The Keto Diet and Intermittent Fasting

The keto diet and intermittent fasting are two popular diets for losing fat, gaining lean muscle mass, and boosting your energy levels.

Many people wonder whether combining intermittent fasting with keto can help you experience even greater results.

The short answer is yes. Intermittent fasting on the keto diet is a simple ‘hack’ that can definitely accelerate the results and benefits.

What is Intermittent fasting?

If you’ve slept overnight and not eaten for 12 hours, then you’ve already experienced intermittent fasting! It simply means that you go for a specific period of time without eating. Some people choose 12 hours, 16 hours or even 24-48 hours. Whatever period of time you select is called your ‘fasting window.’ When you are outside the fasting window, you eat normally.

The key is to know when and for how long to fast. That way you aren’t tempted to snack during that time.

The difference with intermittent fasting is that usually when you eat throughout the day, you’re in a fed state. This makes your body keep digesting and absorbing nutrients from your meals.

Most people who have breakfast, lunch, and dinner will remain in this state during the day, and into the night. The only time their digestive system gets a break is when they’re sleeping.

When your body to enter the fasted state (usually after about 8-12 hours), it means that accelerated fat burning can now take place. Essentially fasting kicks your body into the same ketosis state as being on the keto diet does.

Keto is accelerated with Intermittent Fasting

Since the keto diet is designed to force the body into running on ketones from a very low-carb intake, you’re essentially fasting yourself of carbs. In a way, this mimics regular actual fasting that takes place with intermittent fasting.

When you restrict your body’s primary fuel source on the keto diet, adding fasting can kickstart your body into ketosis. Once you’re there, you just need to stay on the keto diet to stay in ketosis.

Also, when on the keto diet, you may find it easier to fast for extended periods of time, since your body becomes adapted to the fat burning and you are less hungry.

Here are other benefits that intermittent fasting with keto can give:

– Balancing blood sugar
– Improving nutrient absorption
– Detoxification
– Clearer mind, less brain fog
– Increased fat burn during exercise

On top of all this, intermittent fasting can help with unnecessary snacking and extra caloric intake throughout the day. And it’s as simple as setting a goal to not eat for as little as 8-12 hours. As you build your fasting window, you may find you can last 12-16 hours and then perhaps even 24 hours without too much worry.

If you are serious about kick-starting your keto journey, then intermittent fasting can give you that extra push you need. Once your there in the ketosis state, it’s much easier to stay on the keto path and achieve your goals.

Whether you’re looking to lose weight, manage a chronic medical condition, or simply want to overhaul your eating habits, changing your diet for the better is one of the best ways to improve your overall health.

Dr Jerry Hizon, MD strives to demystify the complex science of nutrition, giving his patients sound nutritional guidance designed to set them up for long-term dietary success, whatever their specific goals may be.

How to measure your Keto Diet success

When you start the Keto diet how do you know when you have achieved nutritional ketosis? How do you know if the diet is successful? Have you actually reached ketosis?

There are three different types of ketones we can measure in the body to see if we are in ketosis: acetone, acetoacetate, and Beta-Hydroxybutyrate (BHB).

Measuring Acetone

Acetone is the least invasive ketone to measure, as it is found in the breath. Since acetone is not the ketone used for energy by the body this is not a direct measure of ketosis. The presence and level of acetone positively correlates with BHB and can be used as a less precise measure of ketosis. When measuring ketones with breath, the Ketonix will light up with a color corresponding to the amount of ketones present. Usually yellow to red is the goal.

Measuring acetone can be done by using a Ketonix breathalyzer. The device can be used multiple times without anything more to purchase. While a little pricey, about $189-$239, the one-time investment is the only investment.

Measuring Acetoacetate

Found in the urine during the first few weeks of the Keto diet, measuring acetoacetate is relatively easy to do. This method is probably the least effective because it is dependent on the user’s ability to correctly identify which color the stick actually is and the overflow of ketones not the actual level of ketones in the body is what is measured here. When measuring ketones from a urine stick match the color of the stick to the color on the label, usually the darker purple, the higher the levels of ketones.

Acetoacetate can be measured using ketone urine strips like Ketostix, which are inexpensive around $10 for 50-120 strips. Measuring ketones through the urine is only feasible for 2-4 weeks at the beginning of the Keto diet, after that the body is Keto-adapted this is no longer an effective way to measure ketones.

