Hey Anita, your body actually can use both ketones and glucose for energy but your heart and brain actually prefer using ketones over glucose whereas your muscles and other organs go back and forth. Check out this podcast that was recently done with our founder Anthony Gustin – it will help clear a lot of things up! https://www.healthfulpursuit.com/podcast/e59/
When your body is severely deprived of energy (calories), it resorts to breaking down both fat and lean tissue (such as skeletal muscle) to generate fuel. Intuitively, the goal of a ketogenic diet is to increase body fat breakdown so it can be burned as fuel, but when you greatly restrict your calorie intake, you significantly increase lean tissue breakdown as well.
Fourteen patients consented to a repeat biopsy 3–6 months after completion of the initial three month period. These repeat biopsies were offered to monitor the short term effects of weight reduction on liver histology and some of the data have been included in an earlier report.11 Further biopsies after 15 months of the programme were not considered clinically indicated or ethically justified, especially in those patients with a sustained improvement in liver enzymes. Overall, there was a striking improvement in steatosis after weight reduction (p<0.0001) (fig 5). In seven patients there was also an improvement in the stage of fibrosis (p = 0.02) (fig 6).
"What determines whether you're gaining or losing weight is whether you're eating more calories than you're burning," says Michael Rosenbaum, MD, associate professor of clinical pediatrics and clinical medicine at Columbia University Medical College in New York. "Burning more calories through exercise will allow you to eat more or lose more weight."
NAFLD—sometimes referred to as a "fatty liver"—occurs when more than 5 percent of the liver's total weight is made up of fatty tissue. Excessive fat in the liver can lead to scarring, which may increase the risk of liver cancer or liver failure. People with NAFLD are more likely to develop type 2 diabetes, and people with type 2 diabetes are more likely to develop NAFLD. In fact an estimated 70 percent of people with type 2 diabetes also have a fatty liver. Obesity is also a major risk factor for NAFLD.
My case was a quandary: I already exercised diligently, running about four miles most days. I had long ago given up red meat and most cheese. Yet my bad cholesterol last October was 169, way above my recommended high of 130 and an optimal 100. (People’s LDL goals depend on their number of risk factors such as smoking, diabetes or high blood pressure.)
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.
The prevalence of obesity and overweight has risen at an alarming rate over the past 20 years.1 In addition to increasing the risk of the development of type 2 diabetes, hypertension, and dyslipidaemia, excess body weight also has an adverse effect on the liver. Non-alcoholic fatty liver disease (NAFLD) is an increasingly recognised condition that is often seen in patients who are overweight or diabetic or in those with the insulin resistance syndrome.2 It encompasses a wide spectrum of liver pathology, ranging from steatosis to steatohepatitis, fibrosis, and cirrhosis.3 In patients with NAFLD, the clinical risk factors that are associated with liver injury include elevated body mass index (BMI), visceral adiposity (increased waist circumference), presence of type 2 diabetes, and systemic hypertension.2,4,5
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A seldom discussed yet extremely important aspect of weight loss is liver function. The liver is the chief operator of detoxification in the body. In our modern day society, many of our foods are laden with hidden toxins and void of nutrients. Many fad diets cause the liver to work overtime in an attempt to keep up with the high fat and nutritionally void foods and weight loss gimmicks. This eventually causes the person to gain more weight in the end as the demand on the liver is too high.  Throughout this process, the liver literally becomes more and more sluggish in function and eventually becomes "fatty". Once a liver has reached the fatty stage, the function is extremely impaired and weight loss becomes an impossibility. The liver's job of detoxifying blood and metabolizing fat is compromised and the metabolism greatly slows. 
I practice a Cyclical Ketogenic diet where I incorporate a higher carb day once a week. The day following a higher carb day, I follow an intermittent fasting day where I do not eat anything (no fats either) for 20-24 hours. I do this as a cellular cleanse (autophagy) as well as a way for my body to get back into ketosis. Would it be helpful to add an exogenous ketone on this particular “fasting” day to get into ketosis quicker? Would I notice better results or is my own nutritional ketosis enough? I am relatively fit with a pretty low fat percentage for my gender and age, but I am always striving for an even leaner “more chiseled” look.
Weight loss, from changes in diet and an increase in physical activity, is the primary treatment for most cases of fatty liver disease and NASH. In many cases, weight loss seems to have a very direct effect: as people lose weight, the fatty liver becomes less fatty. Crash dieting is a bad idea, though, because rapid weight loss (losing 4 pounds a week or more) can wind up damaging the liver. Of course, if sustained weight loss were easy, a lot of today's health problems would be solved, not just fatty liver disease and NASH.
This might be hard to hear, but coffee and donuts are not a match made in heaven. Apparently, the caffeine in your coffee can inhibit your body's ability to process the sugar in your glazed breakfast. In one study published in the American Journal of Clinical Nutrition, Canadian researchers found that when men consumed one to two cups of regular coffee an hour before a sugary meal, their blood sugar shot up 16 percent more than if they had one to two cups of decaffeinated coffee before the meal. The researchers suggest that caffeine causes your body's cells to be less responsive to insulin, causing short-term insulin resistance, says Fear.
“Primarily for me, [it] definitely is true that sugar is probably one of the most addictive things that you can possibly put into your body,” Fantocone says. “Even to this day, if I eat sugar consistently or a couple of times throughout a week, I’ll notice that I’ll want more again. I had to build that awareness in myself that was what was happening.”
Safety Warning	Caution: Not intended for those under the age of 18, pregnant or nursing mothers, those trying to get pregnant, or those sensitive to caffeine. Do not take this product if you have a known medical condition or if you are taking medications. Consult a healthcare professional before using this or any other dietary supplement. Do not consume caffeine from other sources while taking this product. Discontinue use immediately if nausea, sleeplessness, or nervousness occur. This product may contain up to 120mg of naturally occurring caffeine per serving which is equivalent to about 1.3 cups of coffee.

