The New Rules of Keto

1. What is the definition of a ketogenic diet

a. Ketogenic
2. What is the goal of someone assuming a ketogenic diet
a. Weight loss
b. Health
c. Food Preference
3. Old Rules
a. 30-50g total daily carbs
b. 2:1-4:1 fat:protein ratio
c. Fiber counted in total carbs
d. No Alcohol
e. Vegetables are an afterthought
f. No differences between men and women
i. https://www.ncbi.nlm.nih.gov/pubmed/11706283
4. First 4-8 weeks are critical (same rule?)
5. New Rules
a. Carbohydrates are activity dependent
i. GDAs
ii. MCTs/Exogenous Ketones
b. ~1:1 fat:protein ratio
c. Net carbs
d. Some alcohol
e. Vegetables are vehicles for fat
f. Women metabolize fat differently than men
 What is the Definition of a Ketogenic Diet?

Do you remember when you were in grade school, you had to remember a lot of definitions? It
was a part of the education systems effort to expand young vocabularies. Definitions are very important
to understand. If you’ve ever tried speaking another language, the importance of definitions is a
relatable concept, as we can easily mix up words when learning a new language and say something we
do not intend to say.

Having a diverse vocabulary allows children (and adults) to express exactly what they mean to
express. Definition are very literally meaning. Have you ever attempted to describe a complex emotion
but there is no single word that seems appropriate? Instead you’re forced to say, “I’m this and I’m that,
but not like thaaat, know what I mean?”

A lot of the time, the listener can relate, as humans each experience similar emotions at one
time or another. For example, perhaps at one time you have felt leucocholy. You can’t possibly know if
you have or not, as you may not know the definition. Here it is, straight from Merriam-Webster:

Leucocholy – A state of feeling that accompanies preoccupation with trivial and insipid
diversions. “Though it seldom laughs or dances, nor ever amounts to what one calls joy or pleasure, yet it
is a good easy sort of a state”

One feeling leucocholy is not sad, nor are they exuberant. They’re more tepid, but not
indifferent, and easygoing. Happy, but not thaaat happy – a mild amusement or comfortable feeling
associated with an ordinary or familiar state of affairs.

In this example, is it not much easier to simply say “leucocholy” than the three sentences used
above that attempt to describe the noun?

Diets are often defined by the foods the diet has determined are acceptable for followers to eat.
This can be done directly, as with a vegan diet, which directly instructs followers to not eat any animal
products. It can be done indirectly as well, such as with keto. We can eat foods that are very low in
carbohydrates, which narrows it down to meat, eggs, fish, dairy, nuts, oils, most vegetables, and some
fruits.

We might also define a diet by its descriptors. A high-fat, low-carb diet; a low-FODMAP diet; etc.
When it comes to language, some would say we only need be able to understand one another – that is
the whole reason for inventing words in the first place.

However, once you learn and understand language, things like grammar and syntax suddenly
become more helpful than we initially realize. But, you’re not reading this for a lesson in punctuation.
Suffice to say, definitions are important for complete comprehension of an idea or concept.

We want to pay attention to the details. The question is, “what is the definition of a ketogenic
diet?” Not, “what do you eat on a ketogenic diet?” Nor is it, “how would you describe a ketogenic diet?”

No. The definition of ‘ketogenic diet’ is simply this:

A diet that produces the formation of ketone bodies by way of ‘excessive’ beta-
oxidation of lipids.
 Any other definition is likely answering a different question. Such a definition may not be wrong
per se, and we may understand each other perfectly fine. However, what you see here is the true
definition of a keto diet.

Take note of what is absent from the definition. There is no mention of macros. There is nothing
that says high-fat or low-carb. There is no mention of bacon or avocados. A ketogenic diet is any diet
producing more substantial rates of ketone production than “normal.” It’s important to also notice the
latter half of the definition, “by way of excessive beta-oxidation of lipids.” This excludes transient ketosis
as a result of exogenous ketone or MCT supplementation. However, it can include fasting or fat fasting.

Although supplementing ketones (which we are, obviously, a fan of) is worthwhile, it doesn’t
instantly mean the diet is ketogenic. For example, a high-carb dieter can reap some, not all, of the
benefits of ketones via exogenous supplementation, but they are not generating ketones, and therefore,
they’re not ketogenic.

Also note ‘excessive’ in particular. We say excessive here not because ketones should not be
elevated, but rather because they exceed the “normal” range. The normal range is currently defined
based on carbohydrate-dependent metabolism and high-carb diets, so the word ‘excessive’ may or may
not remain applicable – we hope it does not.

Traditionally, the dietary parameters for keto have been derived from early medical research in
epilepsy and more recently diabetes/metabolic syndrome. Thus, a ketogenic diet’s parameters are some
variation of 30-50g of total carbohydrate or 5% of total calories per day and the remaining calories
coming mostly from fat (~75-85% of total) and protein (~15-20% of total).

Presently, however, this “definition” is outdated. The early research on ketogenic diets was
focused on specific populations. Nowadays, everybody is at least thinking about keto even if they are
not following a ketogenic diet or have not tried one. Most people are not beholden to the special
populations studied in the early medical research. Those parameters are part of the old rules.

Of course, maybe you are someone with epilepsy or you are someone with diabetes and using a
ketogenic diet to manage the disease. The new rules are not for you. To some extent, the old rules were
not for you either, but I’ll bet you figured that out when making modifications along the way.

The new rules are for the rest of us. The healthy, or at least mostly healthy folks, and don’t be
too hard on yourself with the definition of healthy! EVERYBODY has some unhealthy tendencies. I’ve
done a lot of research participant screening questions for studies. One of the criteria for most of our
investigations is the participant must be healthy, so the screening question is, “do you consider yourself
to be healthy?”

We expect most people to be healthy (most participants are college students) and answer
accordingly, yet we get interesting responses sometimes. Instead of a simple yes/no answer, we often
get lengthy responses from self-conscious individuals. People will say no they are not healthy, but for
the most ridiculous reasons, such as, “I don’t consider myself healthy because sometimes I only workout
three times a week and a few times a month I don’t pack a lunch and eat out at work instead.” This
person is perfectly healthy.
 The new rules are for anyone without a few specific diseases – the 2 named above as well as
cancer, Alzheimer’s disease, and other neurological disorders that require a more aggressive therapeutic
ketogenic diet. Overweight/obese individuals, the new rules are for you. Regular person that wants to
do keto the right way, the new rules are for you. Fitness folks, the new rules are DEFINITELY for you!

Myself, I’m a fairly high-level powerlifter qualified to compete at the national and world level
with an elite, but not international elite (the highest level), total per United States Powerlifting
Association standards. I have been following the new rules for well over 5 years now.

When I started, I was not satisfied eating chicken, broccoli, and rice all the time; I was not
squatting over 600 lbs; I was not benching over 400 lbs; I was not deadlifting over 600 lbs; I was not very
muscular (by my own standards); and despite my BMI being overweight since high school, I’ve never
been fat, though I was never lean either – just sort of soft.

Nowadays, that darn BMI will tell you I’m firmly obese, usually hovering around 220 lbs when
not getting to a competition weight of 198 lbs. I can squat and deadlift over 600 and bench over 400 lbs,
and I am always single-digit body fat percentage. More importantly, I can actually enjoy my diet and use
it to facilitate my goals without being miserable at every meal.

Maybe all of that would have happened in time regardless of diet. Maybe not. My personal
account is not equipped to say one way or the other. But the research I’ve conducted is perfectly
equipped to support the new rules. My research is on the flexibility within a ketogenic diet using the
specific definition outlined earlier in this chapter.

Keep this definition of ketogenic diet (one that generates ketones) in mind as you read the
remainder of this e-book. It is critically important for understanding the 6 new rules of keto dieting.

Reasons for Going Keto or Low-Carb

If you’re reading this e-book, you may already know a few of the benefits associated with a
ketogenic diet. This section will not be exhaustive. However, you may find you still learn something –
there is quite the array of benefits! If nothing else, you will find some inspiration, and learn some hard
facts.

Weight Management, Body Composition, & Fat Loss

More often than not, keto dieters are drawn to the dramatic fat and weight loss benefits of a
ketogenic diet. These results are not overstated. I’ve been tuned in to keto diets and working with all
different sorts of people, and many of them have tried “everything” – in some very early cases, I was the
one having them try a variety of tactics. Nothing else that I tried produced results like a ketogenic diet.

In the scientific literature, we’ve seen the same thing. One of the most dramatic has been a
12.7kg (28 lbs) loss over just 24 weeks. These results are sustainable as well. Over a one year period, Commented [jj1]: https://annals.org/aim/fullarticle/7174
another study has observed a 13.1 kilogram (28.9 lbs) loss of body weight over 1 year. Average weight 51
loss over a 1-2 year period just by going low carb is approximately 5.4 kg (12 lbs). The longest Commented [jj2]: https://academic.oup.com/ajcn/article
intervention study in humans to date lasted 4 years. It was a non-keto, low-carb study, and participants /90/1/23/4596906
lost 7.5 kg (16.5 lbs). Commented [jj3]: bueno review
 In non-clinical populations, this is still true. Keto dieters lose more weight and more fat than
low-fat dieters. More importantly, they lose more body fat while maintaining or improving muscle mass.
In gymnasts, who were already ripped to start the study, 30 days of ketogenic dieting took them from
5.3 to 3.4 kg of fat mass, while muscle trended upwards, yielding a weight change of -1.6 kg. This is
perfect for an athlete that operates best with great strength relative to their body mass.

Next up is a personal favorite, it was our first ketogenic study on weight lifters. My colleagues
and I studied male weight lifters for 11 weeks. They increased their lean body mass by 7% with the keto
diet, but only by 4% with a low-fat, equal-protein diet. Likewise, fat mass decreased by 13% in the low-
fat group, but it decreased by an astounding 22.4% with our ketogenic diet! Commented [jj4]: cite

These guys were already lean, and they lost another quarter of their entire body’s fat mass in
less than 3 months! Amazing!

Last but not least, my dissertation research extended our work into concurrent (weights &
cardio) training and it included women for the first time. The results were very much the same. Without
calorie restriction, the keto group (men and women combined) lost 1.1 kg (2.4 lbs) vs. a 0.3 kg gain in
the carbohydrate diet group. This translated to a 2.1 kg gain in muscle for both groups, yet the keto
diets lost 1.5x more body fat at -3.2 kg fat mass. Commented [jj5]: cite

Endocrine and Cardiovascular Health

Being a nutrition scientist today is very exciting. I should say, rather, it’s very exciting if you’re
someone who embraces science and the fact that, at any time, something we believe to be true turns
out to be false or vice versa. This is called a scientific revolution, and we’re right smack dab in the middle
of one.

Most of you will remember when dietary fat was demonized. It was only a few years ago that
the national recommendations softened their hardline position against dietary fats, recognizing their
essentiality in human nutrition. Those adhering to the guidelines were experiencing a lot of negative
side effects from reducing the fat in their diet to the levels suggested by the national recommendations.
Despite the small steps taken in recent, years, we still have a long way to go until the guidelines are
accurate and represent what we already know; fat is our friend. Carbs are really what increase our risk
of illness.

But it is not so simple that we can broadly say “carbs are bad.” Perhaps no illness is affected by
carbohydrates in the diet more than diabetes. Carbs directly affect risk of insulin resistance when
individuals are chronically exposing themselves to elevated blood glucose levels over time. However,
having a piece of cake occasionally within the context of an otherwise low-carb approach isn’t going to
have any impact on disease risk whatsoever, unless the person is already at risk or diabetic. Blood
glucose would go up, then it will go down in about an hour or two.

