Nevertheless, we care about HDL because it is a marker of disease, just as a fever is often the visible sign of an underlying infection. If HDL is decreased, then it may be a clue that the underlying situation is also worsening. What happens to HDL during fasting? You can see from the graph that 70 days of alternate daily fasting had a minimal impact upon HDL levels. There was some decrease in HDL but it was minimal.
Modified Knodell fibrosis score in patients before (1st biopsy) and after (2nd biopsy) weight reduction. Hepatitis C virus (HCV) genotype 1 (n = 4); HCV genotype 3 (n = 7); and non-HCV (n = 3). Total group median before = 3 and after = 2 (p = 0.02). Open symbols represent those patients with additional histological features of non-alcoholic steatohepatitis.

As KE drinks achieved a significantly higher d-βHB concentrations than KS, we investigated factors that may be important in the use of ketone drinks to achieve nutritional ketosis. Initially we determined the repeatability of blood ketosis following KE drinks and found little variation in kinetic parameters between individuals. Variability between participants was less than within the population, and accurate individual prediction of the d-βHB Cmax following a body-weight adjusted KE drink was achieved. Variability within individuals was likely due to normal daily changes in GI function, including gastric emptying, portal blood flow or intestinal transit time, which may alter KE hydrolysis and absorption.

The information we provide at virtahealth.com and blog.virtahealth.com is not medical advice, nor is it intended to replace a consultation with a medical professional. Please inform your physician of any changes you make to your diet or lifestyle and discuss these changes with them. If you have questions or concerns about any medical conditions you may have, please contact your physician.


Cholesterol is a steroid with several functions in the body including repairing cell membranes, production of Vitamin D and producing hormones. While two-thirds of cholesterol is produced in the liver, diet can affect cholesterol production. Low-density lipoprotein, or LDL, is also known as “bad” cholesterol because once oxidized it can damage arteries and produce an inflammatory response. High-density lipoprotein, HDL, or "good" cholesterol, removes cholesterol from the arteries, prevents oxidation of low-density lipoprotein and may help inflammation. Lack of exercise, obesity, and a diet high in red meat, high-fat dairy, fried foods, and sugars can increase low-density lipoprotein and lower high-density lipoprotein.
This one seems pretty obvious – no kidding, weight loss reduces your body mass. That’s the whole point. But body size is one of the biggest factors driving your overall metabolism. It takes calories to maintain all those extra pounds of fat tissue – fat might burn fewer calories than muscle, but it absolutely does burn some calories just by existing. If you have 50 or 100 pounds of extra fat, they’re burning a lot of calories every day just by being there, not to mention the extra calories you burn carrying them around from place to place.
Obesity is also recognised as an independent risk factor for the progression of fibrosis in other chronic liver diseases.6 A number of studies have now demonstrated an association between increased BMI or visceral adiposity and hepatic steatosis7 and fibrosis8 in patients infected with hepatitis C virus (HCV). In overweight patients with chronic HCV, we recently demonstrated an association between increasing insulin levels and increasing hepatic fibrosis, suggesting that host metabolic factors also contribute to disease progression.9 Similarly, in patients with alcoholic liver disease, elevated BMI and fasting blood glucose were independent risk factors for hepatic fibrosis.10
“We could have found out that if we cut carbs, we’d lose way more fat because energy expenditure would go up and fat oxidation would go up,” said Kevin Hall, an obesity researcher at NIH and an author on many of these studies. “But the body is really good at adapting to the fuels coming in.” Another related takeaway: There appears to be no silver bullet diet for fat loss, at least not yet.

If your liver cannot handle the excess fat and sugar coming at it, then fat and sugar will pile up in all the wrong places all over your body – hardening your arteries, your brain, and generally accelerating aging across the board. Thus, it is appropriate to think of your liver not only as a backup system trying to cope with excess, but also as an organ of last resort, a type of a last stand, before more difficult health issues take hold.


