Will Quest Protein Shake Keep Me From Ketosis

For reasons I'm notwithstanding struggling to understand, the idea of "nutritional ketosis" (NK, to be distinguished from starvation ketosis, SK or diabetic ketoacidosis, DKA) is ofttimes discussed and debated in much the aforementioned style as religion or politics. Perhaps this can be said of all diet, which is a shame.  Nevertheless, in my continued defiance of such sensitive topics, I'd similar to add another layer of complication and nuance to this give-and-take.

The "rule of thumb" for NK is that caloric intake is determined every bit follows (this excludes a subset of ketogenic diets known as calorie-restricted KD which, as the name suggests, is specifically restricted in calories):

1. Carbohydrate (full, not "cyberspace"): less than l gm/day, just ideally closer to 30 gm/day
2. Protein: up to one to one.5 gm/kg, but ideally below about 120 gm/day
3. Fat: to satiety

Allow me illustrate what this looks like for Joe (left), Jane (middle), and Jeff (right — an example of a calorie restricted KD), iii hypothetical people in NK — merely each with different caloric requirements.

As a general rule, as caloric requirement increases the proportion of calories derived from carbohydrate and protein decreases (and the contribution of dietary fat increases), even while accented intake of carbohydrate and protein increases.

Anyone who has bought a blood ketone meter knows how tough it tin exist to get "into" ketosis by carbohydrate restriction (since everyone asks, I employ the Abbott Precision Xtra meter which uses 2 different strips: i for glucose and one for beta-hydroxybutyrate, or BHB).  Most practitioners consider the minimum threshold of NK to be a fasting serum level of BHB above 0.5 mM.  I'thousand a bit more stringent in my practise and like to run into fasting BHB levels above ane mM.   To requite you a sense of ane person's numbers (mine), over a 6-month stretch in 2022, when I was in NK, my mean (i.e., arithmetics average) morning time fasting level was 1.7 mM with a median value of 1.4 mM.  The highest morn level during that period was 5.2 mM.  (The highest morning level I have ever measured in myself is v.seven mM.)

Just, it took me a long fourth dimension to get it right, peculiarly since at the start of my foray into NK I was consuming between iv,000 and 4,400 kcal per day.  (My average daily caloric intake for weight stability was about 3,800 kcal per day, which was validated by doubly-labeled water.)  I could still easily "fall out" of NK.  For example, on my daughter's 5th birthday she insisted I have some of her tikka masala (contains lots of sugar), naan staff of life, and mango ice cream.  How could I say no to a altogether girl who insisted on going to the nicest Indian restaurant in San Diego?  As to be expected, the next twenty-four hour period my BHB was 0.2 mM, and it took me ii days to get back higher up 1 mM.

Hither'southward a little secret I'1000 about to let everyone in on… I like carbohydrates. I dearest sushi (though I now generally eat sashimi).  I love Indian and Thai food, though I adopt to make curry myself to keep carbohydrate out.  I make (and eat) the all-time hummus this side of the Nile River. I've figured out how and when I can eat them to meet the following weather:

1. Stay in NK (except on a few occasions like my girl's altogether);
2. Increase my anaerobic performance;
3. Preserve almost (but not all*) of the benefits I enjoyed when I was much more strict about my ketogenic diet.

How, you ask? By learning to summate my glycogen arrears.

(*) For me, the leanest torso limerick I achieved as an adult was in strict NK with no attempts to do what I'm near to describe below.  Since I'thousand not a model and nobody cares if my trunk fat is 7% or 10%, I'grand happy to be a piddling less lean if it gives me the flexibility to increase performance and alive a slightly more sane life.  At least for now.

PLEASE NOTE: I take never suggested, and can't imagine I ever volition propose, that a KD is "best" or "correct" for everyone.  What I describe beneath may seem farthermost, both in the amount of work required and the actual application.  I fully acknowledge that (1) this is a highly analytical approach to eating, and (2) that I'm a "freak" (my married woman's words, non mine). I certainly don't do this frequently, unless a lot is on the line (eastward.g., a large ride), but I like having this technique in my armamentarium.