Measuring Beta-Hydroxybutyrate (BHB)

Found in the blood, BHB is the most precise measurement of ketosis and is measured the same way as glucose. This method is the most invasive as pricking the finger is needed to obtain the blood to be tested. When measuring the BHB, the ideal range for weight loss is about 1.5-3 mmol/L and for a therapeutic diet (think cancer support) it is from 3-6 mmol/L.

A blood meter and strips are needed to perform this measurement, and these can be pricey, the strips alone run from $5-10 and the meters are around $40-60.

Are There Other Ways to Measure?

Yes, once you have been on the Keto diet awhile, there are signs you can look for that will indicate you are in ketosis. These include:

  • Reduced hunger, you can go longer than 2 hours without eating
  • Mental clarity will be increased
  • Stable energy throughout the day, no afternoon crashes
  • Reduced cravings

While these are not a way to measure your ketone level, once you have established your Keto diet and tested your levels, you can begin to know how your body feels when in ketosis and when you have slipped back into using glucose. If you cannot tell a difference, then testing with one of these methods will be necessary.

As always, before beginning a new diet or lifestyle change, please consult your doctor, especially if you are on medication.

– Erin Kirkpatrick

What to know about a Ketogenic Diet during Pregnancy

There is a lot of agreeance among the health and nutrition fields that point to a ketogenic diet as an aid to fertility. While ketosis can be helpful in helping one get pregnant, the question is: is it safe to maintain a keto diet while pregnant?

Ketosis vs. Ketoacidosis

There is a bit of controversy whether the answer to this question is yes or no, and most doctors are still trying to “get with the curve” and understand/ grasp what a ketogenic diet is. Such doctors in the latter half of the controversy, are hesitant to recommend or even steer patients away from “low-carb” dieting while pregnant based on their concerns not on ketosis, but something called ketoacidosis.

Ketoacidosis is a state in which the body has an extremely high number of ketones and blood sugar levels. The result is a dangerous acid-base (pH) imbalance. Such a state is unhealthy for any individual, pregnant or not.
Ketosis, on the other hand, is a metabolic state in which the body uses fats (ketones) as fuel versus carbohydrates. In ketosis blood sugar is normal, there is a healthy pH (acid-base) balance, and ketone levels are relatively low. This is considered a “healthy” state of the body.

Maintaining a healthy keto diet leads to a state of ketosis, not ketoacidosis. Ketosis can be healthy for both mom and child when it comes to pregnancy.

Natural Pregnancy and Ketosis Connection

Keto and pregnancy are naturally connected. Nausea and curved appetite during pregnancy cause many women to go in and out of ketosis naturally. In addition, pregnant women naturally become insulin resistant to provide the developing child with proper nutrients, making them more sensitive to carbohydrate intake. Thus, maintaining a ketogenic diet during pregnancy may help aid these natural processes.

In addition, ketosis can be a healthy and natural adaptation for the baby. Keto-adapted babies have an easier time converting ketones to acetyl-coA and myelin. Such conversions aid in brain and neural development of the child.

Eat Whole Foods and Listen to Your Body

While a keto diet, and ketosis, can be good for both the mother and child throughout pregnancy, there are a few fundamental concepts to consider.

Do not focus on weight loss. Many who start the keto diet do so for the weight loss benefits. This should not be the goal of pregnant women on keto. It is important that both the mother and child get the proper nutrients and calories and weight gain is a natural and healthy component of pregnancy.

Do not be strict keto. It is not uncommon to go in and out of ketosis just based on fluctuations in appetite and nausea throughout pregnancy. Listen to your body and the baby and do not fret or put your body through additional stress to try and maintain a constant state of ketosis. If your craving a piece of whole grain sourdough toast, feed the baby what it wants.

Whole food, nutrient-dense, and calorie sufficient should be the focus. This may be redundant, but when pregnant, making sure the baby and mother get proper nutrients and caloric intake is the primary concern when it comes to diet. The best way to achieve these things is to eat whole foods like vegetables, fruits, nuts, legumes, and grass-fed meats. One should avoid processed and packaged foods.

