low carb keto fluOver the first few days (up to two weeks) of eating low-carb, you may run into some frustration. Where is all of this energy I’m supposed to have? Why do I want to mow through that bag of chips right now? Am I coming down with a cold? For some people, the transition from burning glucose to burning fat comes with unwanted symptoms that range from slightly uncomfortable to miserable. This transition period is known as keto flu, or low-carb flu. It’s real, and it can be pretty terrible.

But, it’s temporary.

What is Low Carb Flu?

Low carb flu, or keto flu, is a set of symptoms that you may feel over the first few days of limiting carbohydrates. Low carb flu isn’t a flu or infection at all, and it’s not a medical term. It got its name because some of the symptoms of carb restriction can feel like you’re sick with the flu.

Low carb flu has dissuaded millions of people from pursuing and sticking to a healthy diet. You can laugh now that you’re fat-adapted and humming along on stored body fat, but you’ve forgotten just how terrible the transition from sugar-burning to fat-burning can be.

Symptoms of Keto Flu, or Low Carb Flu

It shows up differently for everyone. Some people, likely the ones who are metabolically flexible to a degree before even starting, won’t notice much trouble. That’s somewhat rare. More often, people new to carb restriction will experience some degree of:

  • Headaches
  • Brain fog
  • Malaise, fatigue, listlessness, and other synonyms for “exhaustion”
  • Feeling lightheaded or dizzy
  • Irritability
  • Mood changes
  • Constplation
  • Diarrhea
  • Nausea
  • Vomiting
  • Muscle aches
  • Lack of motivation
  • Feelings of anxiousness
  • Cravings

At some point, you’ll just have to accept the reality of the situation: you’re shifting from a sugar-burning metabolism to a fat-burning metabolism. You’re building the metabolic machinery necessary to burn fat. You’re updating your body’s firmware, and it’s a big update. That takes time.

How Long Does Keto Flu Last?

Generally, you can expect keto flu to last 4-7 days.

Most commonly, people who have symptoms with low-carb will experience symptoms If the results of one study are representative, it takes about five days on a low-carb, high-fat diet to increase AMPK and start building new fat-burning mitochondria.https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0032-1312656‘>2 And sure enough, most people report that the low-carb flu lasts from four to seven days—right on target.

But that doesn’t mean we have to like it. So, what can you do to speed up the transition and reduce the pain and suffering?

Here are a few strategies to help you cross the rocky terrain of keto flu more quickly.

11 Keto Flu Remedies to Make Low Carb Easier

  1. Eat fatty fish or take fish oil
  2. Support your stress systems
  3. Don’t skimp on salt
  4. Eat enough potassium
  5. Take magnesium
  6. Stay hydrated
  7. Eat more fat
  8. Include medium-chain triglycerides (MCTs)
  9. Consider ketone supplements
  10. Move around at a slow pace
  11. Reduce carbs gradually

1. Eat fatty fish or take fish oil

One theory is that low-carb flu is caused by the release of stored arachidonic acid from adipose tissue. Since AA is the precursor to inflammatory molecules implicated in headaches,http://www.ncbi.nlm.nih.gov/pubmed/1901193‘>4 If this is true, taking extra fish oil or eating fatty fish like sardines or salmon should counter the omega-6-induced inflammatory response triggering the headaches. If this isn’t true, eating fish is still a good idea.

2. Support your stress systems

There’s a good chance you have been fueled by glucose for most of your life. So, when glucose suddenly isn’t available, your body might think you’re in danger – that you’re in a time of scarcity or famine. That triggers your stress response, and your adrenal glands release cortisol, which makes you store body fat.

An easy way to combat this is with adaptogens – supplements that act directly on your body’s stress mechanisms. Adaptogens help to modulate the stress response so that the physical effects of stress are less pronounced.

3. Don’t skimp on salt

Going low-carb increases salt requirements on multiple levels. First, when your body dumps glycogen, it doesn’t just dump the water that accompanies it. You’re also losing tons of sodium. Second, a byproduct of low insulin is reduced sodium retention,http://www.ncbi.nlm.nih.gov/pubmed/7332312‘>6 To replenish your stores, Use Lite-Salt (a potassium salt) along with your regular salt, and eat lots of non-starchy green vegetation, like spinach. Other great potassium sources include avocados and yogurt (if you get real yogurt, the bacteria have consumed most of the sugar).

5. Take magnesium

Notice a theme here? Electrolytes matter when you’re going keto.

Although losing water doesn’t really flush out magnesium like it does other electrolytes, we do need extra magnesium to regulate sodium and potassium levels in the body.https://www.mdpi.com/2072-6643/10/10/1348/htm‘>1

Things like sleep deprivation, chronic stress, and gut dysbiosis are also shown to cause cravings for a variety of physiological reasons. But let’s say you’re getting a solid 8-9 hours of uninterrupted sleep, your stress levels are under control, your gut microbiome is balanced — and you’re still struggling with cravings. Then what?

Why Can’t I Quit Sugar?

Cravings are often more psychological than they are physiological. Maybe you’ve noticed that too. Maybe you’ve noticed that you start to have cravings any time you have a stressful day or feel anxious or deprived or smell something that reminds you of your favorite snickerdoodle cookie from childhood. In my experience, these are the top 5 emotionally driven reasons you might still be struggling with sugar cravings:

1. Your Diet is Too Restrictive

Eliminating certain foods and food-like items like grains, sugar, and refined carbohydrates is a good thing in general. But being too restrictive — or perceiving how you’re eating as a diet can end up backfiring. In fact, this study shows a direct correlation between food restriction and cravings.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4114146/‘>3 are also in charge of housing your memories and experiences.

