Last month (March ’17) I did two extended fasts. I separated the two fasts by four days. The fasts were both ten days.
I tracked a bunch of numbers during the last fast including my Blood Ketone levels. I bought a Precision Xtra meter to measure Blood Ketones. The meter cost $25 on Ebay.
The meter comes with no strips. The strips are really expensive, at about $3 a strip. They are more accurate than any other home method of measuring Blood Ketones.
Blood Ketone numbers greater 0.5 indicate that you are in Ketosis. I saw numbers as high as 6.8 while doing extended fasting. Most non-fasting days I get values around 2.0.
The Ketonix 2017 model that I recently purchased has been disappointing. Previous year models seemed to work better for others.
Seems that the reason they were better was that the previous models used a different unit of measure and produced a wider range of “normal” Ketogenic readings.
The new scale is in PPM which is a lower scale than the previous model used. From the article: Measuring breath acetone for monitoring fat loss: Review
In normal healthy individuals, BrAce can range from 0.5 to 2.0 ppm. Adults on ketogenic diets (e.g., high fat with low carbohydrate) can have elevated levels of up to ∼40 ppm.
The article includes a graph which has the same data:
This actually correlates to what I measured with my Ketonix. I got numbers from 4 (in Ketosis) to 22 (when fasted 10 days).
That correlates to the scale above which shows a Ketogenic Diet in an adult to go from 2 to about 40.
The problem is that the middle of this Ketogenic Diet scale is 10. It took me several days of fasting to get to this level. So for normal Ketogenic dieting there’s not enough scale to blink the colored LEDs on the unit. If you look at the fasting scale you can see I never reached the higher levels I should have been seeing at 10 days into a fast.
Seems like the unit sort of works and sort of doesn’t work. If it is accurate for PPM then I would never see a number above 50% if I was at the very top of the Ketogenic diet scale – which is not realistic.
From (Ketone body metabolism and cardiovascular disease):
Ketone body oxidation becomes a significant contributor to overall energy metabolism within extrahepatic tissues in numerous physiological states, including the neonatal period, starvation, postexercise, and adherence to low-carbohydrate diets, when circulating ketone body concentrations increase from ∼50 μM in the normal fed state to up to 7 mM. Circulating ketone body concentrations rise to ∼1 mM after 16–20 h of fasting in healthy adult humans but can accumulate to as high as 20 mM in pathological states like diabetic ketoacidosis
Therefore, the metabolism of ketone bodies may influence numerous human disease states relevant to cardiovascular disease, including obesity, diabetes, atherosclerosis, and heart failure.
Had Mexican food last night. Did well. Here’s how I did it.
- No chips/salsa.
- Ordered fajitas. Forget the name of it (Vallerta Fajitas maybe?). Had chicken, beef, chorizo and shrimp. Very oily/greasy. Included onions, green peppers, cauliflower, broccoli. Tasted good. No chips/salsa.
- No rice.
- No beans.
- No tortillas.
Blood sugar 2 hours later was 95 (pretty much normal for me).
The Glycemic Index rates food based on their impact on blood glucose levels with white bread coming in at 100. In theory, a system like that sounds like a great deal for Diabetics who need to control their blood sugar levels. If you eat foods which produce smaller increases in your blood sugar you shouldn’t have the excursions into the highs that damage people. And that is true, but is it enough?
As often used, the Glycemic Index puts food into two categories – either good (Low GI), or bad (High GI). This GI chart breaks it into three categories:
In a sense, a Ketogenic diet is the ultimate form of a Low Glycemic index diet. Keto only has food that have very, very low Glycemic Index items. The diet eliminates all of the food on the chart including most Low GI foods. Of course the chart is way out of proportion with actual food usages. Jellybean candy has its own value listed. Some other items, like French Fries, occupy a huge portion of the American diet through fast food.
By way of comparison, Meat has a GI of 0, most nuts have a GI of 10 and vegetables which grow above ground have a GI of 20. You can’t beat that for Low GI.
But why not just eat the Low GI foods? Well, for diabetics they aren’t quite good enough. As the last study listed shows, they do help, but not nearly as well at getting people off T2D medications.
Which is better for T2D subjects, a ketogenic diet or a low glycemic index diet? Both are touted to help diabetics. The last study (on the previous post) showed a modest improvement in HbA1C using the Glycemic Index (about .5).
A 24-week study was done just to answer that question (The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus).
The study subjects were:
Eighty-four community volunteers with obesity and type 2 diabetes
The subjects were randomized and given:
either a low-carbohydrate, ketogenic diet (<20 g of carbohydrate daily; LCKD) or a low-glycemic, reduced-calorie diet (500 kcal/day deficit from weight maintenance diet; LGID).
The goal of the study was to determine which group had the best HbA1C control. Once again, the Low Carb (Ketogenic) diet came out on top.
The LCKD group had greater improvements in hemoglobin A1c (-1.5% vs. -0.5%, p = 0.03), body weight (-11.1 kg vs. -6.9 kg, p = 0.008), and high density lipoprotein cholesterol (+5.6 mg/dL vs. 0 mg/dL, p < 0.001) compared to the LGID group. Diabetes medications were reduced or eliminated in 95.2% of LCKD vs. 62% of LGID participants (p < 0.01).
