Glucose Ketone Index

[Tincup]

I agree with this. But by definition if ketones are 0.5, the person hasn't really undergone a metabolic shift.

I've been "keto adapted" for 10 years. I can run my ketones between 0.2 and >8.0 (max on my meter - the later on extended fasts). If I want more serum ketones, I just change my macros or do extended water fasting. By day 3 of a water fast, my ketones are >5.0 mmol/L and glucose is in the 50's md/dL (3's in mmol/L). My personal objective is to be able to generate ketones and use beta hydroxybuterate when my body needs them. Several years ago, I did a two week Cronometer.com study where I measured all my food with a gram or milligram scale. My carb intake was a mean of 122 g/day with fiber 50g and the range was 80 to 180g. My serum ketones ranged from 0.7 to 1.9 mmol/L during the study. More recently I've been adding more resistant starches such as sorghum, millet and fermented legumes into my diet for gut biome reasons. My ketones generally run around 0.5 - 0.7 with this program. However an extended fast will follow my past pattern (glucose in the 50's and ketones >5) as before. Hence, at least for me, I would suggest that I've maintained metabolic adaptation. I've only once experienced "keto flu" during the last 10 years (when I first adapted).

My understanding is that the longer you are adapted, the more efficient the body becomes in ketone utilization, hence the amount of the ketones in "storage" as betahydroxybuterate is not indicative of production. I've not bothered to recently check breath acetone, which is a better indicator of ketone production, because my meter also registers on methane. My large intake of leaves and other fiber creates a lot of methane confounding the interpretation.

{edit} I also did nineteen consecutive cycles of water fasting for five consecutive days (120 hours) out of every 14 days a couple of year ago (weight stable from the start of one cycle to the next), so am very familiar with significant ketosis. My lowest GKI was when I had a glucose of 31 mg/dL (1.7 mmol/L) and ketones of 6.9 - GKI = 0.25. I then went to the gym and set PR's on my lifts.[/quote]

[mike]

If your ketone level is 0.5 mM, then your absolute level isn't very high and you have not undergone a metabolic shift by definition. Therefore, my point remains unchanged -- the absolute level is probably more important regardless of what the GKI ratio is, although implicitly the absolute ketone level is partially dictated by the level of glucose available. I respect the fact that you are a T1D, but that constitutes 0.3% of the population and is a bit of a unique situation.

I'm actually T2D, so not so unique. While I generally maintain .5 ketones, that is with my normal diet. I have also done multiple extended water fasts of two weeks and more where I go much higher. Most folks that I talk to say that .5 is enough to make a difference in prevention. It provides vascular protection and another source of fuel for the brain. I've had T2D for twenty years, and just had a baseline neurological exam. My cognitive testing was all pretty much at the top of range. The neurologist afterwards said that with my history, he expected a bunch of damage, but looking at the MRI, he was surprised to see no shrinkage or change since my prior MRI 5 years back that I had after my stroke. No micro-bleeding in the cortex. He said I had the brain of a 40 year old, as opposed to my almost 60 years. I must be doing something right!

For more on Cancer and GKI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367849/

edit - Here is a good description of the different GKI ranges: https://foracare.com/glucose-ketone-ind ... ll-health/