It’s been a little more than five years since the first FitBit was sold. Despite hundreds of wearables being sold to date, with 1 in 2 Americans owning one, research shows that at least half of consumers abandon such devices within six months (Rock Health, 2016). Taking thousands of steps doesn’t mean you got results, just that you made an effort. Wrist-based heart rate measurements are also notoriously unreliable.

Result: Once serious players such as Nike and Under Armour have pulled out of a now saturated market split between three companies — FitBit, Apple and Xiaomi. The hope is that these generic devices can be upgraded to provide new value, such as sweat analysis or glucose monitoring, in a way which is consumer-friendly yet accurate.

The second wave: Biometrics in athletics

In 2015, Mark Melancon, pitcher for the SF Giants, made headlines for his pioneering using of high-frequency blood testing (every two months) to optimize his diet and performance. A number of companies, such as InsideTracker and Blueprint For Athletes, provide detailed diet recommendations by comparing a comprehensive blood test against a food database. Other athletes have since followed suit, with the practice spreading to leagues such as the NBA and NFL.

“I think it’s very important to understand what your levels are and why it’s important, but also what helps those different levels, your vitamin levels, and just how your body reacts in different ways according to if you’re low on certain things or high on certain things” — Mark Melancon, SF Giants

Another development in athletics has been the widespread adoption of high-spec wearables and other devices which track vital signs and movement. Whoop, an activity tracker which tracks five metrics to minimize strain and improve recovery and sleep, has seen significant adoption in professional and college leagues. Recently, such devices have begun filtering through to the mainstream, with Whoop adopting a low-cost subscription model, and with the release of the Oura ring.

The third wave: Genetic testing and the microbiome

In the last few years 23andMe and uBiome have made kit-based health testing a popular practice. Gut health in particular is flavor of the month, because it offers to tell consumers what they are doing wrong and how to change it, rather than just what they may be predisposed to. The idea of “diet made just for you” is a powerful marketing tool, with numerous companies promising personalized recommendations in return for your poop and a modest fee. Having good gut health may also help us live longer, healthier lives — in a 2017 study, Chinese who lived to 100 with no known medical concerns or history of disease had a similar gut bacteria to those of healthy 30 year olds.

In reality however, research on the microbiome is still in its early stages. A key issue is separating correlation from causation — to what extent are obesity or diseases like diabetes caused by having certain gut bacteria, and to what extent are those bacteria there because of having that condition vs one’s diet? The credibility of the diet recommendations given by services like uBiome and Viome has also been called into question. Lastly, it seems unlikely that the microbiome will become testable at home— faeces are a non-sterile solid, which creates major hygiene and technical challenges. It also creates a big data gap, because the microbiome changes constantly in response to our diet.

“In one person, if you have your microbiome sequenced, even day to day there are going to be variations.” Dr. Hecht — Professor of Medicine & Microbiology

The next wave: Continuous glucose monitors and urine analyzers

Continuous glucose monitors have until recently only been used by (and available to) diabetics, who need to keep careful control over blood glucose levels. They are also very expensive, with a Dexcom CGM typically costing $1,200 and around $300 for a pack of replacement sensors. Startups such as Sano are trying to make CGMs available to consumers for a fraction of the price — a massive technical challenge, but which if successful will give us much deeper insights into our carb consumption, insulin sensitivity and energy levels than can be obtained from a blood finger prick test. It’s possible that such sensors will become able to track other markers continuously, but that seems unlikely to happen any time soon.

We also believe it will become common for people to test their urine as part of their daily routine. Urine is a sterile liquid which we produce in significant volume every day as a matter of biological necessity, which makes it ideal for health tracking. It contains thousands of biomarkers on our dietary, metabolic and hormonal health, which right now are mostly only accessible via a testing lab. At Bisu, we’re making a bathroom-based device which makes it possible for anyone to capture this data and get results in just a few minutes, so they can get insights into and guidance on their health every day.

But that’s enough shameless plugging — let’s talk about the future.

Integrative omics: The final frontier?

Integrative omics is an exciting area of research which combines genomic testing with something called proteomics and metabolomics to derive deeper insights into our health than isolated genetic, blood or other tests can provide. Proteomics is the study of proteins and metabolomics the study of metabolites, in each case as contained in blood and urine. One of the leading researchers in this area is Prof Mike Snyder, Chair of the Stanford Center for Genomics and Personalised Medicine. While his primary focus has been on the risk of diseases such as cancer, integrative omics also has applications to behavioural health tracking. In a recently published study, Snyder used such techniques to assess the metabolic and inflammatory effects of weight gain and loss in both insulin sensitive and resistance subjects.

