Ketones

The Ketogenic Diet produces three types of Ketone. (Add diagram of the ketones and their relationships.)

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There are three important ketones involved in Ketogenic Diets.

• Acetoacetic acid (AcAc). AcAc is the ketone that is produced by the liver from fats and can be metabolized to provide energy. It could be considered the most directly useful of these ketones to the human body. However, AcAc lowers the blood pH, causing potential acidosis. AcAC spontaneously decomposes into Acetone (half-life 11.7 hours at 27c).
• Acetone. Generally is often believed to be a waste product, but it has now shown to be metabolically active. It is excreted through the breath and urine, which can sometimes be detected as a fruity smell.
• Beta-hydroxybutyrate (BOHB). Unlike AcAc, BOHB is stable and does not change blood pH. AcAc is converted to and from BOHB in the liver and muscles. Technically BOHB is not a Ketone.

1 Relative Ketone Levels

• The ratio between AcAc and Acetone appears reasonably constant, and is based on the spontaneous, one way decomposition of AcAc into Acetone.
• The ratio of AcAc to BOHB is rather more varied and may change with Ketoadaptation.

From "Physiological roles of ketone bodies as substrates and signals in mammalian tissues":

Situation	Ketone Levels (Blood levels of AcAc + BOHB)
Fed	~0.1
Fasted 12-24 Hours	Up to 0.3
Fasted 48-72 Hours	2-3
Fasted 5-6 weeks (plateau)	~8
Post exercise	Up to 2
Late Pregnancy	Up to 1
Late Pregnancy, fasted 48 hours	4-6
Neonatal	0.5-1.0
Hypoglycemia	1-5
Controlled diabetes	Up to 25

Ketone Metabolism

• Ketones are used by most tissues in the body with the exception of those cells that have few or no mitochondria. (more at A review of low-carbohydrate ketogenic diets)
• Cells with no mitochondria include erythrocytes, cornea, lens, and retina
• Cells with few mitochondria include renal medulla, testis, and leukocytes
• These cells are dependent on Glucose.

2 See Also

• The classifications and types of Low Carbohydrate Diet.
• An introduction to the Ketogenic Diet.
• My experiences with ultrarunning on the Ketogenic Diet
  • How the Ketogenic Diet can be used for the treatment and management of disease.
    • Using the Ketogenic Diets to mitigate and treat Epilepsy
    • How Ketogenic Diets might help with Cancer
    • A look at the possible mechanisms of action of the Ketogenic Diet
  • Health Risks of the Ketogenic Diet
    • Health Checks for the Ketogenic Diet
    • Supplements for the Ketogenic Diet
  • The time frame and changes that occur with Ketoadaptation
  • What are Ketones
    • How to measure Ketones
    • What ketone levels to aim for
  • The pros and cons of the Ketogenic Diet for athletes
    • The Science of Ketogenic Exercise
  • The Types of Ketogenic Diet
    • The "traditional" Ketogenic Diet based on the Ketogenic Ratio
      • The ways the Ketogenic Ratio can be calculated
        • The different definitions of Net Carbohydrates
    • Low Glycemic Index Treatment
    • MCT Diet
      • MCT
    • Modified Atkins Diet (M.A.D.)
• My Ketogenic Recipes
• Non-Ketogenic Low Carbohydrate Diets

References