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- Reduce the amount of refined non-fibrous carbohydrates in your diet stabilize your blood sugar and promote ketosis.
- High blood glucose is associated with increased risk of many modern metabolic diseases (eg, diabetes, heart disease, stroke, cancer, Parkinson's and Alzheimer's disease).
- Insulin regulates the release of both glucose and ketones in your bloodstream storage. When you eat insulin goes up. When you do not eat, insulin releases stored energy.
- You become "Resistant to insulin" when your fat cells become full and can no longer stores excess energy effectively.
- When your adipose tissue fills beyond your Personal fat threshold, the excess energy is stored in places always sensitive to insulin (such as liver, pancreas, heart, brain and eyes) and excess energy overflows into your bloodstream as high glucose, triglycerides and ketones.
- Exogenous ketosis occurs when you consume ketone-free or exogenous fat supplements to increase the level of ketone bodies in your blood.
- Endogenous ketosis occurs when you consume less food, as insulin and blood sugar drop and ketone production by your body fat increases.
- Although a low carb or ketogenic diet helps stabilize your blood sugar, the vast majority of the benefits of ketosis occur because of endogenous ketosis.
- Reducing your consumption of processed carbohydrates will help you avoid the nutrient-poor hyperpaisable "junk food" that improves satiety and helps you eat less and thus lose weight sustainably with less effort.
- Reducing your carbohydrate intake to a very low level is not necessarily better, especially if it requires you to significantly increase your dietary fat intake.
- There is nothing magic to have a ketone value in the blood, ketosis or a high fat "ketogenic diet" that will make you lose weight faster.
Diets low in carbohydrates reduce blood sugar
Many people follow a low carbohydrate diet to manage their blood sugar. Foods with less carbohydrate result in a smaller increase in blood glucose.(1) (2) (3) If you have prediabetes or type 2 diabetes, it is a good idea to reduce your carbohydrate intake to drain glucose from your bloodstream.
What are the optimal blood glucose levels?
According to the classical medical definitions:
- "Normal" blood glucose is defined as having HbA1c less than 6.0%,
- "prediabetes" occurs when you have an HbA1c rate of between 6.0 and 6.4%, and
- Type 2 diabetes is diagnosed when you have an HbA1c level equal to or greater than 6.5%.
However, these the classic definitions of "normal" are far from optimal! Your risk of diabetes, stroke, heart disease, cardiovascular disease and cancer increases with HbA1c greater than 5.0%.
By the time you have "prediabetes", the risk of contracting most of the most common Western diseases of aging (such as diabetes, heart disease, stroke and cardiovascular disease) is increased.(4) (5)
If you are interested in continuing optimal rather than what goes on as "Ordinary"Metabolic, the table below presents the suggested goals for HbA1c and blood glucose based on the risk categories of stroke, cardiovascular disease and heart disease presented in the graphs above.
While high glucose levels are bad news (due to glucose toxicity and glycation), high glucose levels are associated with high insulin levels.(6) (seven) (8)
A healthy metabolic person will store excess energy in their fat cells for later use. But over time, you get to the point that your fat reserves can not continue to increase and absorb more energy from your diet. Once you exceed your personal fat threshold, you become "insulin resistant" and you need more and more insulin to store and store energy in your fat cells.
When you become "insulin-resistant", the expansion of your fat cells slows down. Your pancreas can not produce enough insulin to absorb the excess energy from your diet into your fat stores.
Unfortunately, a reduced ability to increase body fat is not as good as sounds. Once your fat cells are full, any excess energy will be redirected to other parts of your body that are still sensitive to insulin (ie your liver, your pancreas, your heart, your brain and other vital organs).
Your pancreas must then work overtime, secreting more and more insulin to retain your stored energy while you use the energy contained in your bloodstream and that food continues to absorb through your mouth.
How to manage your food insulin load
The good news is that you can adjust the insulin load of your diet to help stabilize your blood sugar. Managing your insulin load can be especially helpful if you inject insulin to control your blood sugar because it is almost impossible to combine high doses of high doses of insulin. insulin to large amounts of carbohydrate and dietary protein.
A person with type 1 diabetes can not produce enough insulin to conserve energy in his liver and fat stores. Without exogenous insulin, a person with type 1 diabetes will have their blood sugar and blood ketone levels increase as their stored energy infiltrates their bloodstream.
As shown in the picture of "JL" below, one of the first children with type 1 diabetes to receive insulin, people with type 1 diabetes quickly resume weight with exogenously insulin injections. Exogenous insulin regulates the release of energy stored by your body.
If you inject insulin, you should think about finding the optimal dose of insulin needed to keep blood sugar stable.
- Too much insulin can slow down the release of fat by your body to be used as fuel, your blood sugar will drop and you will feel compelled to eat.
- With too little insulin, you will disintegrate effectively and all your stored energy will be injected into your bloodstream.
