Why Testing Ketones Can Help Prevent Metabolic Syndrome, NAFLD, Obesity, Type 2 Diabetes And More

September 24, 2021

The obesity epidemic we’re living in causes all sorts of life-threatening problems. Metabolic syndrome is one the rise — and it’s starting to affect younger populations too. 

According to Harvard Health Publishing, metabolic syndrome occurs when you meet 3 of the following 5 criteria: 

  1. Obesity: Having a BMI (body mass index) over 30 or a large waistline (greater than 40 inches for men and 35 inches for women) 
  2. Elevated blood triglycerides: Above 150 mg/dL
  3. Low HDL (good) cholesterol: Below 40 mg/dL in men or 50 mg/dL in women
  4. High blood pressure: Having 130 mmHg or above (systolic pressure) or 85 mmHg or above (diastolic pressure)
  5. Elevated blood sugar: Either having a glucose level of 100 mg/dL or above or taking diabetes medications 

And while each of these issues can cause severe health problems on their own, meeting 3 (or more) of the criteria increases your risk of developing cardiovascular disease (including heart attacks and strokes), diabetes, liver and kidney disease, and sleep apnea. 

Not to mention, metabolic syndrome is a relatively young discovery and we’ll likely find other health risks associated with it over time. 

While metabolic syndrome is on rise, there’s something else on the rise: 

Nonalcoholic fatty liver disease (NAFLD). 

NAFLD is the accumulation of liver fat in people who drink little to no alcohol. Usually fatty liver disease is most prevalent in folks who drink an excessive amount of alcohol. 

NAFLD includes a spectrum of liver conditions that can lead to nonalcoholic steatohepatitis (NASH), cirrhosis (advanced liver scarring and damage), and even liver failure.

NASH is an inflamed liver caused by fat accumulation in your liver, which can lead to cirrhosis if you don’t do anything.

While there isn’t a treatment for NAFLD now, there are ways you can prevent it. And early research on mice looks promising that you might even be able to reverse it — as I’ll explain later in this post. 


There’s a strong correlation between NAFLD and increased rates of insulin resistance, type-2 diabetes, obesity, and metabolic syndrome, which are all risk factors for NAFLD. 

NAFLD affects around 15% of people who aren't obese. But it affects up to 95% of people who are obese. Worse yet, NAFLD is becoming more prevalent in children — which was previously unheard of even in the obesity and diabetes epidemic. 

The Real Reason Why So Many People Store Fat In Their Liver And Increase Their Likelihood Of NAFLD 

Liver fat happens because of an imbalance in triglyceride formation and removal in your liver. When your liver creates more triglycerides than it removes, it causes liver fat. 

Your liver stores fat from three main places: 

  1. DNL, or the conversion of sugar to fat 
  2. The breakdown of stored body fat 
  3. Dietary fat

But it’s thought that DNL (the conversion of sugar to fat) wreaks the most havoc in regards to liver fat accumulation. Meaning, excess calories from carbs are the culprit behind NAFLD — as well as insulin resistance, type-2 diabetes, obesity, and metabolic syndrome. 

A high sugar intake is one of the main contributing factors for metabolic diseases. 

But not all sugar is created equal! 

Here’s what I mean: 

Recent research suggests that the type of sugar you consume is as important (if not, more important) in developing metabolic diseases. We consume sugar in several forms. Glucose, fructose, and sucrose (a mix between glucose and fructose) are the most popular. 

But fructose is the bad type of sugar you want to avoid — it can even increase your risk of NAFLD (and other types of metabolic diseases) regardless of your weight.

When you eat glucose, your blood glucose rises and insulin is secreted to shuttle glucose out of your blood and into your tissues so you can use it for fuel because it's stored as glycogen. When your glycogen stores are full, your body converts the excess glucose to fat. 

If you’re overweight or obese, there’s a better chance your body stores excess glucose as fat in places it should be, like in your liver. 

But here’s why fructose is especially harmful: 

Fructose goes directly into your liver upon consumption without the need for insulin and the promotion of sugar to fat during DNL. 

Researchers from the Journal of Hepatology published a study earlier this year that confirms this. 

Their study compared 3 types of sugar-sweetened beverages against a group that contained no sugar-sweetened beverages for 7 weeks. The 3 types of sugar-sweetened beverages included:  

  1. Glucose
  2. Fructose
  3. Sucrose

And then a fourth control group which didn’t have any sugar-sweetened beverages. 

The results? 

The fructose and sucrose group had double the amount of fat production in the liver! The glucose and control group didn’t experience these results. 

Each group consumed about 2 cans of soda per day for this study. Because sugar-sweetened beverages (like your favorite soda) are a significant source of high-fructose corn syrup. Even “healthy” sweetener alternatives, like agave, contain up to 90% fructose (even though they’re marketed as healthier alternatives). 

In summary: 

Fructose is an issue even if you’re at an ideal body weight and have optimal metabolic health. Whereas glucose only becomes an issue if you’re insulin resistant or obese. 

And fatty liver exacerbates insulin resistance which creates a vicious cycle. It impacts your blood sugar regulation and metabolic endocrine control. Which is a recipe for progressive metabolic syndrome. 

If you’d like to improve your liver health, the best (and easiest) things you can do include maintaining a healthy body weight, reducing fructose consumption, working out on a regular basis, eating more choline, and testing your ketones. 

Let’s talk about choline real quick before diving into testing ketones and how a ketogenic diet impacts all this: 

Your liver needs choline to export fats out of your liver. When you don’t get enough choline, you can’t make the LDL particles that shuttle triglycerides out of the liver. You can get choline from eggs, other high protein foods, nuts, and vegetables. 