Millions of people try a low-fat or low-cholesterol diet without realizing that these have already been proven to fail. I hear this all the time. Whenever somebody is told their cholesterol is high, they say “I don’t understand. I’ve cut out all fatty foods”. Well, reducing dietary fat will not change your cholesterol. We’ve known this for a long time. There are marginal changes at best. So, what to do? Statins, I guess?
After precipitation of apoB-100 with isopropanol, LDL apoB-100 concentrations were determined by a modified Lowry method as described previously (6) (coefficient of variation [CV] <4.0%). Total plasma apoB-100 and apoA-I concentrations were determined by immunonephelometry (Dade Behring BN2 nephelometer) (interassay CVs <4.3%). ApoB-100 was quantified from three pooled plasma samples during the isotope infusion; other biochemical assays were performed at baseline before the infusion. Plasma adiponectin and RBP-4 were determined using enzyme immunoassay kits according to the manufacturer’s instructions (interassay CV <7%, Quantikine; R&D Systems, Minneapolis, MN; and interassay CV <10%; Immunodiagnostik, Bensheim, Germany). Plasma CETP activity was analyzed by an exogenous assay (Roar Biomedical, New York, NY). PLTP activity was determined by measuring the transfer of radiolabeled phosphatidylcholine ([14C]dipalmitoylphosphatidyl choline) from unilamellar vesicles to isolated HDL, precipitating the vesicles with a MnCl2/heparin solution and counting the [14C]dipalmitoylphosphatidyl choline remaining in the supernatant (interassay CV <10%). Cholesterol, triglyceride, and HDL cholesterol were determined by standard enzymatic methods. LDL cholesterol was calculated using the Friedewald equation or by direct measurement with triglycerides >4.5 mmol/l. Plasma nonesterified fatty acids (NEFAs) were measured by an enzymatic method (CV <3%; Boehringer Mannheim, Mannheim, Germany). Glucose was measured by a hexokinase method (CV <3%; Bayer Diagnostics, Sydney, Australia) and insulin by an enzyme-linked immunosorbent assay (CVs <8%; Boehringer Mannheim). Insulin resistance was estimated by homeostasis model assessment (HOMA) score (18). Plasma lathosterol and campesterol concentrations were measured by gas chromatography–mass spectrometry (CV <6.0%; Hewlett Packard 5890) (19).