“I just had to take it day by day and do things that didn’t put stress on my joint but still giving my body the workout that it needed,” he said. “There were mentally challenging times, too, and times I would go home in tears or wanted to give up. But I always remembered that the bigger picture was the ultimate goal and the feeling I would get when I achieved it.”
Protein: When people first reduce carbohydrates in their diets, it doesn't seem as though the amount of protein they eat is as important to ketosis as it often becomes later on. For example, people on the Atkins diet often eat fairly large amounts of protein in the early stages and remain in ketosis. However, over time, some (perhaps most) people need to be more careful about the amount of protein they eat as (anecdotally) the bodies of many people seem to "get better" at converting protein into glucose (gluconeogenesis). At that point, each individual needs to experiment to see if too much protein is throwing them out of ketosis and adjust as necessary.
In simple terms, metabolism is the rate at which your body naturally burns the calories you take in. Metabolism is influenced by age, gender and body composition, or lean to fat ratio. The lower the body fat and the higher the lean muscle tissue, the higher metabolism tends to be. A combination of a healthy diet, cardio-vascular exercise and weight training can help you to change your body composition and have a positive effect on your metabolism.
Those surfing the Internet for ways to help their liver are likely to come upon various programs proclaiming a liver flush, liver detox, or some type of extended fasting. Liver detoxification is something that goes on every day of your life. There is no such thing as doing a liver detox program so that your liver is somehow magically squeaky clean. Any nutrients--including various herbs not mentioned here--that support lipotropic function, toxin clearance, or liver protection may be of value as part of a program. They are not a magical remedy.
The catabolic changes in HDL with weight loss could relate to an increase in HDL particle size, which in turn may be a consequence of a reduction in the plasma VLDL triglyceride pool available for exchange with HDL (27). Increased adiponectin can inhibit hepatic lipase activity (28), which could account for the partial correlation in our study between changes in plasma adiponectin and HDL apoA-I FCR. A “balancing feedback” mechanism probably accounts for the tight correlation between changes in catabolism and production of HDL apoA-I after weight loss. Furthermore, the fact that HDL underproduction offset the HDL-elevating effect of depressed HDL catabolism could in part reflect the impact of lowered dietary fat intake on the hepatic expression and secretion of apoA-I (29). However, we found no significant correlation between the changes in HDL apoA-I production rate and dietary saturated fat intake in our weight loss group. That there was no significant correlation between the changes in LDL and HDL FCR suggests that different mechanisms underlie these alterations in lipoprotein metabolism after weight loss.
After a week or two, your body will adjust to a more active lifestyle. That's when it's time to add workouts that increase metabolism. If you are healthy enough for vigorous exercise add one HIIT or Tabata session per week. Then gradually add one or two more. You can also add up to 3 strength training workouts per week to increase your metabolism with lean muscle mass. 
All wine has sugar. This fact was researched in-depth on day seven, when I was having a rough day and desperately wanted to go home to a glass of red. I did learn that while hard alcohols-gin, vodka, whiskey, and rum-don't have added sugar, mixers are loaded with the sweet stuff. I always thought gin and tonics were a healthy option, but it turns out, 12 ounces of tonic water could have 32 grams of sugar-more than the daily recommended amount for adults. I did drink during the challenge, but opted for liquor on the rocks or mixed with club soda (which is sugar-free). I'll admit, gin and club soda isn't as good as a gin and tonic, so I'm making the switch back. The occasional glass of wine, cupcake, or piece of chocolate is worth the added sugar to me. However, I will keep my consumption to a minimum-I'll just savor it that much more now. (Can You Drink Alcohol and Still Lose Weight?)
As you might expect, I felt great for the first few days. The key word there is “felt.” A couple of days wasn’t long enough for the change to have had a physical effect or move the needle on the scale. Maybe it would have if I’d been eating nothing but fast food for three meals a day. But I had gotten so excited at the prospect of cutting back on my sweet tooth that it boosted my motivation. At the end of the 30 days, however, I didn’t end up feeling any different.