If you've watched my presentation from 2022 at the IHMC, and then you're familiar with RQ.  Through years of metabolic testing I have a pretty expert sense of my RQ at whatever moment in time – when I'm sleeping, when I'm sitting effectually (nearly of the time), when I'thou riding my bike at 200 watts, when I'm riding my bike at 400 watts, when I'yard lifting weights, etc.  This allows me to calculate what proportion of my energy I derive from glycogen and what proportion I derive from fatty acid.  Consider the following case:

If I ride my wheel at an average of 185 watts (you'll need a power meter to infer this) for, say, 2 hours, I know my boilerplate RQ is betwixt 0.76 and 0.80.

The approximate formula is %CHO = iii.333*RQ – 2.333, which tin easily be derived from the observation that %CHO utilized increases linearly from 0% at RQ 0.vii to 100% at RQ 1.0.

Furthermore, I know my VO2 at 185 watts is two.9 liters per min, which means (using the Weir formula which I presented previously) my free energy requirement was most 14 kcal per minute, or 1,680 kcal over 2 hours.  Hence, of these 1,680 kcal needed to pedal 185 watts for 120 minutes, 336 to 554 kcal came from glycogen.  In other words, I utilized between 84 and 138 gm of glycogen.

(Past comparison, several years prior to being in NK, this effort in me would have taken place at a slightly higher VO2 – closer to iii.2 liters per min – and at a much higher RQ – between 0.90 and 0.95 – pregnant the exact same work output would take required somewhere between 300 and 400 gm of glycogen!  That'due south a real country of metabolic inflexibility.  Basically, I was entirely dependent on carbohydrates for free energy.)

Since the showtime metabolic priority for ingested carbohydrate is glycogen replenishment, I tin, in this setting, swallow probably somewhere betwixt 60 and 120 gm of carbohydrate following this ride and stay in ketosis.  Why? Because those carbohydrates are prioritized to furnish my glycogen stores AND I am highly insulin sensitive.  Note the *AND* in this last sentence. (The especially acute reader volition realize some of this glycogen debt will be replenished by protein and glycerol, the latter of which is liberated by lipolysis – come across post on fat flux for a primer).

Clearly I didn't consume this amount of sugar on my girl'due south birthday, and so why was I out of ketosis the next day? Because my glycogen debt was not high.  Of class, I knew this and didn't actually care.  But, if I know my wife wants to go out for sushi 1 night, and I know she'south going to make me swallow a California curl, I tin "rig information technology" such that I show upward to dinner with a glycogen debt appropriate enough to enjoy them without significantly interfering with my liver'south BHB product.

Extreme example

At i point, I did ii tough wheel rides on sequent days.  Each solar day we rode 110 miles under challenging conditions.  Over 6,000 feet of climbing each day and very strong winds, which were either headwinds or cross-winds.  On top of this, we rode pretty fast. For the purpose of illustration I recorded everything I did and ate on the second day, which I rode a bit easier than the kickoff day.

The second ride took 6 hours and 5 minutes.  My boilerplate normalized ability output was 225 watts, and arithmetic boilerplate power output was 184 watts.  Based on mechanical work output, this required nearly v,000 kcal.  Factoring in the other 18 hours of that mean solar day, my total energy expenditure was about 6,800 kcal for the solar day, obviously not an average day. (A detailed caption of where the actress 1,800 kcal were expended is beyond what I want to get into now, merely information technology's basically the free energy required to keep me live – send ions, contract voluntary and involuntary muscles, etc. — plus move me effectually, and digest food).

And so what did I consume that day?