3. State of Mental Health

Australian researchers conducted a study on pandemic-related depression, stress, anxiety, and well-being and found that 79% of the participants were struggling with mental health issues due to COVID-19.https://www.researchgate.net/publication/302969772_Effects_of_sugar_rich_diet_on_brain_serotonin_hyperphagia_and_anxiety_in_animal_model_of_both_genders‘>5 the neurotransmitter that regulates your mood. When you eat sugar, you feel happier, more connected, and less stressed out — at least until the sugar crash hits.

4. Current Rituals

Frozen junior mints at the movies. A slice of pie at summer barbeques. Checking out the dessert menu after dinner even though you’re stuffed. Your rituals and your environment  influence your behaviours (i.e. trigger you to search for something sweet).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868755/‘>7

Why It’s So Hard to Stop Eating Sugar

We’re taught early on that sugar equals love and that feeling “better” is as easy as snuggling a pint of Ben & Jerry’s on the couch. Sure, diving into the emotional side of good health can be uncomfortable, but it’s also extremely necessary if you want to get your cravings under control.

The more readily you can express and deal with your emotions, the healthier your mind and your body will be. In my 10+ years as a health coach, I’ve helped hundreds of men and women peel back the layers of their sugar cravings. And you can too. With the following strategies, you’ll learn that your sugar cravings aren’t something that need wrangling — they’re something that you can use to learn more about what you’re really craving.

How to Cut Your Sugar Habit: 5 Strategies to Stop Cravings

1. Add More Variety

A steady diet of grass-fed beef and local, organic veggies looks great on paper in respect to quality, but as mentioned above, might also feel too limiting for where you’re at right now. If you’re constantly dreaming of sugar-laden treats, take this opportunity to diversify your plate. By adding a variety of colors, textures, and flavors, you’re giving your brain and your body the signal that you’re having more, not less. And don’t forget to change it up now and then. Typically opt for ribeye? Try a salmon fillet. Love salads? Try grilled asparagus. Always snack on almonds? Buy some salted macadamia nuts. You get the picture.

2. Keep a Journal

You don’t have to write down all of your deepest, darkest thoughts, but I do recommend keeping a journal of when your food cravings hit — and this is the important part: what you’re feeling when they come on. Do this exercise without self-editing or judgement. Within a week, my guess is that you’ll start to see a connection between your triggers (which could be memories, celebrations, emotions, people, and places) and your sugar cravings. Research shows that having a practice of mindfulness can help you better manage the uncomfortable feelings that fuel your cravings.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4290532/‘>9 levels naturally (and reduce the desire to reach for sugar to feel good) through hugging, laughing, playing, and practicing gratitude. Other things like looking at photos of loved ones, singing, physical exercise, and support from family, friends, and our community here on Mark’s Daily Apple are also great ways to boost oxytocin levels. Emotional trauma of any kind can impact your habits and behaviors as an adult. And while a health coach can help you overcome certain obstacles, it’s crucial to work with a licensed professional trained to navigate these challenges https://celiac.org/about-celiac-disease/what-is-celiac-disease/‘>1 Unfortunately, not everyone who develops Celiac disease will have recognizable symptoms before the condition has wreaked serious havoc in the intestinal system by flattening of the intestinal villi and subsequently decreasing the area for nutrient absorption. For these people, Celiac disease often isn’t diagnosed until after effects of malnutrition have set in (lack of growth in children, diarrhea, stomach pain and/or bloating, vomiting, behavioral changes, etc.). In these cases, biopsies are often taken to assess the extent of damage and to aid diagnosis. Even if biopsies are normal, there is still the chance that nutrient absorption is impaired.

Thankfully, methods for diagnosing gluten sensitivity and related Celiac disease have improved in recent years as awareness has increased and more research has been done. Blood tests for specific antibodies have allowed physicians to diagnose the disease in many cases before much if any damage has occurred. Researchers are also beginning to test for antibodies in the intestinal tract, which may promise an even earlier diagnosis in at-risk individuals.

Is Gluten Intolerance Common?

Gluten sensitivity or intolerance, once thought to be rare, is now believed to affect a third of the population. (Some believe this number is substantially higher.) Experts report that up to 100 million Americans will consume gluten-free food products over the course of a year.https://www.sciencedirect.com/science/article/abs/pii/0167569992900208‘>3 It can appear at any point throughout your lifetime, and sometimes doesn’t manifest itself until a person is in their thirties or even forties.

Given my stance on grains, I obviously suggest avoiding gluten. As mentioned, gluten intolerance is a very common condition and may be underestimated still. Given the relatively recent introduction of gluten (and all grains) into the human diet, gluten intolerance and the related Celiac disease are very unfortunate but not very surprising conditions. In addition to omitting grains from your diet (especially those listed above), you can avoid processed foods, which likely contain trace amounts in forms like hydrolyzed proteins, starch/modified starch, malt, binders, and natural flavorings. If anyone in your family has been diagnosed with Celiac disease or gluten intolerance, it’s a wise idea to talk to your doctor about testing options.

What to Do If You Suspect You Are Gluten Intolerant

If you think you are having reactions to gluten, visit your doctor to rule out celiac disease. Then, it’s simply a matter of avoiding gluten. It’s difficult at first, but soon, you won’t miss them.

Foods that Contain Gluten

Gluten is present in only grains and grain-based foods. Ingredients to look out for if you’re avoiding gluten include:

  • Wheat
  • Oats if not labeled gluten-free (If they’re grown too close to wheat crops, you may end up with rogue wheat grains in the mix.)
  • Barley
  • Rye
  • Triticale

When you’re Primal, you avoid grains, so you may be avoiding gluten by default.

