yes this is what I found – but isn’t this an alcohol tester? I’m being very thick, sorry! I don’t get how it will measure ketones.

  • posted by JGwen
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    Hi Pippilina,
    I have cut and paste information from a couple of websites to help explain. – There is also a link to a website which isn’t the nicest to read because of all the adverts but it does have a video showing how to use one of the cheap breathalysers.
    —————————————-
    There are three types of ketone bodies: Acetone, Acetoacetate and Beta-Hydroxybutryate (BHB). Each of these three can be tested as acetone is a ketone released through the breath, acetoacetate is a ketone released through urine and BHB is (although not technically a ketone it acts like a ketone) in the blood stream and used by the cells for energy.

    Cheap breathalyzers, cannot tell the difference between alcohol or acetone (ketone). The reason why this occurs is that of the sensor that is used within the device.

    There are two different types of sensors housed within breathalyzers:
    1. Semiconductor Sensor (CHEAP, can measure Ketones). A semiconductor sensor electronically oxidizes alcohol by using a tin-oxide substance. The measured current is an indication of the amount of alcohol (or acetone) that is being reacted in the individual’s breath.

    2. Fuel Conductor Sensor (EXPENSIVE – USED BY POLICE can not be used to measure Ketones). Fuel cell breathalyzers contain two platinum electrodes with a permeable acid-electrolyte material is inserted in between. When exhaled air flows past one side of the fuel cell, the platinum instantly oxidizes the alcohol present in the air and generates acetic acid, electrons, and protons.

    Keep in mind that the measurements in acetone would be mmol/L which is the same as the setting that shows you g/100ml of alcohol.

    There is a video on this site which shows you how to use that model of breathalyser to check for ketones.
    https://www.fatforweightloss.com.au/measure-breath-ketones/

  • posted by Mariet
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    JGwen, I ordered one of these and it came the other day; I’m having a bit of trouble refining my technique and thought you might have some pointers (hopes!) 🙂
    I make sure it’s the end of my breath that goes in the machine but have so far only been able to get two positive readings, from about 20 attempts over a couple of days. I am sure I am in ketosis.
    The two positives were both repeat tests- that is, I did a test with nothing detected then immediately tested again; I saw that on the video. The guy also said it was more likely to detect ketones if you’ve been talking, do you find that? I live alone so I’ve been chatting to myself out loud while I get ready to test. It’s making it a fairly time consuming process but I don’t mind that if I can make it work.
    I’d be interested in any technique hints you’ve found while you’ve been testing.

  • posted by JGwen
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    The counter on mine starts at 100, so the technique I use is to take a breath when I press the button, hold my breath until the count gets down to 30 then count out loud until it gets ready to test.

  • posted by Mariet
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    Thank you! Worked perfectly.

  • posted by Pippilina
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    Fabulous – thank you. I will get one.

  • posted by SunnyB
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    Took me a bit of time to get used to using the breathalyser method too, but the link JGwen supplied to me was really helpful – thanks JGwen. It does take a bit of practice to get the technique, though I seem to have cracked it now.

  • posted by JGwen
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    Hi Sixturkeys, I promised to come back with an answer to your question about loosing weight rather than focusing on ketosis, sorry its taken me a bit of time, and sorry its going to be a long message.

    When I started out on this WoE, those who had lost a lot of weight and were in maintenance were suggesting that providing you are eating low carb and are consistently loosing weight then their experience was that you were fine to stick at that level of carbs. – However, as I have over time looked at different parts of the research on which the BDS is based I feel that may not be the best advice.

    There is a huge diet industry founded on the myth of long term weight loss based on calories in/calories out. – Because people do loose weight if they are keeping calorie intake lower than calorie expenditure, but our bodies are smart. If the deficit continues long term then our body adjusts to become more efficient so that that weight becomes stable at the new lower calorie diet. The first edition of the BSD book doesn’t include details of the balance of macros (carbs, protein, fat) to aim for. But we should also remember that the idea behind the book is to kick start weight loss with a 8 week program. – So the importance of not putting our bodies into a state where the body chooses to become more efficient wasn’t that relevant to the program.

