Ketone Body Production and Excretion During Wellness Fasting

Abstract

Introduction : The importance of ketone body metabolism in diabetic patients has been known since the 1970s, but recently β-hydroxybutyrate (βHB) has been identified as a key component of a metabolic signaling pathway. However, many questions remain unanswered about individual differences in the production and excretion of ketone bodies. Objectives: Fourteen healthy subjects were admitted in the ARSOA Wellness Fasting program. During a 4-day fasting period, they received a combination of very low-energy vegetarian diet, physical exercise, meditation, and lectures about healthy lifestyles. Methods: Every morning, participants measured their body composition, blood glucose, and β-hydroxybutyrate (βHB). The first urine of the day was analyzed for βHB, glucose, pH and 7 other elements. Ten milliliters of urine were deep frozen for further quantitative analysis. Peripheral blood was collected on days 1 and 4 for routine biochemical analyses and for the determination of serum levels of hormones. All data were collated in an Microsoft Excel ® file, and transferred to SPSS for statistical analysis. Results: Ketone bodies in the blood increased from 0.3±0.2 mM at day 1 to 1.8±0.9 mM at day 4 of fasting, while the glucose level decreased from 5.8±1.9 mM to 4.5±1.5 mM. Increases in peripheral blood βHB were assigned to 3 groups (0.8-1.2 mM, 1.3-1.8 mM, 1.8-4.8 mM). Pass analysis suggested that decreased insulin and glucose levels under 4.5 mM both seemed to trigger ketogenesis. The βHB/Acetoacetate (AcAc) ratio in blood was about 5, regardless of the βHB concentration, but the range varied from 0.56 to 3.36 in the urine. The highest excreted concentration of βHB was 597 mmol/g creatinine. These values returned to normal ranges on the 14 th day (10 days after fasting). Changes in blood ketone bodies significantly correlated with total thyroxin, while urinary epinephrine changes correlated with urinary ketone bodies. Ketone body production seemed to cause hepatic and renal damage, as indicated by a slight alteration in markers of hepatic function and a 12% decrease in eGFR. Conclusions: Four days of fasting induces hyperketosis with some metabolic changes. The magnitude of changes in ketone body concentrations correlates with the levels of insulin, glucose, triacylglycerol and several hormones. The urinary excretion of βHB abruptly increased in group 3 (more than 1.8 mM). It was 100 times higher than the blood βHB concentration. Further studies are necessary to establish the safety of fasting as a way to induce hyperketosis for therapeutic needs. Our observations of a slight decrease in hepatic function and a 12% decrease in eGFR call for caution.

Study of serum lipase level in pregnant woman presenting with nausea and vomiting

“…It could be due to low caloric food consumption due to severe nausea and vomiting which could have result to weight loss in hyperemesis gravidarum cases. 18,19 A Study conducted by Watanabe S et al 20 obtained decreased blood glucose level in fasting state.…”

Remarkable Weight Reduction for Low Carbohydrate Diet (LCD): Case Report

“…Continuing Super-LCD usually makes the patient elevated ketone bodies and significant weight reduction [13,15,16]. Continuing ketogenic diet seems to be necessary to obtain enough weight reduction [17][18][19]. Furthermore, the ratio of carbohydrate in LCD showed correlation with the degree of weight reduction [20].…”

Changes of Blood Pressure by Wellness Fasting from Chronomedical Aspect

“…In ARSOA Wellness Fasting 4 days program, participants received a combination of the very low-energy vegetarian diet, physical exercise, meditation, and lectures about healthy lifestyles [7,9]. (Figure 1) Data were collected from October 2014 to October 2018.…”

“…We have practiced Kushi macrobiotics for more than 10 years and developed the teaching and practicing system of a 4-day "Wellness-fasting" [7][8][9]. Our previous study in wellness fasting and BHB production by PASS analysis showed that the decreased BMR and insulin significantly contributed to the increase in BHB and acetyl acetate (AcAc) [9]. In this paper, we would like to focus on the changes in blood pressure in conjunction with other physical markers during wellness fasting.…”