But the American Beverage Association issued this statement: "This study confirms that it's calories that count when it comes to weight loss, not uniquely calories from sugar. As the authors noted, when calories from sugar were replaced with calories from carbohydrates, there was no change in weight. This would not have been the case if sugars had a unique effect on body weight."

Blood d-βHB concentrations rapidly increased to a maximum of 2.8 ± 0.2 mM following the KE drink and to 1.0 ± 0.1 mM following the KS drink (Figure ​(Figure1A).1A). After the peak was reached, blood d-βHB disappearance was non-linear, and followed first order elimination kinetics as reported previously (Clarke et al., 2012b; Shivva et al., 2016). d-βHB Tmax was ~2-fold longer following KS drinks vs. KE drinks (p < 0.01, Figure ​Figure1B),1B), and KS d-βHB AUC was ~30–60% lower than the KE drink (p < 0.01, Figure ​Figure1C1C).
The raspberry ketone is actually one of the most expensive products used in the food industry — the natural compound can cost as much as $20,000 per kilogram. Plus, extraction of pure raspberry ketone requires an insane amount of raspberries. Extraction occurs through hydrogenation and takes about a kilogram of raspberries (over 2 pounds) to make 1.4 milligrams of raspberry ketones. Considering a standard supplemental dose for humans is around 100–200 milligrams, that’s a lot of raspberries! This is exactly why some supplement companies use synthetic raspberry ketone, which is much cheaper. (1)

There's a fair amount of guesswork to the estimates, but perhaps as many as 20% of American adults have some degree of fatty liver disease, a condition that used to occur almost exclusively in people who drink excessively. The epidemics of obesity and diabetes are to blame. Fatty liver affects between 70% and 90% of people with those conditions, so as obesity and diabetes have become more common, so has fatty liver disease.


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Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
Many parts of the body come to grief once people become obese or develop diabetes. It's not surprising that our livers do too, given how central they are to a whole suite of metabolic processes. There's some evidence that a fatty liver may add to the already high risk of heart disease among people who are obese or have diabetes. Fatty livers can also develop into cirrhotic ones if the inflammatory processes take off.
“Believe in yourself and know that you can achieve your goals,” Noble says. “Know that this will take some time, but understand that it took time for you to get to your starting point. The principles outlined in this book are easily sustainable, inexpensive to follow and will provide you with basic rules that allow you to structure your life eating at home or in a restaurant if needed.”
Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.
Although no specific treatment exists, weight loss can improve and possibly even reverse fatty liver disease to some degree. Shedding excess pounds through diet and exercise or with the help of weight-loss (bariatric) surgery can prevent additional liver damage when inflammation and scarring is already present. However, any weight loss should be gradual — no more than a few pounds a week — because losing weight too quickly can actually worsen fatty liver disease.

While the efficacy of policosanol remains debatable, the good news is that the clinical studies so far report few to no adverse reactions with usage. While using therapeutic dosages of 5-25 mg daily, liver damage/toxicity and other common supplement concerns have not been seen with policosanol from sugar cane extract or rice bran wax. A list of side effects on Mayo Clinic is not published, presumably because it’s one of the lesser known cholesterol lowering supplements. (21)

What to eat for a fatty liver Fatty liver disease damages the liver, preventing it from removing toxins and producing bile for the digestive system. Making good dietary choices and exercising regularly can effectively manage fatty liver disease. Eating natural foods that are high in fiber and protein can provide energy and help the body feel full. Read now
According to Cederquist, menopause can lower the body’s calorie-burning ability. When women go through menopause, their estrogen levels drop, which can lower their metabolic rate. It can also cause them to accumulate more belly fat. To reduce your overall caloric intake, sign up for Everyday Health's free Meal Planner, a tool that delivers daily recipes and meal ideas based on your weight loss goal.
For the past few million years, the only way for humans to make use of ketones for fuel was to restrict carbohydrates low enough and long enough to induce the liver to make them. This is admittedly hard for many people to do in a world that still believes that dietary carbs are good and fats are bad. An emerging alternative is to consume ketones as a dietary supplement. The research into how these function in the body and what benefits they can confer remains early stage, but there are already a number of such products available for sale. In this section, we will discuss how exogenous ketones affect blood ketone levels, and how they may influence health and disease compared to ketones produced within the body.
Another source of the D-BOHB isomer is an evolutionarily ancient energy source for micro-organisms. Poly-BOHB is a long chain of D-BOHB molecules strung end-to-end. It functions in many single-cell organisms as a concentrated energy source similar to glycogen in mammals, but whereas glycogen breakdown releases individual glucose molecules, poly-BOHB hydrolysis releases single D-BOHB molecules.
Dieting is a numbers game. Ingest fewer calories than you burn, and you’re guaranteed to lose weight. However, calorie counting isn’t easy for everyone, especially if it means giving up your favorite foods. That’s why many individuals wanting to shed those extra pounds have turned to flexible dieting. Instead of traditional calorie counting, this weight loss method allows you to eat foods based on their carbs, fat, and protein while limiting, but not eliminating, sugars. The result is a diet that works and keeps you motivated.