    Our bodies work within a very fine tolerance of sugar levels in the blood stream and so are designed to be very sensitive to levels of carbs in our diet, and release insulin to prevent rises in sugar levels in the blood stream. – Its common on the forum to see reference to figures on blood sugar levels, but its not always easy to picture what they mean in practical terms of just how sensitive our bodies are to levels of sugar in the blood stream. According to different articles I have seen on average an adult has 5 litres of blood. The difference in blood sugar levels between normal and being classified as pre diabetic is the equivalent of less than 1 teaspoon of sugar dissolved in those 5 litres of blood.

    Also research shows a very steep slope in the impact of insulin on our bodies ability to burn fat that in practice we are either in fat burning mode (ketosis) or not depending on our insulin levels.

    I saw today an podcast by Dr Bikman which explained why ketosis is so important in fat burning. Its not one of his better podcasts. But it does provide a useful nugget of information which helps both explain maintenance without having to count calories as well as weight loss. – When insulin is high, then both our muscle cells and fat cells burn just enough energy to meet their needs. When ketones are present then our muscles continue to burn just enough energy for their needs but our fat cells burn extra energy generating heat as well as the energy they need. Apparently there is research to be published on the response of brain cells to ketones to help complete the picture.

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    I have come to the conclusion that a persons background level of insulin, and how high the spike is in response to carbs is a very individual combination. – While some people may be in ketosis at 50g of carbs, others may need to be under 20g. Which gives 4 options for those of us with a lot of weight to loose.
    1. play safe and go for the 20g of carbs as a daily limit.
    2. measure for ketosis so you can work out your own personal levels of a daily limit.
    3. choose to follow Dr Fungs principles of fasting ie fasting for 36 hours plus multiple times a week, and not count macros on your eating days.
    4. Choose a level of carbs you feel comfortable with knowing that the risk is that while you may be loosing weight your body may react as if you are just on a calorie in/out diet.
    ————————————-

    I know it would not be popular with many newcomers to recommend that they jump in at 20g of carbs level. I wouldn’t have taken up this WoE if faced with that option and went through stages of cutting out the obvious carbs in my first couple of rounds, and then worked on reducing carb levels more actively. But on the other hand, I think the science suggests that we should not be recommending people use just weight loss as an indication that they have the right level of carbs once they have got used to the principle of eating low carb.

  • posted by sixturkeys
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    Hi JGwen; thank you for remembering my question and for the very informative reply. What I was not clear about was the idea of 8 week “rounds” – and I’m still unclear on whether ketosis should be a permanent state to aim for, even when you reach a target weight (which might not a very scientific one), or if 8 weeks of going to 20g carbs (with a close eye on other macros) is “enough” to “re-train” your metabolism (if no blood sugar of T2 issues) and tame insulin production/levels. I can see that eating fewer calories (even if the reduction is significant) can lead to weight loss in the immediate but also the body adapting to that level. I was pleased about my discard to date – which I can see from others’ “results” is not the quickest, but now I’m not so sure if I have been going about it in the right way!

  • posted by Pippilina
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    I have been watching a number of you tube interviews with Dr Fung and it is incredibly compelling. Thanks JGwen for the pointer. I am about to embark on a 3 day fast (water only (well herbal teas too)). I wondered if you had any tips for this. Is it a good idea to take Magnesium/calcium etc? I’m trying to cut out all proteins in the two days before to help shift into fat burning so it’s not too grim. I have done a 4 day fast before but it was part of a Vision Quest so more about the spiritual aspects and I was in a tiny circle on a mountain with nowhere to go and noting to do (the point was more to’be’). So… I’m doing this whilst trying to work and be ‘normal’. I have tried to send a PM but think the site is not geared up for it?

  • posted by AnnieW
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    Hi Pippalina. If you are going to take a calcium supplement may I suggest you also take vitamin k2. I am suggesting this as k2 directs the calcium to the bones and away from soft tissue/arteries where it can cause problems. (I am on an osteoporosis forum where this is accepted advice. Also, for info, k2 is different from k1 which is the clotting vitamin. They are not the same thing.)
    Best wishes for a successful fast.

