For today’s edition of Dear Mark, I’m answering three questions from readers. First, does the renewed vigor assailing the keto diet have me worried about my business? Should I start going vegan to cover all my bases? Second, did the “ketones for overtraining” study from last week control for calories? And third, how can a person eat enough fat if they’re avoiding lactose?
Interested to see if Mark’s focus on keto will continue now that the trend factor is wearing off. That VICE piece, flawed though it may be, is part of a much larger media pushback against keto. What are the business implications of aligning yourself with a so-called “fad diet”?
I’ve built a pretty good business by aligning myself and my writing and my products with “fad diets.”
I generally use several factors to determine where to align myself and target my work:
- Personal experimentation. What am I trying? What kind of diet, exercise, and lifestyle modifications am I experimenting with? The quality of my work suffers if I’m not fully engaged on a personal level. I’m not a technical writer. I need to live my subject matter for it to come alive on the page.
- Personal needs. What works for me? What gets me going? What am I interested in, drawn toward on an intuitive level? What am I missing? Even my best products were designed with my own selfish desires in mind. I made Adaptogenic Calm because I needed a way to recover from excessive endurance training, and it turned out that tons of other athletes needed it, too. I made Primal Mayo because I was sick of whipping up a batch of homemade mayo every time I wanted tuna salad without all the soybean oil. I went keto because the research fascinated me. It turns out that the things I vibe with tend to resonate with others, too. Humans are often quite similar to each other. Not all of them, but there are enough that are.
- Your needs. What does my audience want? What do they need? What kinds of questions are they asking me? What feedback am I getting from them? How are they responding to what I’m putting out?
- New information. I’m always ready to pivot when new information is made available or when new research arises. Sometimes a reader will point something out and it will change the trajectory of my thinking and writing. I try not to wed myself to my ideas, to the things I want to be true, even though that’s a human foible that’s unavoidable. I always try to approach a subject in as intellectually honest a manner as I can. To me, new developments, even if they appear to contradict a stance I hold, breathe new life into my work. For example, I’m definitely biased toward lower-carb approaches for most people. They just clearly work better for the bulk of the people who encounter my work and who struggle with their health and weight in modern industrialized countries. Most people don’t perform enough physical activity to warrant perpetual “high-carb” diets, and most people find weight loss is easier and hunger lower on lower-carb, higher protein/fat diets. But at the same time, there’s room for higher-carb intakes, or even moderate-carb intakes. And can people eat high-carb and be healthy? Have populations lived well on high-carb diets? Absolutely.
Keto still satisfies these factors. Now, I’m always looking toward the horizon; I think my ancestors were probably explorers of some sort. It’s in my blood. So I probably will write about something else—next week, next month, and years from now. But my overall “thrust” will still be low-carb/Primal/keto because, well, the stuff just works.
What I wonder after reading this is: Would there have been a significant inter-group difference had calories been controlled for? Ketone esters obviously have some caloric value that the control group did not receive. How much of the benefit is merely having a better caloric intake to support this intense training protocol?
Good question—this is in regards to the study discussed last week. They actually did control for calories. The experimental group got the ketone ester drink. The control group got an isocaloric medium-chain triglyceride-based drink. Both groups consumed the same amount of calories.
Having tracked through to Michael Eades’ blog on cholesterol—how do you increase fat when you are lactose intolerant? A problem for myself and my adult children. I hadn’t realized that high fat was the actual content rather than the percentage!
Oh, man, there are so many ways to increase fat while lactose intolerant.
My favorite way is to focus on whole food sources of fat, rather than isolated fat sources:
- Fatty animal foods: a ribeye, a beef shank, some ground beef. A lamb shank, some lamb chops. Bacon, eggs, sausage.
- Fatty plants: olives, coconut, nuts (favoring higher MUFA nuts like macadamias), dark chocolate. Salads, which aren’t “fatty” without the dressing and meat but I’m counting as “whole foods” because that’s the effect of eating them.
