Getting back into a ketogenic diet in preparation for the Pan Ams in March, I’m working on taking the lessons learned from previous episodes to try and accelerate the process as much as possible.

One thing I’m doing differently is cutting right back on milk. I knew it was insulinogenic, but didn’t think at the volume I consume it would be much of an issue.

“Milk has a higher proportion of insulin calories compared to cheese. Butter and cream have a lower insulin load and proportion of insulinogenic calories.”

food	ND	% insulinogenic	net carbs/100g	insulin load  (g/100g)	calories/100g
butter	0.09	0%	0	1	734
cream	0.08	5%	4	5	431
goat milk	-0.05	40%	4	7	69
full cream milk	-0.10	44%	5	7	65
low fat milk	-0.12	58%	5	7	50
human milk	-0.14	43%	7	8	71
reduced fat milk	-0.13	59%	5	8	51

Another thing I am particularly aware of is the diuretic effect and the loss of electrolytes:

“When carbohydrate intake is restricted, 2 metabolic processes occur, both of which simultaneously reduce total body water content. The first process is mobilization of glycogen stores in liver and muscle. Each gram of glycogen is mobilized with approximately 2 g of water. The liver stores approximately 100 g of glycogen and muscle has 400 g of glycogen. Mobilization glycogen stores result in a weight loss of approximately 1 kg. Patients notice this change as a reduction in symptoms of “bloating” and are very pleased with the effect. The second process is generation of ketone bodies from catabolism of dietary and endogenous fat. Ketone bodies are filtered by the kidney as nonreabsorbable anions. Their presence in renal lumenal fluids increase distal sodium delivery to the lumen, and therefore increase renal sodium and water loss.”

“One group of investigators provided supplements containing 3–5 g sodium/d and 2–3 g potassium/d and found that circulatory competence during submaximal exercise was sustained. These supplements also allowed the subjects to achieve nitrogen balance, which had not been achieved in studies that did not use supplements.”

So that reinforces a focus on hydration, and also considerations for supplementing electrolytes, or at least salt.

On the topic of supplements, I have been using a ketogenic supplement of beta-hydroxybutrate in the form of KetoCaNa (trying the Strawberry Lemonade flavor for a change), but had also ordered some Perfect Keto Base (in the Chocolate Sea Salt flavour), which turns out is easy to drink, at least for beta-hydroxybutrate.

I had also tried some EAS Myoplex Ketogenic Powder Packets (in the Strawberry Banana flavour) as a meal replacement, but found these unpleasant to consume.

So the end result? After six days I hit 3.3 mmol/L of blood ketones, well in the range of 1.5+ for nutritional ketosis.