Where this insulin-centric vision of diabetes and obesity management falls is that it is not passed on to someone who does not inject insulin.
Your pancreas will not secrete more insulin than it needs to retain your fat while your body uses energy from your mouth.
Your glucose should be burned before your dietary fat or body fat. A low carb diet helps to stabilize your blood sugar. However, if you want to reduce your blood sugar and reverse your diabetes, you must find a diet that satisfies you while providing you with the nutrients you need.
When you leave without food, the glucose stored in your bloodstream, your liver and your muscles (glycogen) is reduced. Once the excess glucose is used, your body will turn to your body fat stores to get you fuel. Your liver then converts body fat into ketone bodies for use as an alternative fuel for use by the brain, heart and other vital organs.
This process is called "endogenous ketosis "(note: endogenous means that ketones come from within your body).
Most of the beneficial effects of a ketogenic diet occur during endogenous ketosis (ie, autophagy, mitogenesis, mitophagy, SIRT1 upregulation, and NAD + increase). Your body goes into repair mode to make sure it can survive and reproduce when food is no longer available.
The table below shows my blood sugar and ketone levels in the blood during a seven-day fast. As blood glucose levels decrease, the concentration of ketones in the blood increases to compensate for the lack of energy in your diet. The sum of glucose and ketones can be considered as "total energy" (ie glucose + ketones = total energy).
During fasting, your body can allow total energy in your bloodstream at fairly high levels. This allows you to be ready at any time to hunt or gather food to survive. However, unfortunately, we can not mimic the benefits of energy restriction by adding extra fat supplements or extra ketones to increase ketone levels in the blood.
As with any energy source, your pancreas will increase insulin to actively manage your blood glucose and ketone levels while keeping your body fat in reserve while you get rid of the food that comes from your diet.
Optimal blood glucose level for ketosis
Our understanding of the ketogenic diet is changing rapidly, as the keto is gaining popularity in recent years.
However, there is still a lot of confusion around what constitutes optimal ketone levels.
If there are many people willing to try a ketogenic diet and achieve ketosis, the reality is that it is difficult for most people to reach and maintain " optimal ketone levels "(that is, from 1.5 to 3.0 mmol / L according to this table of ketosis from The Art and Science of Low Carbo Performance)) without prolonged fasting nor continue to add more and more dietary fat.
Giving priority to dietary fat is usually counterproductive in the long run if your goal is weight loss or diabetes management. Soon, you will probably find that you build up excess body fat, which will cause an increase in basal insulin levels and blood sugar.
I had the privilege of letting Dr. Steve Phinney (pictured below in our kitchen preparing his famous blue cheese dressing) at our house for a few days when he spoke at the ### 39, a Low Carb Down Under event in Brisbane. Meanwhile, I asked him about the context of this optimal pattern of ketosis. Steve said that the optimal picture of ketosis is based on ketone levels in the blood of participants in two studies conducted in the 1980s. One was about cyclists who had adapted to ketosis at during a six-week period and another study on ketogenic weight loss. In both cases, these 'optimal ketone levels' (i.e., between 1.5 and 3.0 mmol / L) were observed in individuals recently transition into a state of nutritional ketosis.
However, as more and more people continue to follow a low carbohydrate or ketogenic diet, many find that their ketone levels in the blood continue to decline after a few weeks or months. Even the author of Keto Clarity, Jimmy Moore, recently stated that elevated ketones would not necessarily result in weight loss and that their follow-up was of limited use!
Do we use ketones better so that they do not accumulate in the blood?
Ketone urine strips (which measure acetoacetate in the urine) are considered by many to be of limited use because, too long, the body stops excreting ketones. in the urine when he learns to use them rather than wasting them.
It seems that your body also adapts to use blood ketones more effectively if you follow a low carbohydrate diet. Most people go beyond the "keto adjustment" phase as their body learns to use fats more efficiently and their ketone levels decrease further.
You may think that BHB ketones are the form of storage and transport of ketones that allow ketones to move around your body. Your body reconverts BHB into acetoacetate used as energy.
The BHB ketones that you measure in your bloodstream simply tell you how much energy you have stored as ketones in your bloodstream. Unfortunately, the level of BHB in your bloodstream does not tell you anything useful about your ability to burn fat for fuel. High levels of ketones in the blood can mean you have excessive amounts of unused fuel in your bloodstream.
Like a high blood sugar, a chronically high ketone is not necessarily a good thing. A healthy metabolism works effectively with less fuel that has to be mobilized into the blood (in the form of glucose, ketones or triglycerides).
Just like a fuel efficient car does not need a huge tank, you do not need high levels of ketones or glucose in your blood if your metabolism is more efficient.
Outsourced ketone and glucose values
In 2014, when 'keto' was new and fresh, I was eager to experiment, learn and do everything in my power to lose weight and optimize my health.
