Virtual Conference

Ian Lake

Gloucestershire, UK

Title: Nutritional ketosis is well-tolerated, even in type 1 diabetes: the ZeroFive100 Project; a proof-of-concept study


The objective of this study was to test the feasibility of exercising over a 5-day period while fasting, in those with and without type 1 diabetes mellitus (T1DM).
Eight individuals, ages 29--62 years, two with T1DM, walked/ran around 20 miles per day for five consecutive days while only consuming water. All eight individuals completed the project with no physical injuries or problems with diabetes control. The blood glucose levels ranged from less than 3 mmol/l to 7 mmol/l in those without T1D, and less than 3 mmol/l to 9 mmol/l in those with T1D. The continuous glucose traces in those with T1D showed little variability in glucose levels. The participants without T1D had no symptoms from blood glucose under 3 mmol/l. Ketone levels ranged from 0.3 to 7.5 and the ketone profiles for those with T1D were indistinguishable from the ketone profiles in those without T1D. The respiratory quotient was overwhelmingly in the fat-burning range. All but one person was keto-adapted ahead of the event. Prolonged fasting did neither lead to hunger nor did it negatively affect mood, which, if anything, was enhanced in most individuals.
This proof of concept study has found that in keto-adapted individuals, with or without T1DM, prolonged exercise for 5 days while in nutritional ketosis was feasible, and well tolerated. Nutritional ketosis is not a risk factor for diabetic ketoacidosis; consumption of sugar for energy is not required for distances of up to 100 miles in keto-adapted people; people who inject insulin do not necessarily need to consume carbohydrates unless rescuing a hypoglycaemic attack.
An identical project has been completed by non-diabetic individuals in South Africa with similar results. 


Ian Lake have been a GP for 35 years and work in Gloucestershire. He is concentrating the rest of my career around promoting knowledge of keto diets through my website  There is a healthcare professionals study course suitable for CPD and information for people with Type 1 themselves.  He have a degree in Medical Cell Biology and Biochemistry from Liverpool University and qualified as a doctor in 1985 from Southampton University.