Tuesday, January 14, 2020

Dear Mark: Abandoning the Keto “Fad,” Ketone Study Calories, and Low-Lactose Fat

For today’s edition of Dear Mark, I’m answering three questions from readers. First, does the renewed vigor assailing the keto diet have me worried about my business? Should I start going vegan to cover all my bases? Second, did the “ketones for overtraining” study from last week control for calories? And third, how can a person eat enough fat if they’re avoiding lactose?

Let’s go:

Interested to see if Mark’s focus on keto will continue now that the trend factor is wearing off. That VICE piece, flawed though it may be, is part of a much larger media pushback against keto. What are the business implications of aligning yourself with a so-called “fad diet”?

I’ve built a pretty good business by aligning myself and my writing and my products with “fad diets.”

I generally use several factors to determine where to align myself and target my work:

  1. Personal experimentation. What am I trying? What kind of diet, exercise, and lifestyle modifications am I experimenting with? The quality of my work suffers if I’m not fully engaged on a personal level. I’m not a technical writer. I need to live my subject matter for it to come alive on the page.
  2. Personal needs. What works for me? What gets me going? What am I interested in, drawn toward on an intuitive level? What am I missing? Even my best products were designed with my own selfish desires in mind. I made Adaptogenic Calm because I needed a way to recover from excessive endurance training, and it turned out that tons of other athletes needed it, too. I made Primal Mayo because I was sick of whipping up a batch of homemade mayo every time I wanted tuna salad without all the soybean oil. I went keto because the research fascinated me. It turns out that the things I vibe with tend to resonate with others, too. Humans are often quite similar to each other. Not all of them, but there are enough that are.
  3. Your needs. What does my audience want? What do they need? What kinds of questions are they asking me? What feedback am I getting from them? How are they responding to what I’m putting out?
  4. New information. I’m always ready to pivot when new information is made available or when new research arises. Sometimes a reader will point something out and it will change the trajectory of my thinking and writing. I try not to wed myself to my ideas, to the things I want to be true, even though that’s a human foible that’s unavoidable. I always try to approach a subject in as intellectually honest a manner as I can. To me, new developments, even if they appear to contradict a stance I hold, breathe new life into my work. For example, I’m definitely biased toward lower-carb approaches for most people. They just clearly work better for the bulk of the people who encounter my work and who struggle with their health and weight in modern industrialized countries. Most people don’t perform enough physical activity to warrant perpetual “high-carb” diets, and most people find weight loss is easier and hunger lower on lower-carb, higher protein/fat diets. But at the same time, there’s room for higher-carb intakes, or even moderate-carb intakes. And can people eat high-carb and be healthy? Have populations lived well on high-carb diets? Absolutely.

Keto still satisfies these factors. Now, I’m always looking toward the horizon; I think my ancestors were probably explorers of some sort. It’s in my blood. So I probably will write about something else—next week, next month, and years from now. But my overall “thrust” will still be low-carb/Primal/keto because, well, the stuff just works.

What I wonder after reading this is: Would there have been a significant inter-group difference had calories been controlled for? Ketone esters obviously have some caloric value that the control group did not receive. How much of the benefit is merely having a better caloric intake to support this intense training protocol?

Good question—this is in regards to the study discussed last week. They actually did control for calories. The experimental group got the ketone ester drink. The control group got an isocaloric medium-chain triglyceride-based drink. Both groups consumed the same amount of calories.

Having tracked through to Michael Eades’ blog on cholesterol—how do you increase fat when you are lactose intolerant? A problem for myself and my adult children. I hadn’t realized that high fat was the actual content rather than the percentage!

Oh, man, there are so many ways to increase fat while lactose intolerant.