After having always been upset after reading everything I could and finding myself much bigger after looking for "optimal ketone rates", I decided to compile some of my own test data and online friends who were following also their blood sugar and ketone levels.
I wanted to understand what were the typical blood ketone levels in people who had been on a low carb diet for some time. Once I shared this initial data, other people sent me their data to add to the chart. Later, Michel Lundell from Ketonix shared a large set of anonymized data that allowed me to build a substantial dataset.
The graph below shows the sum of blood sugar levels and ketones (ie total energy) from almost three thousand data points from a wide range of people following a dietary approach low in carbohydrates or ketogenic. Blood ketones appear in blue (bottom) and glucose in orange (top).
On the right side of the chart, we have a high energy state where glucose and ketones are high. Although not as dangerous, this high-energy situation is similar to that of a person with type 1 diabetes who has elevated glucose and ketone levels because of insufficient insulin.
Note: Diabetic ketoacidosis is diagnosed when we have glucose levels greater than 15 mmol / L or 270 mg / dL and ketones greater than 0.5 mmol / L.
On the left side of the graph, we have a lower total energy state. It seems that because they burn fuel efficiently, these metabolically healthy people do not need large amounts of fuel flowing in their blood.
Based on the analysis of these publicly available data, it appears that the average value of blood glucose in a person following a low carbohydrate diet is about 4.9 mmol / L (or 88 mmol / L) with a blood ketone level of about 1.5 mmol. / L.
The table below presents these data in terms of average and 25th percentile and 75th percentile points (with the corresponding values of HBA1c, glucose: ketone index (GKI) and acetone in exhaled air).
Blood sugar levels and ketones during exogenously ketosis
Some people use low-carb or keto drugs for therapeutic purposes (ie to manage chronic diseases such as cancer, epilepsy, traumatic brain injury or dementia ). These people may benefit from higher blood ketone levels to fuel the brain in the event of effective use of glucose.
If you are trying to avoid muscle wasting related to cancer cachexia or if you are trying to feed a growing epileptic child, a high-energy, low-fat diet can be a benefit. However, most people do not require this degree of therapeutic ketosis, especially if weight loss, improvement of satiety or control of blood glucose is the top priority.
People on a therapeutic ketogenic diet may choose to take MCT oils and other added fats in order to achieve high ketone levels and low glucose: ketone (GKI) values. Others target high levels of ketones for brain performance. Others charge exogenous ketones and glucose to form a "dual fuel" for top athletic performance.
This state of glucose and ketone overeating is shown in the table below by people with the highest total energy.
While this may be helpful if you are about to race in the Tour de France, a consistently high energy level of glucose and ketones is not ideal, especially if you are sedentary, trying to lose weight or to improve your glycemic control. Tour de France cyclists perfected their training in a low-energy state to maximize mitochondrial biogenesis and then feed the required work.
One of the benefits of a low carb diet is that it largely eliminates extremely palatable processed foods, which are usually a combination of refined starches and dehydrated foods. vegetal oils. The mixture of refined starch and vegetable oils tends to be very easy to overuse. However, trying to drive high levels of ketones by consuming more fat presents a danger: this would cause an excess of energy, which would increase insulin and promote storage of the fat.
As shown in the table below, from our satiety analysis, reducing your carbohydrate intake can help you avoid high-protein junk foods high in carbohydrates and fats, increase satiety, eat less and lose weight. . However, reducing carbohydrates to very low levels can reduce satiety and increase energy intake.
So, while reducing carbohydrates is beneficial if it takes you away from the hyperpaisable processed foods that combine carbohydrates and fat, too much dietary fat will not be optimal if it leads to significantly increased energy intake.
How much should blood glucose be lower than ketosis?
Many people embark on a ketogenic diet in the hope of managing their diabetes and losing weight. They want lower insulin levels allowing them to burn more body fat for insulin sensitivity and long-term health.
To the left of the total energy table below, we have endogenous ketosis (which means that your body fat is burned as fuel). When your blood contains less energy, your body will rely on your fat reserves to make up the difference and use excess fat and old proteins in your liver, pancreas, brain and other organs (eg , autophagy). This is a great place if you are trying to lower your blood sugar or lose body fat.
Normal blood glucose and ketone range for ketosis
After analyzing thousands of ketone measurements, we present the table of ketone levels below. The data is divided into five quintiles, from the lowest to the highest total energy.
For each quintile, I calculated the average, 25th percentile and 75th blood ketone (BHB) (ie half of the values are between 25th and 75th percentile).
If you are on a ketogenic diet and your metabolism is relatively healthy, you will see BHB ketone values between 0.3 and 1.5 mmol / L. Ketones will be higher if you fast, limit calories, exercise or if you consume more dietary fat than usual.