Those that are of the position that any increase in blood glucose is not good for health don’t
recognize that intermittent carbohydrate feeding actually promotes proper hunger hormone function
and metabolic flexibility. More on that later.

To reiterate, diabetes is the most prevalent endocrine disorder in the United States, and it is
literally defined as the inability to process carbohydrates. It is caused by chronic overexposure to
carbohydrates, especially sugar, and it is exacerbated when carbs and fats are consumed together –
such as in all of the most delicious foods. This is because one inhibits the metabolism of the other. Thus,
when people continuously eat “high sensory” foods, they often end up with diabetes. Unfortunately,
most of our mass produced foods have become high sensory foods, rich in both carbs (often sugar) and
fat, usually with very little protein as well, which is a problem in and of itself.

When diabetics subtract carbohydrates from their diet, the first thing that happens is they
remove the “insult.” Just the absence, or near absence, of dietary carbohydrates functionally cures
diabetes. If no carbs are consumed, no insulin or glucose disposal agents (e.g., metformin) are needed
and complications almost immediately subside.

One of the earliest researchers on ketogenic diets in diabetes, Dr. Eric Westman, has a general
protocol that involves cutting all but a few dietary carbohydrates and simultaneously cutting insulin
dose in half in the first week. They play it by ear for a few weeks, then after 1-2 months, the patients
often don’t need medication anymore. The patients are not completely rid of their insulin resistance,
but they are well on their way.

It depends on the patient and the duration that they’ve had diabetes, but after a few months of
ketogenic dieting, insulin resistance and the inability to process carbohydrates has dissipated. At this
time, it’s important to keep the fundamentals of the low-carb approach for long-term health. However,
they may not need to be keto anymore, they can live out the rest of their life comfortably low carb. And
if they choose to stick to it, that occasional piece of cake actually helps their bodies “remember” how to
metabolize carbs to encourage proper glucose management.

In fact, “removing the insult” can be so powerful that becoming ketogenic is not necessary. The
same study mentioned in the last section that tracked participants for 4 years and used a low-carb (20% Commented [jj6]: cite
of daily energy) had such good results after 6 months that they had an ethical obligation to tell the
“normal” diet group about the dramatic results and offer them the opportunity to switch groups.

Let me explain this from the perspective of a scientist. This almost never happens in this type of
research; if this occurs at all, it’s during a study that is exposing participants to something potentially
harmful (such as new medication) and it gets out of control – NOT that one group is doing so much
BETTER than another. All research studies are monitored by the Institutional Review Board of the
university, hospital, or research site. It is their responsibility to make sure research participants are
being treated humanely, their personal data are protected, their identities are not exposed, and other
general ethical principles. The IRB doesn’t typically intervene, but in this case, they did. And they told
the researchers, “hey we looked at your data after 6 months, and you can’t continue doing this study
with separate groups. The low-carb group is getting so much better – their diabetes is being cured so
much more effectively – than the other group, you have to offer the “normal” group the opportunity to
switch to the low carb group, or you can’t continue conducting research and we’d all be bad human
beings if you didn’t give them the option to go low-carb.” That’s HUGE! To a scientist, it’s absolutely wild
that this happened, and it really speaks to the efficacy of the low-carb approach.

By the way, this isn’t the most dramatic thing that happened during those 4 years. At the final
follow-up, researchers looked at how many participants had ongoing complications between groups. Of
all the patients in the low carb group (those from the beginning and those that switched groups later),
only 7.7% had a cardiovascular incident, and just 1 had passed away. Conversely, for those that never
switched groups, 80% had a cardiovascular event, and 40% had passed away.

It’s not a matter of “my diet is better than yours” or any narcissistic gloating. When it comes to
people who are already diabetic, it’s literally a matter of life and death.

In less dire circumstances, we can pull another amazing story from this study. One participant
was a bus driver that enrolled in the study shortly after his diabetes diagnosis, which caused him to lose
his job because law prohibited him from serving in that position while using insulin, as he would be at
risk to pass out while driving and endangering passengers. He was in the low-carb group, and because of
that, he got his job back. How long did it take? TWO weeks. In just two weeks, he was able to
discontinue his medication use and return to work.

Why, in our society, is there a question of how to treat diabetes? Why do we prescribe
medication first and offer sound dietary advice never? It’s not a question for me, and after reading that,
I hope it is not a question for you either. Moving on.

When discussing the study just now, we talked about cardiovascular incidents in diabetics.
Cardiovascular disease is the leading killer in the united states, and diabetes is a large contributor to that
statistic. When people have diabetes, they most often die from a cardiovascular event – either heart
attacks or stroke.

In short, this is because the symptoms of diabetes, chronically high blood sugar, chronically high
insulin, and chronically high HbA1C, damage the cardiovascular system. It’s a very slow process, usually
taking ~10-30 years for diabetes to set in, then another ~10 years after diagnosis for heart complications
to occur, but they occur nonetheless. Of course, heart disease can set in when there is no issue with
glucose management as well.

Heart disease is broad term that encompasses hypertension (high blood pressure), coronary
artery disease, arrhythmias (irregular heart beat), heart attacks, and congenital heart defects. When we
say cardiovascular events, we also include stroke, which occurs from a limited blood supply to the brain.
The primary objective risk factors for heart disease are high blood pressure or cholesterol, diabetes,
smoking, obesity, and level of physical activity.

Also included in the list of risk factors is “unhealthy diet.” What they, the National Institute of
Health, mean is a high-fat diet. Of course, we already know that’s B.S. Here’s why.

First of all, the definition (there’s that word again!) of “high-fat diet” in the medical literature is
NOT accurate at all. It’s one of the most misleading terms used in all of science; I cannot stand it. The
prototypical “high-fat diet” is 40% calories from fat, 40% calories from carbohydrates, and 20% calories
from protein (High-Sensory Foods). Scientists and medical doctors aren’t mathematicians, but you’d
think they could at least realize that 40%=40%.

At best, this is a high-fat, high-carbohydrate diet. Almost every time, most of the carbohydrates
are sugar as well just to stray from the given nomenclature a little bit more. Yet, because these morons
are so fixated on carbohydrates as the base of a good diet, they think that this is a low carb diet –
moderate at best. It’s as if they are deaf, dumb, and blind to numbers. You really have to wonder why
we listen to these people in the first place.
 Of course, we know that a true high-fat diet is actually high in fat, somewhere around 60% of
calories or more if you’re going for a ketogenic diet. We also know that carbs should be reduced to 20%
or less. Protein is too often an afterthought. The present e-book features keto in the title, which reveres
fat, but protein is the most important of the three nutrients. Increasing the proportion of protein in the
diet is just about always a good thing barring a pre-existing kidney condition or protein enzyme
deficiency. But, I’m getting ahead of myself.

High-fat diets, real high-fat diets, are not risk factors for heart disease. There’s a lot of confusion
here from one perspective. Blood concentration of saturated fats is a risk factor for heart disease. How
does this work?

Logically, one would assume that if we eat saturated fat, our blood levels of saturated fat would
increase. Sound logic. Not the case. Becoming keto-adapted actually reduces blood concentrations of
saturated fats.

I liken this to exposure therapy. When we’re not exposed to enough fat, we “forget” what to do
with it. When we are exposed to more fat in the diet, a light bulb turns on, and the body goes, “oh sh!t,
that’s not supposed to be there. Let me take care of that.”

Now, let’s take on some other “risk factors,” such as the other blood lipids. HDL, or high-density
lipoprotein, aka “good cholesterol” increases with a real high-fat diet. LDL, or low-density lipoprotein,
aka “bad cholesterol” usually increases with a real high-fat diet as well. However, the results on LDL are
not as consistent. As a doctor and a scientist, I’m trained not to use absolute terms like “always” or
“never,” and if you cared to take such a close examination, you’ll probably find that I don’t use them
without some sort of qualifier unless it is something of which I am absolutely sure.

That being said, HDL almost always increases. We can rely on HDL to increase. We cannot rely
on LDL to do the same – it is more variable – but it will probably happen. That doesn’t sound good. Hold
on one second. There are 2 things about HDL and LDL that are more important than their absolute
concentrations. They are the HDL:LDL ratio and LDL particle size.

Just as reliable as HDL, the HDL:LDL ratio improves with low-carb, high-fat, and/or ketogenic
diets. Few studies have the diligence to look at LDL particle size, yet the few that have examined the
variable to this depth have observed a favorable shift with keto diets. That means less small LDL (“bad”)
and usually more large LDL particle (“good”). Because both contribute to the total LDL measure,
sometimes the increase in concentration of large LDL outweighs the decrease in small LDL, and when it’s
not measured, it can be made to look like an unfavorable change.

Perhaps even more important than either HDL or LDL (or total cholesterol for that matter) is
triglycerides. If there was a single marker most predictive of heart disease, it would be triglycerides
[PMC1618385; 3 others]. Several studies cited here strongly suggest that, if we were to use just one Commented [jj7]: https://www.ncbi.nlm.nih.gov/pmc/art
indicator, our efforts should be focused on reducing triglycerides. What is the best way to reduce icles/PMC2664115/pdf/cln63_4p0427.pdf
http://www.onlinejacc.org/content/65/21/2267
triglycerides?
https://www.nejm.org/doi/full/10.1056/NEJMoa1308027
Well, let me tell you, it’s a real shocker. Ketogenic diets almost always have pretty extreme
reductions in triglycerides. Before we delve into that data, though, let’s take a second appraisal here.
These are all blood lipids, but lipids are generally inert – they don’t produce much of a biological
reaction in human systems, unlike glucose, which absolutely has a biological effect (e.g., insulin release),
and when it does not, that’s when we think there is a problem. Fats, in general, are not all that bad.
They’re just being used as markers. My younger brothers aren’t bad guys, we’re young – we text if we
want to communicate. If they call me, however, there’s a pretty good chance something is wrong.
They’re not bad, but their message – the reason they’re calling – probably is just based on the fact that
they don’t call. The phone call itself is being used as a marker, but maybe they just want to chat, and
there is nothing bad after all.

This is summed up in a few sentences in a paper published by Dr. Malhotra, “two thirds of Commented [jj8]: cite 2013 saturated fat myth busters
people admitted to hospital with a diagnosis of acute myocardial infarction really have metabolic and 14 within.
syndrome—but 75% of these patients have completely normal total cholesterol concentrations. Maybe
this is because total cholesterol isn’t really the problem?”

Metabolic syndrome is essentially the combination of diabetes and heart disease – 2 diseases in
1 – most often characterized by poor glucose management, obesity, and dyslipidemia (irregular blood
lipids). Since we already know about both conditions, we can talk about some data.

In people with metabolic syndrome consuming either a ketogenic diet or low-fat diet for 12
weeks, both lost weight, abdominal fat, had reduced triglycerides, glucose, insulin, and circulating
saturated fats. However, comparing the keto diet to the low-fat diet makes it seem like there is no
comparison. Across the board, the improvements in the keto group were a minimum of twice as good.
This includes a 50% decrease in triglycerides (vs. 20%) and a 60% drop in saturated fat (vs. 25%). Commented [jj9]: cite volek, carb restriction positively
affects metabolic syndrome.
But this is in people with metabolic syndrome; they’re more likely to experience such benefits.
Well, it’s a good thing the same thing happens in healthy people as well. From my dissertation research
(in review), the ketogenic diet group (which includes both strict keto and keto supplementing with carbs
pre-exercise) had a 4.5 mg/dL decrease in fasting blood glucose compared to a 6.9 mg/dL increase in the
low-fat group for a total difference of 11.4 points.