Eat more high-quality foods. Stick to a diet with whole, unprocessed foods, and eat them often. "Eating a very low-calorie diet or excessively exercising and not eating enough often leads to a slower metabolism," Anzlovar says. Her clients are often surprised when she tells them they need to eat more. Eat every three to four hours to prevent the starvation mode that tells your body to conserve energy instead of burning it.
An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood. Under normal circumstances, these enzymes reside within the cells of the liver. But when the liver is injured, these enzymes are spilled into the blood stream, and can lead to diseases like fatty liver, type 2 diabetes, obesity, and hepatitis. Several medications also can increase liver enzyme test results.
Most of the research done on Exogenous Ketones has been done in the context of disease research, I.E. the effect taking them has on Alzheimer's, Epilepsy, Cancer, Diabetes, and Heart Disease.  Some research has been done on using Exogenous Ketones for athletic performance, and within those studies the focus was on whether they provide an extra source of fuel for the body when pushed to it's limits.

Other medications that may cause liver inflammation, most of which will resolve when the medication is stopped. These include antibiotics such as nitrofurantoin (Macrodantin, Furadantin, Macrobid), amoxicillin and clavulanic acid (Augmentin, Augmentin XR), tetracycline (Sumycin), and isoniazid (INH, Nydrazid, Laniazid). Methotrexate (Rheumatrex, Trexall), a drug used to treat autoimmune disorders and cancers, has a variety of side effects including liver inflammation that can lead to cirrhosis. Disulfiram (Antabuse) is used to treat alcoholics and can cause liver inflammation.
Nonalcoholic fatty liver disease (NAFLD) — a condition in which excess fat accumulates in the liver of people who drink little or no alcohol — has become one of the most common liver diseases in the U.S. It's estimated that the disorder affects up to 20 percent of American adults. Researchers believe this is associated with rising rates of obesity. While some studies have shown a benefit from vitamin E and the prescription medication pioglitazone, the focus is generally on treating the risk factors.
The most expensive but highly regarded test is the direct calorimetry test. A direct calorimeter is a large insulated, air-tight chamber. During a test you spend at least an hour inside the chamber with minimal movement. During that time your released body heat (including expired carbon dioxide and vapors) is measured. Based on these measurements, a resting metabolic rate is calculated. In most situations, this test is not practical due to the expensive equipment needed and the time you need to spend laying in the chamber.
Methods and Results: In the first study, 15 participants consumed KE or KS drinks that delivered ~12 or ~24 g of βHB. Both drinks elevated blood D-βHB concentrations (D-βHB Cmax: KE 2.8 mM, KS 1.0 mM, P < 0.001), which returned to baseline within 3–4 h. KS drinks were found to contain 50% of the L-βHB isoform, which remained elevated in blood for over 8 h, but was not detectable after 24 h. Urinary excretion of both D-βHB and L-βHB was <1.5% of the total βHB ingested and was in proportion to the blood AUC. D-βHB, but not L-βHB, was slowly converted to breath acetone. The KE drink decreased blood pH by 0.10 and the KS drink increased urinary pH from 5.7 to 8.5. In the second study, the effect of a meal before a KE drink on blood D-βHB concentrations was determined in 16 participants. Food lowered blood D-βHB Cmax by 33% (Fed 2.2 mM, Fasted 3.3 mM, P < 0.001), but did not alter acetoacetate or breath acetone concentrations. All ketone drinks lowered blood glucose, free fatty acid and triglyceride concentrations, and had similar effects on blood electrolytes, which remained normal. In the final study, participants were given KE over 9 h as three drinks (n = 12) or a continuous nasogastric infusion (n = 4) to maintain blood D-βHB concentrations greater than 1 mM. Both drinks and infusions gave identical D-βHB AUC of 1.3–1.4 moles.min.
But why does fasting work where regular diets fail? Simply put, during fasting, the body switches from burning sugar to burning fat for energy. Free fatty acids (FFA) are oxidized for energy and FFA synthesis is reduced (body is burning fat and not making it). The decrease in triacylglycerol synthesis results in a decrease in VLDL (Very Low Density Lipoprotein) secretion from the liver which results in lowered LDL.
If you're healthy and eating a balanced diet, your body controls how much fat it burns, and you don't normally make or use ketones. But when you cut way back on your calories or carbs, your body will switch to ketosis for energy. It can also happen after exercising for a long time and during pregnancy. For people with uncontrolled diabetes, ketosis is a sign of not using enough insulin.
You can cut calories and keep your appetite in check by replacing candy and other high-sugar foods with complex carbohydrates. Fruit, vegetables and whole-grain varieties of bread, cereal and rice contain carbohydrates that take your body longer to use. Whole-grain cereals contain less added sugar than many processed cereals. Substituting white rice, which has a glycemic index of 89, with brown rice, with a glycemic of 50, can keep your blood sugar levels steady and reduce your urge to eat between meals, helping you lose weight.
That’s why David Zinczenko developed Zero Sugar Diet. The easy-to-follow 14-day plan is designed for even the most hardcore sugar addicts to reduce their intake of added sugars and fast track their weight-loss goals. And you won’t just notice the number on the scale creeping down; cutting back on sugar will help you sleep better, give you more energy, and even make you look younger.

