carbohydrate

One of the questions that is asked over and over on low carb websites and forums of all persuasions is “what sweeteners can I use”?

Well, I was going to write this blog post all by myself, but I have come across three incredibly useful resources recently, so I will bow to them.

Top 10 Natural Low-carb Sweeteners

First comes a handy list of low-carb sweeteners from the Keto Diet App (I have just bought this and will review it soon).

The list isn’t nearly as comprehensive as the Sugar and Sweetener Guide, below, but covers most of the sweeteners that we get asked about:

  1. Stevia
  2. Erythritol
  3. Xylitol
  4. Mannitol
  5. Chicory root inulin
  6. Raw honey
  7. Coconut palm sugar
  8. Maple syrup
  9. Date syrup
  10. Blackstrap molasses

There are some there that anyone into low-carb would bristle at, never mind if you’re on a ketogenic diet.  However, their “get out of jail free card” as far as I am concerned is this, from that blog post:

Sugar is sugar – no matter how healthy it is, it will impair your weight loss.

Hear, hear!  And probably kick you out of ketosis, and wreck your blood glucose numbers if you’re a diabetic.  The article describes each one, with pros and cons, and lists them in terms of sweetness, net carbs, glycemic index and do on.

Shame it doesn’t mention Luo Han Guo, which should be in there as sweetness index 300, 0 carbs, 0 GI, and a pro of not having the bitter aftertaste that some find stevia has.

Sugar and Sweetener GuideThe Sugar and Sweetener Guide

Next is an amazing website: The Sugar and Sweetener Guide.  It is a positive encyclopedia of all things sweet, both natural and artificial.

Probably the place to start is the “Comprehensive All Sweetener List” and then look at the “Sweetener Values including Calories and Glycemic Index“.  It list sweeteners by “Sweetness Index”.  Given that sucrose has a sweetness index of 1 (and fructose of 1.7, which explains why sucrose tastes less sweet than ordinary table sugar, which is a mixture of sucrose and fructose, and powdered glucose, sweetness index 0.75, tastes even less sweet), I was amazed to discover that there is a natural sweetener, Thaumatin, with a sweetness index of 2000, and an artificial sweetener, Neotame, with a sweetness index of 8000!  The mind boggles.

The Sweetener Book

Lastly there is The Sweetener Book by D. Eric Walters, Ph.D.  If the other two resources haven’t answered all your questions, then this might do it!  You can buy a paperback: [simpleazon-link asin="0989109208" locale="us"]The Sweetener Book (US Edition)[/simpleazon-link], or [simpleazon-link asin="0989109208" locale="uk"]The Sweetener Book (UK Edition)[/simpleazon-link] or the US Kindle Edition, or the UK Kindle Edition.

Again, it covers an encyclopaedic amount of information about sweeteners that everyone is discussing, and many you’ll only have heard of if you’re a food scientist.

You can review the contents of the book on the website: http://www.sweetenerbook.com/

Food Babe Investigates Stevia: Good or Bad?

At the head of this post I said I had three important links.  SInce then, I have discovered this article by the Food Babe in which she looks critically at the way some (most?) commercial brands of stevia re made.  In particular, some of the (“Stevia in the Raw”, for instance) has more erythritol than stevia, and the erythritol is made from GMO corn).

I don’t agree with 100% of what she says.  At the bottom of the post she says

And when all else fails, choose a suitable alternative and forget stevia altogether. Lisa uses honey and pure maple syrup, and I personally prefer coconut palm sugar, since it is low glycemic (making it more diabetic friendly)

Well, if you’ve followed some of the links above, especially the “Sweetener Values including Calories and Glycemic Index“, you will have formed your own opinion about honey, maple syrup and coconut palm sugar.  All depends whether you are T2 diabetic and/or if you’re trying to stay in ketosis.

[simpleazon-image align="right" asin="B000V3IV3O" locale="uk" height="160" src="http://ecx.images-amazon.com/images/I/317R0BJJLuL._SL160_.jpg" width="160"]Folk on the ketogenic diet usually test their ketogenic status using Ketostix.  You wee on them and (hopefully) they go pink to purple.

However, they are significantly less than accurate!