Other markers followed suit. Insulin decreased by 0.7 mcIU/mL versus a 1.0 mcIU/mL increase in
the low-fat group. Guess what happened to triglycerides. They decreased by 11.4 mg/dL compared to a
17.9 mg/dL increase in the low-fat group. Keep in mind, these participants are young, most in their early
20’s, active, working out 5 days per week with me under supervision (and I’m busting their asses each
and every day), and healthy, we screen them before they’re admitted. We also observed benefits of
keto for HDL (+8.5 vs. +2.7 mg/dL, nonsignificant p = 0.08 – see what I mean by almost?) and cortisol (-
7.7 vs. +23.8 ug/dL) in these folks. Men also had a tendency to increase their total and free testosterone.

The point of this entire subsection is… there are plenty of benefits to go around. The
observations of clinical research seem, at least so far, to translate to individuals that are already healthy,
just in smaller magnitudes. Therefore, if you’re already healthy you could probably be healthier.

I want to emphasize here, again, that our ketogenic study included a “targeted” ketogenic
approach, which featured supplemental carbohydrates pre-exercise on exercise days. It didn’t change
the benefits of the ketogenic diet in those that were already healthy, and those benefits were not all
that different from the benefits we observe in the clinical populations. Moreover, it did not affect their
state of ketosis, which we measured weekly. Double moreover, as we discussed in the previous
subsection, these keto dieters are looking better, with less body fat and at least as much muscle. We
didn’t talk about athletic performance, though, did we?
 Performance

This area of a ketogenic diet is a little bit more controversial. People generally accept that you
can lose more body fat and gain equal quantities of muscle. However, results on performance are a little
bit split. To explain, we need a quick detailing of energy metabolism.

If we’re going all out during maximal effort exercise, we primarily use the ATP-CP system for the
first 10-15 seconds. Then, we shift over to, primarily, the glycolytic system, which uses only glucose, up
to about 2-3 minutes. Finally, we shift to the oxidative system, which lasts virtually into infinity (at least,
as long as anyone would volunteer to exercise for) and can use all macronutrients – fat, carb, and
protein.

Keep in mind here that all examples citing a ketogenic diet are using a standard ketogenic diet
with minimal carbohydrate consumption.

For long duration endurance performance, and I mean like longer than marathon distance
(ultra-endurance, if you’re savvy), there’s a likely advantage for a ketogenic diet or a fat-adapted
metabolism. In a 100km cycling time trial (oxidative), a keto-adapted group improved their times by 4
minutes compared to just a 1 minute improvement in high-carb dieters. This did not reach statistical
significance (p=0.057; close enough, in my opinion), but we should keep in mind how impressive this is
when considering that the high-carb group had to eat carbs during exercise (30-60+ grams per hour –
standard practice), but the keto group ate no calories during the entire ride. If you’re an ultra-endurance Commented [jj10]: cite mcswiney
athlete, you know how crazy this sounds. For the rest of you, it’s hard to explain, but basically would be
considered impossible to do on a carbohydrate-based diet.

In that same study, they tested maximal power output relative to body weight. This test is very
different from a 100km time trial, as it is a very short sprint – usually 30 seconds (glycolytic). Notice that
they improved relative to body weight. What happens on a ketogenic diet? Reductions in body weight,
so there’s an advantage for keto when looking at the relative measurement.

Typically, when looking at absolute (not body weight adjusted) power output in the same test
(it’s a fairly common test), it declines or stays the same with low-carb diets. In our first study on
ketogenic diets, participants in the keto group had a mild decrease of 15 W after 10 weeks vs. the carb
group’s increase of nearly 80 W. After week 10, we re-fed the keto group carbs for a week. At week 11,
they gained just as much ability to generate power as the carb group. Thus, carbs aren’t needed for Commented [jj11]: cite wilson
exercise adaptation, but when it comes to anaerobic (glycolytic) exercise, they are needed to realize
those adaptations.

In the MMA keto study and in my dissertation research, we didn’t just do one sprint – we did 6.
We then compared the power output between each of the 6 sprints. The carb groups get very tired by
the sixth set. Between the first and final set, their power output decreases by 140 W, but the ketogenic
group only has a decline of 70 W. They’re more resistant to fatigue – even if the exercise is using
primarily glycolysis. However, their performance during the first set is still compromised.

Remember, we had 2 different keto groups. One had been using supplemental carbs pre-
exercise for all of their training sessions. That group had NO decline in power during the first set. In fact,
they possibly had a small advantage, increasing 34 W compared to just a 26 W increase in the carb
group. Compare that to the strict keto group, which had a change of -28 W. These results were similar to
those observed with the vertical jump test, the strict keto group improved, but not to any large degree.
However, the keto + carb group had a more robust improvement in their jump performance.

It would be convenient to say that it is just supply. If we supply carbs, then we’re fine, but it’s
not that simple. When we go through extended periods of low-carb dieting, we lose some of the ability
to metabolize carbs the way we need to. It sucks, but that’s the truth, and as your friend, I’m here to tell Commented [jj12]: cite schwel PDH
you the truth. I don’t like it either.

In our first study, it wasn’t just that carbs were supplied, but that they were supplied for a whole
week. The participants had a week to “re-adapt.” In my dissertation, they achieved ketosis without
losing any carbohydrate metabolizing ability by using carbs strategically. They didn’t go out and binge on
Taco Bell randomly and without reason, they just ate carbs pre-exercise. Very important.

Also of note, the ketogenic group showed equal gains in both upper- and lower-body strength
(ATP-CP) and 5km run performance (glycolytic/oxidative), including their performance during two, high-
intensity (glycolytic) hill segments.

A couple of other studies on performance. Volek was the first to describe ketogenic metabolism
during aerobic exercise. He found much of what you might expect, and a few things you might not. First,
ketogenic diets increase fat oxidation and decrease carb oxidation during steady state exercise. That one
should be a given. This might be a surprise, though. Second, keto-athletes (ultrarunners) had the same
pre-exercise muscle glycogen (carb storages) levels, the same muscle glycogen levels immediately post-
exercise, and the same muscle glycogen levels after 2 hours of recovery. Third, these athletes
maintained ketosis eating 10% of their calories (a relatively high calorie diet, to boot – necessary for
these athletes) as carbs. Commented [jj13]: cite volek

Finally, this study is likely the most detailed study on ketogenic diets in sport ever. It’s really cool
stuff if you are a nerd, like me, but probably just a bunch of mumbo jumbo if not. Here are a few quick
take home points. First, they induced ketosis with supplemental beta-hydroxybutyrate (BHB) at a dose
of 573mg/kg body weight pre-exercise. Second, these ketones contribute to their energy supply 17% of
their total energy used during exercise. Third, it dynamically, dynamically altered their metabolism in
favor of total fat oxidation. This extended so far that a 24% reduction in intramuscular triglycerides was
observed after exercise with the BHB drink vs. a 1% decline with the carbohydrate control drink. This
also spared muscle glycogen. Fourth but not least, the BHB drink improved their 30-minute cycling time
trial performance (which took place after a 1-hour pre-fatigue). This suggests that, for example, even if
you were a really fast, elite-level marathoner completing the 26.2 mile race in 2 hours, your second half
of the race would be faster if you had ketones. Commented [jj14]: cite cox

We don’t know a lot about ketogenic diets and performance yet, but we do know a few things.
As performance is directly tied to body composition, we reiterate here that even in people who are
already fit, a ketogenic diet only stands to have a total improvement on their body composition –
decreased fat, increased or no difference in muscle gain. Typically, this helps performance. With keto
diets, strength gains are no affected, endurance performance is not affected for short distance and
possibly enhanced for long distance, and immediate power output early during an exercise bout is
compromised. However, it can be maintained or improved with strategic carbohydrate consumption,
and this likely confers long-term benefits beyond our current set of knowledge.
 Worthy Mentions

A ketogenic diet has numerous uses, but weight and other preventable disease risk reduction
are the most “popular” reasons for going keto. Nonetheless, here are a few other areas that are either
so commonplace that it is not worth discussing at length or the data between clinical and nonclinical
populations is lacking or irrelevant to improving fitness.

Epilepsy. Ketogenic diets are so effective for treating epilepsy that people actually let us get
away with saying so. Commented [jj15]: cite anyone

Cancer. Some types of cancer may find it difficult to survive and spread with elevated ketones
and/or poor glucose availability. Commented [jj16]: cite dom

Cognition. Some of the “biohacking” effects of keto extend into improving focus and memory,
especially during fasting. Other data suggest this may extend into actual disease as well, such as
Alzheimer’s disease. Commented [jj17]: cite that one neuro review by
baranano
Inflammation. Part of the benefits for diabetes and heart disease are rooted in inflammation as
well. Inflammation has a mixed role in exercise and fitness, where acute inflammation is necessary, but
chronic is a problem. Keto diets have been shown to reduce some inflammatory markers. Commented [jj18]: https://www.ncbi.nlm.nih.gov/pubme
d/25686106
Fertility and Reproductive Health. Ketogenic diets may alter testosterone levels and function in
males. Anecdotally (and through my own personal observation of clients), although no research I know Commented [jj19]: cite volek saturated fat ratio study
of outside of PCOS, ketogenic diets help women regulate their menstrual cycles, which is f*cking huge
for them because many can come off of that poison birth control. Sorry, I thought one of you told me to
tell you how I really feel! There is also evidence for the diet improving fertility, likely as a two-fold Commented [jj20]: https://www.sciencedirect.com/scien
function of better sex hormone status and removing all the toxic “food” from our pre-keto diets. ce/article/pii/S0378512212003362

Traumatic Brain Injury. Ketones can be used by the brain as fuel substrate. During a traumatic
event, having extra ketones can help brain cells survive long enough that less brain damage occurs. Commented [jj21]: https://journals.sagepub.com/doi/pdf
/10.1038/sj.jcbfm.9600543
This is just my anecdotal perspective. A ketogenic diet helps with just about every facet of https://journals.sagepub.com/doi/pdf/10.1177/0271678X1
health. Many of our modern problems are a result of our own doing – not just massively excessive 8808947
carbohydrate intake, but plastics, heavy metals, xenoestrogens, phytoestrogens, and god knows what
else that we’re exposed to on a regular basis. Point is, I put someone on a ketogenic diet and all of a
sudden problems they weren’t even complaining about go away. And it happens all the time.

This is an entirely different topic that deserves a book of its own, but we, humans, are meant to
survive primarily on meat. The brief rationale being that fats and proteins (found in meat) are essential
(carbs are not), we have a carnivore’s digestive system, we’d have no micronutrient deficiencies eating
that way, it’s in our bone record, etc. etc. etc. There is but a single Archetype for dieting. It is a low-carb
diet. It’s not a carbohydrate elimination diet, but our biology is designed for limited carbohydrate
consumption, even though it may not be as limited as we think due to the blindness from our current
perspective.

In our history, we chanced upon meat – it was occasional. In between, we’d munch on anything
– grass, tree bark, you name it. Occasionally some fruits. At least during the summer months, fruit
probably wasn’t all that uncommon, but we were active all the time. Walking, chasing, running,
standing, dancing. Early humans didn’t spend a lot of time being still. Any carbs that were eaten were
burned up almost immediately. They were eaten in smaller quantities, and they were managed. We can
learn from that.