  • posted by Pippilina
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    Hi Annie,
    I wasn’t going to to take calcium – do I need to for a 3 day fast?

  • posted by JGwen
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    Hi Pippilina,
    I am sorry I have never done a 3 day water only fast so I can’t offer you any advice from experience. – I lost most of my weight by eating low carb and time restricted eating (Initally skipping breakfast and eventually moving to a 6 hour eating window each day).

    I have started to do 3 x 36 <> 42 hour fasts. But I do have coffee with double cream as well as water during my fasts. -I am finding this length of fast is helpful for breaking out of habits of associating finishing work / having a break from work with eating. As well as having a physically active job I am also a volunteer on a research project which involves one high intensity weight training session each week for 12 weeks and over the course of a year there are 4 detailed medicals including a body composition scan. – I decided it was a good compromise to stick with IF, while involved in this research project.

    There is a facebook group for Dr Fung and you will find lots of people on it that could offer you advice on Extended Fasts. https://www.facebook.com/groups/obesitycodenetwork/?fref=nf = Be careful there is more than one facebook group for Dr Fung but this is the official one supported by the clinic where there are moderators who strictly keep the posts aligned with Dr Fungs advice.

    I have once done 4 days following the fasting mimicking diet. – This is where you eat low carb and low protein to maximise autophagy for 5 days but its not recommended to do this more than once a month. The Professor who developed the idea sells a very expensive package of shakes and meals but you don’t have to bother with that. There are plenty of websites which describe a meal plan you can follow for yourself. I did it simply because I had a stack of stir frys in the fridge and couldn’t be bothered to drive into town to go shopping.

  • posted by AnnieW
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    Apologies Pippilina, I misunderstood your earlier post.
    I used to do water and black coffee only 48hr fasts and didn’t take any supplements as I didn’t know/think about them. The longest I do now is 16/8 on most days and I do take supplements for my bone health, although calcium isnt one of them – I get all of that through calcium rich vegetables and dairy.

  • posted by JGwen
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    Hi Sixturkeys.
    I think the answer to your question of if one cycle of 8 weeks is enough or if you have to do more is going to be very individual.
    If someone is Insulin Resistant it means they have a higher level of insulin even when fasting so even a small amount of carbs can tip you out of ketosis, at the other end of the scale endurance athletes who follow a keto diet can apparently tolerate upto 100g of carbs a day and stay in ketosis.
    There seems to be as many opinions on the benefits / ratios of the amount of time to be in ketosis and out as there are experts selling their services. Part of the issue is how invasive and costly it would be to test the different options. In the case of calorie counting and exercise its practical to have a group of people staying in a house for months under close supervision by dietitians and fitness trainers because its possible to make it into a competitive TV program (The biggest loser). I read one research paper where they were testing the impact of ketosis on 10 volunteers, the volunteers lived in a facility for 2 weeks with a carefully controlled diet, but they also underwent daily physical tests including muscle biopsies and blood tests throughout the day. Somehow I can’t see a TV executive agreeing to fund a long term competitive version of that or too many people being willing to volunteer to be on a long term research program which involves daily muscle biopsies.
    The reason I have started to incorporate fasting in my weekly program is because I got back to the weight I was traditionally at for most of my adult life following repeated rounds of BSD and then stuck. – Dr Fung refers to this as body set point, and publishes advice that you can reset this to a lower point by fasting. Also as I come up towards the 100lb weight discarded mark I think its important to fast to prevent loose skin.
    I read an article a couple of months ago on the topic of long term ketosis which made a lot of sense to me. This authors point of view is that we evolved to mostly eat a low carb diet so would have been in ketosis most of the time, but there would have been periods during the year when there was a glut of fruit or berry’s and our ancestors would have taken advantage to lay down their own fat stores to carry them through the periods when the hunting was poor.
    Once I get down to my target fat percentage/look I think I will try to follow this principle. – Maybe once a month have a couple of days out of ketosis, and spend the rest of the month mixing up time restricted eating / keto / fasting.

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