Dr. Bret is genuine with his right questions. He is asking all the questions his audience wants to know. And in a step-by-step model, from the beginner's mindset. To drive an informative interview, you are subject master and listener at the same time. It's your specialty but your scientific telling is adjusted to the broader audience. In that way, many people can benefit. Thank you⭐
Dr. Annette Bosworth has done so much research in this realm. I highly recommend her new book, Keto Continuum, easily accessible by the lay person and available in paperback, Kindle or on my personal favorite, Audible. Would also love to see her interviewed on this channel. ~Steph
I have been low carb for the last 15 years and I can testify that my blood ketones are always about 0.3-1.0 , and in fact it been low is in my opinion a marker that you are using it for energy
What a wonderful interview!!!! I was getting crazy because I bought a breath meter and my numbers were very, very high. Then, I decided to compare the numbers using the strips (they're very, very expensive in Brazil), and I got very different numbers. When are we going to have the CKM ????? I don't know if you talked about it (I haven't finished watching yet... I was to excited and I had to say Thanks before finishing) but I had worn a CGM for a while and I loved it... Hoping same thing to measure my ketones. Thanks a lot....
I am doing keto, while my husband only does low carb. We are healthy, 51 years old individuals. I want to lose a bit weight, while he is close or at the weight which is good for him. We do hiking twice a week. Usually his ketones are above 1 and mine between 0.5-1.0 once we come back from the hike in the afternoon. We are only having a coffee with cream/Half-and-half before driving out from home, so we just broke our nightly fast with a little coffee, then not eating again for another 7-8 hours. He was prediabetic (not anymore), I don't have any issues neither with my insulin, nor my thyroid. I was always frustrated that he has much higher ketones levels than I have, though I am the one who follows the keto diet, not him 😂 I think this video clarified a bit why is this difference. Thank you.
I suggest there needs to be a refinement of the "keto" definition Which in general assumed to mean keto/carnivore But there is also the keto/mediterranean/ vegetarian diet which, and my experience, obtains all the benefits that the carnivore crowd claims BTW, the keto/carnivore crowd claims that the benefits of their "keto" diet derive exclusively from the carnivore side ... Conveniently (even cultishly) ignoring the confounding benefits from the low carb side
Super interesting. Great interview skills Brett snd your preparation is truly impressive. I also love the fact that there are no ads. Your info is so good and informative. Thank you. Is there a keto breath monitor that you would recommend? Regards Michele
For the last 5 years on IF/keto/LCHF/carnivore, I've measured my BG, BK and weight first thing in the morning after a visit to the loo and before eating or drinking anything. Why? It standardises the measuring point. I do BG and weight most days, but BK weekly because the meter strips are more expensive. I plot it all in MyFitnessPal along with what I eat, of course. I use this as my "conscience"!
A breath-meter might not be accurate but I would think a reading indicates some ketones. I try to use it the same way each morning at the same time. (Inhale five seconds, breathe out ten seconds until lungs are empty.) I really dislike finger pricks. If the pricks could be take elsewhere that would be different. Breath meters begin to malfunction after a year of daily use (and you have to change mouth pieces.) The one I use measures in increments of five.
I have the breath meter. It simply tells me if how much am I into the fat burning mode. I am eating carnivore. There are days when I can't avoid eating bread and cookies. ( The carb addicted brain sometimes win. ). I will then check and the meter will tell me how low I am away from fat burning mode. If I go on a long fast, thats when the breath meter shows I am in high fat burning mode.
I for one will be glad when the science becomes better correlated to the evidence! I have been doing keto 4 months on LCHF & IF OMAD with total carbs below 20 gm and still can't get decent readings on glucose or ketones. I just came off a 48 hour fast and glucose was over 100 and ketones below 1 both days. So getting a pattern to tell me something worthwhile is really hard although I have lost weight. I think the lowest I have seen my glucose was 78 and the highest ketones 1.5 but the variance in fasted glucose with ketones above 1.0 was between 78-114. That's with no cheating and around 1000-1200 cals/day. I used the Atkins meal-tracker for the first 2 months to get an idea of the food macros after I got the monitors. That part was fairly easy. But if this is due to insulin resistance how will I know if it is improving???