Old Rules

There are five old rules of ketogenic dieting that we are eliminating from now on for people who
are already, or who have become, healthy (free of diabetes, epilepsy, cancer, and neurological
disorders). Specifically, this means that you are not attempting to treat any disease with a ketogenic
diet, except overweight/obesity. Here are the old rules and what is wrong with them.

Number 1. Limit Total Daily Carbs to 30-50g Per Day; 5% of Total Calories

This is a rule of ketogenic dieting that is one of the reasons it is so often called “the” ketogenic
diet. In the old school medical literature, where they are using the diet to treat a medical condition, the
researchers call it “the ketogenic diet.” However, there is more than one way to achieve nutritional
ketosis. In fact, it’s right there in their own definition. 30-50g implies at least 21 different ways, and
that’s just using whole numbers!

The correct phrasing is “a ketogenic diet.” Many types of diets can be ketogenic. The absence of
a diet at all is highly ketogenic. Stop eating and your ketones will go through the roof!

A diet can be ketogenic with 30g of total daily carbs, sure. I would be absolutely astounded if it
were not ketogenic. Luckily for us, however, a diet can be ketogenic with 130g of carbs. A diet can even
be ketogenic with 230g of carbs! I would go so far as to say it can be ketogenic with several more
hundred grams of carbs, but I have not tested that much, so I will refrain.

230g, though, I can personally attest to that. It was actually 250g the first time I experimented
with it. I had my normal 50g spread throughout the day. On this particular day, I had a lot of leg training
volume planned. I mean a lot. We don’t f*ck around. It’s a six-figure number. A no decimal, only comma
size number. I had 100g of carbs before starting (+40g protein), 50g during, and 50g (+40g protein) after.
Blood BHB before the pre-exercise carbs was 0.6, which was pretty normal for me (0.3 being considered
a minimum for in ketosis based on BHB concentrations; 0.5 is for total ketones). After the meal but pre-
exercise, 0.1. Not surprised, and not worried. After training, but before post-workout carbs, 0.2 (a small
increase from training, but I was expecting it to be fully suppressed). About two hours after the post-
workout, I had a normal, high-fat meal. BHB an hour after that meal was back in range at 0.4.

For the record, I’m not a huge guy. By my own definitions, I’m medium (Table 1). I’m almost big,
really dang close. Maybe by time you read this, I will be there. I’ve always wanted to be big, and
doggone it, one day I will be.

Size Weight
Small < 200 lbs
Medium 200-224 lbs
Big 225-249 lbs
Huge 250-275 lbs
Freak > 275 lbs
Table 1. This is how “big” you are based on your weight, if you are a male of average to slightly
above average height with a body type that could be described as “not fat” or leaner. This table has
nothing to do with science, and it represents only the opinions of Dr. Jordan Joy, and that girl you like,
but won’t talk to.

If you’re thinking, “okay, yeah. That’s great. For YOU!” Don’t worry. Many other experiments
have been performed! Let’s go total opposite in a series of experiments.

A few years ago, I was dating a girl who had the hobby of mountaineering. She was pretty
accomplished, and early on her journey to doing the seven summits. We lived in Denver at the time, so
she’d go train on one of the many mountains available from which to choose every weekend. I went
sometimes. Ok, like ten times. Tops. Not bad for a three year stretch.

My personal accomplishments aside, she was keto as well, but on her big training days on the
mountain, she ate plenty of carbs. Like 100-200 grams pretty much every trip, sometimes more,
sometimes none – depending on the goal for the day. She’d measure her BHB when she got home then
usually again at night. A lot of the time, she was in when we returned. If not, she was back in ketosis
before bed. This was the case every time. Even after I told her she didn’t need to test anymore, she kept
it up. I knew the result, but it was nice to have confirmation that this was a very reliable protocol week
in and week out.

We toyed around with the concepts a bit in other athletes with the same observations, but the
real test, was when we really put it to the test (duh!). In a real life study. Also known as my dissertation.

The study (actually a series of studies – 4 phases in total) was fairly complex. Relevant to this
discussion, we had participants in ketosis for 10 weeks (phase 1). During that time, they were training 5
days per week under my supervision. We tracked their diets, total activity, and blood BHB
concentrations. After the 10 weeks, they continued training exactly as they had during the final 4 weeks
of the first intervention. The only difference was that they had carbs before exercising (phase 2). We
started with 10g and increased the dose by 10g every 2 days until their BHB concentrations sank below
0.3.

Everybody made it to 20g. After that, some started to lose it. I was, and I remain, very suspicious
they deliberately tested out so they could start their vacation. Some admitted as much. The least likely
person to maintain ketosis (the one with the smallest body) was one of the ones who lasted the longest.
At 60g of supplemental pre workout carbs, we had 2 participants (~10%) left, but we had to stop
because the semester had officially ended. Who knows who long they’d have lasted, but it is curious
that the final 2 were both smaller girls that also happened to be the most diligent about turning in their
food logs and being dedicated to the work. My gut tells me many more could have survived up to 60g
(~100g total carbs per day – DOUBLE the old rule’s upper limit) as well.

Nonetheless, the program was not nearly as rigorous as doing 100,000+ lbs of weight training
volume or hiking mountains (both of which probably expending around 1,000 calories – ballpark
estimate). In context, the men in the study had an average weekly lifting volume of 79,000 lbs spread
over 3 sessions plus 2 days of cardio. Thus, we can determine that one’s ability to maintain ketosis in the
face of carbohydrate ingestion is related to exercise, and we do NOT need to limit carbs to 30-50g per
day.

A beloved friend and mentor of mine, Dr. Eric Serrano, said to me a few years ago,
“carbohydrates are activity dependent.” I think that is the best way to sum up the role of carbs in human
nutrition. Carbs provide energy; they provide energy via a unique metabolic pathway (anaerobic
glycolysis) that is absolutely vital to athletic performance; and that is very, very nearly their ENTIRE
function. That’s literally all they do – provide calories. Hmmm, what do modern countries have a
problem with? Oh yeah, consuming too many calories! This is such an obvious problem and solution, I
remain utterly baffled the so-called experts are SO out of touch.

On the flip side, ketogenic advocates are so anti-carb they limit their athletic capacity and
longitudinal progress. You may not have a direct interest in your athletic ability, but you should. The
ability to do work and exercise volume (amount of exercise) is perhaps the most important factor for
reaping the benefits of working out, be that muscle gain, fat loss, to run faster, or get stronger.

In next section on the new rule interpretation focus on benefits of carbs for exercise

Number 2. Consume a 2:1 – 4:1 Fat to Protein Ratio

This concept emphasizes that keto dieters should consume 2-4 times as many grams of fat as
they consume grams of protein. The idea behind it is to eat enough fat to maintain ketosis. I’m here to
tell you, that is completely unnecessary.

Rule number 2 is already disrupted a tiny bit by rule number 1. However, we’re specifically
targeting protein here. Fat is important for maintaining ketosis; this is undeniable. Ketones will increase
during, and for a short period after, exercise as well. Consuming more protein is absolutely essential for
those who are exercising, and that means protein will likely be required in amounts that exceed 15-20%
of total daily energy and definitely undo any high fat to protein ratio.

Not to mention, even if you are not exercising, more protein will help you stay leaner, maintain
more muscle mass, preserve strength, and support good health.

I was brought up in a protein research-oriented labs. My first mentor, Dr. Wilson, consistently
referred to our lab as studying “the science of bodybuilding,” so of course, we had a keen interest in
protein. As such, we stuck to prescribing protein on a grams per kilogram basis even when we became
interested in keto – a significant contributor to one of the new rules.

It wasn’t actually until I was ketogenic for a few years that I even learned about the ratio. We
read the scientific literature – not so much forums and other internet chatter that seem to be more
focused on the ratio. When I learned about it, it caught me off guard. I was in a meeting with the higher
ups at Quest Nutrition and we were just nerding out about keto. They asked me about my diet, and at
that time, it was roughly 220g fat and 200g protein per day. They were surprised.

Ron, the CEO, said, “Wow, a 1:1 ratio! And you are in ketosis?”

I replied, “Yeah I stay in ketosis, but it’s a 2:1 ratio?” The concept of a ratio was foreign to me at
the time – I based my nutrition around calories, so with roughly equal quantities of fat and protein by
grams, the caloric ratio of fat to protein would be ~2:1.

I was politely corrected and happy to have learned something new. Then they brought out some
new keto food items they were piloting. They were a 5:1 ratio, and of course, they tasted amazing.
 All along, I had been unwittingly breaking this rule of eating considerably more fat than protein.
Not because I wasn’t eating enough fat – 220g daily is quite a bit, certainly enough to make the ordinary
cardiologist’s head explode – but because I was eating “too much” protein.

This is a perfect example of why the definition of a ketogenic diet is so important, and why we
CANNOT define a ketogenic diet by macronutrient ratios or quantities. The 200g of protein that I was
consuming daily at the time was exactly what I needed based on every bit of conventional science on
the topic.

To follow the old rule would have been a tragic mistake for someone like myself. I was lifting
pretty intensely at least 5 days per week, and protein is the most essential nutrient to facilitate recovery
and muscle growth. No buts about it!

Unless you are someone with one of the aforementioned diseases, there is no need to limit
protein intake. Limiting protein is done at your own detriment, and there is no need to fixate on a 2:1,
3:1, or 4:1 ratio. There is no need to even do a 1:1 ratio – you can be slightly under and still maintain
ketosis. More importantly, you will maintain an increased ability to oxidize fats.

In next section on the new rule interpretation focus on benefits of protein for exercise & BC

Number 3. Track Total Carbohydrate Intake

As part of “the” ketogenic diet, followers are supposed to limit their total carbohydrate intake
to 30 – 50g daily. What a bunch of malarkey!

Obviously, the issue with the 30 – 50 grams per day portion of this rule has been addressed, but
now we’re focused on the total carbs portion of the rule. This is perhaps the most asinine rule of “the”
ketogenic diet!

If you ask me, any diet that limits vegetable intake is downright foolish. We (scientists) are so far
from knowing everything about nutrition, but we know there is one thing in which we have a ton of
confidence - vegetables are good for you.

Vegetables are a forgotten factor in keto diets. In fact, lots of guys, and probably a few girls too,
develop an interest in the diet because vegetables are not emphasized or outright discouraged. This is
evident in some of the older publications on “the” ketogenic diet, which gave participants a salad once
per day as their only vegetable intake because total carbs were being kept low.

First of all, I could eat as much salad as comfortably possible and still not make it to 30g of carbs.
This is not conjecture – I literally buy salad packs and eat the whole damn thing (3.5 servings) as part of
one meal. Nobody is knocking themselves out of ketosis because they just couldn’t stop themselves
from eating too much kale, okay?

Second, what is so bad about fiber that we are including it in total carb counts and effectively
limiting fiber intake? Fiber is generally healthy. It’s not quite as important as many will proclaim it to be,
but it is good for us, nonetheless.

Getting 30 grams of fiber or more every single day is an unnecessarily large quantity of fiber for
most goals on a ketogenic diet (although, this is certainly achievable). Really, you just need a few grams
to help prevent becoming impacted (constipated). Conversely, eating huge amounts can cause
constipation as well. Fiber also helps with controlling blood sugar and blood lipids.

All of that is fine and dandy, but one of the most perplexing facts about fiber avoidance on a
ketogenic diet is related to how fiber is digested – and yes, it is digested. In a healthy gut, fiber is
fermented. The products of fermentation are none other than short-chain fatty acids (ketone bodies, for
all intents and purposes), butyrate, acetate, and propionate.