However, as ketone levels in the blood probably decrease over time, as your body adapts to a ketogenic diet, try to resist the temptation to continue adding dietary fat to maintain high levels of ketones for ketosis.
The data cited above are consistent with ketone data from the annual results of the Virta study (Phinney et al., 2017), which aimed to motivate diabetics with ketosis to improve their blood glucose management and to reverse diabetes.
The graph below shows the distribution of BHB rates during the first ten weeks of the Virta trial. Even though the ketone values were higher, many people had ketone values in the blood of less than 0.5 mmol / L.
Despite taking a ketogenic diet under the supervision of Steve Phinney and the Virta team, most study participants did not achieve ketone-qualified ketosis levels. nutritional value (ie, BHB> 0.5 mmol / L). Despite this, their reduction in HbA1c was substantial. Many people on insulin have been able to reduce or eliminate their insulin requirements. They also lost a lot of weight.
The graph below shows the average results of Virta in the first year, with ketones increasing from 0.18 mmol / L to 0.6 mmol / L initially, then decreasing to less than 0.3 mmol / L and over one year.
The two-year results, which will be published shortly, show that ketone levels in the blood remained at 0.27 mmol / L after two years of ketogenic diet. The graph below summarizes the evolution of ketone values over the two years of the study.
While the Virta program participants initially found an increase in blood ketones in the "ketosis food zone" (ie, greater than 0.5 mmol / L) on average after ten weeks, their ketones blood levels returned to a slightly higher level than the control group. Western diet. At no time did their ketone values approach the optimal ketone zone (ie, 1.5 mmol / L as commonly defined as ketosis).
We also found a similar trend in our Nutrient Optimizer weight loss challenge, with blood glucose initially increasing during the first two weeks of weight loss when people focused on foods rich in satiety-rich nutrients. After about four weeks, however, ketone levels in the blood dropped significantly as people continued to lose weight and lower their blood sugar.
It was interesting to see that people identified as insulin-resistant tended to have blood ketone values slightly higher than those who said they were insulin-sensitive. It appears that physically fit and metabolically healthy people tend to have lower blood ketone levels and lower blood sugar levels, especially after following a low carb diet or ketogenic.
However, regardless of the ketone values in the blood or the fact that people think they are insulin-resistant, the Nutrient Optimiser Challenge data also showed that people tend to lose weight at a similar pace, whether they are identified as insulin-resistant or insulin-sensitive.
Optimal ketones for ketosis
Sauf si vous gérez une maladie chronique pouvant bénéficier de taux élevés de cétone (par exemple, la maladie d'Alzheimer, la maladie de Parkinson, la démence ou l'épilepsie), vous pouvez potentiellement économiser beaucoup d'argent et vous angoisser en vous concentrant sur le maintien de votre glycémie à un niveau optimal, sans vous soucier de votre taux de cétones dans le sang.
En accord avec la priorité à l'oxydation, le glucose dans votre sang doit être brûlé avant la graisse dans votre alimentation et la graisse dans votre corps. Si vos réserves de glucose sont constamment saturées, votre glycémie sera bloquée et vous ne pourrez pas utiliser votre graisse corporelle.
Votre glycémie permet de déterminer efficacement si votre réservoir de glucose est plein et si vous devez consommer moins de glucides dans votre alimentation.
Une fois que votre glycémie est stabilisée avec un régime pauvre en glucides, vous pouvez alors donner la priorité aux aliments et aux repas riches en nutriments à forte satiété afin de continuer à perdre du poids et à inverser votre diabète.
Comment Nutrient Optimiser peut-il aider?
Si vous avez besoin cétose thérapeutique Pour vous aider à gérer une maladie chronique telle que la maladie d’Alzheimer, de Parkinson ou la démence, l’algorithme Smart Macros Optimizer de Nutrient Optimizer peut vous guider pour réduire votre charge d’insuline au point d’atteindre les niveaux de cétone nécessaires pour atténuer nos symptômes. Cependant, la réalité est que la plupart des gens n’ont pas besoin d’un régime cétogène thérapeutique riche en graisses avec des taux élevés de cétones.
Si tu as besoin de contrôler votre glycémie, L'algorithme Smart Macros de Nutrient Optimiser vous guidera pour réduire votre consommation de glucides jusqu'à ce que votre glycémie se stabilise tout en vous concentrant sur des aliments et des repas nutritifs.
Si vous cherchez à losing weight, Nutrient Optimiser vous aidera à vous concentrer sur des aliments et des repas nutritifs à haute satiété qui vous aideront à contrôler votre appétit, de sorte que vous n’ayez pas à vous battre pour combattre votre faim que vous finirez par perdre.
Nous aimerions que vous vérifiiez dès maintenant votre rapport Free Optimizer pour nutriments afin d’obtenir vos objectifs macro initiaux ainsi que des aliments et des repas nutritifs qui vous feront avancer dans votre cheminement.