Keto Lie #12: If in Doubt, ‘Keep Calm and Keto On’.

If you try keto, love it, and it’s working for you, then more power to you!  I’m not about to try to stop you. 

However, the typical advice when people run into roadblocks with their keto diet is to ‘eat more fat to raise ketones’ and ‘keep calm and keto on’.

If you have plenty of ketones but are still not losing weight, it might be helpful to dig a little deeper to understand what is happening and how you can tweak your diet to ensure you start moving towards your goals.  

This final chapter digs into the concept of oxidative priority to understand how your body uses available fuels and how you can intelligently manage the inputs of the various fuels based on your body’s requirements to get the outputs you want. 

Oxidative Priority

To understand why ‘keto’ fails for some people, it’s helpful to understand a little more about how your body uses fuel.  As mentioned in Lie #5, oxidative priority refers to the order in which you use the fuels available to your body (i.e. alcohol, ketones, glucose, protein and fat). 

Imagine if you poured crude oil on the ground, poured petrol on top of it, and lit a match.  The petrol would burn off quickly while the oil may not even ignite.  This is because oil burns slowly, while petrol burns rapidly. 

Volatile fuels like gas are hard to store.  By contrast, it’s easier to store large amounts of energy as unrefined crude oil.  The more we refine these fuels, the easier they are to burn.  Similarly, the degree of refining and the balance of macronutrients causes the fuels in your body to behave differently.  

The fact that different macronutrients are harder to convert to usable energy and there are more losses in their conversion goes by several names, including:

Most of us do not overeat protein because it is so satiating.  Your appetite for high-protein foods shuts down once you’ve had enough.  It is more difficult for our body to convert protein to energy (ATP), so it is a poor energy source for everyday use. 

This means that our two remaining primary fuel sources are carbs and fat.  Although your body needs to maintain some glucose in your bloodstream, you won’t burn the fat in your blood if you already have excess glucose in circulation.

Because you can only store about 5 g of glucose in your blood (about a teaspoon’s worth), a little dietary carbohydrate can quickly change your blood sugar levels (particularly if your liver and muscles are already full of glycogen and your fat stores are also full). 

We can convert sugar to fat (via de novo lipogenesis), but most of the time, it’s the fat in our diet that is stored because your body tries to burn off the glucose first, and any leftover dietary fat can easily be stored. 

It’s not necessarily that fat is a better fuel source than carbs, but it’s the glucose that will show up in your bloodstream and register on your meter after you eat.  Glucose essentially floats on top of the fat in your bloodstream and your adipose tissue

So, to access your body fat, you need first to deplete both the glucose and fat from your blood. 

In your body, your fuel tanks are separate but interconnected.  As you deplete the glucose in your blood, it will be refilled from the glycogen stores in your liver (note: glycogen is just the fancy name for the storage form of glucose), and the glycogen stores in your muscles will be reduced.  As the glycogen in your liver becomes depleted and you can no longer easily top up the glucose in your blood, your body will turn to the fat in your blood, and then finally, your body fat.  

You can think of your available fuels as though they are stacked up on top of each other (as shown below). 

So, when you measure blood glucose, you are not just measuring the sugar in your blood.  You are really measuring all the fuels stacked up in your body.  If your glucose is high, all the other fuel tanks are also full to the brim! 

What Does This Mean for You?

  • You have very little room to store alcohol or ketones.  In addition, they are more volatile than other fuels, so they must be used first. 
  • Most of the protein you eat is used for muscle protein synthesis (MPS) and other critical bodily functions.   
  • While ‘excess protein’ not used in MPS can be converted to energy (ATP), this usually only happens when you are not eating enough carbs to supply your body with glucose.  Your body will then use the protein in your diet to make the glucose it requires via gluconeogenesis.  If you are under-consuming dietary protein, it will use the protein on your body (i.e. muscles) as a last resort.
  • Excess protein (i.e., not required for muscle repair and other bodily functions) can be excreted in the urine (i.e. it is not used for energy).  A little bit of ‘labile protein‘ circulates in your bloodstream, but not much. 
  • Protein has the highest thermic effect (i.e. 20 to 35% of energy is lost in the conversion to usable energy), so your body has to work hard to convert it to use for energy.  We don’t usually consume ‘excess protein’.  Your body prefers to get energy from fat and/or carbs, so higher protein foods tend to be more satiating once you’ve had enough.  
  • Your body has some capacity to store glucose in the liver, blood and muscle, but not a lot compared to your body fat stores.
  • You have some fatty acids in your bloodstream to use for fuel but an enormous capacity to store excess energy that you do not use. 
  • The amount of energy your liver drip feeds into your bloodstream from day to day is tiny compared to the amount of energy you store as fat. 
  • Some people can hold a tremendous amount of fat in their fatty tissue before it backs up and overflows into their bloodstream (i.e. insulin resistance, pre-diabetes or Type 2 Diabetes). 
  • Meanwhile, due to genetics and other factors, other people have a much smaller ultimate capacity in their fat cells before it overflows (i.e. they develop Type 2 Diabetes even though on the outside they appear thin).  This difference in fat storage capacity is known as the Personal Fat Threshold.
  • You need to deplete the upstream fuels before your body uses that unwanted fat on your butt and your belly.