Firstly, as you head towards “nutritional ketosis” two substances are produced that are found in the urine: acetoacetate and beta-hydroxybutyrate.  It is the latter, beta-hydroxybutyrate that we are interested in, but, as Phinney and Volek say:

the strips that test for ketones in the urine detect the presence of acetoacetate, not beta-hydroxybutyrate

They go on:

In the kidney, this process of keto-adaptation is also complex. Over time, urine ketone excretion drops off … This decline in urine ketones happens over the same time-course that renal uric acid clearance returns to normal  and thus may represent an adaptation in kidney organic acid metabolism in response to sustained carbohydrate restriction.

[simpleazon-image align="right" asin="B005CVV2AE" locale="uk" height="160" src="http://ecx.images-amazon.com/images/I/515TE8b8jLL._SL160_.jpg" width="106"]So we are not only measuring the wrong thing (acetoacetate vs beta-hydroxybutyrate), but over time acetoacetate excretion drops off (which is why so many people in ketogenic forums and Facebook groups keep asking why they are “no longer in ketosis” (as measured by the Ketostix) when they are being good and sticking to the diet.  Phinney and Volek conclude:

These temporal changes in how the kidneys handle ketones make urine ketone testing a rather uncertain if not undependable way of monitoring dietary response/adherence. Testing serum for beta-hydroxybutyrate is much more accurate but requires drawing blood, and it is expensive because it is not a routine test that doctors normally order.

From [simpleazon-link asin="B005CVV2AE" locale="uk"]The Art and Science of Low Carbohydrate Living[/simpleazon-link]

Well, there’s something they didn’t know when they wrote that: you can now do serum testing (testing the level of beta-hydroxybutyrate in your blood) at home with a simple meter that is similar to a blood glucose meter.

I have recently found a brand-new meter, an upgrade from the Precision Xtra, which is called the Freestyle Optium.  I got mine for free!  Further down this post, I will tell you how (although it may only be possible in the UK).  So what follows between the rules is how it was until recently, and how it may still be outside the UK.

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There are a couple of meters you can use, and they have been tested and compared by Jimmy Moore in his n=1 reports on his own progress with nutritional ketosis.  One of the meters comes out badly in his review: you have to remember that these meters were not intended for the likes of us, who are trying to achieve nutritional ketosis, as defined by Phinney and Volek.

They are designed for Type 1 diabetics who are trying to avoid keto-acidosis (more of this further down this blog post).  Which is why one of the meters just says “LO” for low measurements: that’s good enough (and good news) for someone who is Type 1.

Jimmy comes out in favour of [simpleazon-link asin="B0000537OO" locale="uk"]Precision Xtra Meter[/simpleazon-link], because it is capable of the levels of accuracy that we need.

However, especially if you live outside the USA (like, in the UK, as I do for a significant part of the year) the cost of the test strips for  the Precision Xtra is a serious expense.  In Amazon UK this pack is £66 plus £2 delivery for 10 (yes, that’s right, TEN!) strips. [simpleazon-image align="left" asin="B001EL30TM" locale="uk" height="160" src="http://ecx.images-amazon.com/images/I/21xRxYm7hhL._SL160_.jpg" width="160"]

That comes to £6.80 every time you do a test.  I suspect you won’t test all that often!  The meter from Amazon.co.uk is £25.48, including delivery.

If you are in the USA, the cheapest place I have found to get a Precision Xtra is MedExSupply.com, where, at the time of writing (August 10, 2013), it was $18.00.  The best source of test strips is Universal Drugstore in Canada, where they come out at $2.00 a strip (plus $7.00 shipping).  UDS need a prescription from your physician:here’s the e-mail they sent me describing what they need: Universal Drugstore e-mail.

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However, that’s the bad news.  Here’s the good news: I just got a brand-new, latest model meter for free, and 10 β-ketone test strips for £16.99.  (Actually, I bought three boxes and paid extra for express delivery.)  That comes out to $2.55 a test.

Optium in hand

Abbott Freestyle Optium

I had got so frustrated with my research that I Googled Abbott (the makers of the Precision Xtra) and discovered that they have a company in the UK, Abbott Diabetes Care.  I called them and asked them about the Precision Xtra and they said that there’s a new model, the Freestyle Optium, and would I like them to send me one for free.  I said yes, and two days later it arrived.  It is a very cool little machine!

It measures both blood glucose and blood ketones (FreeStyle Optium β Ketone test strips for self-testing your blood ketones).

After quite a bit of Googling I found by far the cheapest source of these test strip on eBay: Freestyle Optium Beta B-Ketone Test Strips Pack Size 10.

If you want one too, call Abbott Diabetes Care in the UK on 0500 467 466 (it’s even a free phone number).

