Ketolysis is the process of breaking down ketones to ultimately provide energy through the Krebs Cycle and mitochondrial oxidative (using oxygen) phosphorylation. Ketone bodies are broken down in the mitochondria of virtually all tissues in the body. The liver is a notable exception, being unable to utilise ketones as a fuel because liver cells lack acetyl-CoA thiolase, a key enzyme in the ketone oxidative pathway. BHB enters the mitochondria of the cell through a monocarboxylate transporter, undergoes conversion to acetoacetate by BHB dehydrogenase and then addition of a CoA group from succinyl-CoA by 3-oxo-acid transferase. The resulting acetoacetyl-CoA acts a substrate for the formation of two molecules of acetyl-CoA in a reaction catalysed by acetyl-CoA thiolase. Acetyl-CoA is then available to condense with oxaloacetate and enter the Krebs cycle.

The most common and relatively minor short-term side effects of ketogenic diet include a collection of symptoms like nausea, vomiting, headache, fatigue, dizziness, insomnia, difficulty in exercise tolerance, and constipation, sometimes referred to as keto flu. These symptoms resolve in a few days to few weeks. Ensuring adequate fluid and electrolyte intake can help counter some of these symptoms. Long-term adverse effects include hepatic steatosis, hypoproteinemia, kidney stones, and vitamin and mineral deficiencies.

Your muscles need blood glucose for fuel, which means that when you take that barre or CrossFit class, you’re helping move blood sugar from the bloodstream into the muscles where it’s then burned up. Over time, this can lower blood sugar levels and increase insulin sensitivity (i.e. how well your cells are able to absorb glucose from the blood and use it for energy). Intense exercise can temporarily raise blood sugar, so if you have poor blood sugar control, it make sense to start moderate (think: walking, jogging, or yoga), and then work your way up.

While exercise is a great way to bring down your blood glucose immediately, remember that physical activity should be a part of your lifestyle, not just a tool for producing one good test result. Getting your recommended periodic A1C tests will help you and your doctor determine if your blood glucose control is on target. And when you use your meter to test at home and at work, be sure to look for patterns in the results. This can help you and your diabetes care team tell whether you need to adjust your diet, medications, or both. The most important thing you can do to manage diabetes well is to control your blood glucose, and exercise is a key step toward reaching that goal.

Other mechanisms that have been suggested include: changes in ATP production making neurons more resilient in the face of metabolic demands, altered brain pH affecting neuronal activity, direct inhibitory effects of ketone bodies or fatty acids on ion channels, alterations in amino acid metabolism, and changes in synthesis of the inhibitory neurotransmitter GABA. (10)
The best part about this bread is that it makes it so much easier to eat a low carb diet. Yes, there are some savage beasts (joking) that don’t miss bread at all and are happy to just eat bacon seven times a day, but if you’re anything like me, bread was a staple of your diet growing up and you still have a look of yearning in your eyes when they drop that bread basket in the middle of the table at family dinner. I feel your pain. This low carb bread recipe is your shoulder to cry on.
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