My favorite way is to focus on whole food sources of fat, rather than isolated fat sources:

  • Fatty animal foods: a ribeye, a beef shank, some ground beef. A lamb shank, some lamb chops. Bacon, eggs, sausage.
  • Fatty plants: olives, coconut, nuts (favoring higher MUFA nuts like macadamias), dark chocolate. Salads, which aren’t “fatty” without the dressing and meat but I’m counting as “whole foods” because that’s the effect of eating them.
  • Whole avocados: great source of potassium, fiber (if you want that), and polyphenols.

Foods like my Primal Mayo or avocado oil dressings, while technically “isolated” or “refined,” allow and promote the consumption of nutrient-dense whole foods like tuna (tuna salad), eggs (deviled eggs, egg salad), cruciferous veggies (slaws), and steaks (try searing a steak covered in mayo). And even our mayo isn’t nutritionally bereft—it contains choline, folate, and all the other good stuff found in eggs. And our dressings are full of spices and herbs that confer health effects through their phytonutrients.

Also, don’t think you have to focus on “increasing fat.” That’s the mindset that leads to things like chugging olive oil and eating a bowlful of sour cream. High level athletes who need calories at any cost can get away with and even benefit from that, but for most people it makes more sense to focus on reducing excess carbohydrates and eating whole-food sources of fat as they appear naturally.

Also, the lactose intolerant can still have dairy. Try hard cheeses, Greek yogurt, and yogurt and kefir that’s clearly marked “low” or “no lactose.” Butter is fine in all but the most severe cases, and cream is not far off from butter. Ghee is another good cooking fat that should be near zero in lactose.

Anyone else have good “lactose-free” fat sources? Anyone else worried about “keto as a fad”?

Thanks for reading, everyone. Take care!


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Keto Pills: Why I’m Highly Skeptical

keto pills inlineThere are a dizzying number of keto pills on the market now. They promise easy weight loss, increased energy, and the benefits of ketosis without the pesky following-a-strict-diet part.

As savvy MDA readers, you know that optimal health never comes in a bottle. You also know that I’m a proponent of wise supplementation to support a Primal diet and lifestyle when appropriate. I’ve said before that I think exogenous ketones can be useful in specific circumstances, though they’re never necessary for success.

The question at hand is whether keto pills are likely to offer any benefit or if they’re a waste of money. I focused on pills that seem to be popular on Google searches and Amazon—ones with names like Ultra Fast Keto Boost, Super Fast Keto Boost, Keto Burn Xtreme, Instant Keto, and Keto Slim Rx. (My Amazon search history is shot now. This is the sacrifice I make for my readers.)

First Impressions: Are Keto Pills a Scam?

My first impressions weren’t positive—let’s just say that. 

These products are being sold as diet or weight management pills. Their descriptions strongly imply, or sometimes state outright, that the pills will help you lose weight and “enjoy a slim and fit physique.” Most of the claims center on the general promise that being in ketosis causes you to burn fat and, by extension, lose weight (it doesn’t necessarily), and that their products will help keep you in ketosis (a claim I’ll investigate below).

The biggest red flag was when I noticed how many Amazon customers were trying to find the keto pill featured on the TV show Shark Tank. This was news to me, so I did some digging. Apparently there was a popular scam a while back wherein sellers claimed that their keto pills appeared on Shark Tank, and the sharks went wild for them. You didn’t miss anything. This never happened.

Only one product that I looked at—Keto Burn Xtreme sold by Advanced Life Science—still had that on their Amazon page as of December, 2019. It seems like some of the other products might have been falsely advertising this in the past based on older reviews and questions, though.

So it wasn’t looking good off the bat, but I’m an open-minded guy. Bad marketing doesn’t necessarily mean an ineffective product. Sure, the Amazon reviews for these pills are pretty negative overall, but maybe people just aren’t giving them a fair chance? Some folks like them, after all. Let’s try to be objective here.

Do These Keto Pills Contain Ketone Bodies?

Assuming you can trust the labels: Yes. 

Exogenous ketones come in two forms: ketone salts and ketone esters. Ketone salts in commercial products are the ketone body beta-hydroxybutyrate (BHB) bound to a salt. Ketone esters are ketone bodies bound to alcohol.