- Whole avocados: great source of potassium, fiber (if you want that), and polyphenols.
Foods like my Primal Mayo or avocado oil dressings, while technically “isolated” or “refined,” allow and promote the consumption of nutrient-dense whole foods like tuna (tuna salad), eggs (deviled eggs, egg salad), cruciferous veggies (slaws), and steaks (try searing a steak covered in mayo). And even our mayo isn’t nutritionally bereft—it contains choline, folate, and all the other good stuff found in eggs. And our dressings are full of spices and herbs that confer health effects through their phytonutrients.
Also, don’t think you have to focus on “increasing fat.” That’s the mindset that leads to things like chugging olive oil and eating a bowlful of sour cream. High level athletes who need calories at any cost can get away with and even benefit from that, but for most people it makes more sense to focus on reducing excess carbohydrates and eating whole-food sources of fat as they appear naturally.
Also, the lactose intolerant can still have dairy. Try hard cheeses, Greek yogurt, and yogurt and kefir that’s clearly marked “low” or “no lactose.” Butter is fine in all but the most severe cases, and cream is not far off from butter. Ghee is another good cooking fat that should be near zero in lactose.
Anyone else have good “lactose-free” fat sources? Anyone else worried about “keto as a fad”?
Thanks for reading, everyone. Take care!
The post Dear Mark: Abandoning the Keto “Fad,” Ketone Study Calories, and Low-Lactose Fat appeared first on Mark’s Daily Apple.
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There are a dizzying number of keto pills on the market now. They promise easy weight loss, increased energy, and the benefits of ketosis without the pesky following-a-strict-diet part.
As savvy MDA readers, you know that optimal health never comes in a bottle. You also know that I’m a proponent of wise supplementation to support a Primal diet and lifestyle when appropriate. I’ve said before that I think exogenous ketones can be useful in specific circumstances, though they’re never necessary for success.
The question at hand is whether keto pills are likely to offer any benefit or if they’re a waste of money. I focused on pills that seem to be popular on Google searches and Amazon—ones with names like Ultra Fast Keto Boost, Super Fast Keto Boost, Keto Burn Xtreme, Instant Keto, and Keto Slim Rx. (My Amazon search history is shot now. This is the sacrifice I make for my readers.)
First Impressions: Are Keto Pills a Scam?
My first impressions weren’t positive—let’s just say that.
These products are being sold as diet or weight management pills. Their descriptions strongly imply, or sometimes state outright, that the pills will help you lose weight and “enjoy a slim and fit physique.” Most of the claims center on the general promise that being in ketosis causes you to burn fat and, by extension, lose weight (it doesn’t necessarily), and that their products will help keep you in ketosis (a claim I’ll investigate below).
The biggest red flag was when I noticed how many Amazon customers were trying to find the keto pill featured on the TV show Shark Tank. This was news to me, so I did some digging. Apparently there was a popular scam a while back wherein sellers claimed that their keto pills appeared on Shark Tank, and the sharks went wild for them. You didn’t miss anything. This never happened.
Only one product that I looked at—Keto Burn Xtreme sold by Advanced Life Science—still had that on their Amazon page as of December, 2019. It seems like some of the other products might have been falsely advertising this in the past based on older reviews and questions, though.
So it wasn’t looking good off the bat, but I’m an open-minded guy. Bad marketing doesn’t necessarily mean an ineffective product. Sure, the Amazon reviews for these pills are pretty negative overall, but maybe people just aren’t giving them a fair chance? Some folks like them, after all. Let’s try to be objective here.
Do These Keto Pills Contain Ketone Bodies?
Assuming you can trust the labels: Yes.
Exogenous ketones come in two forms: ketone salts and ketone esters. Ketone salts in commercial products are the ketone body beta-hydroxybutyrate (BHB) bound to a salt. Ketone esters are ketone bodies bound to alcohol.