If you find information about this for other countries, let me know and I’ll add it here.  And when my test strips arrive next Tuesday, I’ll let you know how I get on.

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See also:

Ketogenic What is a Ketogenic Diet, in a nutshell?
Ketogenic A Guide to Ketosis
Ketogenic What is the Ketogenic Diet Good For?
Ketogenic Tips for Starting and Restarting Ketosis
Ketogenic On Ketogenic Diets
Ketogenic How to Use the Keto Calculator
Ketogenic Ketone Testing
Ketogenic A one-page intro to Ketogenic Diets, to hand to medical sceptics
Ketogenic 203 Comments on Mark Maunder’s “Basic Ketogenic Diet”

I am a member of three on-line “keto communities”, as well as blogging about ketogenic diets myself:

A frequent question in these communities is “what should I eat?”  This question might mean “what proportion of carbs, proteins, and fats should I eat?”  It might mean “what actual foods can I eat, and in what quantities?”  In every case the answer is always “it depends …” which is highly frustrating for the person asking the question.

There are some calculators out there, but quite a few people, especially those less confident as computer users, or less confident with math (or both) have had trouble using them.  This blog post intends to help!

At the moment it is only talking about one calculator, Martin Ankerl‘s Keto Calculator: http://keto-calculator.ankerl.com/.  This video should explain all.  Below are some links that you might find helpful.  Some notes appear as the video runs: you will find them easier to read if you make the video full screen (click the icon in the bottom right of the video).

httpv://www.youtube.com/watch?v=vyRnunLjDvI

kcal or kilo-calories.  It’s all very confusing, but a calorie is the amount of heat that it takes to warm up one cc of water by one degree centigrade.  A Calorie (with a capital “C”), also known as a kilo-calorie (kcal) is what nutritionists use, and most people just lose the “k” and don’t bother with the capital “C”.  So, if you see kcal or kilo-calorie, just know that that is what dieters call a “calorie”.  Summary: don’t worry: ignore the “k”!

Basic Metabolic Rate: The energy it takes to stay alive without losing or gaining weight.

Lean Body Mass: How heavy you would be if you had no body fat.  Note: if you had NO body fat, you would be dead!  You always need some, just to stay alive.

[simpleazon-image align="left" asin="B00BKRQ4E8" locale="us" height="107" src="http://ecx.images-amazon.com/images/I/31Bq256DbwL._SL160_.jpg" width="160"][simpleazon-image align="right" asin="B00BKRQ4E8" locale="uk" height="107" src="http://ecx.images-amazon.com/images/I/31Bq256DbwL._SL160_.jpg" width="160"][simpleazon-image align="left" asin="B0077L8YOO" locale="us" height="160" src="http://ecx.images-amazon.com/images/I/41Gn7SxiNWL._SL160_.jpg" width="160"][simpleazon-image align="right" asin="B0077L8YOO" locale="uk" height="160" src="http://ecx.images-amazon.com/images/I/41Gn7SxiNWL._SL160_.jpg" width="160"]

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Body Fat Percentage: What percentage of your weight is body fat.  There are various ways of measuring it.  Many fancy modern bathroom scales will do it for you, if you just step on in bare feet.  Pictures on the left for USA, on the right for UK.

A simpler method is to look at pictures of people, labelled with their body fat, and pick out the nearest to you.  There is a good set of body-fat pictures here.

MFP: My Fitness Pal — software to help you keep a food and exercise log, and work out what you have eaten in terms of carbs, protein and fats.  (It’s free!)  Go to their home page, scroll down a little and watch the video.  I am not going to create a MyFitnessPal “how to” video, because there are dozens on You Tube.  Here’s one I picked at random:

httpv://www.youtube.com/watch?v=ReLbeXq0vTI

That’s it for now: I will be adding a tutorial on http://www.eatthismuch.com/ a little later.

Effective Exercise: I believe that Nordic Walking is the best exercise for people on a ketogenic diet.  Overview here, “How to Get Started with Nordic Walking” here, Who can do Nordic Walking here.

See also:

Ketogenic What is a Ketogenic Diet, in a nutshell?
Ketogenic A Guide to Ketosis
Ketogenic Tips for Starting and Restarting Ketosis
Ketogenic On Ketogenic Diets
Ketogenic Ketone Testing
Ketogenic A one-page intro to Ketogenic Diets, to hand to medical sceptics
Ketogenic 203 Comments on Mark Maunder’s “Basic Ketogenic Diet”

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