The protocols carried out in these studies were approved by the the South West Frenchay NHS REC (15/SW/0244) (Study 1) and London Queen's Square REC (14/LO/0288) (Study 2 and 3). The studies were carried out in accordance with the recommendations of the Declaration of Helsinki, apart from pre-registration in a database. All subjects gave written informed consent in accordance with the Declaration of Helsinki.
These results demonstrate that maintenance of weight reduction and increased physical activity result in a sustained improvement in ALT, fasting insulin levels, and HRQL in overweight patients with chronic liver disease. This sustained improvement was seen both in patients with NAFLD and in those with steatosis in association with another chronic liver disease.

Grade of hepatic steatosis 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 = 2 and after = 1 (p<0.0001). Open symbols represent those patients with additional histological features of non-alcoholic steatohepatitis.
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While I am not yet at my ideal body weight, the improvements are dramatic. My blood glucose is now normal and stays normal throughout the day (and I’m not taking diabetes medication), and my liver enzymes have decreased and are now within the normal range. The important point is that you do not need to get all the way to your ideal weight to see dramatic improvements in liver health and other important health benefits. This is not an all-or-nothing proposition, and every little bit helps.
“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.”
In the Type 2 Diabetes Reversal program, we correct the insulin resistance which is the root cause of type 2 diabetes. Our patients are able to get off the oral diabetes medications and insulin injections. Our patient are able to get their blood sugar level under control, reversing the course the disease and get off their oral diabetes medications and insulin injection.

The first step was filling out daily logs of everything I ate, when, where and even why — for example, whether I felt hungry before eating. This exercise helps determine whether clients eat because they’re hungry or to fill a psychological need. The logs are also designed to find out how much saturated fat or trans-fat people consume, in foods such as hamburgers or many baked goods.


There are several predictors of how fast or slow a person’s metabolic rate will be. These include the amount of lean muscle and fat tissue in the body, age, and genetics. Women tend to burn fewer calories than men. Having a higher metabolic rate means your body uses food for fuel (instead of storing it as fat) more quickly. But you can still gain weight if you consume more calories than your body needs. Counterintuitively, heavier people generally have higher metabolic rates than skinny folks to meet the fuel demands of their larger bodies.
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