Hi Robin, I really recommend you read Ketocontinuum by Dr Annette Bosworth. She goes into this phenomenon in detail. When your FBG stays around 100 even though you’re fasting and eating LCHF, she explains that it’s because your body is depleting glycogen. It makes sense - where would that blood sugar come from except your own stores? I did keto carnivore and OMAD for over a year and still felt like I had high insulin levels. I finally started doing some alternate day fasting and 72 hour fasts to really lower my insulin. You’ll get there! Each day is one step towards greater health. Good luck!
@@gretchen5074 Thank you Gretchen. I do have a fatty liver and that may explain the higher levels of glucogen. Following that last 48 hr fast, my numbers have improved and I lost a couple more pounds to boot!
Those readings sound great to me. Your body is doing ‘adaptive glucose sparing’ and also produces only the ketones it needs, so very little is left over in the blood.👍
Interesting discussion. FWIW Keto x 2 years. Routinely 2.5-4.5. Fasting I run 4-7. Last time hit 7.8. Once was too high for meter to read (keto coach). I test an average of 3 times daily (data nerd).
I test once daily, before my one meal and usually run low 3s. Two weeks ago, on a fasting week, I tested HI on the device two days running, which turns out is anything above 8. Usually, while fasting, I'm in the 5.5-6 range.
i was worried why it was taking me so long to get into ketosis and also autophagy ...i clocked while doing a water fast the ketosis between 27 and 36 hours.
I sure wish someone would come up with a device like a CGM that you wear forever that will not only check your blood sugar, but your BHB as well. Someone knows how to do this, and it would be so helpful for diabetics, but getting insurance to pay for it is hard to do.
I signed up for a 28 day trial of a CGM. It's VERY inaccurate. It usually reads 20 points below what my meter says. I woke up from a nap this evening and the CGM said 49. I stumbled into my work room and did the finger stick five minutes later, it said 105.
@@jselectronics8215 I used the Free Style Libre brand and they have an explanation as to why that happens. The meter is about 15 minutes behind your blood meter because the CGM is measuring interstitial fluid, not blood.
@@adorableadornments1101 That's the one I have. They explained the 15 minute difference but I find it's way slower than that and still very inaccurate. Data from this evening while watching youtube: 7:58 PM CGM = 49 8:05 PM blood = 109 8:08 PM CGM =74 8:21 PM CGM = 59 9:10 PM CGM = 87 10:35 PM CGM = 65 11:40 PM CGM = 79 11:45 PM blood = 107
@@adorableadornments1101 I was unaware of how the CGM measured. I never used one. But I have used a Keto Mojo for both values. So blood glucose is not always the same as interstitial glucose, right? Because of insulin sensitivity, or lack thereof?
You can't just get insulin tested all the time though. Well I guess you could but it would be very expensive. Insurance don't cover insulin tests and you'd constantly running to the doctor for tests and waiting for the lab work to come back. If you're low carb then ketones are the way to go. If you're not showing ketones then apparently your insulin is too high.
You can get your insulin tested through an online test you buy, then take to an independent facility. You’d probably save some money and wouldn’t have to get doctor’s approval every time. But it’s still not as easy as just testing ketones, which will indicate insulin is low enough to burn fat.
Ketones are a direct measure of fat metabolism IN THE LIVER. They do not indicate that cells of the body are utilizing the Ketones for energy. To say when we see Ketones your "body is burning fat' is incorrect and misleading. When a body is consuming ketones for energy in the same amount as the liver is metabolizing fat - there should be no excess ketones to record on a monitor.
Downside... both my husband and myself have biosense and they both died within months. Not to mention, you said no additional costs with the breath sensors. That is not true. You have to pay to clean/recalibrate them. We are very disappointed with the biosense especially with such a large investment. Keto MOJO is so much better. The reason we did biosense was to avoid pricking. At least the keto MOJO works and more accurate.
Great question. I can’t find the answer to that either. The closest I get is that you can’t tell the difference between using body fat and dietary fat on a daily basis, but if you lose fat over time, you have the answer.
@@asarcadyn2414 It seems that our body would burn the fat we eat first and then go to the "reserves" of stored body fat for required energy. In that case, it seems we would want to eat higher protein, moderate fat and low carbs.
@@vlm5723 That makes sense, although I’m realising that my intuition is often wrong when it comes to nutrition😁. The obvious thing to do for overweight people is eat the minimum lean protein needed for health and have no carbs or dietary fats so much the 70% fat in the keto diet comes from the body not the diet. However, I have no idea if this would work for optimal weight loss.