The Glycemic Index diet subjects had comparable results to the other study with an HbA1C drop of 0.5. More impressively around 50% more of the ketogenic dieters were able to reduce or eliminate diabetic medications.
From (The Truth About Protein Absorption: How Often You Should Eat Protein to Build Muscle):
When you eat protein, your stomach uses its acid and enzymes to break it down into its building blocks, amino acids. These molecules are transported into the bloodstream by special cells that line the small intestine, and are then delivered to various parts of the body. Your small intestine only has so many transporter cells, which limits the amount of amino acids that can be infused into your blood every hour.
The article goes on to say that different proteins sources are absorbed at different rates.
According to one review, whey clocks in at 8 to 10 grams absorbed per hour, casein at ~6.1 g/hr, soy at ~3.9 g/hr, and cooked egg at ~2.9 g/hr.
Here’s a really interesting point that I didn’t know about:
For instance, the presence of protein in the stomach stimulates the production of a hormone that delays “gastric emptying” (the emptying of the food from the stomach). This slows down intestinal contractions and thus how quickly the food moves through the small intestine, where nutrients are absorbed. This is one of the ways your body “buys the time” it needs to absorb the protein you eat.
That seems to be the mechanism by which protein gets processed by the body. That’s how the area under the curve for protein is so long.
The article goes on to say that:
Carbohydrates and fats can move through your small intestine and be fully absorbed while the protein is still being worked on.
The page then quoted a study (Protein feeding pattern does not affect protein retention in young women) which indicated that it doesn’t matter if the protein is consumed all at one time (Intermittent Fasting style) or over the course of the entire day.
It was higher during the experimental period, but not significantly different in the women fed the spread or the pulse patterns [59 +/- 12 and 36 +/- 8 mg N/(kg fat-free mass. d) respectively]. No significant effects of the protein feeding pattern were detected on either whole-body protein turnover [5.5 +/- 0.2 vs. 6.1 +/- 0.3 g protein/(kg fat-free mass. d) for spread and pulse pattern, respectively] or whole-body protein synthesis and protein breakdown. Thus, in young women, these protein feeding patterns did not have significantly different effects on protein retention.
Took a blood sugar measurement before dinner last night and measured 80. Wow. Spent most of the day earlier around 100 (a few points above and below). My body is really expecting dinner and is pumping its own insulin in preparation. I may have to shake things up and try skipping dinner one day for a 40+ hour fast – just to confuse my body. If I do it, I will be careful to measure frequently to avoid going too low. LOL. Hard to imagine such a thing “naturally”.
Weight took a unexpected bounce up this morning. I had 5 pcs of bacon and 4 eggs for dinner last night with a lot of cheese. Cooked the eggs in all the bacon fat. My guess is the weight pop was due to the salt in the bacon and the rest of the meal. It’s the really cheap bacon from Sam’s Club. The cheapest out there. I need to upgrade my food sources but it’s tough living in the boonies. Maybe a trip to the big city is in order.
No beer again last night.
Blood sugar when I got out of bed was around 104. Incredible number for me since I’ve never seen numbers like that while I was on Insulin shots. Just measured in the middle of the day and it was 101. My seven day average is at 111. Down from 125 last week and down from 159 last month when I was on Insulin.
Disappointing news on the Blood Glucose meter front. I had switched to the Bayer Contour Next that came with my Insulin pump last year. I liked it since the numbers were higher on that meter than on my OneTouch Ultra meters (they measure close to each other). I also like that it looks like a USB stick and has a USB jack at the one end. Their charting software makes decent graphs.
Problem is my insurance company only allows OneTouch. There’s a USB cable for the OneTouch UltraMini that costs $29.99. If I’m hitting numbers in the 110s and lower I really don’t need to download my numbers. So I guess I am stuck with the OneTouch UltraLink and OneTouch UltraMini meters. Only reason I really need a cable is to make graphs to upload to this BLOG.
The dumb part is that although there is software for the OneTouch meters, the version I have only works in conjunction with the Insulin Pump. The meter sends the value to the pump and the pump can be uploaded to the software. No pump? No uploading.
Lost my taste for alcohol and haven’t wanted one in a couple of days. Haven’t had one either. Wanted to want to have a beer last night and I know that the low calories I had eaten for dinner would leave me hungry so I tried to talk myself into going and getting a beer. Couldn’t do it.
Not sure if it is my desire to keep down carbs or just not enjoying the taste as much when I am on ketosis.
Surprised that it is noon and I am not feeling particularly hungry since my dinner was just a double paddy burger without a bun at Five Guys last night.
Starting to enjoy being in ketosis.
Noticed this morning that my body was out of ketosis. My detection method is the metallic taste in my mouth when I am in ketosis. Now, 2 hours later I am back in Ketosis. My pump delivers .5 U/hr between 4 AM and 12 PM. The rest of the time I am pumping .25 U/hr.
I am not adding any bolus today so that I can try to understand the effects. I took a Metformin 850 mg when I got up so part of the following effect may be from the Metformin. Numbers were up early on but I am watching the numbers over the day.
- 7:20 – 130
- 8:20 – 154
- 9:20 – 130
- 10:20 – 116
- 11:20 – 118
- 12:30 – 127 (physically active – working in the kitchen)
- 1:20 – 118
- 2:20 – 108
- 3:20 – 111
- 5:40 – 113
I have gotten pretty much the same response when I used Insulin so why use Insulin?