During the last series on using a Freestyle Libre continuous glucose monitor (CGM) I documented the effects of a typical Western high carbohydrate diet on my blood sugars. Many of the meals I ate were obvious treats containing a lot of sugar, but many were just traditional foods, like toast, which still had a significant impact.
In this series I’m going to show the progression into nutritional ketosis (NK), that is, the process by which my body adapts to using ketones from fat breakdown as a major fuel source. The definition of nutritional ketosis is somewhat in flux but it’s generally accepted that NK begins around 0.5 millimolar of ketones as measured in the serum or blood. I will be using my KetoMojo ketone meter every day to show you the results I’m obtaining.
To start off this experiment, I was not particularly careful on my diet over the weekend. I ate quality food, mostly, but not very low carb.
Starting Tuesday, July 30th, I began to follow a ketogenic diet and will continue to strive to keep my carb intake 20 gms per day or less with a maximum of 50-60gms per day for the two week duration. These are recommendations I often give patients with type 2 diabetes and they are very successful in reversing that disease process. My default carb goal is about 75-100 gms per day. I’ve learned over the years that this is the level at which I feel really well and energetic. I focus on my carbs from whole foods such as fruit and sweet potatoes and allow variation from day to day depending on my activity level and taste buds. So a day of hiking might allow for more carbs after returning home while a day of office work I’d try to be more strict.
My diet log for yesterday is pretty simple. I ate three eggs fried in ghee and two pieces of Swaggerty sausage for breakfast along with my multiple cups of black coffee (3 gms of carbs). Lunch was with a friend at Archers BBQ consisting of 1/2 lb of pulled pork and unsweetened tea (0 gms of carbs). I know unsweet tea is sacrilege in the South but there’s a reason diabetes is so prevalent here too. Dinner was two roasted chicken thighs with sauteed onions and mushrooms (5 gms of carbs). My daughter and I then went to work out at VitalSigns which was 40 minutes on the elliptical and 25 minutes of resistance training with machines and body weight exercises. Trying to keep up with a cross country running Freshman during her workouts has left me sore many times this summer. After our work out, I made a protein powder shake about an hour before heading to bed (2 gms of carbs). That’s actually eating later in the night than I really want to, but I felt like the shake was a good idea. Part of the whole purpose of these meters is to allow someone to become more self-aware and be able to respond to their body’s needs instead of just following an regimented program that can’t adapt.
The nutritional content of my day was very low at about 11 gms of carbs for the whole day. Protein was pretty close to my max goal. From prior personal experience, I don’t feel great when my protein intake gets too far above 160 gms for too long, but that can be dependent on my fat intake. This has been called rabbit starvation by Arctic explores like Vilhjalmur Stefansson due to eating the lean protein of rabbits without enough accompanying fat. However, I don’t want anyone to think that’s a prescriptive level, just my experience with my own diet.
So what was my result after one day of a ketogenic diet, a moderate intensity exercise for about an hour and fasting for 8-9 hours while asleep? Unsurprisingly, it was pretty normal. My ketones were still pretty low.
The human liver makes glucose continuously and can supply all the needs that the body has. Additionally, it stores about 2500 kcals of glucose as glycogen. That would take about 2-3 days of minimal activity to burn through or about 2-3 hours of intense activity. My one day of low carb intake and modest calorie expenditure is not enough to move me into nutritional ketosis. We’ll see what tomorrow holds.