" "

Meat products make up a big part of the keto diet, but experts stress the importance of choosing quality. "Since the keto diet is based a lot on animal proteins, it's important to buy organic poultry and grass-fed, organic beef," says Aimee Aristotelous, RD. "Not only do organic selections help with limiting environmental toxins, but grass-fed options of red meats even change the composition of fats." The result, she explains, is that your body is able to better absorb those healthy fats.
Therefore, more people experiencing "keto crotch" need to visit doctors to determine what's really happening. It could be that some of the people claiming "keto crotch" are instead detecting smells that are not related to their diets. Many different smells could emanate from your crotch, some are normal, some are not. Conversely, who knows for sure what a drastic change in your diet may do to different parts of your body? There is still a lot unknown about the links between nutrition and your various bodily functions. You are a complex system with many unknowns. The keto crotch could be a real phenomenon, but more scientific evidence and studies are needed.
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Note that urine measurements may not reflect blood concentrations. Urine concentrations are lower with greater hydration, and after adaptation to a ketogenic diet the amount lost in the urine may drop while the metabolism remains ketotic. Most urine strips only measure acetoacetate, while when ketosis is more severe the predominant ketone body is β-hydroxybutyrate.[36] Unlike glucose, ketones are excreted into urine at any blood level. Ketoacidosis is a metabolic derangement that cannot occur in a healthy individual who can produce insulin, and should not be confused with physiologic ketosis.
After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[19] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[18] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[19] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[45]
I'd recommend starting with glucose and hemoglobin A1C, along with a good multi like https://bengreenfieldfitness.com/multi and a fish oil like the one at greenfieldfitnesssystems.com – Anyways, I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60 minute consult, whichever you'd prefer. I can schedule ASAP after you get that.
3) Cholesterol levels usually go up with inflammation, because inflammation causes damage to the tissues, and cholesterol is manufactured and released in circulation to patch things up. So, again, eating high fat is the best way to drop inflammation; not increase it. My hsCRP are always below 0.1, and most of the time, below detection level. Oxidation of cholesterol causes inflammation; not the other way around. So, your point about inflammation is a non-issue.
Question: I have recently done my 23&me DNA test and have also put my info into AthletiGen. I’m curious about your thoughts about high fat/low carb diet in context of this info. My test says I am ‘2x more likely to loose weight on a low fat diet’, and that I have ‘normal sensitivity to weight gain due to saturated fat intake/and unsaturated fat intake’, & ‘likely to eat normal amounts of carbs’! All interesting but in the ketosis context, I took this to mean that eating high fat/low carb would not be of greatest benefit to me?! (I have tried getting into ketosis prior to all the new supps, for about 3 months, and I couldn’t get in to it (tested w/ blood finger prick) and didn’t feel great). Which leads me to wonder what Macro ratio would be best, as I’m also a endo-meso)!
Hi Ben…first, I have learned so much from you, thank you! I’m interested in using exogenous ketone supplements and I have a question for you. I just read the transcript of an interview Dave Asprey did with Dr. Richard Veech (episode 299). He advises against them, and says they can even be harmful. I was disappointed to read this, and wanted to ask you about it, since I respect your opinion greatly….thank you.
First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (about 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[48]
Sensational article. I am experimenting with a low carb diet, high fats and moderate protein. I am not keeping strict notes on what I eat but I cut out almost all fruit and I eat eggs, spinach, kale, chard, avacados, hard cheese, walnuts (raw organic) and grass fed meet and butter. I take about 25-30ml of Brain Octane straight a day. I take your probiotic and colostrum (I need to get more regular) and I consume bone broth four days a week. I am looking to live longer and be healthier during that long life. In the short term I want to be smarter and be able to handle stress better. I would also love to avoid cancer and drop a deuce every day. My question is: Is there a point of carb consumption where even combining it with exogenous ketones using your recommendations it would be less effective or cause negative outcomes? Could one consume all the cards and sugar one wanted and use the supplements and still be getting into ketosis and reaping the benefits?
The keto diet isn’t new, and it’s been around for nearly a century. It was originally developed to treat people with epilepsy. In the 1920s, researchers found that raised levels of ketones in the blood led to fewer epileptic seizures in patients. The keto diet is still used today to treat children with epilepsy who don’t respond well to anti-epileptic drugs.[2]
Hi Ben – Great article. I had trouble at the end figuring out if you were now eating high fat (60-80% of calories), or if you went back to something closer to 50% fat calories and higher carbs and are using exogenous ketones to get int ketosis when needed. Are you doing any carbs at night or a refeed, or just having higher carbs on most days? Thanks
The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy.[26][27] It is approved by national clinical guidelines in Scotland,[27] England, and Wales[26] and reimbursed by nearly all US insurance companies.[28] Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.[9][29] About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults.[9] A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.[5][30]
Considered a symptom of the keto flu, your breath on this diet often smells fruity at first. This is because acetone is a by-product of ketosis and is eliminated mostly through the lungs and the breath, according to a study in the journal International Journal of Environmental Research and Public Health in February 2014. Acetone is a type of ketone known for having a fruity aroma in smaller concentrations. “It’s hard to say exactly how long it will last as it depends on the person, but it’s common for someone to experience this side effect for a few weeks,” says Asche.
There’s not enough of it to matter in coconut oil, it tastes bad, and it often results in stomach/gastric upset, but it does get converted quickly into ketones. If your MCT oil brand of choice makes your throat burn or has a weird flavor, one reason may be that the distillation did not remove enough of the C6. There are other reasons this can happen too, discussed below.