Gluten-free grains, starches and flours

If you’re avoiding gluten and buying replacement foods, you may see ingredients including:

  • Amaranth
  • Rice
  • Arrowroot
  • Almond flour
  • Sorghum
  • Buckwheat
  • Cassava root
  • Teff
  • Corn
  • Flaxseed
  • Coconut flour
  • Potato starch
  • Millet
  • Quinoa
  • Soy
  • Tapioca

Just because it’s gluten free doesn’t mean it’s healthy or Primal. Read this article on grains before you decide to dig in. This article lists flours that are Primal-friendly. 


The post Dear Mark: Gluten Sensitivity, Intolerance, Celiac Disease, and Grains appeared first on Mark’s Daily Apple.

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benefits of intermittent fastingAt this point, intermittent fasting isn’t a new concept, nor is it a difficult one. You take in all of your calories for the day within a limited window of time, and the rest of the day, you stick with water, maybe a cup of coffee, or tea in the morning if you feel so inclined. The idea is that giving your body a period of time “off” from digesting food allows your cells to heal and renew in other ways.

A Practice Born Because Calorie Restriction is Unpleasant

Intermittent fasting became popular because calorie restriction was found to contribute to healthy aging. A few mouse and worm studies seem to show that drastic reductions in food intake over a long period of time could prolong your life.

The research is compelling, but I’m not convinced actively restricting your calorie intake through sheer will is the true path to enjoyable longevity. I don’t want to be thin, frail, distractible, or preoccupied with food. I’d rather be vibrant and full of zest. I want to eat big strapping meals of steak and veggies smothered in butter without worrying about calories. I want to maintain muscle mass and have enough energy to go on long hikes and have the legs to still leap for high passes (over the young guys) at the end of Ultimate games. And as I appreciate the neuroprotective and autophagy-promoting qualities of calorie restriction, I’d rather not expend the mental energy and fortitude required to maintain such a regimen day-in and day-out.

Intermittent fasting is the workaround. Pushing off breakfast for a few hours gives me all of the benefits of calorie restriction, without all the misery.

Fasting is the way to have your cake and eat it too. Beyond the already proven benefits of a Primal Blueprint low-carb lifestyle, fasting once in a while seems to offer many of the same benefits of calorie restriction – you know, stuff like increased longevity, neuroprotection, increased insulin sensitivity, stronger resistance to stress, some cool effects on endogenous hormone production, increased mental clarity, plus more – but without the active, agonizing restriction.

You just eat Primally, focusing on meat and vegetables with plenty of animal fat, and skip meals on occasion. A sixteen-hour fast is on the low-but-still-effective end, or you could opt for longer, more intermittent fasts – say, a full twenty-four hours once or twice a week. Women may need to time fasts a little differently than men. More on that here.

When you’re done with the fast, eat as much as you want (which usually isn’t an issue, once you’re keto-adapted). It essentially turns into “eat when you’re hungry,” because let’s face it: eating the types of foods we evolved eating induces powerful satiety and makes eating the right amount of food a subconscious act. Fasting becomes a whole lot easier (and intuitive) when you’ve got your food quality dialed in. And I’ll come back to that little caveat at the end here.

“Fasting” was the top search term for MDA last week, and I hadn’t done a big post on it in a while, so I thought I’d do a comprehensive rundown of all the benefits (some conclusive, others prospective) you can expect to obtain from IF.

You can have a fun night out and stay on track. Instantly download the Primal and Keto Guide to Dining Out

Intermittent Fasting and Longevity

Everyone wants to live longer, but I find longevity pointless if you’re not enjoying yourself. Otherwise, life becomes dreary.

The popular c. elegans worm enjoys increased longevity with both twenty-four and forty-eight hour IFs via signaling through a gene that we all have.full PDF) from the 1940s found that varying amounts of twenty-four hour IFs (every other day, every fourth day, every eighth day, etc) prolonged the lifespan of rats without retarding or stunting the growth (as occurred with calorie restricting them). Female rats responded best to every eight day fasts, while males responded best to every other day fasts.

Reductions in brain insulin signaling have been shown to increase lifespan in animals, either by calorie restricting or actively knocking out brain insulin receptors.http://www.ncbi.nlm.nih.gov/pubmed/21244426‘>3

Blood Lipids

Going in and pharmaceutically manhandling your cholesterol synthesizing equipment is one thing; eating real food and exercising, resulting in possible alterations to your lipid profile, is another. We don’t set out to force your blood lipids into submission, but lifestyle changes that happen to change them for “the better” are usually a good thing. Fasting brings potent changes to blood lipids in an “organic” way – you’re just letting your machinery do its thing on its own – and this is probably a very good thing.

Intermittent fasting is as effective or even more effective than calorie restriction in improving metabolic syndrome markers in overweight women, and it’s a whole lot easier to stick with.http://www.ncbi.nlm.nih.gov/pubmed/20300080‘>5

I discussed this last week, but it can’t hurt to mention that short-term alternate day fasting wrought improvements in LDL particle size and distribution in obese adults.http://www.ncbi.nlm.nih.gov/pubmed/20815899‘>7

Heck, intermittent fasting even helped cocaine addicts stick to their treatment and rehab program.http://www.ncbi.nlm.nih.gov/pubmed/18184721‘>9 In fact, here’s a review of most of the animal anti-cancer evidence.http://www.ncbi.nlm.nih.gov/pubmed/19135806‘>11 This is refreshing news. A preliminary studyhttp://ajpregu.physiology.org/content/296/1/R29.full‘>13 I’ve found this to be the case for me. If the body “needs” food right after a workout, why would hunger be blunted? This is why I tend to hold off on the eating post-workout. Every little bit helps, especially as you age.