Fiber is like a direct injection of ketones to the gut. This is important beyond our
comprehension, as we know very little about the microbiome despite its recent popularity. However, we
do know a few things. A healthy microbiome produces more butyrate than it does other SCFAs, and
butyrate fuels the cells along the intestinal wall, improving their health, and theoretically providing
better control over what does or does not actually enter our bodies. Things in the digestive tract are
NOT in our bodies yet – they are in a tube which passes through the body – and it is the intestinal wall’s
job to control what enters (amino acids, fats, vitamins, etc.) and what does not enter (pathogens,
allergens, viruses, etc.). Plus, we ketoers like butyrate – probably our favorite ketone.

Fiber should not be included in carb counting. If anything, it should be included as a fat!

Forget about fiber, though. Yes, it has its benefits, and we’re not actually going to forget it, but
we also need to consider everything else in vegetables that we could lose by avoiding them with silly,
old total carbohydrate rules. Fiber is often just used as an indicator of plant intake, so it gets a lot of
undeserved attention anyway. Good for us? Yes. Essential? No – there are no essential carbs.

Vitamins and minerals? Yes, yes, we all know about the vitamins and minerals. However in many
cases, meat has a greater concentration of vitamins and minerals – especially organ meats. Some
vitamins do still need to be obtained from vegetables, though, as they are not abundant in meat or nuts,
but that’s not what I want to highlight about vegetables.

We’ve covered the pertinent macronutrient in veggies, touched on the micronutrients, but what
we should be talking about are phytonutrients. The group of nutrients specific to plants that we will not
obtain otherwise except through herbs, which are basically salad greens anyway.

One thing we know that is near universally present in disease is a poor oxidation and
inflammation status. While it is true that vitamins can act as antioxidants and some vitamins may help
with inflammation, it is actually the other phytonutrients that are better suited for this role – plus a bevy
of other benefits.

Again, we are far from knowing everything, but here’s a few things we do know about a few
common customers. Here is just one vegetable as an example; peppers.

Peppers have a lot of upside – not just as it relates to health markers. They do contain plenty of
antioxidant and potentially anti-inflammatory components, such as carotenoids. There are also
flavanols, like luteolin and quercetin, which can inhibit carbohydrate absorption and adipogenesis. The
phytochemical, chlorogenic acid, is also a carb absorption blocker, may reduce blood pressure, and
improve mood. Of green tea fame, gallic acid has neuroprotective, anti-fungal, and anti-viral effects.
However, my favorite thing about peppers are the capsicum carotenoids and capsaicin. These nutrients
may activate vanilloid receptors to increase metabolic rate, stimulate lipolysis, inhibit PPARγ-related fat
storage, improve androgen receptor sensitivity, and increase muscle protein synthesis.

Peppers are just one vegetable that we can tout. Many have, nay, ALL vegetables have positive
effects on health. By no means whatsoever should their consumption be discouraged.

Notice that “inhibits carbohydrate absorption” was mentioned twice when talking about
peppers. This is one of those weird things that, when you think about it, support ketogenic diets as a
whole. We evolved to sense things like chlorogenic acid, and the body, in response, limits carbohydrate
absorption when eating one of the only things in our evolutionary past that could contain carbs despite
the carbohydrate concentration in most vegetables being all but absent entirely.

But the old rules push us away from vegetables even though it’s very nearly a zero-sum game in
terms of the carbohydrates. To practice this rule is detrimental to good health, fit physiques, and peak
performance. Do NOT track total carbs.

Complementary new rule is about net carbs

Number 4. No Alcohol.

Before going into detail about anything on this topic, if you have any sort of liver damage or
dysfunction, you should NOT be consuming alcohol at all.

Similar to previous discussions on carbs and protein, we’re loosening up with a little alcohol.
Whenever possible, the old school approach to keto was to eliminate alcohol consumption. If not
possible, or thought to be impossible, participants were allowed very limited quantities of dry red wine.

What are the metabolic consequences of alcohol consumption?

None are particularly great. Alcohol is processed like a poison, which it is. That means it gets
metabolic priority, and some factors of regular metabolism are put on the back burner, including fat and
ketone metabolism.

Ketones are produced when we’re processing more fat than we can completely metabolize. Fats
will first go through a series of beta oxidation before they can be turned into utilizable energy as ATP.
Beta oxidation “trims” off bits of fat (2 carbons), so the bits may then enter the Krebs cycle, during
which ATP is made. If there are too many bits to “fit through the doors” of the Krebs cycle, the bits turn
into ketones and float out into the blood and urine instead.

This makes alcohol & keto a difficult topic to discuss. Long-term, consistent alcohol consumption
(and abuse) eventually damages the liver (primary site of nutrient metabolism) and can increase ketones
as a result because the secondary part of fat metabolism is not functioning properly. This is NOT a good
kind of ketosis, nor is it nutritional ketosis.

In the short term, alcohol may increase or decrease ketones depending on which point in fat
metabolism is slowed down. For some, beta-oxidation will be slowed, and for others, entry to the Krebs
cycle may be slowed. This may decrease or increase blood ketones, respectively.

Either way, this really doesn’t matter. If I may channel my inner Tyler Durden (as if there is any
other kind!), “You are not your fvcking ketones!”
 I don’t want to say that ketones don’t matter, they do. However, if you’re so obsessed with
always maintaining some specific level of ketones, you can stop. You should stop, and in case you have
not noticed, every rule so far has been suggesting as much.

The benefit of a ketogenic diet is re-teaching your metabolism how to use fat. I say re-teach
here because, as infants, toddlers, and children, we’re very good at metabolizing fat. However, through
years and years of conditioning the metabolism, we become carbohydrate dependent. We forget how to
metabolize fat.

Therefore, if you have successfully achieved ketosis and maintained that lifestyle for even just a
month or two, having a drink (or extra protein/carbs) will not make your body instantly forget how to
metabolize fat even though alcohol does make us dumb and forgetful. Worst case scenario, you get
blackout drunk, eat a bunch of pizza, then get back into ketosis while you’re sick and starving the next
day.

On that note, I must give you a preview of the new rule pertaining to alcohol. Rather, what it is
NOT.

It is not the “drink alcohol all the time with no consequences” rule. It is simply a softening of the
“never” or “as little as possible” notion that currently exists. If you have no desire to drink, that’s
perfect. There are some mild benefits from an occasional beverage related to stress reduction, but by no
means is it so dramatic that you should be drinking. It’s just that the old rule of complete, or near
complete, abstinence is not warranted.

new rule – ketogenic lifestyle, moderation, if desired

Number 5. You Should be Fasting or Fat-Fasting Regularly

This one is not often positioned as a rule, but it is too often interpreted as one.

Fasting, and keto seem to go hand-in-hand so much that on several occasions after discussing
with someone about them trying low-carb or keto, I am asked, “how often do I have to fast?”

You never need to fast. You never need to fat-fast. These are simply tools that help increase
ketone concentrations. You can use them. There is nothing wrong with the techniques, but it is not
necessary to do either of these things at all.

From a methodological standpoint, fasting is the simplest method of weight loss. It may not be
easy, but you literally do nothing – there’s no planning or meal scheduling, and it can actually be
somewhat liberating. It can also be a tool for helping heal relationships with food and cut cravings. This
makes it an attractive option for those that think they can handle, or are willing to endure, the
counterintuitive nature of fasting.

However, it is not without drawbacks. One of the most important new rules of keto is to eat
more protein. If you’re fasting, you’re not going to be eating much protein. At the very least it will be
difficult to obtain all the protein that is needed in a day if, for example, following a time-restricted
feeding pattern that allows a 4-hour feeding window.

If fasting chronically, just as would happen with a calorie-restricted diet, metabolism will slow
down and stall long term weight and fat loss. Fasting intentionally and very effectively reduces energy
availability, which is the leading reason that it can be effective for weight loss. However, low energy
availability reduces exercise capacity, thereby reducing the physiological adaptations to exercise (aka,
gainz) and potentially reducing muscle mass.

Unless you’re already “bodybuilding big,” it’s a bad idea to lose muscle mass. Yes, I acknowledge
that I am an intelligent meathead, and although every fiber of my being is against losing muscle for
vanity and performance reasons, that’s not the root cause of the prior statement.

As we age, we’re going to lose muscle mass. As early as 40, age-related muscle loss (sarcopenia)
may begin. It may not be noticeable at first, but unless action is taken, it is likely occurring. Muscle mass
and strength are strong predictors of mortality in elderly persons. Having more muscle and strength
helps with balance, reducing risk of falls, increases functionality, improving independence and reducing
depression, and has a host of other benefits that extend far beyond looking good or supporting an ego.

Fasting is a tool that need be used deliberately, appropriately, and with caution. The correct way
to fast, and when to do it, is new rule #5, which we will discuss later.

corresponding new rule = when to fast and how

1 Rule to Rule Them All

There is one rule – one very important rule – that does not change. Anybody who is new to the
ketogenic diet absolutely must be committed to doing at least 4 weeks strict, by-the-book, keto. No
fancy rules, no leniency, no bullshit.

The adaptation phase is critical. It usually sucks, and it should be fought through so that it may
end as fast as possible. There is much to discuss on this topic.

First, the adaptation phase is often called “keto flu.” I HATE the phrase. It’s wrong. There’s no
other way to say it, it’s just the completely wrong term to use for the symptoms:

 headaches
 lethargy
 weakness
 brain fog
 fatigue
 irritability
 nausea
 cravings
 cramps

Do you know what these symptoms really are? They are withdrawal symptoms! The phrasing,
“keto flu,” places the blame on a ketogenic diet, but keto has nothing whatsoever to do with producing
the symptoms. They are 100% rooted in carbohydrate dependence. People eat carbohydrates constantly
throughout each and every day for probably decades before they get on a ketogenic diet, and it creates
a legitimate physical dependence on sugar and carbohydrates. When carbs suddenly vanish from the
diet, the body doesn’t know what to do – it goes through withdrawals.
 Carbohydrate withdrawal severity is related to a few factors that I’ve noticed during the process
of getting hundreds of newcomers situated with a ketogenic approach. Here they are:

1. Prior Experience

This is the most impactful influencer that I’ve noticed. If someone has done low-carb or keto in
the past, adapting (or re-adapting) is easier. The severity of symptoms increases directly with the time
between low-carb experiences. In other words, the more time spent eating an abundance of carbs, the
harder it is to reduce the amount of carbs in the diet without symptoms.

A lot of the time, when working with athletes, especially physique athletes or fitness models,
they have some prior low-carb experience. The standard practice for weight and fat loss in bodybuilding
is to cut carbs, and it has been for decades. Sometimes it’s common of female athletes, regardless of
sport, to unhealthily restrict carbs – usually all foods – for purposes related to physical appearance or
demands of sport. Each of these groups tend to experience few to no symptoms of carbohydrate
withdrawal, and if symptoms to present, they are usually mild.

As personal experimentation, I’ve come out of ketosis for a few hours. I’ve also come out for a
few weeks, as well as everything in between. If I’m out for anywhere up to 2-3 days, such as on a short
vacation, I don’t get any symptoms when re-adapting. Unless, those 2-3 days were spent binging or
really committing to taking some time off and indulging. I did that one time and decided it was not
worth it to do it again. Having a single “cheat meal” with carbs does nothing as far as symptoms, and
even having 2 consecutive days of refeeding with ~300-400g “good” carbs daily doesn’t produce adverse
effects. Longer durations, though…

It took me about two weeks to write my entire dissertation. During that time, I literally did
nothing else other than what was biologically essential. For 12 days straight, I woke up, made coffee,
and started writing until the day ended. For the first week, I ate through all the keto-friendly foods I had
in the house. The final 5-6 days? All pizza all the time. That was a 2-day headache.