“(1) Weight gain is associated with the activation of strong inflammatory and hypertrophic cardiomyopathy signatures in blood; (2) although weight loss reverses some changes, a number of signatures persist, indicative of long-term physiologic changes; (3) we observed omics signatures associated with insulin resistance that may serve as novel diagnostics; (4) specific biomolecules were highly individualized and stable in response to perturbations, potentially representing stable personalized markers” — Integrative Personal Omics Profiles during Periods of Weight Gain and Loss (2018)

There is also developing research to show that it may be possible to identify different dietary patterns based on certain metabolite signatures. By combining this metabolite analysis with detection of inflammation markers through proteomics, the body’s response to such foods can be monitored also. I believe in our lifetime we’ll have a mass spectrometer in our toilet gathering huge amounts of protein and metabolite data every single day, and cross-referencing these against our genetic profile and other data such as our heart rate, blood biomarkers, sleep duration and quality. This data will be shared automatically with an AI acting as our personal, secure health advisor, before it even reaches our physician, and will be used to provide personalized advice, food and supplements. That’s a health future to get excited about!

“My money is on the toilet…based on biometrics, considering all that can be done by sampling by what’s going on with someone, believe it or not, we can learn a lot about your health with a smart toilet “ Ted Smith, CEO @ Revon Systems

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Here are some of the benefits:

1: More stable energy levels

On a non-keto diet, your blood sugar levels rise and fall in response to the amount of carbs you eat and how easily those carbs are absorbed, which can make you feel sluggish. On a keto diet the body produces a steady stream of ketones, which helps keep your energy levels stable.

2: Better appetite control

Not only are your blood sugar levels more stable on the ketogenic diet, but it reduces production of ghrelin (the “hunger hormone”) and helps maintains levels of CCK, a hormone which makes you feel full. This helps avoid overeating and weight gain by suppressing your appetite.

3: Easier weight loss

Provided you’re eating fewer calories than you need, it’s much easier to lose weight on a ketogenic diet because your body is primed to use fat as its main source of energy. This has been shown by several studies which demonstrated superior fat loss on low-carb and ketogenic diets.

4: Improved focus and brain function

The ketogenic diet has long been used to treat people with epilepsy, and several studies have indicated neuroprotective effects in subjects with both healthy and impaired cognitive function. Many keto dieters claim less need for sleep, better memory and focus, and heightened alertness.

5: Better sleep

Many keto dieters claim they experience better sleep while on a low-carb diet. This was confirmed in a research study by the University of Sydney, which found that subjects in ketosis enjoyed longer deep stage sleep and reduced REM (dream phase) sleep.

6: Greater endurance and improved recovery

Several studies have shown that the ketogenic diet can improve physical endurance by reducing consumption of glucose stored in the body as glycogen. Some athletes have also reported less inflammation and oxidative stress and improved recovery after intensive exercise.

7: Higher good cholesterol, lower bad

There is evidence to show that the keto diet is good for heart health. Studies have shown that the keto diet reduces levels of triglycerides and LDL (“bad” cholesterol), and increases HDL (“good” cholesterol). Higher HDL levels are associated with lower risk of heart disease.

8: Reduced inflammation and improved skin

There is evidence that the ketogenic diet reduces inflammation and improves skin condition. It is well known that diets high in sugar can increase the severity of acne and frequency of breakouts. Another reason is that intake of poly-unsaturated fatty acids such as DHA and EPA is high, which reduce oxidant production and inflammation.

9: Avoid or reverse Type 2 Diabetes

By depriving the body of glucose, the ketogenic diet makes it easier for the body to become sensitive to insulin again and so control blood sugar levels. In one study, the keto diet helped 95.2% of patients with T2D to eliminate or reduce glucose-lowering medication within 6 months.

10: Avoid or slow progression of cancer

There is evidence to show that a low-carb diet may slow the progression of cancer by starving cancer cells of glucose. This is because cancer cells are very receptive to insulin but cannot metabolize fatty acids for energy. Bisu advisor Dr. Dom D’Agostino is an expert in this area, and you can read more here.

The post 10 reasons to try the ketogenic diet appeared first on Bisu.