Most products of beta oxidation of fats will continue to be metabolized by the Krebs cycle as long as there are some glucose available. Only when the cellular Krebs Cycles are closed will the the liver convert the products of beta oxidation of fats to ketones. Ketones are then primarily consumed by our brain, heart, and kidney. Under these conditions glucose is synthesized via gluconeogenesis to maintain BGL.
They did. Getting blood from the vain is better compared to a finger prick. You can't really do the vain version yourself. It depend on the device and it's tricky to do that yourself. Also you can't do it too often people will start to worry about you when your vain starts to look bad.
I am at 3.8 but I am having alot of gut discomfort. I do not feel like I am evacuating in proportion to my intake. I am 370 lbs and have not been heeling so I am going at the weight loss aggressively. I am in between doctors visits so I am just curious if I should be worried.
Dr. Bret is genuine with his right questions. He is asking all the questions his audience wants to know. And in a step-by-step model, from the beginner's mindset. To drive an informative interview, you are subject master and listener at the same time. It's your specialty but your scientific telling is adjusted to the broader audience. In that way, many people can benefit. Thank you⭐
Dr. Annette Bosworth has done so much research in this realm. I highly recommend her new book, Keto Continuum, easily accessible by the lay person and available in paperback, Kindle or on my personal favorite, Audible. Would also love to see her interviewed on this channel. ~Steph
Thanks, have ordered Keto Continuum
I have been low carb for the last 15 years and I can testify that my blood ketones are always about 0.3-1.0 , and in fact it been low is in my opinion a marker that you are using it for energy
does it sometimes experience lower levels ie. right after a meal or in the morning, fasted?
Good to hear. Mine are 0.3-0.6 pretty regularly after several years of keto.
The only time my ketones go over .5-.7 is if I fast. On the 2-3 day of fasting, I will shoot up over 2.
What a wonderful interview!!!! I was getting crazy because I bought a breath meter and my numbers were very, very high. Then, I decided to compare the numbers using the strips (they're very, very expensive in Brazil), and I got very different numbers. When are we going to have the CKM ????? I don't know if you talked about it (I haven't finished watching yet... I was to excited and I had to say Thanks before finishing) but I had worn a CGM for a while and I loved it... Hoping same thing to measure my ketones. Thanks a lot....
Awesome discussion. I learned a lot.
What a great discussion!
Interesting that there’s now a CKM available 😉
Great information! This answered a lot of questions that I had about blood testing. Thank you for sharing this information.
Thanks for the ketone strip knowledge. I was getting discouraged. Now I understand. And great information and interview.
Can we have a link to the paper?
Great questions, guiding the interview Dr. Bret!
I am doing keto, while my husband only does low carb. We are healthy, 51 years old individuals. I want to lose a bit weight, while he is close or at the weight which is good for him.
We do hiking twice a week. Usually his ketones are above 1 and mine between 0.5-1.0 once we come back from the hike in the afternoon. We are only having a coffee with cream/Half-and-half before driving out from home, so we just broke our nightly fast with a little coffee, then not eating again for another 7-8 hours. He was prediabetic (not anymore), I don't have any issues neither with my insulin, nor my thyroid.
I was always frustrated that he has much higher ketones levels than I have, though I am the one who follows the keto diet, not him 😂
I think this video clarified a bit why is this difference.
Thank you.
I suggest there needs to be a refinement of the "keto" definition
Which in general assumed to mean keto/carnivore
But there is also the keto/mediterranean/ vegetarian diet which, and my experience, obtains all the benefits that the carnivore crowd claims
BTW, the keto/carnivore crowd claims that the benefits of their "keto" diet derive exclusively from the carnivore side
... Conveniently (even cultishly) ignoring the confounding benefits from the low carb side
Super interesting. Great interview skills Brett snd your preparation is truly impressive. I also love the fact that there are no ads. Your info is so good and informative. Thank you. Is there a keto breath monitor that you would recommend? Regards Michele
What could be really useful as an early diagnostic tool and potential prophylaxis of future disease is a Continuous Insulin Monitor.