One of the years after my undergrad, I went back to my hometown for 2 weeks. It wasn’t all bad
all the time like that pizza binge, but I was subjected to plenty of ma’s home cooking and, of course, had
to hit up all the good local food spots. There were some intermittent headaches between when I could
behave and when I did not, as well as another 2-day headache after getting back to normal.

Experiences are individual, so while I only get headaches, another may only get irritable or brain
fog or a combination.

2. Age

Directly related to prior experience is age. Usually, older people have been carbohydrate
dependent longer than younger people. More often than not, young people (early 20’s) do not
experience any symptoms. Those that do, it seems to be a single day of headache or irritability, but
nothing that’s very noticeable or lasts very long. On the other hand, those in their fifties or older almost
always experience some sort of withdrawal symptoms, usually for longer (several days – even extending
past an entire week), and with greater severity.

While doing my PhD, I managed to convince my major professor (a classically-trained RD) who
was approaching retirement to try a keto diet. She taught one of my classes that semester. During one
class about 4 days after starting, she had the brain fog bad enough to dismiss us early. I came to find out
she was sneaking some fruits, but we fixed that and she was more comfortable the following week.

3. Activity

We like exercise. Both prior exercise experience AND exercise during adaptation can augment
the adaptation process. Having some “pre-conditioning” to using fats as fuel will come with any sort of
exercise, but it’s more pronounced in some types of athletes than others.

Those with a background in endurance sports come partially “pre-adapted.” Longer distance
endurance athletes get really good at utilizing fats as part of their adaptations to their sport. Here’s an
example.

A “crossover test” is an aerobic exercise test that progressively increases exercise intensity
(running speed, in this case) while taking intermittent measures of metabolism to see when athletes
shift from fat (used during lower intensity exercise – the “fat burning” zone) to carbs (used during higher
intensity exercise – such as sprints). An elite ultrarunner may only “cross over” at very, very high
intensities. Some athletes I’ve tested previously have completely maxxed out the speed on our treadmill
(22 mph) before they even start to nudge their metabolism towards carbs – well above 90% of their
maximum running speed. However, non-athletes or power athletes will cross over at much lower
intensities, such as during a comfortable jog.

This should not be all that surprising, though. If we associate good health with being
metabolically capable of disposing fats (using them as fuel), we will suffer less – or not at all – during
carbohydrate withdrawals because we’re already adapted. This is achieved with crazy long running and
ketogenic diets. However, if we’ve already suffered through endurance adaptations, suffering through
keto adaptation is minimized or already achieved – remember that exercise will increase ketones by
itself.

During the adaptation phase, exercise helps in other ways. If you’re already “pre-adapted,” then
great. Most of us, however, are not. Even if we may not have any growing pains from being young or
having prior experience, the metabolism must still make a few changes.

Performing the correct types of exercise will speed the process along.

We already are coming to terms with retitling “keto flu” to carbohydrate withdrawals. What do
we do with other types of addictions? We flush the system.

How do we flush carbs out? We train.

Two of my greatest friends, Dr. Wilson and Dr. Lowery, tested a great theory about “keto flu.”
They compared the effects of steady state cardio and interval training on the rate of keto adaptation.
They found that both forms of exercise facilitated adaptation, but interval training was more effective Commented [jj22]: dbl check
than standard cardio. Why?

Likely, this is due to high intensity exercise burning up all the available glucose, yet steady state
exercise was busy burning primarily fat. It may sound counterintuitive – burning fat during exercise
should train us to metabolize fat, right? Well, yes, it will. However, if we speed glucose depletion, we
force the body to adapt faster.
 There is a total amount of “suck” that one will experience during withdrawals. It may be
nothing, or it may be pure hell. One thing is for sure, though, you’re going to feel the totality of it. The
“suck” can pass quickly or it can linger – the type of exercise performed will help push things down one
path or another.

As a reverse scenario, supplying “accidental” carbs during adaptation extends and worsens
withdrawals. Remember my major professor? Part of the reason it sucked so much for her was because
of the occasional fruit. Incorporating some fruit strategically AFTER adaptation is ok, but definitely NOT
during adaptation.

Having any significant amount of carbs will prevent the body from learning – like if you’re
teaching a 1st grader some basic computation, but instead of letting him/her work through the problems
themselves, you just give them the answers. They don’t learn that way, and the body doesn’t fat adapt
in the presence of carbs.

What’s worse, if you just have a few carbs, you’re providing just enough that the body tries to
cling to its old ways without even alleviating any of the withdrawal symptoms. You just get stuck in
limbo – keto purgatory. Of course, if you have a lot of carbs prior to adaptation, you alleviate the
symptoms, but you also go back to adaptation square 1.

The lesson here is to keep one rule, one of the most important rules, the same. You MUST adapt
before you can become more flexible with your diet and following the new rules. Think of it as a test. If
you can pass for the first 4 weeks (minimum), you are worthy of practicing the new rules.

How long before you may adopt the new rules? Here’s a rule of thumb. If you are completely
symptom free after the first five days of adapting (and have actually been adapting – no cheating!), you
get the green light for the new rules after 4 weeks. However, if you are not symptom free after the first
5 days, I strongly recommend you extend the adaptation period to ensure you won’t regress to keto
purgatory.

For every 2 days following the first 5 days that you experience symptoms, extend your
adaptation period for 1 week.

 Symptom free after 7 days – adaptation phase = 5 weeks.

 Symptom free after 9 days – adaptation phase = 6 weeks.
 Symptom free after 11 days – adaptation phase = 7 weeks.
 Symptom free after 13 days – adaptation phase = 8 weeks.
 Symptom free after 15 days – adaptation phase = 9 weeks.
 Symptom free after 17 days – adaptation phase = 10 weeks.
 Symptom free after 19 days – adaptation phase = 11 weeks.
 Symptom free after 21 days – adaptation phase = 12 weeks.

Now, let’s get on to the good stuff!

The New Rules of Keto

You have to know where you’ve been before you can move forward. The old rules are not Commented [jj23]: check quote
appropriate for most of us who are using low-carb or keto diets for wellness or fitness – especially
fitness. The old rules were born from disease states, and use for the treatment of disease is how the old
rules should be applied – not for those already well or with important body composition and/or athletic
goals.

Protein and carbohydrate are absolutely vital to the development of favorable body
composition and athletic performance, respectively. Of course, we already know that each has the
propensity to “kick one out of keto.” How do we balance our non-fat nutrient intake without issue?

This is a major focus of the new rules of keto. The overarching concepts surround learning how Commented [jj24]: can we upload all of this text to a
to use nutrients to our advantage and without fear or apprehension. Learn to be deliberate and act with page but redirect the page to another website page, say the
email signup page, so we can get keywords without giving it
intention in this regard. In fact, be intentional with all of your actions, not just as they pertain to dietary
away totally free?
decisions.

Now, time for some CARBS!

Number 1. Carbohydrates are Activity Dependent

I’ve worked in the nutritional supplement industry for a long time and for some big-name
companies either as a full-time employee, a business consultant, or a contracted scientist. Like the YEAR
Boston Celtics, there is a “Big 3” in the supplement science world. Conveniently – and just like the Celtics
– they all start with the letter “C” – caffeine, creatine, and carbohydrates!

Except in those with a genetic polymorphism for slow caffeine metabolism, each of the Big 3 C
supplements are THOROUGHLY supported by research. We’re talking about thousands of studies here.
Let me be very clear. Carbohydrates are NOT essential nutrients in human nutrition. Neither are caffeine
or creatine. However, each are very potent ergogenic supplements in the diet.

Carbohydrates are supplemental to the diet, and as reviewed in previous chapters, this is one
big reason why we have such high prevalence of preventable disease – we’ve mistaken a nutritional
supplement for the “foundation of human nutrition,” as is stated in at least several textbooks used to
educate undergraduate nutrition majors.

If you’re thinking, “but carbs are in my food…” know this. It’s very likely that ALL of your
supplements are found in at least one food or another. With few exceptions, the FDA does not permit
any non-natural supplements, which means that everything must be found in nature.

Herbal supplements are edible plants, like ginger or turmeric (curcumin); amino acids and
creatine can be fermented from plant sources or isolated from animal products; and caffeine comes
from coffee beans, as we all may know.

The only difference is we don’t need to consume these things; they are not essential (apart from
those that are, such as the essential amino acids, which we obtain via protein consumption). Hence,
they are classified as supplements no matter how much we believe we need caffeine to survive.
Carbohydrates may be treated the same way.

Carbs are effective ergogenic aids due to their exclusive role in anaerobic metabolism.
Anaerobic metabolism (and, thus, carbs) is the ONLY way we can fuel high intensity exercise, which
involves lifting, sprinting, or any other activity that generates lactic acid. Conveniently, via our evolution,
we’ve developed our own biological machinery to manufacture just as many carbs as our bodies need to
survive.

Note the common theme throughout the text – there is an emphasis on language. Taking my
own advice to be intentional, word choice is deliberate. Our bodies will produce enough carbs to
survive. Not to thrive.

Carbohydrates are absolutely, 100% required for anaerobic metabolism – not MCT, ketones,
aminos, or anything else. There is no way around this, and the body will not produce enough for the
body to thrive during athletic events. A “pure” ketogenic athlete may very well perform adequately and
finish the race, for example. However, unless this is an ultramarathon, it’s probable that the ketogenic
athlete will not win that race. Even if it is an ultramarathon that the ketogenic athlete might win,
introducing some carbohydrate before or during the event only stands to help the athlete finish faster.
And it is a race after all!

So, why not eat carbs? Because of some stupid, weird rule that if you’re keto, you’re not
“allowed” to eat any carbs, effectively limiting maximal performance? That’s foolish. Carbohydrate
abstinence is arbitrary during athletic events.

This extends to training as well. In a time-restricted carbohydrate feeding model (note: not
totally fasted, just refraining from carbs), which consisted of carbohydrate consumption only prior to
anaerobic training, performance and body composition gains are enhanced compared to control diets
(cite burke). Commented [jj25]: ref

This is the “train low” strategy, which involves aerobic training without prior consumption of
carbs to enhance fat oxidation (fat burning). I encourage you to continue “training low” when
performing low to moderate intensity exercise (as a ketoer, you would anyway). However, during high-
intensity exercise (a race pace run, any weight lifting scheme producing lactic acid or pumps (e.g. more
than 5 reps and/or for max effort training), or interval training), you should begin including some carbs.

If you don’t exercise, you should start exercising!

The next question we’ll answer is a bit more complicated than “to do or not to do.” How many
carbs? Well, that all depends.

Mostly (almost entirely), it depends on how many will be utilized during exercise, which means
it depends on training intensity and training volume. If your exercise intensity is not high enough, you
won’t have a metabolic shift from fat (aerobic metabolism) to carbs (anaerobic metabolism). If you’re
not training for very long, you may not require any additional calories at all.

Conversely, exercising at higher intensities, and especially exercising at higher intensities for a
long time, may require a great quantity of carbs. Remember, this could be several hundred grams under
the right conditions.