1. The keto diet is a great way to lose weight and improve your health and performance
2. Ketones are molecules produced from fat for use by the brain and body when not enough glucose is available
3. To get into ketosis, reduce your carbs to 50g or less a day, eat high fat and moderate protein
4. Avoid any starchy or sugary foods (inc. bread, pasta and potatoes), and beer. Drinking a little wine or low-carb spirits is ok
5. Drink more water, increase your salt intake and eat plenty of leafy greens to avoid “keto flu” symptoms such as headaches
6. You can measure ketones from blood, urine or breath. 1.5–3.0mmol/L is optimal for blood, over 0.5mmol/L for urine, and 2ppm for breat

What is the keto diet?

The keto diet (or “ketogenic diet”) is a low-carb high-fat diet that changes your body into a fat-burning machine, and can help you lose weight and improve your performance and health. Millions of people use this diet regularly and swear by its benefits — including for instance weight loss and improved physical and mental performance. For some people this diet is a necessity because of their medical condition, but many others choose it as a way of life. Regardless of one’s motives, the keto diet is safe, can be fun and has long-lasting benefits.

What are the benefits of keto?

Being in ketosis makes it easier for the body to release fat for energy, which can make the keto diet very effective for losing weight. It also has other benefits, such as reduced hunger, improved blood sugar control, more stable energy levels, improved physical endurance, and better sleep and focus. The keto diet was originally used to help treat drug-resistant epilepsy, and there is even evidence to show it helps prevent the growth of cancer cells.

Provided you’re in a caloric deficit, the keto diet will turn you into a fat-burning machine

What does “keto” mean?

Your body’s primary fuel is glucose, which it obtains from carbs and to a lesser extent protein. If your blood sugar and glycogen (stored glucose) levels are low, your body will need to use an alternative source of fuel, and that’s where ketones come into play. Ketones are small molecules produced from fat in the liver, which unlike fatty acids can be used by the brain and nervous system. We often have very small amounts of ketones circulating in our blood, but when in ketosis this level rises significantly and becomes measurable.

How can I get into ketosis?

Step 1: Reduce your carb intake to no more than 50 grams

50 grams of carbs is roughly equivalent to two slices of bread, two medium-sized potatoes or one large one, or one cup of dry pasta. However, you should eat less than this as many foods which are not starchy or sugary contain small amount of carbs — it all adds up! If you are exercising regularly you may be ok with 100 grams of carbs, but we recommend 50 grams as a starting point.

Step 2: Dramatically increase your fat intake

To get into optimal ketosis, most (70–80%) of your calories should come from fat. That means loading up on avocados, cheese, bacon, sausages, eggs, nuts, butter, coconut and olive oil. Because fat is very calorie-dense, be careful to eat slowly and to satiety — you can still gain weight in ketosis!

Step 3: Moderate your protein intake

Because your body can make some glucose from protein, eating too much protein may reduce your body’s production of ketones. While there are mixed views on this area (some suggest protein intake makes no difference, or at least will not knock you out of ketosis), we generally recommend staying on the side of caution. As a general rule, stay at or below 1 gram of protein per day per kg of bodyweight (0.45g/lb). So if you weigh 70kg (154lbs), that’s about 70 grams of protein a day, or 300g of raw skinless chicken breast.

Step 4: Increase your intake of water, salt and leafy green vegetables

This is because going into ketosis causes your body to lose both water (removed from the body as part of glycogen when carbohydrate stores are depleted) and electrolytes (reduced carb intake means lower insulin secretion, and insulin helps the body to retain sodium). Failing to do so can result in uncomfortable symptoms known as “keto flu”. Eating more green vegetables ensures you have enough potassium relative to sodium in your diet, as an imbalance can caused increased blood pressure.

A classic keto meal of steak, whole eggs and red bell peppers

What should I eat?

Are there any risks to being on keto?

Even though the keto diet has many benefits, it is not for everyone. You should generally avoid it if you have problems with your liver or kidneys, are taking medication for diabetes or high blood pressure, or are currently breastfeed. If in doubt, consult your physician first before making decisions about changing your diet.

The keto diet is also not a license to eat any kind of fatty foods you like as long as your carb intake is low — it’s important to eat the right kind of fats and give your body the nutrients it needs.

How long does it take to get into ketosis?

While it generally takes 2–3 days, some people take longer than others. The time taken will vary depending on your carb intake, how much glycogen (stored carbs) your body has, whether you are in a caloric deficit, and how high your fat intake is.

How can I check if I’m in ketosis? How much is enough?

You can check if you are in ketosis by measuring the ketones in your blood, urine or breath.

1. When testing in blood, 1.5–3.0mmol/L is generally considered optimal
2. For urine, anything between 0.5–6mmol/L is considered optimal
3. For breath, 2ppm (parts per million) is considered optimal

Each of these measures has various pros and cons, which we’ll go into in another post.

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