Baseline – Modern Processed Diet

To help unpack what this means in practical terms, the diagrams below show you how you can unlock each of these fuel tanks and burn your body fat.   Alcohol, ketones, and protein are not generally significant fuel sources.  Therefore, we only need to focus on glucose and fat. 

The body has four main storage compartments for energy – blood glucose, liver and muscle glycogen, fatty acids in the blood and body fat.  These storage containers are all separate but interconnected to a degree.

You can think of the energy flowing downhill from left to right (based on oxidative priority).  If one of the downstream storage containers is overfull and the upstream tanks become depleted, the energy can flow back upstream due to excess pressure in the other fuel tanks.  For example:

  • when the glucose in your blood becomes depleted, it can be replenished by the glycogen in your liver (via glycogenolysis),
  • the glycerol backbone of fat can be converted to glucose (via glyceroneogenesis), and
  • once the free fatty acids in your blood become depleted and you don’t have excessive amounts coming in from dietary fat, they are topped up from your body fat stores (via lipolysis).

This diagram above shows glucose in your blood, glucose in your liver and muscles (stored as glycogen), fat in your blood (as fatty acids) and fat on your body as four separate tanks, all connected by a ‘pipe’.  You’ll notice that the pipe connecting each of the fuel tanks flows downstream towards the right. You should also note that the ‘pipe’ is not drawn at the bottom of each tank, indicating that you don’t need to empty each tank for the downstream fuels to be used but rather deplete them to normal healthy levels.

When we eat nutrient-poor, hyper-palatable foods, we continually fill our fat and glucose stores at the same time. All of these fuel tanks are full, and the ‘upstream’ fuel sources become ‘backed up’, so you never need to call on your body fat for energy. 

Even worse, it is so easy to overeat these highly processed, hyper-palatable foods.  We have no off switch for them when they are available, so all storage tanks get full to overflowing.  This leads to energy toxicity, metabolic syndrome, Type 2 Diabetes and obesity, etc.

In the following scenarios, we’ll consider what happens to each of these fuel tanks when consuming one of three different dietary scenarios:

  1. low-carb/high-fat;
  2. low-fat/high-carb; and
  3. adequate protein/lower carb/lower fat.

Scenario 1 – Low-Carb/High-Fat Diet

The good news is that when we reduce carbohydrates using a low-carb or keto diet, we can start to drain our glucose stores. 

Even if you are not eating carbs, your body can always refill your blood sugar from the glycogen stores in your liver and muscles.  This is why your blood sugars may continue to rise when you haven’t eaten anything for quite a while. 

Also, if the downstream fuel tanks are backed up with the fuel, you will still see high blood sugars.  The blood sugar, glycogen and fatty acids in your blood will never go to zero because they will be topped up from the downstream storage tanks (via gluconeogenesis).  This is why people with more body fat tend to have higher waking blood sugars. 

Because your blood glucose is a small fuel tank (5 g of glucose or about 20 calories worth), it fills and empties quickly both before and after meals.  It’s also straightforward to measure using a glucose metre (also known as a glucometer) to get a precise understanding of your current energy status.  When we measure glucose, we are getting a good understanding of whether all the downstream fuel tanks are also overfilled.

So, if your blood sugars are higher than normal, you are likely in an energy surplus with plenty of fuel on board.  But when your blood sugars drop below your normal, it may be time to eat. 

Most of the time, waiting until blood glucose has fallen below their typical pre-meal blood sugar stops people from overfilling their upstream fuel tanks.  This, in turn, causes your body to call on the liver and muscle glycogen to refill the blood glucose and usually forces people to deplete the fatty acids in their blood, which can be refilled from their body fat, and voila, fat loss from the body!

However, some people get into trouble when they refeed with a high-fat, low-protein diet.  These foods have low satiety, so we end up eating more of them. Therefore, we consume more calories when our diet has a higher percentage of energy from fat.

If the fat in your bloodstream is continually topped up from your diet, there is never an opportunity for body fat to flow back into the bloodstream to be used. 