For the last 5 years on IF/keto/LCHF/carnivore, I've measured my BG, BK and weight first thing in the morning after a visit to the loo and before eating or drinking anything. Why? It standardises the measuring point. I do BG and weight most days, but BK weekly because the meter strips are more expensive. I plot it all in MyFitnessPal along with what I eat, of course. I use this as my "conscience"!
A breath-meter might not be accurate but I would think a reading indicates some ketones. I try to use it the same way each morning at the same time. (Inhale five seconds, breathe out ten seconds until lungs are empty.) I really dislike finger pricks. If the pricks could be take elsewhere that would be different. Breath meters begin to malfunction after a year of daily use (and you have to change mouth pieces.) The one I use measures in increments of five.
I have the breath meter. It simply tells me if how much am I into the fat burning mode.
I am eating carnivore. There are days when I can't avoid eating bread and cookies. ( The carb addicted brain sometimes win. ).
I will then check and the meter will tell me how low I am away from fat burning mode. If I go on a long fast, thats when the breath meter shows I am in high fat burning mode.
This is great information. Thank you!
I for one will be glad when the science becomes better correlated to the evidence! I have been doing keto 4 months on LCHF & IF OMAD with total carbs below 20 gm and still can't get decent readings on glucose or ketones. I just came off a 48 hour fast and glucose was over 100 and ketones below 1 both days. So getting a pattern to tell me something worthwhile is really hard although I have lost weight. I think the lowest I have seen my glucose was 78 and the highest ketones 1.5 but the variance in fasted glucose with ketones above 1.0 was between 78-114. That's with no cheating and around 1000-1200 cals/day. I used the Atkins meal-tracker for the first 2 months to get an idea of the food macros after I got the monitors. That part was fairly easy.
But if this is due to insulin resistance how will I know if it is improving???
Hi Robin, I really recommend you read Ketocontinuum by Dr Annette Bosworth. She goes into this phenomenon in detail. When your FBG stays around 100 even though you’re fasting and eating LCHF, she explains that it’s because your body is depleting glycogen. It makes sense - where would that blood sugar come from except your own stores? I did keto carnivore and OMAD for over a year and still felt like I had high insulin levels. I finally started doing some alternate day fasting and 72 hour fasts to really lower my insulin. You’ll get there! Each day is one step towards greater health. Good luck!
@@gretchen5074 Thank you Gretchen. I do have a fatty liver and that may explain the higher levels of glucogen. Following that last 48 hr fast, my numbers have improved and I lost a couple more pounds to boot!
Those readings sound great to me. Your body is doing ‘adaptive glucose sparing’ and also produces only the ketones it needs, so very little is left over in the blood.👍
@@asarcadyn2414 Thanks I googled that and it makes more sense now.
Interesting discussion. FWIW Keto x 2 years. Routinely 2.5-4.5. Fasting I run 4-7. Last time hit 7.8. Once was too high for meter to read (keto coach). I test an average of 3 times daily (data nerd).
Wow, it takes a three day fast before I hit 4.0
I test once daily, before my one meal and usually run low 3s. Two weeks ago, on a fasting week, I tested HI on the device two days running, which turns out is anything above 8. Usually, while fasting, I'm in the 5.5-6 range.
@@jselectronics8215 I may have more fat to burn.
Are you taking exogenous ketones?
@@asarcadyn2414 no. I don't.
Awesome content Doc! Thanks!
i was worried why it was taking me so long to get into ketosis and also autophagy ...i clocked while doing a water fast the ketosis between 27 and 36 hours.
Maybe you should state right up front that this guy works for Biosense.
excellent video, thanks
Excellent
Good data and help.
I sure wish someone would come up with a device like a CGM that you wear forever that will not only check your blood sugar, but your BHB as well. Someone knows how to do this, and it would be so helpful for diabetics, but getting insurance to pay for it is hard to do.
I signed up for a 28 day trial of a CGM. It's VERY inaccurate. It usually reads 20 points below what my meter says. I woke up from a nap this evening and the CGM said 49. I stumbled into my work room and did the finger stick five minutes later, it said 105.
@@jselectronics8215 I used the Free Style Libre brand and they have an explanation as to why that happens. The meter is about 15 minutes behind your blood meter because the CGM is measuring interstitial fluid, not blood.