Neurological Health

Fasting doesn’t cause your brain tissue to waste away, contrary to what some people will tell you. It’s actually good for brain health. Any dietary restriction tends to increase neuronal plasticity and promote neurogenesis, but it was IF that had the greatest effect (with the fewest downsides).http://onlinelibrary.wiley.com/doi/10.1046/j.1471-4159.2003.01586.x/full‘>15 That is, mice who ate larger meals more infrequently saw greater increases in brain and overall bodily health. Still another study found that IF was beneficial for peripheral nerve function in mice by promoting the maintenance of the neuronal pathways responsible for locomotor performance.http://www.ncbi.nlm.nih.gov/pubmed/21106691‘>17), which is the process by which cells recycle waste material, eliminate or downregulate wasteful processes, and repair themselves. Why is autophagy so important? It’s required to maintain muscle masshttp://www.ncbi.nlm.nih.gov/pubmed/20104028‘>19  It reduces the negative effects of aginghttp://www.ncbi.nlm.nih.gov/pubmed/17934054‘>21

Without the autophagy that fasting provides, you would get very few of the benefits. Fasting even increases neuronal autophagy,http://www.ncbi.nlm.nih.gov/pubmed/21051570‘>23 (which mean better performance down the line), improved muscle protein synthesis,http://www.ncbi.nlm.nih.gov/pubmed/20187284‘>25 (you’ll earn your meal and make more muscle out of it if you train on an empty stomach). Studies on Muslim athletes during Ramadan show no effect on performance while fasting,http://www.ncbi.nlm.nih.gov/pubmed/19787180‘>27 in those who exercise and fast rather than just fast. When you train in a fasted state, glycogen breakdown is blunted28 and more fat is burned, leaving you more glycolytic energy in the tank for when you really need it and less body fat. Those are just a sampling of the benefits to fasted training; there are dozens more.

Mental Well-being and Clarity

A lot of health influencers will tell you that failure to eat something every few hours will cause mental fog and sluggishness, so keep a banana or a granola bar on your person at all times. Of course, this is all based on an assumption that we need to supply exogenous carbs on a regular basis to properly fuel the brain. This notion that fasting is only the province of anorexics or “caveman” has kept many people from experiencing the vast array of benefits.

I maintain that one’s comfort in handling intermittent fasting effortlessly does increase dramatically when you’ve reprogrammed those cells (and genes) to predispose your body to derive most of your day-to-day energy from fat, as opposed to constantly dipping into glycogen stores (as happens when we rely so much on refeeding carbs every few hours).

Overall, fasting just seems right. It’s like a reset button for your entire body, presumably across a large spectrum of maladies and dysfunctions. It puts your body into repair mode – at the cellular level – and it can restore normal hormonal function in the obese or overweight. Now, you don’t have to fast, but it’s definitely something to consider.

Have you tried intermittent fasting yet? Let me know how intermittent fasting has worked – or hasn’t – with your lifestyle in the comment section!


The post The Myriad of Benefits of Intermittent Fasting appeared first on Mark’s Daily Apple.

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fat adaptedWhen describing someone that has successfully made the transition to a Primal or Keto way of eating I often refer to them as “fat-adapted” or as “fat-burning beasts”. But what exactly does it mean to be fat-adapted? How can you tell if you’re fat-adapted or still a sugar-burner?

As I’ve mentioned before, fat-adaptation is the normal, preferred metabolic state of the human animal. It’s nothing special. It’s just how we’re meant to fuel ourselves. That’s actually why we have all this fat on our bodies – turns out it’s a pretty reliable source of energy.

Here’s what you need to know about the benefits of becoming fat adapted, or keto adapted, and why it works with your biology.

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Are Being in Ketosis and Being Fat Adapted the Same Thing?

Fat-adaption does not necessarily mean you’re in ketosis all the time. Ketosis ketosis describes the use of fat-derived ketone bodies by tissues (like parts of the brain) that normally use glucose. That happens after you’ve depleted your glucose stores, and your body starts producing ketones for energy. When you’re in ketosis, you can usually detect ketones in your bloodstream.

Fat-adaption describes the ability to burn both fat (through beta-oxidation) and glucose (through glycolysis).

The Disadvantages of Primarily Burning Sugar for Energy

To understand what it means to be fat adapted, it’s useful examine what it means to depend on sugar for energy.

It Is More Difficult to Access Stored Fat for Energy When You’re Dependent on Sugar

What that means is, when your body is primarily looking for sugar for fuel, your skeletal muscle doesn’t as readily oxidize fat for energy.

What happens when a sugar-burner goes two, three, four hours without food, or skips a whole entire meal? They get ravenously hungry. A sugar-burner’s adipose (fat) tissue even releases a bunch of fatty acids 4-6 hours after eating and during fasting, because as far as your biology is concerned, your muscles should be able to oxidize them. After all, we evolved to rely on beta oxidation of fat for the bulk of our energy needs. Once your blood sugar is all used up (which happens really quickly), hunger sets in, and your hand reaches into the chip bag yet again.

A Sugar Burner Doesn’t Readily Access Dietary Fat for Energy

As a result, more dietary fat is stored than burned. Unfortunately for them, they’re likely to end up gaining lots of body fat. As we know, a low ratio of fat to carbohydrate oxidation is a strong predictor of future weight gain.http://onlinelibrary.wiley.com/doi/10.1111/j.1748-1716.1970.tb04764.x/abstract?systemMessage=Due+to+scheduled+maintenance+access+to+the+Wiley+Online+Library+may+be+disrupted+as+follows%3A+Monday%2C+6+September+-+New+York+0400+EDT+to+0500+EDT%3B+London+0900+BST+to+1000+BST%3B+Singapore+1600+to+1700‘>2 If you’re unable to effectively beta oxidize fat (as sugar-burners often are), you’d better have some quick snack options on hand.

