How to measure your Keto Diet success

When you start the Keto diet how do you know when you have achieved nutritional ketosis? How do you know if the diet is successful? Have you actually reached ketosis?

There are three different types of ketones we can measure in the body to see if we are in ketosis: acetone, acetoacetate, and Beta-Hydroxybutyrate (BHB).

Measuring Acetone

Acetone is the least invasive ketone to measure, as it is found in the breath. Since acetone is not the ketone used for energy by the body this is not a direct measure of ketosis. The presence and level of acetone positively correlates with BHB and can be used as a less precise measure of ketosis. When measuring ketones with breath, the Ketonix will light up with a color corresponding to the amount of ketones present. Usually yellow to red is the goal.

Measuring acetone can be done by using a Ketonix breathalyzer. The device can be used multiple times without anything more to purchase. While a little pricey, about $189-$239, the one-time investment is the only investment.

Measuring Acetoacetate

Found in the urine during the first few weeks of the Keto diet, measuring acetoacetate is relatively easy to do. This method is probably the least effective because it is dependent on the users ability to correctly identify which color the stick actually is and the overflow of ketones not the actual level of ketones in the body is what is measured here. When measuring ketones from a urine stick match the color of the stick to the color on the label, usually the darker purple, the higher the levels of ketones.

Acetoacetate can be measured using ketone urine strips like Ketostix, which are inexpensive around $10 for 50-120 strips. Measuring ketones through the urine is only feasible for 2-4 weeks at the beginning of the Keto diet, after that the body is Keto-adapted this is no longer an effective way to measure ketones.

Measuring Beta-Hydroxybutyrate (BHB)

Found in the blood, BHB is the most precise measurement of ketosis and is measured the same way as glucose. This method is the most invasive as pricking the finger is needed to obtain the blood to be tested. When measuring the BHB, the ideal range for weight loss is about 1.5-3 mmol/L and for a therapeutic diet (think cancer support) it is from 3-6 mmol/L.

A blood meter and strips are needed to perform this measurement, and these can be pricey, the strips alone run from $5-10 and the meters are around $40-60.

Are There Other Ways to Measure?

Yes, once you have been on the Keto diet awhile, there are signs you can look for that will indicate you are in ketosis. These include:

  • Reduced hunger, you can go longer than 2 hours without eating
  • Mental clarity will be increased
  • Stable energy throughout the day, no afternoon crashes
  • Reduced cravings

While these are not a way to measure your ketone level, once you have established your Keto diet and tested your levels, you can begin to know how your body feels when in ketosis and when you have slipped back into using glucose. If you cannot tell a difference, then testing with one of these methods will be necessary.

As always, before beginning a new diet or lifestyle change, please consult your doctor, especially if you are on medication.

– Erin Kirkpatrick