All the keto pills contain ketone salts because they are easier and less expensive to manufacture than esters. On the label they’ll list BHB bound to minerals, such as “calcium beta-hydroxybutyrate” and “magnesium beta-hydroxybutyrate.”

Do the Pills Contain Enough BHB to Be Effective?

Short answer: No, not likely. 

A keto pill might “work” because it successfully raises blood ketone levels or because it brings about a desired outcome such as weight loss or improved athletic performance. In any case, keto pills are unlikely to hit the mark, but I’ll get to that.

Both ketone salts and esters raise blood ketone levels, but esters are considerably more effective. In laboratory studies, even large doses of ketone salts usually yield blood ketone levels to between 0.5 and 1.0 mmol/L. That’s enough to qualify as being in ketosis, but it’s not a knock-your-socks-off result by any means. It’s what you’d expected from following a standard keto diet. Still, plenty of people notice that they have more energy and decreased appetite in this range.

It’s probably not enough to profoundly affect certain health markers or athletic performance. For example, a panel of respected exogenous ketone researchers agreed that blood ketone concentrations in excess of 2.0 mmol/L are needed to boost athletic performance. Ketone esters can get you there, which is why most studies demonstrating the efficacy of exogenous ketones use esters. Studies using ketone salts yield decidedly more mixed results.

How Much BHB Salt Is Needed to Be Effective?

There is no agreed upon minimally effective dose for BHB salt. However, let’s use some laboratory studies as a reference point:

  • In this paper, Study 1, participants received about 24 grams of BHB, and their average blood ketone levels peaked at 1.0 mmol/L.
  • In this study, researchers gave participants 11.7 grams of BHB prior to exercise and then a second dose 45 minutes later during exercise. Blood ketones averaged 0.6 ± 0.3 mmol/L.
  • These researchers gave participants two doses of 18.5 grams BHB, which they noted was 60% more than the standard dose recommended by the manufacturer, prior to exercise. Blood ketones measured 0.33 ± 0.16 mmol/L prior to exercise and 0.44 ± 0.15 mmol/L at the end of exercise about an hour later.
  • Finally, these participants ingested 0.3g/kg of BHB, which would be about 24 grams for a 175-pound individual. Blood ketone levels peaked below 1.0 mmol/L.

How Do Keto Pills Measure Up?

Answer: Badly

Of the keto pills I looked at, the highest dose of BHB I saw per serving was 1000 mg, or 1 gram, in Ultra Fast Keto Boost Pro.

It turns out that many of the products contain the same BHB product, goBHB®. For example, Ultra Fast Keto Boost, Insta Keto, Keto Burn Xtreme, and Keto Slim Rx* sold on Amazon by nutra4health LLC are all the same goBHB blend at different price points ($19.95 – $39.95 for 30 servings). Super Fast Keto Boost and Ultra Fast Keto Boost—same thing. Per serving, goBHB contains 800 mg of BHB.

(*This is not to be confused with the other Keto Slim Rx product on Amazon that doesn’t disclose its ingredients but does promise you can “achieve your dream body” and “skyrocket your ketosis!!”)

Many pills contain even less than that. Pure Keto Boost and Instant Pure Keto list 800 mg of another blend that includes BHB salts plus other ingredients, so less total BHB. Others I checked out contained 700 mg or less.

I’m extremely dubious that 800 or even 1000 mg would meaningfully boost blood ketone levels. This is a mere fraction of the dose used in research. If the researchers could give 1 gram of BHB instead of 12 grams or more and still get a measurable effect, they would. Plus, reputable brands of exogenous ketones such as Perfect Keto and KetoCaNa offer 11.4 and 11.7 grams of BHB per serving, respectively.

Finally, it’s worth mentioning that none of the Amazon reviews I read for any of these products mentioned that the reviewer had tested their blood ketones and saw a rise after taking the pills. (And I read a lot of reviews. Too many.)