Breast Feeding and Ketosis

It is recommended that one breastfeeds, on or off keto. Breast milk is better than formula. Breast milk is high in natural fats, whereas most formulas are high in carbohydrates and sugar. If one has the ability, breast milk is a better option to make sure the baby is getting proper nutrients and not getting addicted to a high carbohydrates and sugar diet at a young age.

Additionally, coconut oil, a common component of the keto diet, can assist in lactation and allows breast milk to contain lauric acid that helps support a babies’ healthy metabolism.

Clinical Guidance

It is highly suggested that you start the diet before getting pregnant. Switching from burning primarily carbohydrates as fuel to fats as fuel can be a stressful transition on your body. Avoid extra stress on the baby and mom by navigating this transition before conception.

Also, it is best to have some clinical guidance while maintaining a ketogenic diet during pregnancy. A doctor can make sure that both the mother and the baby are getting enough nutrients and calories and monitor healthy levels for both mom and child. Because some health professionals are still trying to “catch-up” to the ketogenic diet, it may be helpful to explain your dietary choice as one in which you are avoiding sugar and focusing on healthy vegetables, fruits, and proteins versus telling them you are on a keto diet. Or better yet, seek a health professional that does understand the keto diet.

Take-Away Message

It is safe and arguably healthier for both mom and child to maintain a ketogenic diet during pregnancy. It is vital that the mother listens to her body, gets enough calories, and focuses on whole food consumption during this process. It is recommended that a mother seek clinical guidance to help navigate and monitor.

Dr Jerry Hizon

How To Measure Your Ketone Levels

When you start a ketogenic diet, one of the most common questions is how to measure your ketone levels. Most people on a keto diet do this because they want to see if there are in ketosis.

To get started measuring your ketone levels, there are three types of ketone bodies to know about:

Acetone
Acetoacetate
Beta-Hydroxybutyrate (BHB)

Unlike protein intake, where the daily amount is determined by your lean mass weight, the number of carbs to enter ketosis can be estimated using three methods.

1) Blood Ketone testing

The level of BHB in your bloodstream will tell you how much you have in your fuel tank but it will not measure the metabolic usage of ketones. Blood ketone testing is the most accurate way to measure ketone bodies.

Blood ketone testing can precisely determine the level of ketones in your blood. But the drawback is that they are more expensive. The testing meter costs $40 and the test strips cost $5 each. If you are testing your ketone levels daily, it could cost you $150 per month.

2) Ketone Breath testing

A non-invasive and cheap alternative is to measure ketones is to use breath acetone concentration. Acetone is one of the ketone bodies that results from a break down of acetoacetate. The level of acetone will reflect the metabolic usage of ketones.

The Ketonix Acetone Breathalyzer is available and offers an easy and inexpensive way to test your breath ketones (acetone). Keep in mind that breath ketones do not always exactly correlate with blood ketones and are affected by several factors (alcohol consumption and water intake).

3) Ketone Urine strips

Ketostix, Uriscan, and other urine detection strips are not as accurate as the blood and breath test. This because they only measure the level of acetoacetate. These are the excess ketone bodies that are not utilized by the body and are excreted via urine.

Urine ketone strips can still be useful during the initial phase of the ketogenic diet when you simply want to test the level of carbohydrates in order to enter ketosis.

Some people use them to test if they are sensitive to certain foods that may be keto-friendly but still have a negative effect on their progress.

The good news is they are easy to use and fairly cheap to buy. You’ll only pay about $10 for 50 strips, which adds up to about $6 a month if you test yourself daily. If urine detection strips don’t work for you, use one of the other two methods.

4) Your own observation

Listening to your body’s signals is another way of finding out whether you are in ketosis. When your body is in ketosis, you may smell of acetone. This could be sensed in your breath, sweat or urine. Some people refer to this as ketogenic “fruity” smelling breath. If you detect any of these signs, you are more than likely in ketosis.

Don’t Focus Just on Ketones

Recently, I’ve noticed a growing obsession when it comes to measuring ketones precisely. Although urine detection strips may not be accurate for keto-adapted people, they work for most of those that have just started the ketogenic diet.

By the time most people become keto-adapted (which takes 3-4 weeks) most of them understand what to eat and what to avoid without any real need to measure the precise level of ketone bodies.

In the end, what really matters is not ketones but the effects of low-carb diets: weight loss and improved health.

Dr. Jerry Hizon