I’ve been following Jimmy Moore’s N=1 experiment with staying in nutritional ketosis on his blog, but it was instructive to actually watch the man eat during his visit last week. His meals are WAY high in fat now and he watches his protein intake. I must admit, despite everything I’ve read about the benefits of ketosis, when I watched Jimmy scooping gobs of butter and sour cream on his cheesy scrambled eggs in the morning, I couldn’t help thinking, “Wait a minute … you’re losing weight eating like this?”
The reason he’s doing this is that he discovered eating low-carb doesn’t necessarily mean being in ketosis, or at least not in the zone that Drs. Jeff Volek and Stephen Phinney call nutritional ketosis: a blood ketone level of between 0.5 and 3.0 mM. As they explain in their terrific book The Art and Science of Low-Carb Living, it’s within this zone that we can easily tap body fat for fuel and keep our brains happily supplied with ketones.
When Dr. Atkins was practicing and writing his books, he urged people to test their ketone levels with ketone urine strips. That was the technology available at the time. Unfortunately, the ketones in urine aren’t necessarily an accurate reflection of the ketones in the bloodstream, which is the level that matters. The reason for the disparity is that as you become keto-adapted, you tend to use more of the ketones for fuel instead of excreting them. The newer and better technology is a device similar to a glucose meter that tests ketone levels in the blood.
As Jimmy Moore explained on his blog, he was surprised when he first used a ketone meter and saw that despite being on a very low-carb diet, his blood ketone level was only 0.1. After adjusting his diet, he’s hanging around the 2.0 level most of the time – and he’s losing weight again.
For the record, I don’t believe everyone has to be in nutritional ketosis to lose weight. People lose weight on all kinds of diets, including paleo diets that aren’t particularly low-carb. I lost weight on The Zone diet, which at 40% carbohydrates is hardly a ketogenic diet. But for people like Jimmy who are hyper-responders to insulin-producing foods, staying in ketosis may be the key.
People who pooh-pooh low-carb diets like to point out that protein foods raise insulin and therefore the “high-protein” Atkins diet can’t possibly work by lowering insulin levels. Hogwash. When we cut carbohydrates, most of us replace the bulk of those calories with fat, not protein. We’re still consuming fewer insulin-producing foods, and we end up with lower overall insulin levels as a result. But the pooh-poohers do have a point, even if it’s not exactly the point they wanted to make: for some people, a low-carb diet may not work in the long term unless they restrict their protein intake as well.
Let’s return to Jimmy Moore’s experience. We all know (because he’s been quite public and honest about it) that Jimmy lost 180 pounds on the Atkins diet, but then slowly regained about half of that. I’m speculating here, since we don’t have records of Jimmy’s insulin levels during the time he was gaining weight, but let’s suppose for the sake of argument that he was eating enough extra protein to raise his fasting insulin level, despite consuming very few carbs. It doesn’t take much extra insulin to significantly inhibit the release of fatty acids from the fat cells. Take a look at this graphic, which was included in a study by Dr. Volek:
As you can see, the ability to release and burn stored fatty acids falls off sharply as fasting insulin levels increase, even within what’s considered the “normal” range. As the text accompanying the graphic explains:
In fact, adipose tissue lipolysis is exquisitely sensitive to changes in insulin within the physiological range of concentrations. Small to moderate decreases in insulin can increase lipolysis several-fold, the response being virtually immediate. Insulin also stimulates lipogenesis [creating new body fat] by increasing glucose uptake and activating lipogenic and glycolytic enzymes. Small reductions in insulin levels, such as that easily achieved with dietary carbohydrate restriction, remove the normal inhibition on fat breakdown.
Dr. Volek was writing about carbohydrates in that paper, but if excess dietary protein also elevates fasting insulin in some people – even to a relatively small degree – that could cause a similar suppression of ability to burn body fat. That might explain (again, I’m speculating here) why Jimmy regained a lot of weight on his low-carb diet and why he’s losing again now. Restricting calories didn’t work, adding “safe starches” to his meals didn’t work, but lowering his protein intake and getting an even higher proportion of his calories from fat is working, at least so far. He’ll report on his experiment in an upcoming post, so I’ll let him announce the specific results.
Naturally, Jimmy’s experiment piqued my curiosity about my own blood ketone levels, so I bought a meter (a Precision Xtra by Abbot Labs) through Amazon. After a week or so, I determined that on my typical diet, I seem to hang right around 0.8 mM, the lower end of nutritional ketosis. I also learned that I can be pushed out of ketosis more easily than I would have previously suspected.
On Saturday night, Chareva and I took the girls to Red Lobster for a belated anniversary dinner. I ate a lobster, some scallops, two skewers of shrimp, a salad with bleu cheese dressing, three tortilla chips with lobster-cheese dip, two mushrooms stuffed with lobster and cheese, and broccoli drenched in butter. Very low-carb with lots of fat, but also lots of protein. Before bed, I had two glasses of red wine. The next morning, my blood ketone level had dropped to 0.2. Could be high protein intake, could be the wine, could be both.
My belly is almost flat these days, so I don’t have a burning need or desire to lose more weight, but what the heck, I think I’ll experiment with my diet, keep track of my blood ketone levels, and see if it makes any difference. I tried eating more protein and less fat awhile back, and nothing changed. If I get into a consistent state of nutritional ketosis and lose that last little bit of softness around the waist, that would be cool. I certainly have no objection to putting extra butter and sour cream on my eggs.
Below I’ve posted an interview Dr. Andreas Eenfield conducted with Dr. Steve Phinney about why a good low-carb diet should also be a high-fat diet, not (as the goofballs in the media always seem to think) a high-protein diet.