1. Breakfast (pre-ride): 5 scrambled eggs, two sausage links, 3 pieces of bacon, coffee with foam.
2. In ride nutrition (I spread this out over half dozen hours): xiv oz (not a typo) of salted cashews, 2 Quest bars, i peach, ane apple, 6 bottles of Biosteel High Performance Sports Drink, water. (Since I know someone will ask, I did non consume super starch this day since I was craving cashews every bit my carbohydrate source and was craving more sodium, given the xc+ degree temperature.)
3. Late lunch/early dinner (postal service-ride): 2 oz ham, 3 oz pulled pork, large salad with oil and vinegar dressing, two slices of cheddar cheese, half-dozen mini hamburger patties, 2 tomatoes.

What did this corporeality to?

• Fatty – 351 gm, or three,160 kcal of fatty
• Protein – 245 gm, or 980 kcal of protein
• Saccharide – 321 gm, or 1,284 kcal of carbohydrate

(I used package information and Nutritionist Pro software to calculate this.)

Hence, on this day I consumed about 5,400 kcal in total at the post-obit ratio:

• Fatty – 58%
• Protein – xviii%
• Carbohydrate – 24%

By all conventional wisdom I should not have been in ketosis the next morning time, right?

The following morning, my BHB level was 2.2 mM and blood glucose was 5.ane mM.

Teaching point I can't resist: Post-obit 2 days of meaning caloric deficit, most 3,000 kcal in full, I should accept in theory lost nearly a pound (mostly fat, possibly some muscle) which would have been noticed on a calibration.  Instead, I gained eight pounds over those 2 days! Certain it was mostly water retentivity, both from the glycogen (small) and the fluid accumulating in the interstitial space ("thirds space" fluid losses, large) due to a systemic inflammatory response.  This happens under extreme conditions of practice.  In fact, the harder I exercise, the more weight I gain, transiently.  I am at my absolute lightest following 2 days of travel (i.e., residuum).  So before freaking out at the sight of the scale, go on in heed that nigh twenty-four hours-to-twenty-four hours weight movement in our bodies is indeed water movement into and out of the plasma and interstitial space, respectively.

What'due south my point?

Context matters!  If I ate even one-quarter of that amount of carbohydrate and two-thirds of that protein on a normal twenty-four hours – say, 2.5 hours of riding or 1.5 hour of riding followed by 1 hour of pond, or a day of travel with no exercise – I would have been out of ketosis for two days or more than. (Of class, my appetite on those days would not have allowed me to swallow v,400 kcal without feeling ill, but I won't get into that until a later postal service.) Just on this 24-hour interval, with these glycogen demands, I was able to maintain the perks of ketosis AND glycolysis simultaneously.

There are days, though, when I overshot my glycogen need and terminate upwardly with a low BHB and high fasting glucose the following morning time. Conversely, there are days I underestimate my glycogen depletion and wake upwardly with very high BHB levels and very low glucose levels (i.e., BHB levels college than glucose levels, when both measured in mM).

Final thoughts

I felt a fleck similar I was in unchartered territory because the literature on nutritional ketosis hadn't really (to my reading) explored this level of extreme activeness.  In future posts, I may write well-nigh other experiences and self-experiments, including my experience with exogenous (i.east., synthetic) ketones (which I did not employ on this ride, simply have experimented with on other rides – no, this is not "raspberry ketones" or other such gimmicks).

2017: You can read most ane of my earliest experiences with exogenous ketones in this mail.

Are carbohydrates necessary to produce 225 watts or more for hours on end? Yes. But, the key is knowing how much you need and when to accept them.  A lower RQ at a given level of intensity ways less need on glycogen. In my experience, working with athletes and non-athletes, most tend to brand ii errors (for lack of a better word):

1. They over-estimate their sugar requirement, and/or
2. They forget that no cistron influences RQ – and therefore substrate requirement – more than dietary composition during lead upwards to event (or "life", which is sort of the ultimate event).

Know your engine, get-go.  And then fuel it appropriately.

Source: https://peterattiamd.com/ketones-carbohydrates-can-co-exist/

Posted by: venturahowell.blogspot.com

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