Sugar Burners Use Stored Glucose Quickly During Exercise

Depending on the nature of the physical activity, glycogen burning could be perfectly desirable and expected, but it’s precious, valuable stuff. If you’re able to power your efforts with fat for as long as possible, that gives you more glycogen – more rocket fuel for later, intenser efforts (like climbing a hill or grabbing that fourth quarter offensive rebound or running from a predator). Sugar-burners waste their glycogen on efforts that fat should be able to power.

The Benefits of Being Fat Adapted

There are some compelling advantages to being fat adapted or keto adapted, which may move you to make the switch if you haven’t already.

People Who are Fat Adapted Often See Improved Insulin Sensitivity

A ketogenic diet “tells” your body that no or very little glucose is available in the environment. The result? “Impaired” glucose tolerance http://www.ncbi.nlm.nih.gov/pubmed/19407076‘>4

Being Fat Adapted Means You Go Longer Between Meals

A fat-burning beast can effectively burn stored fat for energy throughout the day. If you are fat adapted, chances are, you can handle missing meals and are able to go hours without getting ravenous and cranky (or craving carbs).

You Can Better Utilize the Fat You Eat for Energy

A fat-burning beast is able to effectively oxidize dietary fat for energy. If you’re adapted, your post-prandial (after mealtime) fat oxidation will be increased, and less dietary fat will be stored in adipose tissue.

When You’re Keto Adapted, You Always Have a Fuel Source

A fat-burning beast has plenty of accessible energy available in the form of body fat, even if he or she is lean. If you’re adapted, the genes associated with lipid metabolism will be upregulated in your skeletal muscles.http://www.ncbi.nlm.nih.gov/pubmed/18801964‘>6 If you can handle exercising without having to carb-load, you’re probably fat-adapted. If you can workout effectively in a fasted state, you’re definitely fat-adapted.

You Can Still Burn Glucose When Fat Adapted

It’s not that the fat-burning beast can’t burn glucose – because glucose is toxic in the blood, we’ll always preferentially burn it, store it, or otherwise “handle” it – it’s that we do not depend on it. I’d even suggest that true fat-adaptation will allow someone to eat a higher carb meal or day without derailing the train. Once the fat-burning machinery has been established and programmed, you should be able to effortlessly switch between fuel sources as needed.

A fat-burning beast will be able to burn glucose when necessary or available, whereas the opposite cannot be said for a sugar-burner. Ultimately, fat-adaption means metabolic flexibility. It means that a fat-burning beast will be able to handle some carbs along with some fat. When you’re fat adapted, you will be able to empty glycogen stores through intense exercise, refill those stores, burn whatever dietary fat isn’t stored, and then easily access and oxidize the fat that is stored when it’s needed.

If you want to feel these benefits and more, sign up for Keto Month and get

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How Do You Know if You’re Fat Adapted or Keto Adapted?

There’s really no “fat-adaptation home test kit.” I suppose you could test your respiratory quotient, which is the ratio of carbon dioxide you produce to oxygen you consume. An RQ of 1+ indicates full glucose-burning; an RQ of 0.7 indicates full fat-burning. Somewhere around 0.8 would probably mean you’re fairly well fat-adapted, while something closer to 1 probably means you’re closer to a sugar-burner. The obese have higher RQs. Diabetics have higher RQs.http://www.ncbi.nlm.nih.gov/pubmed/20864947‘>8 What do these groups all have in common? Lower satiety, insistent hunger, impaired beta-oxidation of fat, increased carb cravings and intake – all hallmarks of the sugar-burner.

It’d be great if you could monitor the efficiency of your mitochondria, including the waste products produced by their ATP manufacturing, perhaps with a really, really powerful microscope, but you’d have to know what you were looking for.

No, there’s no test to take, no simple thing to measure, no one number to track, no lab to order from your doctor. To find out if you’re fat-adapted, the most effective way is to ask yourself a few basic questions:

  • Can you go three hours without eating? Is skipping a meal an exercise in futility and misery?
  • Do you enjoy steady, even energy throughout the day? Are midday naps pleasurable indulgences, rather than necessary staples?
  • Can you exercise without carb-loading?
  • Have the headaches and brain fuzziness passed?

Yes? Then you’re probably fat-adapted. Welcome to the human metabolism you were wired for!

That’s it for today, folks. Send along any questions or comments that you have. I’d love to hear from you guys.


The post What Does It Mean to Be Fat Adapted or Keto Adapted? appeared first on Mark’s Daily Apple.

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carb timing carb refeedThe Primal Blueprint is generally considered a low-carb way of eating, especially in contrast to the Standard American Diet and the like. We’re not anti-carb. My Big-Ass Salad is a huge bowl of carbs from vegetables, after all. We’re selective about the sources of our carbs and generally mindful about how many we take in.

Given that, readers always want to know the “right” way to incorporate carbs. Which carb sources? How many? When? How often?

The Primal Blueprint Food Pyramid and Carb Curve provide answers to the first two questions. The latter two… well, those are more complicated.

I’ve written about these topics many times, but the questions keep on coming. Today I’m going to try to condense the main points into one post. I’ll touch on some issues you’ve raised in the comments of recent posts, too.

In truth, I keep getting questions because there are so few definitive answers about the optimal way to incorporate carbs in your diet. Underlying hormonal and metabolic health, activity level, and lifestyle variables to make it impossible to make across-the-board recommendations. Few studies address these issues, and those that do always use standard high-carb diets in their manipulations.

The best I can do is explain the logic behind different strategies and encourage you to experiment. As with so many things, it might take time to discover which strategies work best for you.

Carb Timing, Carb Cycling, and Carb Refeeds, Oh My!

Let’s get some terminology out of the way.