We have seen this in a number of people using Data-Driven Fasting who have very low blood sugars but are still carrying a lot of body fat.  Due to a mistaken belief that fat is a ‘free fuel’ because it doesn’t raise insulin over the short term, they are continually refilling their fat tank even though their blood sugars may look great.

When people get stuck at this point, we recommend focusing on incrementally increasing the percentage of protein in their diet by dietary fat. 

This improves satiety and allows both the glucose and fat fuel tanks to be drained.  We’ll discuss this more in Scenario 3 – Adequate Protein/Lower-Carb/Lower-Fat, but first, let’s touch on the Low-Fat/High-Carb scenario. 

Scenario 2 – Low-Fat/High-Carb

In Scenario 2 (Low-Fat/High-Carb), even though blood glucose and glycogen stores are continually being filled, so long as there is only a small amount of dietary fat, blood fats will still be depleted.  Hence, stored body fat will flow back into the bloodstream to be used for fuel. 

While a very low-fat diet can be useful for weight loss, the reality is that very few people (unless they adhere to an ultra-strict whole food plant-based diet) can sustain a diet with low enough levels of fat to drive fat loss over the long term.    Unfortunately, they tend to gravitate back to foods that are a mixture of carbs and fat, which allows us to consume more calories as we fill all fuel tanks at the same time. 

The majority of our modern processed, packaged foods are a combination of starch, sugar and fat from vegetable oil which makes refined fat hard to escape for most people.

Scenario 3 – Adequate Protein/Lower Carb/Lower Fat

In this scenario, we have a diet that is lower in fat and lower in carbohydrates with adequate protein. This style of diet tends to have a higher nutrient density than the other scenarios.  We are satiated when we have met our nutritional requirements. Once we have obtained the nutrients we need, we are less likely to continue eating.

When we eat, we need to get sufficient protein and nutrients.  You can think of carbs and fat as fuel, and we don’t need as much of it if we are already carrying a lot of unwanted body fat on our body and a build-up of glucose in our liver and blood. 

As we dial back both dietary fat and dietary carbs, we deplete the carb and fat fuel tanks in our body, and our body fat can flow back into the bloodstream to be used. 

Foods with a higher protein percentage and higher nutrient density tend to be very hard to overeat. So, in time, the body fat has an opportunity to flow back into our bloodstream from storage.

While you don’t have to jump to a super high-protein extreme, slowly dialling back your easily accessible energy from both carbs and fat (while still getting adequate protein and nutrients) is THE SECRET to ensuring fat loss from your body. 

If we can progressively increase the percentage of protein in the diet (by reducing energy from both carbs and fat), we will tend to consume fewer calories as we drain our carb and fat fuel tanks. 

How to Ensure You Continue to Make Progress

To ensure you continue to make progress, you can follow the following steps. 

  1. First, dial back refined carbs to achieve non-diabetic blood sugar variability.  Your blood sugar should not rise more than 1.6 mmol/L or 30 mg/dL or after meals most of the time.   This is where the ”magic” of low-carb and keto happens.  This doesn’t have to be a very low-carb, high-fat or keto diet, just enough to stabilise blood sugars and reduce cravings that occur when blood sugars plummet below normal.   
  2. Next, we can use meal timing and the elimination of snacks to continue the fat-loss journey.  You can use your blood sugar as a fuel gauge to validate your hunger.  In our Data-Driven Fasting Challenges, we tend to see active people consume two or three meals a day, with less active people opting for one or two meals per day guided by their blood sugars.  
  3. If you are not achieving weight loss or your waking blood sugar is not decreasing with a main meal and a discretionary meal, it’s likely that you are consuming excessive amounts of dietary fat.  You should look to increase your protein percentage, food quality and nutrient density by reducing the foods that provide more energy from fat in your diet.   We focus on this more in our Macros Masterclass and Micros Masterclass

This approach is summarised in the table below. 

StepLimitDescriptionWhen to progress
1. Stabilise blood sugars< 1.6 mmol/L or 30 mg/dL rise after mealsReduce processed carbs to achieve healthy blood sugar stability.When BG rise after meals is < 1.6 mmol/L or 30 mg/dL
2. Meal timing/intermittent fastingOne main meal with one discretionary meal (OMAD+)Reduce the number of times you eat per day.  Continue until you have one main meal with a discretionary meal that you eat based on blood sugar/weight target.When average meals per day are less than 1.5. 
3.  Increase protein % by dialling back dietary fat.Work up to 40-50% protein.Slowly increase protein % (by reducing dietary fat) until weight loss re-commences.When you have reached your target weight, body fat, waist:height or waking glucose. 

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