“Loss of muscle mass as we age has a number of serious consequences,” notes Clark. “Muscle is metabolically active and helps boost daily energy expenditure and mitigate age-related weight gain.” Losing muscle mass can also decrease functional strength and heighten the risk of falls, notes Clark. Falls are the top cause of death from injury in older populations, according to the Institute of Medicine Division of Health Promotion and Disease Prevention.
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.
-Cancer: Numerous studies have found that the risk for cancer increases with high blood sugar, which makes sense, since cancer cells feed primarily on glucose. This includes cancers of the endometrium, pancreas, and colon and colorectal tumors. Tim Ferriss recently hosted a fantastic article by Peter Attia about this very issue, and how ketosis may indeed be a potential cancer cure.
Under these circumstances, as soon as the body’s limited reserves of glucose starts to run out, your entire body switches its fuel supply to run almost completely on fat. The levels of the fat-storing hormone insulin levels become very low, and fat burning increases dramatically. You thus get easy access your fat stores, and can burn them off. This is great for losing excess weight. Studies prove that keto diets result in more weight loss, faster. There are also more potential benefits.
Might not be nutritional. Could be a training issue. Could be fascial. Could be neurotransmitter. If you're taking 1 serving of UCAN perhaps you need two. Not sure of ht, body wt, etc. I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60 minute consult, whichever you'd prefer. I can schedule ASAP after you get that.
Some research suggests that ketogenic diets might help lower your risk of heart disease. Other studies show specific very-low-carb diets help people with metabolic syndrome, insulin resistance, and type 2 diabetes. Researchers are also studying the effects of these diets on acne, cancer, polycystic ovary syndrome (PCOS), and nervous system diseases like Alzheimer's, Parkinson's, and Lou Gehrig's disease.
You said you saw Dr. Jeff Volek at UCONN. I am interested in ketosis to help me with my M.S. I still have questions related to M.S. and not so much as it effects on athletes. I do live in CT, but was unable to locate Dr. Volek at either the Storres or Farmington campus. Would you be able to give me either his e-mail address or telephone number so that I can contact him directly? Your help would be greatly appreciated.
Wow! Amazing article. I don’t read blogs regularly, but I’ll be reading more of yours. I am on day 11 of a fast to get me into ketosis; 7 days bone broth and now on day-4 water only. Intentions are weight loss (10# down, 15# more to go) and immunity improvement/gut help. Planning 9 days of whey water, fermented veggies and mad probiotics when the water days are done (day 14?). After this fast I want to stay fat adapted, start training again and get down to 8% body fat. I believe you have cut that journey significantly with this article. Thank you.
Ben, great article! I recently did my own ketosis experiment and didn’t catch the 100-200g advise until later than I should have, I’m guessing. Great results for 1-2 months but after 3 months I quit sleeping through the night and would wake after about 4 hours of rest each night. My guess is that the extra carbs at night coupled with iodine supplements should allow me to “have my cake and eat it too?” Any other suggestions on the sleep issue? I’ve gone back to High Fat/Low Carb, have improved sleep but I do miss nutritional ketosis and want to try again once my sleep is stable. Thank YOU!!!
So if your high-fat diet includes a high amount of roasted seeds or roasted nuts, nut butters, heated oils such as heated coconut oil or heated extra virgin olive oil, barbecued meats or meats cooked at very high temperatures, then your triglyceride count is going to go up. You should have triglycerides that are less than 150mg/dL, and a triglyceride to HDL ratio that is no more than 4:1, and in most of the healthiest people I’ve worked with, triglycerides are under 100 and the triglyceride to HDL ratio is less than 2:1. If your ratio is whacked, your ketotic diet isn’t doing you any favors.
Ketosis is an option for many people with type 2 diabetes because they still produce insulin, which helps their body maintain a safe level of ketones in the blood. If you’re considering trying ketosis or the ketogenic diet with type 2 diabetes, be sure to consult your healthcare provider first to ensure it’s safe for you. This eating approach may interfere with some types of diabetes medication or be inappropriate for you if you have certain diabetes complications, such as kidney damage.
A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.
More good news: Snacks are totally allowed (and I'm not just talking about carrot sticks). There are plenty of packaged options out there designed for keto fans. FATBAR is one of them. These snack bars have 200 calories, 16 grams of fat, and four grams of net carbs. They're also plant-based and are made with almond or cashew butter, cocoa butter, coconut, pea protein, sunflower seeds, and chia seeds.
Thanks for all of the great info!! I have Hashimoto’s and would really like to try a high fat/low carb diet. You mentioned that this might not be a good option for people with thyroid issues. How do you recommend I modify my diet to lose weight taking into consideration the Hashimoto’s. I take Westhroid, a non-synthetic thyroid supplement to help with my sluggish thyroid. Thanks so much for any advice you can give me. :)
When in the hospital, glucose levels are checked several times daily and the patient is monitored for signs of symptomatic ketosis (which can be treated with a small quantity of orange juice). Lack of energy and lethargy are common, but disappear within two weeks.[17] The parents attend classes over the first three full days, which cover nutrition, managing the diet, preparing meals, avoiding sugar, and handling illness.[19] The level of parental education and commitment required is higher than with medication.[44]