  • Carb timing refers to when you eat your carbs. Usually this means when during the day, morning versus night, but it can also mean relative to exercise or other activities.
  • The term carb cycling encompasses various strategies in which you rotate periods of higher- and lower-carb eating. A common carb cycling schedule is eating low-carb for five or six days, then higher-carb for a day or two. Some people eat low-carb for a period of, say, six to eight weeks, then higher-carb for a week or two. Women may also vary their carb intake around their menstrual cycles.
  • Carb refeeds can be synonymous with carb cycling—the higher-carb days are called “refeed” or “carb-up” days. Carb refeeds can also be less systematic than carb cycling. For example, you might throw in a couple high-carb days because your weight loss has plateaued, or you’re doing some particularly strenuous exercise.

It should go without saying that when I say “carbs,” I mean nutrient-dense, whole-food sources of carbohydrate. I’m talking about sweet potatoes and other root vegetables, in-season fruit, nuts, high-fat dairy, perhaps wild rice and occasional legumes if they work for you. There’s obviously no situation in which I’d tell you to throw back a couple donuts with a soda chaser and call it a refeed.

Why Should You Carb Cycle or Refeed?

The main reason to periodically increase your carbs is to boost your leptin levels. Leptin is an important metabolic hormone that is secreted by adipose cells. Leptin also rises after eating, especially carbohydrates but also protein and maybe fat to a lesser degree.

Leptin’s main job is to signal how much energy is available. When leptin levels fall, the brain understands that we are low on energy. This leads to hunger and energy conservation. Chronically low leptin can interfere with fertility, thyroid and adrenal function, skeletal integrity, and cardiovascular health.

Carb refeeds can “reset” leptin levels. Among other benefits, these bursts of leptin improve insulin sensitivity and may help with weight loss. Sustained caloric deficits lead to decreased metabolic rate—part of the energy conservation adaptation. Refeeds will boost metabolic rate, especially if you also eat more calories along with carbs, and reduce hunger. Plus, occasionally eating higher-carb meals offers a welcome break from constant restriction.

Some signs you might benefit carb cycling/refeeds are:

  • Excessive hunger
  • Irregular menstrual cycles
  • Mood disturbances or depression
  • Low body fat
  • Sleep disturbances
  • Weight-loss plateau
  • Better adherence to dietary goals with occasional “breaks”

In each of these cases, adding carbs is only one of several dietary strategies you might try. Also consider whether you are eating enough calories, and protein, to meet your needs, and whether you are minding your Ps and Qs when it comes to sleep practices and stress reduction.

People who might not need carb refeeds:

  • Carry significant body fat or are insulin resistant
  • Find it easier to adhere to dietary goals when they abstain from higher-carb foods/meals
  • Use low-carb eating regimens therapeutically (e.g., under medical guidance for epilepsy, cognitive decline, or type 1 diabetes)

This should be obvious, but you also don’t need refeeds if you’re not restricting carbohydrates. What does that mean, though? Anyone who is eating a ketogenic diet is clearly restricting carbs. Beyond that, there is a lot of gray area. An extreme endurance athlete eating 150 or even 200 grams of carb per day could be considered low-carb, and hence they might benefit from cycling in more carbs occasionally. Your best bet is to rely on subjective markers of how you feel.

How to Incorporate Carb Cycling or Refeeds

This depends on your goal. If you’re feeling good without carb refeeds, you probably don’t need them. In that case, you might throw in high-carb meals intuitively or when a special occasion offers the opportunity.

Otherwise, you can be more systematic about it. I’d start small and increase as needed. One meal every other week could suffice. You might find you do better with one high-carb day per week, or one meal every three or four days. It’s not uncommon for women to feel better with a slightly higher carb intake than men, but it’s still highly individual.

For weight-loss stalls, consider eating at maintenance calories for a week or two along with including more carbs than normal. This signals to your body that you are no longer in an energy shortage, so it is safe to reverse some of those energy conserving adaptations.

Premenopausal women can try increasing carbs four to five days post-ovulation (around days 19 and 20 of their cycle) and on the first day or two of their period. Women’s bodies are especially attuned to energy shortages, so these periodic boosts in leptin, timed to coincide with greater demand, can be beneficial.

There are no hard rules about how much to increase your carbs. A good place to start is doubling your normal carb intake and adjusting from there. I’d also recommend dialing back your fat intake with higher-carb meals. Triglycerides prevent leptin from crossing the blood-brain barrier.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071301/‘>2 This effect might be especially pronounced in people who have poor glucose control to start with. In one small study, carb timing didn’t matter for participants who were metabolically healthy. For those with impaired glucose tolerance, eating carbs at night led to unfavorable changes on several makers of glucose tolerance compared to eating their carbs in the morning.https://pubmed.ncbi.nlm.nih.gov/26741119/‘>4 The sleep low group also lost fat but not lean mass. Using the same protocol, researchers showed that after only a week of sleeping low, the men improved their performance on a 20k cycling time trial, whereas the control group showed no improvement.https://academic.oup.com/ajcn/article/85/2/426/4649589‘>6 I’d say if you want to try this, you probably don’t need a lot of carbs—maybe half a small sweet potato with dinner, a piece of fruit, or a tablespoon of honey in a mug of herbal tea.

Cortisol Levels Respond to Carb Intake

Here’s the argument: Cortisol naturally rises in the morning as part of the sleep-wake cycle. One of cortisol’s effects is to mobilize stored energy from fat. Insulin opposes the action of cortisol and inhibits the release of fat from adipose tissue. If you eat carbs in the morning, you increase insulin. Therefore, you counteract the desirable high cortisol levels that characterize a healthy circadian rhythm. You also interfere with fat burning.

