Ketogenic Diet Improves Insulin Sensitivity and Lowers Inflammation 

Another important strategy that can prevent or even reverse insulin resistance and/or type 2 diabetes is nutritional ketosis. It can also have a dramatic impact on your weight, finally allowing you to shed unwanted pounds, as your body begins to burn fat as its primary fuel. In short, by optimizing your metabolic and mitochondrial function, nutritional ketosis helps set you squarely on the path to better health.

In fact, emerging evidence suggests a high-fat, low-net carb, low- to moderate-protein diet (in other words, a diet that keeps you in nutritional ketosis) is ideal for most people. Even endurance athletes are turning away from conventional high-carb strategies and adopting this way of eating because it boosts physical stamina and endurance. Beyond insulin resistance and type 2 diabetes, there are a number of applications for nutritional ketosis, including the following:

  • As a treatment for seizures and neurological conditions such as Alzheimer’s and Parkinson’s
  • Cancer
  • Longevity
  • Hormone regulation; polycystic ovary syndrome
  • Nervous system disorders such as multiple sclerosis

How to Enter Into Nutritional Ketosis

The most efficient way to train your body to use fat for fuel is to remove most of the sugars and starches (net carbs) from your diet. At the same time, you’ll want to replace those carbs with healthy fats. I explain the ins and outs of implementing this kind of diet, and its many health benefits, in my new book “Fat for Fuel.”

As a general guideline, a dietary intake of about 20 to 50 grams or even less per day of net carbs (total carbohydrates minus fiber) while also keeping protein low-to-moderate is usually low enough to allow you to make the shift to nutritional ketosis (the metabolic state associated with an increased production of ketones in your liver; i.e., the biological reflection of being able to burn fat).

However, each person responds to foods in a different way. Some people can enter into full ketosis while eating as much as 70 to 80 grams of non-fiber carbs. Others, especially if you’re insulin resistant or have type 2 diabetes, may require less than 40 grams, or even as little as 30 grams per day, to get there.

To find your personal carb target, it’s important to measure not just your blood glucose but also your ketones, which can be done either through urine, breath or blood. This will give you an objective measure of whether or not you’re truly in ketosis. Nutritional ketosis is defined as blood ketones that stay in the range of 0.5 to 3.0 millimoles per liter (mmol/L).

That said, using a nutrient tracker will radically improve your ability to understand precisely the macronutrient composition of the foods you eat, and will help you to keep to your ketogenic diet nutrient targets. My first choice is That’s my upgrade to the basic Cronometer nutrient tracker, and the default is set to macronutrient levels that will support nutritional ketosis.

The Importance of Cycling In and Out of Ketosis

An oft-ignored component of nutritional ketosis is the importance of cycling through stages of feast and famine, opposed to continuously remaining in nutritional ketosis. Nutritional ketosis is a powerful intervention, but if you do it continuously, it can actually be counterproductive.

You need to have days where you eat more net carbs and more protein, especially with strength training, to prevent sarcopenia. The “metabolic magic” actually occurs during that refeeding phase when net carbs and protein are increased, which increases muscle growth. After a day or two, you then cycle back into nutritional ketosis. Typically, this is done once a week.

Should You Use a Glucose Monitor if You’re Not Diabetic?

As noted in a recent Time Magazine article,11 many healthy people are now starting to wear 24-hour continuous glucose monitors, myself included. In the video above, I talk with Dr. Daniel Pompa about the benefits of doing this.12

One of the reasons I wear the glucose monitor is because it helps me to fine-tune my Peak Fasting regimen — an intermittent fasting program that involves fasting for at least 12 hours, ideally eating your last meal at least three hours before bed, to avoid generating excessive reactive oxygen species.

In addition to eating a ketogenic diet, Peak Fasting is another important strategy that can help prevent or reverse diabetes and other chronic disease, as this kind of eating schedule really helps kick start your metabolism to burn fat rather than sugar. This too is discussed at length in my new book, “Fat for Fuel.”

When I wrote the book, I used a Dexcom monitor.13 You insert a sensor beneath your skin for a week, which then takes continuous glucose readings every five minutes. It really helped me fine-tune and evaluate how different foods impacted my glucose levels.

This tool helped me understand the importance of feast-famine cycling. In other words, I strongly believe one should not be on a ketogenic diet long-term, even if you have cancer. You remain on it only long enough for your body to burn fat for fuel and then you have 1 to 2 days a week of higher carb and protein intake, and cycle back to ketogenic the other days.

Type 2 Diabetes Is Preventable and Reversible

I’ve often said that type 2 diabetes is easily preventable, and nearly 100 percent reversible. Four key lifestyle strategies to accomplish this are exercise (ideally including some high-intensity interval training once you’re able), non-exercise movement throughout each day, a whole food-based ketogenic diet and Peak Fasting.

The intermittent fasting need not be a lifelong endeavor. Once you’ve normalized your condition, you can stop. Also remember that cycling through periods of “feast and famine” is typically more effective than remaining in nutritional ketosis indefinitely. That said, a ketogenic diet is really more of a lifestyle than a “diet.”


As for physical movement, research suggests standing and moving about as much as possible during the day may be even more important than having a regular exercise regimen, although the latter will surely optimize your health and fitness in ways non-exercise movement cannot so, ideally, do both.