How Keto Impacts Metabolic Syndrome And NAFLD

High-fat, low carb ketogenic diets can help reverse and improve the outcomes of several metabolic conditions including NAFLD. 

That might seem counterintuitive, but the best way to reduce fat in your body is by consuming a high-fat diet. 


Because when you restrict your carbs, your body converts dietary fat into ketone bodies. 

Ketones help prevent the formation of triglycerides in the liver because your liver sends these ketone bodies to other parts of your body to use as fuel in the absence of carbs. 

Here’s where it gets even better: 

By restricting your carbs, you might even reduce liver fat without reducing your caloric intake or losing weight. 

One study compared caloric restriction to carb restriction in patients with NAFLD for 2 weeks. 

The caloric restriction group consumed 1200 calories per day. And the carb restriction group consumed less than 20 grams of carbs per day. 

Both groups lost weight and improved their NAFLD. But the carb restriction group experienced a greeter reduction in liver fat — even though they ate 200 more calories per day on average. 

The low-carb diet group had greater rates of fat oxidation — which also favorably affected liver fat oxidation. 

Weight loss itself promotes the reversal of NAFLD (and several other metabolic conditions). And keto also supports weight loss because eating more fats and proteins increases your level of satiety. Meaning, you feel fuller for longer by eating less calories.

The Importance of Testing Ketones

With all that said, the importance of testing ketones in your body should be clear. 

When your cells don’t have enough glucose, they burn fat as fuel instead. And by testing your ketones, you can know whether you’re in ketosis (burning fat as fuel) or not. Plus, some ketone monitors also test your glucose levels so you can make smarter diet decisions and prevent (or reverse) some warning signs of metabolic diseases, including NAFLD. 

The only true way to know if your body is in ketosis is by testing your ketones. Your body is unique. Different people need to restrict carbs more or less to enter ketosis. 

Not to mention, the role exogenous ketones play in this:

Exogenous ketones are ketones that come from nutritional supplements (or another outside source). And they help your body enter a state of ketosis faster. 

NAFLD triggers inflammation, oxidative stress, and fibrosis (liver scarring) when left unchecked. And early mice research looks promising for using exogenous ketones to help reverse these problems. 


Because exogenous ketones might reduce oxidative stress and produce an anti-inflammatory effect. Plus, entering ketosis can help you lose weight — which further helps improve various metabolic conditions. 

A research study published in Cell Metabolism tested this hypothesis that ketones reduced NAFLD in mice. 

In the study, researchers gave mice free access to a diet that contributes to obesity — such as high processed foods — for 10 weeks to induce NAFLD. After this 10-week period, they divided the mice into 3 groups for 12 weeks: 

  1. Control: remained on the same diet 
  2. Pair-fed: remained on the same diet but controlled for calories (they matched caloric intake to the average intake of group 3 from the day prior) 
  3. Ketone ester: remained on the same diet but 30% of the calories from carbs were replaced by the ketone ester 

The results after 12 weeks?

  • Liver weight went down 50% for the pair-fed group and 58% for the ketone ester group compared to the control. 
  • Markers of NAFLD significantly improved with ketone supplementation compared to both other groups. Specifically, with lowered liver fat content, inflammation, and liver cell “ballooning” (a key feature of NASH). This suggests that ketone supplementation is superior to reducing caloric intake. 
  • The ketone ester group mice lost significantly more weight despite eating equal calories to the pair-fed group. 

While this study used mice, it looks promising. But we’ll need more tests conducted on humans to confirm these results. 

Here’s what it means for you: 

If you test your ketone levels and you’re struggling to enter ketosis, taking exogenous ketones via nutritional supplements could help you enter ketosis faster and reverse some of the negative health consequences of various metabolic conditions, including NAFLD. 

How To Test Ketones With A Ketone Monitor 

Ketone monitors are an easy, effective, and relatively inexpensive way to test your ketones daily so you can prevent, reverse, and treat metabolic conditions.

A good starting ketosis level is around 0.5-1.0 mmol/L. And the optimal ketosis level for most people is 1.0-3.0 mmol/L. (And your Ketone Monitor will tell you exactly what ketosis level you’re at even if you don’t understand the measurements.) 

Anything over 3.0 mmol/L is usually reserved for therapeutic ketosis — meaning, you go more aggressive with it to ease medical conditions such as cancer, epilepsy, or endocrine and metabolic disorders (such as diabetes). 

But most people thrive in the 1.0-3.0 mmol/L range. 

As for what ketone monitor you should purchase, I recommend two types of ketone monitors to my clients: 

1. Keto Mojo’s Ketone Monitor

Keto Mojo’s ketone monitor is the first that has a Glucose-Ketone Index (GKI) built in. Testing both glucose and ketones is important for assessing your given response to food. And helping you prevent, reverse, and treat metabolic conditions 

GKI is also used as a metric for other types of therapeutic uses — especially for starving cancer cells. 

If you’d like to grab a Keto Mojo Ketone Monitor, you can grab one using my affiliate link for a special discount here

Even though a blood test is the most accurate way to test for ketones, I realize not everyone wants to prick their finger everytime they test their ketones. 

In that case, I recommend… 

2. The Biosense Breath Meter

The Biosense Breath Meter instead tests your breath for ketones. While it’s not quite as accurate as a blood test, it’s the next closest thing! 

If you'd like to grab a Biosense Breath Meter using my affiliate link and save 20% here.

Both the Keto Mojo and Biosense meter include an app so you can track your results over time.

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