Can Ketone Pills Make You Lose Weight?

Answer: No.

These pills claim that they’ll put you in ketosis, which will melt away body fat. Unfortunately, being in ketosis does not guarantee that you’ll burn body fat. You lose weight on a keto diet they same way you do on any other diet: by expending more energy than you ingest.

That said, it’s fair to say that ketosis is an advantaged state for weight loss. Ketones both suppress appetite and increase energy, meaning it’s easier to eat less and move more when in ketosis. Ketones are also anti-inflammatory and they improve blood glucose regulation. These both contribute to having a healthier metabolism so you trend toward your ideal body weight with less resistance.

If these pills actually support ketosis, which I doubt, their main benefit would probably be appetite suppression, not increased fat burning per se, as they imply. Anyway, the sellers frequently state that these should be used in conjunction with a low-carb or keto lifestyle to be beneficial. Thus, even if someone loses weight while taking them, it would be impossible to attribute it to the pills directly.

The Verdict

It’s obvious what I think: Save your money.

If you want to be in ketosis, drop your carbs, play around with intermittent fasting, or just go do a hard workout and wait to eat until W.H.E.N. (when hunger ensues naturally).


Related Posts from MDA

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Ways to Get Fiber, Vegan Macros & Does Collagen “Count” as Protein?

Welcome to the first Instagram Live of 2020! It’s been awhile, hasn’t it?

I’ve received some awesome questions from you guys, so I have four that I’ll answer today. And, of course, keep those questions coming. Feel free to comment below or send me an email or DM on Instagram.

What are some good ways to get fiber in your diet?

So, good ways to get fiber… I think the most obvious is vegetables and fruit. They are super-duper nutritious and have loss of fiber. Other heavy-hitters are oats, ground flax, beans, lentils, quinoa, avocado (did you know avocado is a good source of fiber?). And if you work with me as one of my nutrition clients, you will track your macros and your daily fiber intake. Fiber is so good for digestion, gut health, hormones, weight loss, and more. Fiber goals will depend on the individual. I typically tell my clients to aim for 25 to 35 grams. But, of course, it depends on the person. If you don’t typically eat fiber, going from eating no fiber to 25 grams in a day might cause some digestive issues. Start slow and build up to adding more and more each day.

What would vegan macros look like?

So, that’s the beauty of macros… they work for any diet, so you can be vegan, vegetarian, paleo, gluten-free… whatever way of eating you enjoy. For a vegan, I would typically lower their protein goal, increase their carb goal, and go with a moderate fat goal. Giving a vegan a super high protein goal is just not realistic. I mean, are they going eat tons of tofu? I don’t know… maybe they really like tofu, but it doesn’t seem very appetizing. As a vegan, it’s tough to get a ton of protein, so I would give them more of a realistic balance, especially with regard to carbs for foods like beans, lentils, and grains. I’d start with a ratio like P 20% C 50% F 30% and see how it goes.

Does collagen “count” as protein?

I think it does. You’ve probably heard that collagen is not a complete protein because it doesn’t have all the essential aminos acids in it. I read somewhere it has 8 of 9 of them, so that’s why it’s not technically a complete protein. If you’re eating meat and other sources of animal protein, you’re good to go. You got your bases covered as far as amino acids go.

One thing to know about collagen is that it works better with vitamin C. You don’t necessarily need to consume it with a vitamin C supplement, but if you’re having collagen in in your coffee in the morning, have some fruit or broccoli or something with vitamin C to help it work better.

What is something that drives you crazy about Mal and vice versa? 

Mal is probably gonna kill me for even mentioning this because I annoy him so much about it, but he’s a really heavy breather at night and sometimes snores. It just drives me nuts! I used to wear earplugs, but I feel out of the habit. Now we have a window fan on the floor in our bedroom that drowns out the heavy breathing/snoring.