@@adorableadornments1101 That's the one I have. They explained the 15 minute difference but I find it's way slower than that and still very inaccurate. Data from this evening while watching youtube:
7:58 PM CGM = 49
8:05 PM blood = 109
8:08 PM CGM =74
8:21 PM CGM = 59
9:10 PM CGM = 87
10:35 PM CGM = 65
11:40 PM CGM = 79
11:45 PM blood = 107
Ketones at 10:32 PM were 0.7
@@adorableadornments1101 I was unaware of how the CGM measured. I never used one. But I have used a Keto Mojo for both values.
So blood glucose is not always the same as interstitial glucose, right? Because of insulin sensitivity, or lack thereof?
Dou you know of anyone developing a continuous insulin monitor?
I think that is more important to test the insulin level than the ketones
You can't just get insulin tested all the time though. Well I guess you could but it would be very expensive. Insurance don't cover insulin tests and you'd constantly running to the doctor for tests and waiting for the lab work to come back. If you're low carb then ketones are the way to go. If you're not showing ketones then apparently your insulin is too high.
You can get your insulin tested through an online test you buy, then take to an independent facility. You’d probably save some money and wouldn’t have to get doctor’s approval every time. But it’s still not as easy as just testing ketones, which will indicate insulin is low enough to burn fat.
Ketones are a direct measure of fat metabolism IN THE LIVER. They do not indicate that cells of the body are utilizing the Ketones for energy. To say when we see Ketones your "body is burning fat' is incorrect and misleading. When a body is consuming ketones for energy in the same amount as the liver is metabolizing fat - there should be no excess ketones to record on a monitor.
Downside... both my husband and myself have biosense and they both died within months. Not to mention, you said no additional costs with the breath sensors. That is not true. You have to pay to clean/recalibrate them. We are very disappointed with the biosense especially with such a large investment. Keto MOJO is so much better. The reason we did biosense was to avoid pricking. At least the keto MOJO works and more accurate.
So how do you know if you are burning fat you have eaten in your meal that day, or stored fat from your body?
Great question. I can’t find the answer to that either. The closest I get is that you can’t tell the difference between using body fat and dietary fat on a daily basis, but if you lose fat over time, you have the answer.
@@asarcadyn2414 It seems that our body would burn the fat we eat first and then go to the "reserves" of stored body fat for required energy. In that case, it seems we would want to eat higher protein, moderate fat and low carbs.
@@vlm5723 That makes sense, although I’m realising that my intuition is often wrong when it comes to nutrition😁. The obvious thing to do for overweight people is eat the minimum lean protein needed for health and have no carbs or dietary fats so much the 70% fat in the keto diet comes from the body not the diet. However, I have no idea if this would work for optimal weight loss.
calorie balance
@Asar Cadyn! sounds like the correct answer! Thank you!
Bret, you should fix the light in your videos....
Great, thanks!
Most products of beta oxidation of fats will continue to be metabolized by the Krebs cycle as long as there are some glucose available. Only when the cellular Krebs Cycles are closed will the the liver convert the products of beta oxidation of fats to ketones. Ketones are then primarily consumed by our brain, heart, and kidney. Under these conditions glucose is synthesized via gluconeogenesis to maintain BGL.
You said it makes a difference where you prick for blood for the ketone meter, but I don't think you said where is the best place to prick.
They did. Getting blood from the vain is better compared to a finger prick. You can't really do the vain version yourself. It depend on the device and it's tricky to do that yourself. Also you can't do it too often people will start to worry about you when your vain starts to look bad.
@@seesharp81321 vein
@@cassieoz1702 Haha, thanks I didn't check the spelling. I'm not native English speaking, I'm Dutch
Isn’t just eating will raise insulin for a bit , which would lower your keto.
Lots of times I will go to bed peeing dark purple then wake up measuring at trace amounts. On the ketostix.
So right after I wrote the first comment then he verified what I said! Lol 😂
He says "right?" way too much. Very hard to listen to.
Right :)
Oh Trey! 😍😘🤣
Siempre lo mismo lástima no me traduce UA-cam inglés no entiendo me encantaría saber de qué habka
The PHD is not hard to look at, lol
😙
I am at 3.8 but I am having alot of gut discomfort. I do not feel like I am evacuating in proportion to my intake. I am 370 lbs and have not been heeling so I am going at the weight loss aggressively. I am in between doctors visits so I am just curious if I should be worried.
MAke some home made probiotics with pickled cucumber in brine. Works wonders for my gut.