All the keto pills contain ketone salts because they are easier and less expensive to manufacture than esters. On the label they’ll list BHB bound to minerals, such as “calcium beta-hydroxybutyrate” and “magnesium beta-hydroxybutyrate.”
Do the Pills Contain Enough BHB to Be Effective?
Short answer: No, not likely.
A keto pill might “work” because it successfully raises blood ketone levels or because it brings about a desired outcome such as weight loss or improved athletic performance. In any case, keto pills are unlikely to hit the mark, but I’ll get to that.
Both ketone salts and esters raise blood ketone levels, but esters are considerably more effective. In laboratory studies, even large doses of ketone salts usually yield blood ketone levels to between 0.5 and 1.0 mmol/L. That’s enough to qualify as being in ketosis, but it’s not a knock-your-socks-off result by any means. It’s what you’d expected from following a standard keto diet. Still, plenty of people notice that they have more energy and decreased appetite in this range.
It’s probably not enough to profoundly affect certain health markers or athletic performance. For example, a panel of respected exogenous ketone researchers agreed that blood ketone concentrations in excess of 2.0 mmol/L are needed to boost athletic performance. Ketone esters can get you there, which is why most studies demonstrating the efficacy of exogenous ketones use esters. Studies using ketone salts yield decidedly more mixed results.
How Much BHB Salt Is Needed to Be Effective?
There is no agreed upon minimally effective dose for BHB salt. However, let’s use some laboratory studies as a reference point:
- In this paper, Study 1, participants received about 24 grams of BHB, and their average blood ketone levels peaked at 1.0 mmol/L.
- In this study, researchers gave participants 11.7 grams of BHB prior to exercise and then a second dose 45 minutes later during exercise. Blood ketones averaged 0.6 ± 0.3 mmol/L.
- These researchers gave participants two doses of 18.5 grams BHB, which they noted was 60% more than the standard dose recommended by the manufacturer, prior to exercise. Blood ketones measured 0.33 ± 0.16 mmol/L prior to exercise and 0.44 ± 0.15 mmol/L at the end of exercise about an hour later.
- Finally, these participants ingested 0.3g/kg of BHB, which would be about 24 grams for a 175-pound individual. Blood ketone levels peaked below 1.0 mmol/L.
How Do Keto Pills Measure Up?
Of the keto pills I looked at, the highest dose of BHB I saw per serving was 1000 mg, or 1 gram, in Ultra Fast Keto Boost Pro.
It turns out that many of the products contain the same BHB product, goBHB®. For example, Ultra Fast Keto Boost, Insta Keto, Keto Burn Xtreme, and Keto Slim Rx* sold on Amazon by nutra4health LLC are all the same goBHB blend at different price points ($19.95 – $39.95 for 30 servings). Super Fast Keto Boost and Ultra Fast Keto Boost—same thing. Per serving, goBHB contains 800 mg of BHB.
(*This is not to be confused with the other Keto Slim Rx product on Amazon that doesn’t disclose its ingredients but does promise you can “achieve your dream body” and “skyrocket your ketosis!!”)
Many pills contain even less than that. Pure Keto Boost and Instant Pure Keto list 800 mg of another blend that includes BHB salts plus other ingredients, so less total BHB. Others I checked out contained 700 mg or less.
I’m extremely dubious that 800 or even 1000 mg would meaningfully boost blood ketone levels. This is a mere fraction of the dose used in research. If the researchers could give 1 gram of BHB instead of 12 grams or more and still get a measurable effect, they would. Plus, reputable brands of exogenous ketones such as Perfect Keto and KetoCaNa offer 11.4 and 11.7 grams of BHB per serving, respectively.
Finally, it’s worth mentioning that none of the Amazon reviews I read for any of these products mentioned that the reviewer had tested their blood ketones and saw a rise after taking the pills. (And I read a lot of reviews. Too many.)
Can Ketone Pills Make You Lose Weight?
These pills claim that they’ll put you in ketosis, which will melt away body fat. Unfortunately, being in ketosis does not guarantee that you’ll burn body fat. You lose weight on a keto diet they same way you do on any other diet: by expending more energy than you ingest.
