My Thoughts On Exogenous Ketone Supplements

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You have probably seen posts all over the internet promising weight loss, sports performance, mental clarity and more from using exogenous ketones, but are they safe and will they help you achieve your goals?

First, you may want to understand what exogenous ketones are. “Exogenous” refers to something that is not produced within the body. Alternatively, “endogenous” describes something produced within the body. The liver will naturally produce ketones from fatty acids during extended periods with low blood glucose.¹ Glucose, free fatty acids and ketones are able to supply energy to the mitochondria of cells, which are our aerobic energy powerhouses. But unlike free fatty acids, ketones can cross the blood brain barrier and can be used for energy by the brain cells and the central nervous system. This can be especially important during times of low blood glucose. When there are sufficient levels of ketone bodies in the bloodstream, the body is said to be in “ketosis.”

This ability for ketones to provide energy when glucose levels are low would have been especially important when we could not just go out to any grocery store, fast food restaurant or into our pantry to eat something for energy.

Some benefits, as listed below, have been observed during times when the body is producing its own ketones. This can be done through starvation or nutritional ketosis, which involves reducing insulinogenic foods (carbohydrates and protein) and increasing fat to a level that reduces blood levels of glucose enough that the body believes it needs ketones for fuel.²

Based on these benefits, companies have started to produce synthetic ketones that we ingest in order to increase blood levels of ketones: exogenous ketones. Some manufacturers state that these can be taken to get the body into “ketosis” without any modification to diet. But that means that if a person were to use these exogenous ketones while still eating the Standard American Diet (SAD), he would have both glucose in his blood, as well ketones. This is not a natural state and the glucose in the blood is still going to cause an insulin spike.

If the idea of ketosis is to retrain the body to use ketones for energy, artificially supplying ketones will not aid in this goal. In addition, we are looking for long-term improvements through dietary and lifestyle changes. Popping a pill or drinking a supplement without other changes is not a long-term solution.

Additionally, supplemental ketones are generally very high in sodium and potassium, which may not be healthy for everyone and can cause blood pressure issues, especially when taken numerous times per day.³

Purported benefits of exogenous ketones:

·      Weight Loss – One exogenous ketone supplier claimed that exogenous ketones can lead to weight loss, but no studies were provided to back this up. The vendor's website only provided studies showing that endogenous ketones helped with weight loss (obviously as they are made from fatty acids so stored body fat is broken down to make them), quickly jumping to the conclusion that the two must lead to the same results. Two of the experts on using ketogenic diets for health state that exogenous ketones have not been proven to help with weight loss. ⁴ Additionally, several studies show that using exogenous ketones reduced lipolysis (the breakdown of stored fats for energy).⁵

·      Provide energy – Exogenous ketones will provide energy, since they are a direct energy source, but if there is also glucose in the bloodstream, insulin will increase, which puts the body into a storage mode, pushing glucose into fat storage.

·      Sports performance – One study concluded that there is not enough evidence to support the claim that ketones can support sports performance.⁶ But another study showed that exogenous ketones helped to increase endurance and reduce lactic acid accumulation.⁷ In addition, a third study showed that exogenous ketones can spare glycogen use. But while this may help to sustain longer endurance exercise, it is spared through a reduction in carbohydrate oxidation⁸ possibly compromising higher intensity efforts during the endurance event (i.e. that last kick to pass someone or cross the finish line under a time goal may be at risk).  Overall, there is really no consensus on the effects of exogenous ketones on sports performance and more studies are needed. I think it’s also important that studies be done on steady state endurance athletes and athletes that need to constantly move between fat and carbohydrate burning, such as cyclists or mountain bikers.

·      Decrease appetite - A recent study found that supplementing with ketone ester lowered the amount of ghrelin, sometimes called the “hunger hormone,” which led to decreased appetite.⁹ Most of the exogenous ketone supplements on the market today are ketone salts, not ketone esters. Ketone esters are raw ketones that enter the bloodstream more quickly than ketone salts, which elicits a quicker response but the esters taste pretty bad and can lead to GI distress. For that reason, most of the exogenous ketone supplements on the market are ketone salts.

·      Improved mental clarity - Some people report better mental clarity and energy but most reports like this are anecdotal and there are few studies that point to proof of these types of benefits.¹⁰

Despite all this, there are times that exogenous ketones can be beneficial:

·      They can help with energy when a person is transitioning from a higher carbohydrate diet to nutritional ketosis. Exogenous ketones have been found to help avoid the “keto flu.”

·      They can help for some additional mental clarity if used in conjunction with a lower carbohydrate diet.

·      If an athlete is already metabolically flexible (able to burn both carbohydrate and fat efficiently for fuel), exogenous ketones may help with sports performance.

I have experimented with Keto/OS and Perfect Keto. I did not notice any change with Keto/OS but noticed a slight improvement in mental function and reduction in appetite with Perfect Keto. The chocolate sea salt flavor was pretty darn good in my fatty coffee.