As you might expect, I felt great for the first few days. The key word there is “felt.” A couple of days wasn’t long enough for the change to have had a physical effect or move the needle on the scale. Maybe it would have if I’d been eating nothing but fast food for three meals a day. But I had gotten so excited at the prospect of cutting back on my sweet tooth that it boosted my motivation. At the end of the 30 days, however, I didn’t end up feeling any different.


Ketone monoester and diester compounds may circumvent the problems associated with inorganic ion consumption in KS drinks. KE ingestion rapidly increased blood ketone concentrations to >5 mM in animals (Desrochers et al., 1995a,b; Clarke et al., 2012a) and the first oral, non-racemic KE for human consumption, (R)-3-hydroxybutyl (R)-3-hydroxybutyrate, raised blood βHB concentrations to 3–5 mM in healthy adults (Clarke et al., 2012b; Shivva et al., 2016) and athletes (Cox et al., 2016; Holdsworth et al., 2017; Vandoorne et al., 2017). However, the pharmacokinetics and pharmacodynamics of this KE with confounding factors, such as prandial state or multiple KE drinks, have not been characterized.
Resting Metabolic Rate (RMR): The amount of calories burned while in a resting/quiet state. RMR for an average person is the largest part of total metabolism accounting for 65-75% of calories burned daily. We have little control over RMR unless we add a significant amount of muscle or weight leading to an increase of calories burned (3-6cals/day/pound depending on muscle to fat content).
Fasting blood samples were collected prior to all interventions. Following consumption of study drinks (details below), blood, expired gas and urine samples were collected at regular intervals for 4 h. Water was freely permitted and participants remained sedentary at the test facility throughout the visit. A subset of participants returned for samples 8 and 24 h after the ketone drinks (Study 1).
Firstly, in a randomized four-arm cross-over study, blood βHB concentrations were compared following ingestion of equal amounts of βHB as a KE or a KS at two doses by healthy volunteers at rest (Study 1; n = 15). Secondly, in a randomized five-arm cross-over study, inter- and intra-participant repeatability of ketosis was examined following ingestion of identical KE drinks, twice whilst fed and twice whilst fasted. As a control, participants also consumed one isocaloric (1.9 kCal.kg−1) dextrose drink (Study 2; n = 16). Finally, blood d-βHB was measured after equal amounts of KE were given as three drinks (n = 12) or a constant nasogastric (NG) infusion (n = 4) (Study 3; total n = 14) over 9 h.
Beans and whole grains such as brown rice, quinoa, and whole wheat have more fiber and don’t spike your blood sugar. They will lower cholesterol and make you feel full longer. Other carbs, like those found in white bread, white potatoes, white rice, and pastries, boost blood sugar levels more quickly so you feel hungry sooner, which can lead you to overeat.