That said, it’s fair to say that ketosis is an advantaged state for weight loss. Ketones both suppress appetite and increase energy, meaning it’s easier to eat less and move more when in ketosis. Ketones are also anti-inflammatory and they improve blood glucose regulation. These both contribute to having a healthier metabolism so you trend toward your ideal body weight with less resistance.
If these pills actually support ketosis, which I doubt, their main benefit would probably be appetite suppression, not increased fat burning per se, as they imply. Anyway, the sellers frequently state that these should be used in conjunction with a low-carb or keto lifestyle to be beneficial. Thus, even if someone loses weight while taking them, it would be impossible to attribute it to the pills directly.
It’s obvious what I think: Save your money.
If you want to be in ketosis, drop your carbs, play around with intermittent fasting, or just go do a hard workout and wait to eat until W.H.E.N. (when hunger ensues naturally).
Related Posts from MDA
- Exogenous Ketones Explained: Who Should and Shouldn’t Take Them
- How to Lose Weight with the Keto Diet
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For today’s edition of Dear Mark, I’m answering a question about taking ketones for overtraining from a reader.
I just saw this article the other day and I’m wondering what you think of it. Should high-carb athletes (or regular carb athletes) be taking ketone supplements? Is there any reason why they shouldn’t? It’d be awesome to get the “best of both worlds,” but is it safe?
I saw that one too. Very interesting. Here’s the full study they reference.
Okay, so what’s this all about?
Most ketone ester studies have looked at the benefits to performance. An athlete takes ketones prior to training, then they measure the effect it has on subsequent performance. It’s useful in that situation, improving performance by a few percentage points. I’ve noticed the same thing. Whenever I use ketones—which is rarely—I’ve usually taken them before an Ultimate Frisbee session.
Other studies have looked at post-training ketone supplementation, but only acutely. They’d have trainees work out or compete and then take ketones, with the effects including increased protein synthesis and glycogen repletion. Good to know, but what about long-term post-training supplementation? Would those acute effects translate to long-term effects?
This recent study aimed to find out. Instead of having the athletes take the ketones before or during training, or after but only in the short-term, they had them take them post-training consistently over a period of several weeks to see if they’d aid in recovery. They did.
All the athletes in the study trained twice a day. In the morning, they did either HIIT—high intensity interval training, 30 second all out cycle sprints with 4.5 minutes rest—or IMT—intermittent endurance training, 5 × 6 min with 8 min recovery or 5 × 8 min with 6 min recovery. Evenings, they did steady state endurance training. This was a heavy schedule designed to promote overtraining. There was a lot to recover from.
Both groups showed evidence of overtraining:
- Lower adrenaline at night. Increased adrenaline at night is a hallmark of overtraining and can make it really hard to get a good night’s sleep.
- Blunted decrease in resting heart rate. Acutely, stress increases heart rate. But over the course of several weeks of overtraining, an athlete’s resting heart rate will drop. Taking ketones led to a lower reduction in resting heart rate, indicative of lower stress.
- Improved bone mineral density. Ketone-takers had slightly higher bone mineral density than the control group, in whom bone mineral density decreased. This is a marker of positive response to training. In overtraining, bone mineral density tends to drop.
- Increased tolerance of training. Those who took ketone esters had a higher subjective tolerance for training on subsequent days, indicative of improved recovery.
The group who drank ketones had better numbers, though.
And when they tested both groups with a two-hour endurance session at the end of each week, the ketone-takers had better performance: more power output during the last 30 minutes.
In the past, I’ve expressed skepticism over high-carb eaters adding exogenous ketones to their diets. It just seemed physiologically “wrong” and unnatural to mix ketones and high-carb intakes, since the normal prerequisite for ketosis was a low-carbohydrate intake.