Based on what we know about how ketones and glucose function, I don’t feel that these expensive supplements are worth the cost when we can use our bodies to produce ketones in a healthy way using nutritional ketosis. 

⁴ how-to-make-endogenous-ketones-at-home/


The Benefits of Gratitude


We all have bouts in our lives where we feel gratitude towards others for doing something special for us but what would happen if we made gratitude a daily part of our lives? There are many different physical, emotional and mental benefits of practicing gratitude.

How can you add more gratitude to your life? It can be as simple as thinking about 1-3 things you are grateful for upon waking or before you fall asleep. It can also be more in depth by creating a gratitude journal, where you write down your feelings of gratitude on a daily basis. You could even write a gratitude letter to someone that has had an impact in your life. I've been thinking through three things in the morning and some days it's harder than others, but there are always at least three things I can be thankful for. I would like to involve my family so I'm going to add it to our dinner discussion, which currently includes the following questions: 

  • What was the most fun part of your day?
  • What was the hardest part of your day?
  • What was the silliest part of your day?
  • Now I will add - what or who are you most thankful for today?

Here are some other ideas to involve your kids, as kids that practice gratitude are more kind to others, get better grades and care more for the environment. 

  • Share stories of others practicing gratitude to help younger kids understand what it means.
  • Make small, unexpected gestures of gratitude a part of your lives, such as leaving a post-it note of thanks when a family member helps you out.
  • Encourage kids to start their own journal.
  • Include a statement of thanks with bedtime hugs or prayers.

How Well Do I Burn Fat?

I test myself periodically to see how efficient I am at burning fat. This also helps me to prepare my race day nutrition. I tested myself in May 2016 and again in November 2016 and didn't see much change. When I did Boulder Ironman this past June, I had planned to do another test before the race but my training schedule didn't really have a place for it, so I just used my old data. I'll be (finally) posting my race report shortly, which will show that I took in a little less than I had in past Ironman races, which isn't a whole lot. You can see my prior IM intake here. Boulder Ironman 2014 race report and Ironman WI 2015 race report. To prepare for this last IM I used my test results from last November, which show that my calorie need at the targeted race power and HR was about 22-33 carbohydrate calories per hour. 

My ME test last November. I wasn't racing with power but was typically in the 125-135 HR on the bike.

My ME test last November. I wasn't racing with power but was typically in the 125-135 HR on the bike.

I retested myself on 7-17-17. I did more of a race day simulation and had coffee with half and half as I would typically do before training. I was pleasantly surprised to see how much I had improved even after following my Fat Adapted Fueling plan for over 4 years. You can see below that my required carbohydrate calories decreased further (justifying my slightly lower intake in Boulder IM mid-June) and I was still burning more fat at higher power levels so my bike power has increased. I'm using power to race now and my target was between 140 and 150 watts for the full Ironman. Based on that, and my fat-burning efficiency, my required intake was approximately in the range of 12 and 35 carbohydrate calories per hour. 

My carbohydrate calorie needs per hour, 10% is the minimum and 30% the maximum. Since I'm very efficient at burning fat, I can take in closer to 10%.

My carbohydrate calorie needs per hour, 10% is the minimum and 30% the maximum. Since I'm very efficient at burning fat, I can take in closer to 10%.

What I found even more interesting was how much higher my power and heart rates were before I crossed over into burning more carbohydrate than fat. The pictures below show my data from last November and this week (July 2017). I increased my crossover point from a heart rate of 135 to 146 and from 175 watts to 220 watts. 

Crossover point in November 2016 was at heart rate of 135 and power of 175.

Crossover point in November 2016 was at heart rate of 135 and power of 175.

Crossover point in July 2017 was at heart rate of 146 and watts of 220.

Crossover point in July 2017 was at heart rate of 146 and watts of 220.

The other great result is how quickly I returned to predominantly burning fat after crossing over. I reduced the power from 220 to 140 watts and was burning more fat than carbohydrate within about 30-45 seconds. That's important to know if you walk through aid stations or take recovery breaks in a longer race. Once I further reduced the power to 120, I was using fat for more than 90% of my calories. That's pretty darn good!

I will admit that I've allowed myself a little more flexibility in my intake during the last few months of my IM training because my intensity was higher for this training cycle. I felt I needed to add a bit more carbohydrates strategically around my key training sessions. I wondered how that would impact my fat burning but clearly there was no negative impact. I believe my long term application of my Fat Adapted Fueling program continues to pay off. Also, the test done last November was at beginning my training season and had just completed my off season so that likely impacted my fitness negatively. 

Are you wondering how this affects the top end? I have done two sprint triathlons this year and was as fast as I have ever been, even two weeks post Ironman. I won my age group in both races. It felt good to go hard and empty the tank.

All this shows that long term, consistent dietary changes will continue to pay off. In addition, the longer one follows a program, the more it allows for occasional "splurges" while still progressing towards goals.