Monitoring Progress on a Ketogenic Diet

Monitoring progress on a ketogenic diet involves three basic activities:

1. Having baseline laboratory blood tests performed periodically.
2. Monitoring your blood glucose and ketone levels to determine how your food and supplement choices affect them.
3. Making adjustments and troubleshooting.

Keeping a food and supplement log, and recording blood glucose and ketone readings on a consistent basis are absolute musts. There is just no other way to understand the effect of your choices on blood glucose and ketone values without tracking what and how much you eat and what supplements you take. The other benefit of logging food, supplements and blood measurements is having this information available to share with a health care professional when you have trouble moving toward your blood sugar and ketone targets.

Measuring Blood Glucose and Ketone Levels

Monitoring can be done with a glucose and ketone meter such as the Precision Xtra by Abbott Laboratories. If you have a choice, the Precision Xtra has been shown in studies to take more accurate readings.

The meters are inexpensive, but ketone strips in particular are quite expensive. You can purchase the Precision Xtra ketone strips online from a website called Universal Drugstore (www.universaldrugstore.com) for what I consider to be a more reasonable price. For the visually impaired, there’s a meter called the Prodigy Voice which gives results by sound. The company’s website is www.prodigyvoice.com.

There are two ways to test for ketones: urine test strips or home blood meters. For the first two weeks of the diet ketones can be tested using Bayer Ketostix which measure urine ketone levels. However, over time this method is not as accurate as blood testing. After several weeks on the diet a metabolic adaptation causes most of the initial type of ketones (acetoacetate) to get converted to beta-hydroxybutyrate (another type of ketone).

Since the “Ketostix” test for acetoacetate, they won't be able to detect ketones accurately once that metabolic adaptation occurs. However, these strips can be used for the first two weeks of the diet, after which a blood ketone meter or laboratory test should be used.

I hope this has been helpful!

Until next time,