There are many misconceptions about ketosis. The most common is mixing it up with ketoacidosis – a rare and dangerous medical condition that mostly happen to people with type 1 diabetes if they don’t take insulin. Even some health care professionals tend to mix up these two situations somewhat, perhaps due to the similar names and a lack of knowledge about the distinct differences.
To understand exogenous ketones, you should know that there are three types of ketones: beta-hydroxybutyrate (BHB), acetoacetate (ACA) and acetone, and all three are the normal by-products of fat breakdown by your body. In much the same way as glucose, ketones can be used by your tissues, especially your brain, diaphragm and heart and are actually a far more efficient fuel source than glucose.

Fairly recently, the diet was introduced as a weight-loss diet by an Italian professor of surgery, Dr. Gianfranco Cappello of Sapienza University in Rome. In his 2012 study, about 19,000 dieters received a high-fat liquid diet via a feeding tube inserted down the nose. The study showed an average weight loss of more than 20 pounds in participants, most of whom kept it off for at least a year. The researchers reported a few minor side effects, like fatigue.
Urine test for diabetes: What you need to know Urine tests for diabetes check for protein, ketones, and glucose. They are frequently used for diagnosing and monitoring diabetes, and to assess people who are experiencing symptoms, such as fatigue or nausea. Depending on the results, recommendations may be given about medication or lifestyle changes that could help. Read now
As you may know, "keto diet" is short for ketogenic diet, because who has the time to say "genic." It is a high-fat, moderate-protein, and low-carb diet with approximately 80% of your calories from fat, 15% from protein, and only 5% from carbohydrates. The goal of the diet is to induce ketosis in your body. The theory is that typically your body may rely on burning the carbs that you eat rather than the fat stores in your body for energy. The thinking is that by severely restricting the amount of carbs in your diet your body may then be forced to burn your body fat instead. Breaking down this fat then results in ketones, which is not some acapella group, but instead organic compounds made up of carbon, hydrogen, and oxygen atoms. One type of ketone produced is acetone, which is in certain types of nail polish removers. This accumulation of ketones may result in "keto breath", which is a rotten fruit or metallic smelling bad breath that can smell a bit like, surprise, surprise, nail polish remover.
Burns fat: You can drop a lot of weight — and quickly — on the keto diet.[3] Ketones suppress ghrelin — your hunger hormone — and increase cholecystokinin (CCK), which makes you feel full.[4] Reduced appetite means it’s easier to go for longer periods without eating, which encourages your body to dip into its fat stores for energy. Learn more here about the keto diet and weight loss. 
If you're healthy and eating a balanced diet, your body controls how much fat it burns, and you don't normally make or use ketones. But when you cut way back on your calories or carbs, your body will switch to ketosis for energy. It can also happen after exercising for a long time and during pregnancy. For people with uncontrolled diabetes, ketosis is a sign of not using enough insulin.