It makes sense, but the data doesn’t clearly support it. Studies in healthy menhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3033415/‘>8 fail to show a marked decrease in cortisol levels following carbohydrate consumption. In fact, when the men in that first study consumed carbs, protein, and fat in isolation, cortisol levels were highest in the carb-only condition. Likewise, when researchers in another study fed women high-protein or high-carb meals, the high-carb meals resulted in higher, not lower, cortisol levels among women with abdominal obesity (the kind linked to metabolic syndrome), but not peripheral obesity.https://link.springer.com/article/10.1007/s00394-013-0497-7‘>10

There may be a benefit to eating more of your total calories in the morning, but that’s not about carbs per se.

Morning Carbs May Cause Cravings

This is anecdotal, but I’ve had many people tell me that if they start their day with a high-carb breakfast, even complex carbs, they feel hungrier and more snacky all day. If this is you, by all means listen to your body and avoid carbs in the morning.

Reasons to Consume Carbs around Exercise

There are a couple good reasons to target your carbs around exercise. One is their ergogenic effect—that is, their ability to enhance performance. Now, you know I’m a staunch advocate for becoming a fat-burning beast. I think it should be every athlete’s goal to burn as much fat as possible at all levels of intensity. Heck, I even have a book, Primal Endurance, that is all about helping endurance athletes minimize their reliance on carbs.

Still, there’s no denying that carbs can help you tap into top-end speed and power. I’ve always made room for the strategic use of carbs in training, and especially in racing. Train low, race high is a viable strategy for athletes at all levels. For athletes who are engaged in prolonged high-intensity efforts (not my preference), carbs may well be necessary to deliver their desired performance. Hardcore CrossFitters, for example, usually do better when they use carbs around exercise.

Taking in some carbs before or during intense exercise isn’t the same as eating 200 grams of carbs and sitting on the couch. During exercise, those carbs are utilized quickly for energy. Exercise actually increases the ability of cells to take up glucose from the bloodstream, thanks to a glucose transporter in muscle cells called GLUT4 that doesn’t rely on insulin.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019055/‘>12 The carbs you eat then will preferentially go to topping off glycogen.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019055/‘>14 And contrary to what that swole dude at the gym might have told you, you don’t need to throw down post-workout carbs to build lean muscle. You should worry more about getting adequate protein in your diet than about how many carbs you’re eating.https://pubmed.ncbi.nlm.nih.gov/10805507/‘>16

On the other hand, proponents of eating carbs and fat together will tell you that eating fat alongside carbs is desirable because fat blunts the glycemic response. However, the empirical data here are inconsistent and, frankly, confusing. I’m not hanging my hat on this effect.

What’s clearly true is that carbs + fat = delicious. It’s easier to overeat the combo of the two than to overeat either one by itself. In that sense, you might want to watch your consumption of mixed meals if you’re trying to lose weight. At least be mindful of the total caloric load.


When it comes to both carb cycling and carb timing, there is no one-size-fits-most strategy. As with most things we talk about here, you’re going to have to experiment to see what works for you. Hopefully this post has given you some ideas. To summarize the main points:

I think there is fairly decent evidence that carb cycling and/or carb refeeds may benefit you if you typically eat a low-carb diet, especially if it’s also calorie (energy) restricted. You don’t have to, though, especially if you’re feeling good.

Personally, I’m a bigger fan of listening to my body and allowing my carb intake to vary according to my circumstances and intuition rather than adhering to a particular schedule. Your mileage may vary. Premenopausal women in particular may do well to consider being more intentional about it. If you’re going to try incorporating carb cycling, the exact strategy you should try depends on what you hope to accomplish.

As for carb timing, morning versus night, I’m not convinced that it matters a whole lot for most people. If you have chronically low cortisol, or your daily cortisol rhythm is out of alignment, you might do well to consume most of your carbs later in the day. If you’re struggling with insulin resistance, try eating breakfast and including some carbs. For sleep issues, experiment with adding some carbs in the few hours before bedtime.

If you’re using carb cycling or carb timing strategies in the service of a longer term goal—losing weight, sleeping better, improving glucose tolerance—pick a strategy and stick to it for at least a few weeks if not months unless it’s clearly not working for you. If your first experiment doesn’t work, you can always try tweaking the timing, types, and/or amount of carbs you’re eating. Be patient.

For some people, carb cycling or carb timing turns out to be the key to resolving a persistent health issue. For others, they have more of a fine-tuning effect. Still for others, they make no obvious difference.

Are they worth trying? Absolutely, if you want. I’m definitely sold on targeting your carbs around exercise; that’s a clear yes in my book. Even then, though, I like to mix up my fueling to challenge my body. Sometimes I eat right after a workout, sometimes I wait. Sometimes I go out fasted, other times I eat beforehand. That’s how I roll.

How do you roll? Are you gung-ho about a particular carb strategy? Has changing up the timing of your carb intake led to any profound shifts in your health? If yes, I want to hear about it in the comments.


Carb Refeeding and Weight Loss
Does Carb Cycling Work? It Depends.
Dear Mark: Should I Increase Carb Intake for Weight Loss?
Carb Refeeds for Women: Do They Help With Fat Loss?


The post Definitive Guide to Carb Timing and Carb Cycling appeared first on Mark’s Daily Apple.

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why am I getting low ketone readingsEven after publishing several books and hundreds of  articles that draw upon the science of ketosis and low-carb living, I keep researching, thinking, revisiting, and discussing the underpinnings of ketosis. My writing partner, Brad Kearns, and I maintain a running dialogue on all things keto. The latest conversation revolved around two very common questions or “problems” that keep coming up in the ketogenic community: why am I getting low ketone readings?

It’s a fair question. Why do some people on a keto diet register high ketones while others eating the same way register low numbers?