In other words, if you’re soft and wimpy, you don’t deserve a cookie. If you train like you mean
it, you do deserve a cookie! Maybe 2 cookies… And the best part is your body will THANK you for it!
 I know, I know – you’re low-carb/keto for the fat loss benefits. Remember, the aforementioned
study did not just find a benefit to endurance performance. They also found that this strategy improved
body composition, including fat loss!

It is true, they compared this to an equal amount of carbs normally distributed throughout the
day, so let’s look at another.

As has been alluded to a couple of times now, I’ve researched this myself (along with my team,
of course). Let’s start with a more pressing question, “will adding carbs pre-exercise reduce the fat loss
effects of my keto diet?” before giving the “how much” answer.

Nope! In our work, the strict keto group and the targeted keto group (group eating carbs, but
maintaining ketosis – monitored by blood BHB concentrations) lost about the same amount of weight. In
fact, adding the 20g of carbs pre-exercise helped them lose about 1.2% more fat mass for a total loss of
3.0 kilograms of pure fat vs. just 2.7 kilograms in the strict keto group. For reference, the carbohydrate
diet control groups (one supplementing 20g carbs pre-exercise as well, one not) lost an average of just
1.5 kilograms of fat.

Keep in mind that this study was only 9 weeks long, so that’s 1kg of fat loss every 3 weeks, and
every participant was active, aged 18-30 years old, and already fit. They didn’t have a lot of body fat to
lose, but they still made pretty incredible progress losing almost a pound of fat every week.

How could this be the case? If restricting carbs helps with fat loss, why would having more
(about 150% more!) help facilitate fat loss?

Probably more important for changing body composition than diet is training. Even if it is not -
and it’s near impossible to definitively say one way or another - training is the only other factor that
could even compete with diet as the #1 influencer of body composition. You have to train pretty hard to
look like you train pretty hard. Let’s look at how hard the two groups were able to train.

First, the targeted keto group improved their 5km run time by over 10%. All of the three other
groups only improved by ~7%. More importantly, the strict keto group had an immediate decrease in
their ability to generate power – how hard they could “push.” As good as every other group got, the
strict keto group got that much worse. Literally, they changed 100% as much as the three other groups,
but in the opposite direction.

This is no isolated incident – many studies have reported nearly identical results. The strict keto
group changes by about -25 watts while the other group increases by about 25 watts. In our first study,
Dr. Wilson, Lowery, and myself added carbs back into the keto participants’ diets after post-testing.
BOOM, power suddenly returns – all of their gains were realized.

When keto athletes supplement with 20g of carbs pre workout, they never lose it in the first
place. They improved by 34 watts, compared to an increase of 25 watts with the carbohydrate diet and
an increase of 30 watts with the carbohydrate diet + 20g pre-exercise carbs.

If you’re thinking, “oh, well, those carbs must have at least negatively affected their health!” I
don’t blame you, but you’d be wrong. I remind you again, all participants were already healthy, so these
improvements are just a nice bonus to the body composition and performance boosts.
 The strict keto group had a 4% decrease in blood glucose. The targeted keto group had a 6.5%
decrease.

The strict keto group had an 8% increase in HDL good cholesterol. The targeted keto group had a
28% increase.

The strict keto group had a 20% decrease in triglycerides. The targeted keto group had a 22%
decrease.

The trend continues for just about every marker, and we measured 26 health-related variables.

Now, all participants had 20g of supplemental, pre-exercise carbs. How did we determine that
amount?

Well, we tested the “carbohydrate threshold” of the exercise program in a group of keto
participants. 100% of participants, even if they screwed up their keto diet, maintained ketosis with 20g
of supplemental carbs. We chose 20g because we determined there was 0 room for error, which is
important for research.

In practice, this can change, and 20g is probably a minimum tolerable quantity for most exercise
programs. If you recall from earlier in the text, we may go up to 100 or 200 grams of carbohydrate for
optimal performance. This may risk “knocking” someone “out of” ketosis, but this is absolutely a
temporary state.

The best way to figure out your own carbohydrate threshold is to test yourself. A blood ketone
meter will be much better than urine for this purpose. Start by getting a baseline – take it right before
exercise but prior to taking any pre workout or carbs. Do NOT eat a high-fat meal right before
measuring, and do NOT use any MCT right before either. This can “falsely” raise ketones, and you want a
repeatable baseline measure.

Then take some supplemental carbs, and go workout. Keep track of your workout, so you have
an idea of volume and intensity, then measure ketones again ~3 hours after training and again before
bed. Repeat with different quantities of carbohydrate prior to the SAME workout to get a feel for your
own carbohydrate threshold, and remember that your total daily (net) carb intake will influence state of
ketosis as well.

Or, if you want it more spelled out, here are some guesstimates.

For endurance activities, first identify the intensity of the session. If this will be a high-intensity
effort (> 75% VO2Max or heart rate reserve, replace 85-100% of the energy that will be used during the
session as carbohydrates before and/or during (if longer than 1 hour) the session. If the intensity will be
below that threshold, but would accurately be described as moderate (e.g., ~60 - 74.9% VO2Max or
HRR), replace 25-50% of the energy that will be used during the session as carbs before and/or during
the session.

Estimate 110 Calories burned per mile running or 50 Calories per mile cycling. Below 60%, there
is no need to replace. If you are performing a cardiovascular activity for fat loss, only replace if it is a
high-intensity session, as it is the performance during the activity that will drive fat loss versus the mere
act of performing the exercise, as is the case with moderate to low intensity activity.
 For weight training, a lot depends on the body size and muscles being trained. There will be a
little more guesswork than with endurance training. If you don’t really like math, just do this:

 Arm workout only = 0.1g carbs pre workout per pound body weight
 Chest or Back workout only = 0.2g carbs pre workout per pound body weight
 Legs (and you sorta train – you know who you are) = 0.35g carbs pre workout per pound
body weight
 Legs (and you mean it) = 0.5g carbs split between pre and during workout per pound
body weight

If you perform in excess of 150 reps for a single body part in a single session, add 0.05 g per
pound for arms, 0.075g per pound for torso, and 0.1 g per pound for legs. If you train a single muscle
group twice per week, get an extra 0.05 g per pound before the 2nd weekly upper body session and/or
an extra 0.075g per pound before the 2nd weekly lower body session.

If you do like math…

Typical resistance training sessions will only deplete muscle glycogen by 20-40%. If you’re doing
less than 20 sets per muscle group in a single session, this is you – leave your ego with your amigo.

~1.5% of your muscle weight is glycogen, so if you’re 200 lbs and 10% fat, you have about 173
lbs of muscle (minus an estimated 7 lbs for bone) with 2.6 lbs of glycogen (1.5% of 173), which is 1.18 kg
(divide by 2.2), yielding 1,180 grams of glycogen or 4,700 calories. If you are able to deplete 30%, that’s
354 grams.

Before you get too excited, that would be for your entire body. So unless you go in and do 15
sets for every muscle group on the same day (not recommended), you’re not getting that many carbs
back in your diet! Since you probably do some type of body part split, consider that for women, ~60% of
muscle is in the lower body, and for men, ~55% is in the lower body (unless you’ve been an
upperbodybuilder for a few years – in which case, adjust accordingly).

From there, we kind of just have to guess. Let’s estimate that of the remaining 40-45%, ~5-10%
is in the arms, ~20-25% in the back (all of it – lats, spinal erectors, traps, etc.), and ~15-20% is in the
front (all of it – chest, abs, and include delts). Also, because unlike endurance folks, there are multiple
days between sessions with like muscle groups, it’s not a 1:1 replacement. It’s closer to about 50-60%,
as some glycogen will just be replaced over time. Let’s break it down using the same 200lbs and 10% fat
example with 50% replacement for slightly easier math:

 Leg day – 1,180g glycogen in the body * 0.55 (55% in legs) * 0.3 (30% depleted) * 0.5
(replace half) = 97 grams “extra” carbs
 Chest + Delts day – same math with a % in chest of 0.175 = 31 grams “extra” carbs
 Back day – same math with a % in back of 0.225 = 40 grams “extra” carbs
 Arm day – same math with a % in arms of 0.05 = 10 grams “extra” carbs
 Except for the day-by-day carb adjustments, the diet remains relatively constant, but make sure
your calories are adjusted according to your goal. Again, there is a lot of guesswork, generalization, and
estimation for these, so you may have some individual differences. If you’re doing 300 reps of a single
body part, you’re going to be above 30% depletion and can tolerate/will use more carbs – increase
proportional to the activity and size of the muscle. Thus, make individual adjustments to make sure your
performance is intact and able to improve long term, but also listen to your body and make sure you’re
not going overboard. The idea is to eat just enough, maybe a smidge more or a smidge less depending
on your goals.

And always remember…

You are not your fvcking ketones! Just because blood ketone concentration decreases below the
pre-defined level does NOT mean you have lost the ability to quickly slip right back into ketosis. You
don’t need to come out of ketosis to perform optimally, but you definitely need some carbs (unless
you’re an ultra-endurance or triathlete) if you’re training even moderately hard, which you should be for
optimal results.

The following is what I, Jordan, a powerlifter and your beloved author, ate and how I trained
over the previous ~8 weeks with an upcoming meet still increasing or at least maintaining body weight
(212 lbs). All carbs are net carbs (as we will discuss later), and protein is 241g daily (2.5g/kg because why
not):

 Monday – Heavy Squat & Deadlift Assistance – 3800 Cals, 261g fat, 122g carbs (54g
pre+during as Oreos, milk, and Keto Karb – also a big salad with 21g net prior to that)
 Tuesday – Cardio + Abs (my basic white girl day) – 3200 Cals, 217g fat, 70g carbs (0g
pre, but 20g from carrots & hummus after my post-workout whey protein)
 Wednesday – Off – 3050 Cals, 205g fat, 60g carbs
 Thursday – Bench – 3450 Cals, 238g fat, 85g carbs (31g as Oreos and milk pre – also a
big salad with 40g net prior to that. Mmmm BBQ Ranch.)
 Friday – Heavy Deadlift & Squat Assistance – 3800 Cals, 261g fat, 122g carbs (same as
Monday)
 Saturday – Dynamic Effort & Shoulder Press – 3450 Cals, 238g fat, 85g carbs (same as
Thursday)
 Sunday – Off – 3050 Cals, 60g carbs, 205g fat (Actually, right now, I keep track of just
calories and protein on Sundays, but when I start tightening up the reins to make
weight, this will be implemented)

This yields a weekly diet with averages of 29% protein, 10% carb, and 62% fat. I can personally
attest that every morning which I’ve tested my blood BHB (which is twice in 2 months, because,
remember, it’s not THAT important), I’ve been equal to or greater than 0.4 mmol/L. My training is going
as I’ve expected, which means my bodyweight has increased and my lifts have (pretty substantially)
improved, and I’m on pace to PR in every lift at the meet and probably set a few state records.

Am I in ketosis right after I smash some milk and cookies? Hell no. Am I in ketosis a few hours
later? Sure am. Am I fat? Nope. Am I sick? Only my gainz are sick.

Number 2. Eat More Protein

 In next section on the new rule interpretation focus on benefits of protein for exercise & BC

With a ketogenic diet, protein is allowed, but it is not really emphasized. In some cases, protein
is restricted if a high degree of ketosis is required – such as for the treatment of epilepsy. Under typical
ketogenic parameters, protein is prescribed at 15-25% of calories.

There are two major reasons why this is not an optimal guideline for this macronutrient. First,
most of us are not using a ketogenic diet for the treatment of disease, but we are using it to improve our
body composition and/or performance – 2 things a “normal” ketogenic diet is not designed to do.
Second, protein is best prescribed on a grams per unit body weight basis.