One human study that includes raspberry ketones and other ingredients for weight loss shows promising results. The Journal of the International Society of Sports Nutrition published a randomized, placebo-controlled, double-blind study that evaluated 70 obese but otherwise healthy women who participated in an eight-week weight-loss program. The women were given a multi-ingredient supplement containing primarily raspberry ketone, caffeine, capsaicin, garlic, ginger and citrus aurantium.
Serial drinks or a continuous NG infusion of KE effectively kept blood ketone concentrations >1 mM for 9 h (Figure ​(Figure6).6). With drinks every 3 h, blood d-βHB rose and then fell, but had not returned to baseline (~ 0.1 mM) when the next drink was consumed. There was no significant difference in d-βHB Cmax between drinks 2 and 3 (3.4 ± 0.2 mM vs. 3.8 ± 0.2 mM p = 0.3), as the rate of d-βHB appearance fell slightly with successive drinks (0.07 ± 0.01 mmol.min−1 and 0.06 ± 0.01 mmol.min−1 p = 0.6). d-βHB elimination was the same after each bolus (142 ± 37 mmol.min, 127 ± 45 mmol.min; and 122 ± 54 mmol.min). When KE was given via a nasogastric tube, the initial bolus raised blood d-βHB to 2.9 ± 0.5 mM after 1 h, thereafter continuous infusion maintained blood d-βHB between 2–3 mM. Total d-βHB appearance in the blood was identical for both methods of administration (Serial drinks AUC: 1,394 ± 64 mmol.min; NG infusion AUC: 1,305 ± 143 mmol.min. p = 0.6).
Ketosis means that your body is in a state where it doesn't have enough glucose available to use as energy, so it switches into a state where molecules called ketones are generated during fat metabolism. Ketones can be used for energy. A special property of ketones is that they can be used instead of glucose for most of the energy needed in the brain, where fatty acids can't be used. Also, some tissues of the body prefer using ketones, in that they will use them when available (for example, the heart muscle will use one ketone in particular for fuel when possible).
The metabolic phenotype of endogenous ketosis is characterized by lowered blood glucose and elevated FFA concentrations, whereas both blood glucose and FFA are lowered in exogenous ketosis. During endogenous ketosis, low insulin and elevated cortisol increase adipose tissue lipolysis, with hepatic FFA supply being a key determinant of ketogenesis. Ketone bodies exert negative feedback on their own production by reducing hepatic FFA supply through βHB-mediated agonism of the PUMA-G receptor in adipose tissue, which suppresses lipolysis (Taggart et al., 2005). Exogenous ketones from either intravenous infusions (Balasse and Ooms, 1968; Mikkelsen et al., 2015) or ketone drinks, as studied here, inhibit adipose tissue lipolysis by the same mechanism, making the co-existence of low FFA and high βHB unique to exogenous ketosis.
You can take it in the morning or between meals to put your body into an effortless fat-burning mode. You can also try it before/during exercise as an energy drink. It’s also best to take on an empty stomach for peak mental performance and sharper focus. (PK Pro Tip: Mix it in your morning coffee or tea). After eating a meal will also do, to help you boost yourself back into ketosis.

Healthy, physically active individuals generally have an appropriate BMI, body mass index, and are within their ideal body weight range. This means that the calories they are ingesting are being utilized for energy and to maintain their normal body weight in a balance ratio. When we become less active or ingest more calories than we are using for energy and activity, those additional, unused calories are stored as fat in our adipose tissue.

d-βHB was measured immediately on whole blood using a handheld monitor and enzyme-based reagent strips (Precision Xtra, Abbott Diabetes Care, UK). Samples were stored on ice, centrifuged and duplicate plasma aliquots stored at −80°C. All urine passed during the visit was collected, the total volume recorded, and 1 ml aliquots taken, frozen and retained for analysis.

Over time, out-of-control stress becomes a problem. It raises your blood pressure, and for some people, it might mean higher cholesterol levels. Make it a priority to relax. It can be as simple as taking some slow, deep breaths. You can also meditate, pray, socialize with people you enjoy, and exercise. And if some of the things that stress you out are things you can change, go for it! 


On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.
Christian Finn is the nation’s leading authority on science-based, joint-friendly ways to build muscle. A former "trainer to the trainers," he holds a masters degree in exercise science, and has been featured in or contributed to major media on two continents, including the BBC and Sunday Times in the U.K. and Men’s Health and Men’s Fitness in the U.S.

After two weeks of return to non-ketotic levels (blood ketones measured 0.19 mM), subjects’ rates of hunger and desire to eat were significantly higher than pre-weight loss levels. That’s why the Bulletproof Diet recommends cyclical ketosis, because if you’re in it a lot of the time, but not all the time, you never have to deal with that pesky gnawing hunger.


Do you know people who complain about having a slow metabolism and how they barely eat anything yet still gain weight? Or have you met people who complain about someone they know who can eat whatever he or she wants — including large portions of junk food — due to a fast metabolism and apparently never gain weight. In both cases the individual usually ends by saying, "It's not fair!" These scenarios raise several very good questions:
×