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I talk about that quite a bit here :https://bengreenfieldfitness.com/2015/09/things-your-pee-can-tell-you-about-your-body/
Amazing article – gonna have to print it and read it again. To much to break down in one sitting. Thanks Ben – you’ve pulled together so much insight and references that’s given me greater confidence and conviction. I’m 50 and use to be super active and a seasoned athlete but after a few ‘mid life surgical interventions’ I had to find a better way… Ketogenics has been that for me… no more inflammation… I can’t tell you how great it’s been to be pain free! Keep leading from the front.
Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they might make it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.

In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.[54]
^ Fumagalli M, Moltke I, Grarup N, Racimo F, Bjerregaard P, Jørgensen ME, Korneliussen TS, Gerbault P, Skotte L, Linneberg A, Christensen C, Brandslund I, Jørgensen T, Huerta-Sánchez E, Schmidt EB, Pedersen O, Hansen T, Albrechtsen A, Nielsen R (September 2015). "Greenlandic Inuit show genetic signatures of diet and climate adaptation". Science. 349 (6254): 1343–7. Bibcode:2015Sci...349.1343F. doi:10.1126/science.aab2319. hdl:10044/1/43212. PMID 26383953.
The nerve impulse is characterised by a great influx of sodium ions through channels in the neuron's cell membrane followed by an efflux of potassium ions through other channels. The neuron is unable to fire again for a short time (known as the refractory period), which is mediated by another potassium channel. The flow through these ion channels is governed by a "gate" which is opened by either a voltage change or a chemical messenger known as a ligand (such as a neurotransmitter). These channels are another target for anticonvulsant drugs.[7] 

“For events longer than 60 minutes, consuming 0.7 g carbohydrates·kg-1 body weight·h-1 (approximately 30-60 g·h-1) has been shown unequivocally to extend endurance performance. Consuming carbohydrates during exercise is even more important in situations when athletes have not carbohydrate-loaded, not consumed pre-exercise meals, or restricted energy intake for weight loss. Carbohydrate intake should begin shortly after the onset of activity; [and continue] at 15- to 20-min intervals throughout the activity.”
^ Yiu H. Hui (February 1985). Principles and issues in nutrition. Wadsworth Health Sciences Division. p. 91. Retrieved 2014-05-19. Eskimos actually consume more carbohydrates than most nutritionists have assumed. Because Eskimos frequently eat their meat raw and frozen, they take in more glycogen than a person purchasing meat with a lower glycogen content in a grocery store. The Eskimo practice of preserving a whole seal or bird carcass under an intact whole skin with a thick layer of blubber also permits some proteins to ferment into carbohydrates.
It seems like everyone is talking about the keto diet — the high-fat, low-carb eating plan that promises to turn your body into a fat-burning machine. For that reason, keto has surged in popularity over the past year as a lose-weight-fast strategy. Thank Hollywood A-listers and professional athletes like Halle Berry, Adriana Lima, and Tim Tebow who’ve publicly touted the diet’s benefits, from shedding weight to slowing down aging. Here’s everything you need to know about going keto.

Early studies reported high success rates; in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[19] 
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