Even the RDA (recommended dietary allowance) is a grams per kilogram measure, specifically
0.8 grams per kilogram. However, new methods of determining protein needs suspect that 0.8 is a
significantly underestimated number. As the RDA represents the minimum need for people to remain
healthy, this is a very significant finding. The new method suggests the RDA is closer to 1.2 g/kg, so it is
my recommendation for diets to never be below 1.2 g/kg.

In general, a range of 1.5 – 2.2 grams of protein per kilogram body weight (0.7 – 1 gram per
pound) will be the best combination of practicality and what is optimal to build muscle, improve
exercise recovery, and, yes, even lose body fat.

Consuming less than 1.5 g/kg may slow progress, and obtaining over 2.2 g/kg may be difficult to
do on a daily basis. Nonetheless, one of the most interesting things about protein, a calorie-containing
nutrient, is that consuming boatloads of it will NOT have a negative impact on body composition. If
anything, it may help with fat loss and gaining muscle.

Studies looking at 3.0 – 4.4 g/kg and up to 700 extra calories per week have found no increase in
body fat mass. In fact, the participants consuming 4.4 g/kg experienced a 1.9 kg increase in muscle while
losing 0.2 kg of fat mass without changing their workout routine.

These types of changes are meaningful even when comparing two different high protein diets.
In weight training participants, 3.4 g/kg appears to outperform 2.3 g/kg. Both groups had the same
increase in muscle, but those consuming more protein lost significantly more body fat. The 2.3 g/kg
group lost 0.3 kg, and the 3.4 g/kg group lost 1.6 kg of fat mass. This prevented an increase in total body
weight despite consuming more calories.

Even for those who are not training, more protein promotes a more favorable body
composition. Consuming more protein while in a negative calorie balance retains more muscle while
simultaneously promoting more fat loss, and in older adults, diets with greater protein preserves muscle
mass, function, and happiness.

The aforementioned novel techniques that determine protein needs have suggested that
sedentary elderly individuals may need as much protein per day as young bodybuilders (1.7-2.2 g/kg)
just to maintain.

“But won’t eating that much protein knock me out of ketosis?!”

No, it most likely will not. It may reduce total ketone concentrations, but you will still be
ketogenic by definition. This is of little consequence, as the benefits of ketones are observed even when
they are present at “low normal” concentrations (e.g., 0.3 – 1.0 mmol/L). One exception may be the
neurocognitive, “keto-clarity” benefits some report with greatly increased ketone concentrations.
However, such concentrations only occur with fasting or supplementation.

Protein has the possibility to be converted to glucose, but it won’t do so unless the body thinks
it is absolutely necessary. It is only necessary for ~30-50g of glucose to be obtained (by any means) per
day to fuel obligate anaerobic cells.

All proteins are made up of numerous amino acids, and therefore, amino acids are often
referred to as the “building blocks” of protein. Each amino acid, there are 20 relevant to human
nutrition, may be glucogenic, ketogenic, or both based on its structure. Despite the name, this has very
little to do with how the protein or amino acid will influence the state of ketosis.

Just because an amino acid is ketogenic, doesn’t automatically mean it will increase ketones,
and the same applies for glucogenic amino acids. This only means that they can be converted. They only
are converted if the body needs to harvest protein for energy, which it doesn’t want to do under normal
conditions, so this only occurs when in a calorie deficit.

Most amino acids are only glucogenic, but 5 can be both, and 2 are only ketogenic. One of those
2 is regarded as the “most important” amino acid – leucine.

There is nothing functionally special about that fact, but it is one of my favorites. Leucine is the
nutritional signal to “turn on” muscle protein synthesis (MPS) – the process responsible for muscle
recovery and growth.

About 2.5g of leucine is minimally required to stimulate MPS, but 0.05g per kilogram is required
for maximal MPS activation. Although leucine is the signal, all amino acids are required to physically
form the proteins.

When a sufficient quantity of leucine is ingested, the MPS signal is increased for about 3 hours.
After 3 hours, MPS declines. Thus, for optimal muscle and strength gains, high-protein meals should be
consumed every 3-4 hours. Spacing meals out to 4-5 per day may also help with adherence overall – a
topic for later.

The leucine quantity of different protein sources vary, but whey has the most at ~9-12%,
followed by other animal sources (~7-9%) then plant sources (~4-7%).

Each of these last few, finer points are presented just to represent the different levels you may
explore in meeting your protein needs. First, you should meet your total daily requirements. Second,
consider spacing your protein in equally sized portions over 4-5 meals per day.

Do not hesitate to increase your protein! It is absolutely critical for optimizing your body!

Number 3. Track Net Carbs

Complementary new rule is about net carbs

More carbs, more protein, and … more carbs? AGAIN?!

I promise I am not trying to trick you into falling out of ketosis! I just want you to eat more
vegetables. Low-carb veggies!
 When following a ketogenic diet, it becomes very easy to “forget” to eat vegetables. They’re not
normally delicious, they lack the all-important fat and protein, and the most abundant nutrient is
carbohydrate – sounds like a recipe for a keto disaster!

The greatest disaster, however, would be not eating vegetables! They’re packed with tons of
phytonutrients and fiber, and just about every scientific study in existence is in favor of vegetable
consumption. But they’re mostly carbs. How can we reconcile? More importantly, how can we make
them taste good?! I’m here to tell you everything you need to know about vegetables, fiber, and net
carbs.

Even within the scientific literature on ketogenic diets, the dietary guidelines are pushing low
total carbohydrate consumption, but there is literally no reason whatsoever to avoid low-carbohydrate
vegetables. First, let’s talk about a few of the benefits of fiber.

When research talks about a “high fiber diet,” researchers are usually using fiber as a marker of
diet quality. More specifically, it’s the researchers answer to, “are the study participants eating enough
vegetables, fruits, and whole grains?” Obviously, we don’t care so much about the fruit (avocados and
coconuts are fruits, by the way!) and not at all about the whole grains. But we should care about our
actual fiber and vegetable intake.

Fiber in and of itself, even supplemented fiber, improves cholesterol levels, reduces blood
glucose and insulin concentrations, reduces glycation, and enhances satiety. How does fiber do all these
wonderful things?

Fiber decreases total glucose absorption. At least by 10%. This is in the face of high carbohydrate Commented [jj26]: https://www.ncbi.nlm.nih.gov/pubme
consumption. It is likely an even greater percentage if your net carb intake (non-fiber, non-sugar alcohol, d/12209371
non-allulose) is low.

As a quick aside, remember that net carbs are total carbs minus sugar alcohol, fiber, and
allulose. If the sugar alcohol is not erythritol, I recommend only subtracting 50%, as that is about how
much will actually be absorbed as glucose. Xylitol and maltitol, for example, can increase blood glucose
because about 50% of the compound is utilized by the body, but with eryrthritol, 90% is excreted in the
urine.

Here’s an example of how fiber impacts glucose absorption. If a person eats a meal containing
10g of fiber and 100g of net carbs (110g total carb), it’s really only as though they are eating 90g of
carbs. That doesn’t sound like much, but fiber doesn’t know that it only represents ~10% of the total
carbohydrate load. This offers huge dividends to low-carb and ketogenic dieters.

Each gram of fiber consumed can reduce a fixed amount, not a percentage, of glucose. So if 10g
of fiber can bind, let’s say, 10g of available glucose, and prevent it from being absorbed into the body,
just about every meal a ketogenic dieter consumes has virtually eliminated the possibility that the meal
will affect their blood glucose (or ketone!) levels, as meals will not contain a great deal more net carbs
than they will fiber IF YOU EAT YOUR VEGGIES!

For a more literal example, take asparagus – one of the most “popular” vegetables in fitness and
physique sports. 100g of asparagus has 4g total carbs and 2g of fiber, leaving 2g net carbs. Because the
fiber will limit the 2g of net carbs absorbed, there is effectively no carbs.
 There are so few carbs, asparagus doesn’t even qualify for glycemic index testing – the rating
system that estimates how a food will affect your blood glucose. To perform the test, at least 10 people
need to eat 50g of available (net) carbs and have their blood glucose response tracked. Just so happens,
that would be 2,500g of asparagus! Thus, asparagus, and other low-carb vegetables, get slapped with a
rating of 15 on some GI scales.

When I get people started on low-carb or keto, they often ask how many vegetables they are
“allowed” to eat. I tell them to eat as much as they want! And I require they eat at least 3 servings per
day. If they give a little resistance, I challenge them to knock themselves out of ketosis eating “too
many” low-carb vegetables – it’s just not going to happen!

Now, if you want to claim potatoes as vegetables, well that’s a whole other story. A rather long
one too, if you’re hip to the cook and cool method. In which case, you’re well aware of net carbs!
Hopefully the benefits of fiber (and resistant starch) too!

The advantages to including at least modest quantities of vegetables in a low-carb diet are not
limited to fiber. If you’re someone who is interested in supplements, you’re interested in vegetables.
Most supplements come from vegetables, herbs, and other plants. Turmeric, green tea, maca, horny
goat weed, you name it!

The reason we supplement is not because the supplement ingredients are not found in a food
item at all. Vegetables like broccoli have anti-estrogenic compounds, diindolylmethane and indole-3-
carbinol, peppers contain capsaicinoids and capsicum, which improve metabolism, and all vegetables
contain antioxidants.

We supplement because we cannot obtain an efficacious dose, or as efficacious a dose as we’d

like, from foods alone. Eating broccoli or peppers may contribute to healthy hormone balance and
weight loss, but to consistently eat enough on a daily basis is difficult, so we supplement instead.
However, we don’t even know everything that there is to know about what’s found in vegetables – we
just know they’re really good for us!

Coffee is a well-known example of supplements as food. We consume coffee to obtain caffeine

– about 100mg per cup. Take a step back. Coffee comes from beans. How many beans go into one cup
of coffee? It can vary, obviously, according to how coffee is prepared, but let’s say 75 beans. Imagine
eating 75 beans. Now imagine eating 225 beans, the equivalent of 3 cups of coffee. That’s a lot of coffee
beans! But just by passing some hot water through the ground up beans, we have coffee – a water
extract of caffeine and a few other compounds, a supplement. I bet you didn’t know you were a
supplement manufacturer!

Compared to a powdered caffeine supplement, coffee also provides B vitamins, theacrine,

chlorogenic acids, cafestrol, and other helpful components. Thus, while you may be tempted to
supplement fiber, you’d be missing out on all the other helpful antioxidants, phytochemicals, and more
that are in vegetables – just like consuming a pure caffeine supplement vs. coffee causes you to miss out
on the other beneficial compounds. Theacrine, for example, is in coffee, but we only JUST found out
about how good it is for us. Who knows what else could be in our plant foods that’s helping us out!

Consider just the micronutrients. Broccoli has a good deal of vitamin C, but we also need onions
as a source of sulfur, peppers as a source of vitamin A, etc. If we wanted coffee to not just provide
caffeine, but also a sufficient dose of vitamin B6, we’d need to incorporate some other food items.
Hence, we can’t just get by with limited vegetable intake, we need a considerable total intake and good
variety. They key to doing so within a low-carb or ketogenic diet is with net carbs.

- Other benefits of fiber, vegetables contain other nutrients. Athletics

- How to do it

Number 4. Make Your Ketogenic Diet a Ketogenic Lifestyle

new rule – ketogenic lifestyle, moderation, if desired

Number 5. Fast Only When Fasting Facilitates Your Goals

corresponding new rule = when to fast and how