But this study, and some other research I’ve since explored, makes me wonder if adding ketones to a high-carb training schedule might make physiological sense. There are instances where exercise alone is sufficient to get someone into ketosis. For instance, in multistage ultra-marathoners—men and women running 240 km/150 miles over five days, no amount of dietary carbohydrate was able to keep them out of ketosis. They ate over 300 grams a day and they were still deep into ketosis. They even tried eating over 600 grams a day, and they still couldn’t keep themselves out of ketosis. That tells me that ketone production during protracted training is a feature, not a flaw, of human physiology. The two can naturally co-exist even in the presence of carbs.
The key is “glycogen stripping.” As far back as the 1980s, researchers knew that depleting glycogen stores was a prerequisite for ketosis. Now, back then, most researchers saw ketosis as a negative side effect of glycogen depletion, as something to be avoided and mitigated with “proper” carbohydrate intake. They were unaware of the potential benefits ketone bodies can deliver to athletes.
Ketones are anti-inflammatory. I even know a few high-level athletes who are experimenting with extended fasting during de-load periods to reduce the effects of overtraining and speed up healthy recovery. I make the distinction between healthy and unhealthy recovery. Healthy recovery is true recovery; it speeds up the process without inhibiting healing or training adaptations. Unhealthy recovery can get you back out there quicker but you might miss out on some of the benefits of training. One example of this is using ice baths to recover from intense performances. Doing so will blunt pain and help you get training/competing, but it may inhibit some of the benefits of training, like hypertrophy. Useful when you have to get back out there (it’s the playoffs). Not so useful if you’re trying to adapt to the training (it’s the off-season).
Ketones are protein-sparing. When ketones are present in the body, you are less likely to break down muscle tissue and organs for amino acids to convert into glucose. This makes perfect sense, doesn’t it? As an alternative source of fuel for the vast majority of your body’s tissues, ketones reduce the amount of protein you need to break down to provide glucose.
Thus, contrary to my earlier assessment, what was unnatural about the study wasn’t the combination of ketones and carbohydrates. That can clearly occur in natural settings where glycogen is depleted and elevated levels of physical activity are maintained. The unnatural aspect of this study was the insane level of training these subjects were doing.
Humans are built for high volumes of low-intensity work and movement—walking, hiking, gathering, low-level labor.
Humans are built for low volumes of high-intensity work and movement—fighting, killing and field dressing large mammals, carrying heavy objects.
Humans are not built for high volumes of high-intensity work and movement—”two a days,” sprinting in the morning and going for long bike rides in the afternoon. We can do it, but there are consequences.
So what the ketone esters are doing is restoring the natural balance. They are physiological tricks to restore order in a highly-stressed body asked to perform supranatural feats of endurance.
If you try them out for this reason, I have a few suggestions:
- Don’t use ketones as a way to get back out there and keep overtraining. Instead, use them to enhance the training effect—to improve your recovery, to make your time off more meaningful and effective.
- Consider simply going keto. Adding ketones to a bad diet might be better than nothing at all, but the real benefits come when you commit to going keto, build up those fat-burning mitochondria, and become truly fat-adapted.
Taking ketones after a training session clearly works. But you can get there just as easily, with likely downstream benefits, by going low-carb. I’m reminded of the study from a few years ago where athletes “slept low“: after similarly grueling training, they’d eat a low-carb meal (rather than refuel their glycogen) and go to sleep.
They rapidly reached the very-low carb/ketogenic state for a good portion of the day by depleting glycogen and failing to replace it, from the afternoon snack to the post-workout breakfast. They weren’t just “high-carb.” They were smart carb, filling the glycogen, depleting it, and forcing their bodies to run on fat for a while.
To me, that’s a better (cheaper, too—ketone esters are expensive!) way to get similar results.
But whatever route you take, it’s a good way to spend time in the ketogenic state. The presence of ketones, especially paired with training, is a good thing for anyone.
What’s your experience taking ketones? How do you incorporate ketogenic states into your training schedule?
Thanks for reading, everyone. Take care!
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