Ketogenic Ratio

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The Ketogenic Ratio is the ratio of the weight of fat to carbohydrate and protein in the Ketogenic Diet. So a daily diet that included 200g fat, 10g carbohydrate, and 40g protein would have a Ketogenic Ratio 4:1. While this is a simple concept, there are many factors that make it a little trickier than it appears.

  • A Ketogenic Diet not only specifies the Ketogenic Ratio, but it typically also specifies the maximum amount of carbohydrate, as carbohydrate is far more anti-ketogenic.
  • The Ketogenic Ratio assumes that the total calorie intake matches the ideal intake for age and weight.
    • If fewer calories are taken for weight loss, then the burned body fat needs to be included in the ratio. For example, assume an adult that needs 2,000 calories. If they only consume 100g fat, 10g carbohydrate and 40g protein, the diet provides 1,100 Calories and they burn 900 Calories of body fat (100g). That is a true Ketogenic Ratio of (100+100) to (10+40) or 4:1.
    • It's less clear what happens if more calories are required for exercise. My personal experience suggests extra exercise does not allow for a proportionately greater carbohydrate or protein intake.
  • The carbohydrate intake is measured as Net Carbohydrates, which ignores carbohydrates that are Fiber. Sugar alcohols are sometimes ignored and sometimes included, and probably should be at least partly included in the carbohydrate count.
  • Monounsaturated and polyunsaturated fats tend to produce more Ketones than saturated fat. However, it has been noted that high levels of Omega-6 oil cause Nausea and digestive problems, so Omega-3 and monounsaturated fats may be better.
  • MCT raises Ketone levels directly, even without carbohydrate restriction.
  • The timing of food intake can impact ketone levels. Taking a disproportionate amount of the carbohydrates (or even protein) in a meal can rapidly lower ketone levels.
  • Those with little or no body fat, especially children, may run out of available fat and start to burn muscle, which will drop ketone levels.
  • There are a number of unexpected sources of carbohydrate that can reduce Ketone levels:
    • Carbohydrate can be absorbed via the skin from suntan lotion (sunscreen), lipstick or soap.
    • Toothpaste contains carbohydrate, so it's important not to swallow any while during routine brushing. It may be necessary to rinse with water to wash out any residual toothpaste.
    • Processed foods can contain up to 0.9g carbohydrate per serving while declaring "0g carbohydrate" and other rounding errors can occur. If in doubt stop taking all processed foods to troubleshoot unexpectedly low ketone levels.
    • Medications can contain carbohydrate, especially liquid formulas given to children.
    • IV medication sometimes contains glucose (this is mostly an issue for children being treated for epilepsy with the ketogenic diet).

See Also