I won’t offer definitive answers fit to etch into stone. I will offer my exploration of the research, some educated speculation, and actionable advice you can ruminate on. And by all means get back to me with your take on the questions and my explorations, please. Dialogue is essential to understanding.

What Level of Ketones Indicates Ketosis?

The generally accepted range that indicates ketosis is 0.5-3 mmol/L. I hesitate to define a prescriptive range, though, because so many factors affect readings – what you ate for your most recent meal, how long ago you exercised, and even the instrument you used to test can affect readings.

Why do some people on ketogenic diets produce low ketone readings when they test?

There are several potential explanations for low ketone readings. Some are hypotheses, some are based on your individual biology. A few possible explanations for low ketone readings include:

  • You have developed fat-burning efficiency
  • Keto-adapted people may be able to burn free fatty acids
  • Genetic predisposition to low ketones
  • Recent exercise
  • Total caloric intake
  • Use of exogenous ketones

Let’s dig deeper.

You have developed fat-burning efficiency

One theory is that some keto-adapted people are so efficient at producing and burning ketones that they don’t leave any extra to spill into the urine and breath. They make only as many as they can use and their cells gobble up almost every ketone they produce. Under this argument, low ketone numbers on a ketogenic diet are a reliable sign of full ketone adaptation.

This sounds plausible, but I haven’t seen any empirical evidence that it’s the case.

Keto-adapted People May Be Able to Burn Free Fatty Acids in the Bloodstream

Another theory is that the keto-adapted have built so much fat-burning metabolic machinery in their muscles that they can burn free fatty acids directly and don’t require much additional fuel from ketones. They make enough ketones to fuel the brain, since our brain can’t run on fatty acids directly, but your muscles no longer require as many. Many people who have been in long term ketosis can get by quite nicely on 20-30 net grams of carbs a day and might only show .4 or .7 millimolar ketones on a blood test, but they have plenty of energy from burning free fatty acids and maintain muscle mass on relatively fewer calories than when they were dependent on carbs.

The evidence is inconclusive, but a few indications point to increased ability to extract energy directly from fat as a possibility.

Keto pioneers Stephen Phinney and Jeff Volek found that keto dieters blew higher readings early on in the diet when they were still burning ketones in the muscle. As they grew adapted to free fatty acids as a source of fuel and produced ketones primarily for the brain, ketone levels dropped. It was totally normal. If anything, they were more fat- and keto-adapted at lower ketone readings.

Consider the energy requirements of the brain. Whether it’s running on glucose (most of the population) or mostly on ketones, the brain is a steady state organ that never spikes energy demand. It’s a slow-burn 24/7 at nearly the same output whether you are sleeping, exercising hard, or concentrating hard. While the brain has a substantial caloric requirement (at roughly 2% of our body weight, it uses 20% of our resting metabolic rate), you don’t need a ton of glucose or ketones at any one time to power your brain gracefully all day long. That’s why people can “get away” with lower ketone production and still reap the benefits we expect from eating this way.

Genetic Predisposition to Low Ketones

There’s almost certainly a genetic component to ketone production, too. Take the Inuit, who were rarely in ketosis despite traditionally eating a very low-carb diet.1 It takes several days of deep fasting for them to produce measurable ketones. Yet, they are adept at burning free fatty acids, almost as if they “skip” keto-adaptation and proceed directly to burning fat. Other variants that affect ketone production have yet to be discovered, but they’re out there.

Recent Exercise or Otherwise Increased Energy Demand

If you test your ketones before and after you exercise, you may be surprised to find that your numbers are quite different after you’ve worked out. Remember, ketones are an energy source, not a stamp of accomplishment. Ketones are consumed when there is an energy demand in your body. It doesn’t mean you messed up your diet. Quite the opposite  – it simply means your body used the energy source available at the time. Once ketone bodies are in low supply, your body will burn fat to make more, and that’s a win.

Why do Some People on Long-term Keto Diets Still Get High Ketone Readings?

A few of the previous theories assume that you develop an increased ability to burn fat after you have been in ketosis for a while. But there are people who, after being in ketosis for a long period of time, still get high ketone readings when they test. What gives?

Total caloric intake is a factor in ketone levels

A major factor not often mentioned in whether someone on a keto diet registers high or low ketones is overall calorie intake. How much food are you eating?

Ketones are generated when the amount of dietary fat available to be burned exceeds the supply of oxaloacetate (provided by protein or carbohydrates). It’s not that the body thinks, “This woman needs some ketones, stat.” It’s more like, “I’ve got too much acetyl-COA from all this fat, and I can’t find any oxaloacetate. Time to ask for ketones!”  If you’re the type to use keto to justify chugging olive oil, you’ll generate lots of ketones simply because your fat intake is outpacing the supply of oxaloacetate. Keto athletes eating tons of calories will probably produce more ketones simply because they’re eating so much fat.

If you’ve attained “caloric efficiency” and are eating fewer calories overall, you’ll generate fewer ketones but still experience all of the benefits of being in ketosis.

Use of exogenous ketones result in high ketone readings

Another factor is the use of exogenous ketones. Realistically, you could take your ketone readings, then take keto salts or keto esters, then take your readings again and see a bump. That is what they’re for.

Don’t Get Caught Up in the Numbers

Above all else, focus on how you feel.

  • Can you go without a meal and maintain steady, even energy and concentration?
  • Are you losing body fat, or are you happy with your body composition?
  • Are you thinking more clearly?
  • Has the keto flu come and gone?
  • Are aerobic activities easier than ever?

If you’re experiencing the benefits of ketosis, there’s no need to fret over some numbers on a device. The numbers can’t negate your real world experience.


The post Why Am I Getting Low Ketone Readings on a Ketogenic Diet? appeared first on Mark’s Daily Apple.

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