What drives Mal nuts about me… I leave cabinets and drawers open all the time. I don’t even realize I do it. I feel like I’m pretty aware of what’s going on around me in most situations, but I’m just so oblivious to cabinets and drawers. I shut them as soon as I see them open because I know it drives Mal crazy, but I’m just such a space cadet when it comes to that.

Another thing I’m working on, but, again, it just doesn’t cross my mind…. when I brush my teeth and spit in the sink, I don’t run the water because I think it’s extremely wasteful, so I’ll spit right on the drain and then not wash it down. I just wash off my toothbrush and put it away. Most of the toothpaste spit goes down the drain, but not all of it. It just stays there and that drives Mal crazy. He’s like, “It’s so gross… blah, blah.” So I’m doing my best to wash it down the drain, but sometimes I just forget.

So, there you go. I know it’s all little petty things, but neither of us are annoying at all! 🙂 Anyway, I hope you enjoyed this edition of CNC Live. Keep the questions coming and have a great day!

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Indian Chickpea Salad Recipe

This Indian chickpea salad recipe is a wonderful side dish for any Indian-inspired main course.

While I don’t claim to be any kind of expert on Indian cooking, I do truly enjoy some of the heady combinations those types of spices have to offer. I will often make a bean salad for snacks because they travel well and don’t need to be immediately refrigerated. I can pack a small container full, stick it in my purse and run my errands. If I get hungry, I know I’ve got something healthy in my purse, and as long as I haven’t been away from the house (and fridge) all day, I feel pretty comfortable eating it.

A white serving bowl with a wooden spoon sits filled with this Indian Chickpea Salad, ready to serve.

But if eating this by itself isn’t really your thing, this will also pair well with any Indian-inspired main course. This would pair really well with a Curry Chicken, a Chicken Vegetable Curry Rollups, or even some Chicken Korma or BBQ Tandoori Chicken. Add a side of Naan and you’ve got quite a delicious Indian meal going on!

A further back view of this Indian Chickpea Salad shows two wooden serving spoons in the bean salad, ready to serve up a dish of this deliciousness.


As long as you’ve got a medium-size mixinb bowl and a wooden spoon, this dish is super simple to put together. Simply pour all the ingredients into your bowl and mix well to combine. Season with salt and pepper to taste and serve! Easy!

This will keep in the fridge for up to 4 days.

You can freeze this pretty successfully for up to about 3 months. Just make sure you freeze this in an air-tight container because any air will degrade this pretty quickly in the freezer. A snap-on lid on a container or zipper-top bag if you have one will work best. Just make sure they are freezer-safe and food-safe.

And overhead view looking down into the white serving bowl filled with this Indian Chickpea Salad.

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Copyright Information For The Gracious Pantry


Indian Chickpea Salad

Course: Beans, Side Dish

Cuisine: Indian

Yield: 3 servings

Calories: 234 kcal

Author: The Gracious Pantry


  • 2 cups cooked chickpeas
  • 14.5 oz. canned fire roasted diced tomatoes
  • 2 tsp. curry powder
  • 1 tsp. ground coriander
  • 1 tsp. garam masala
  • 1/4 tsp. ground cinnamon
  • 1/2 cup chopped red bell pepper (chopped fine)
  • 1/4 cup finely chopped red onion
  • 2 tbsp. lemon juice
  • salt and pepper to taste


  1. Add all ingredients to a mixing bowl and stir to combine.

Recipe Notes

Please note that the nutrition data given here is a ballpark figure. Exact data is not possible.

Nutrition Facts

Indian Chickpea Salad

Amount Per Serving (1 cup (approximate))

Calories 234 Calories from Fat 27

% Daily Value*

Fat 3g5%

Saturated Fat 1g6%

Sodium 221mg10%

Potassium 411mg12%

Carbohydrates 41g14%

Fiber 11g46%

Sugar 10g11%

Protein 11g22%

Vitamin A 1355IU27%

Vitamin C 40mg48%

Calcium 101mg10%

Iron 4mg22%

* Percent Daily Values are based on a 2000 calorie diet.

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