What Is Starvation Ketosis?

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Is Ketosis Dangerous?

You may have heard from your doctor that ketosis is a life-threatening condition. If so, your doctor is confusing diabetic ketoacidosis (DKA) with nutritional ketosis, or keto-adaptation. First, some semantics. Our body can produce, from fat and some amino acids, three ketone bodies (a “ketone” refers to the chemical structure where oxygen is double-bonded to carbon sandwiched between at least 2 other carbons). These ketone bodies we produce are: acetone, acetoacetone, and beta-hydroxybutyrate (B-OHB). [For anyone who is interested, they are the 3 most right structures on the figure, below.] Why do we make ketones? For starters, it’s a vital evolutionary advantage. Our brain can only function with glucose and ketones. Since we can’t store more than about 24 hours’ worth of glucose, we would all die of hypoglycemia if ever forced to fast for more than a day. Fortunately, our liver can take fat and select amino acids (the building blocks of proteins) and turn them into ketones, first and foremost to feed our brains. Hence, our body’s ability to produce ketones is required for basic survival. What is diabetic ketoacidosis? When diabetics (usually Type I diabetics, but some Continue reading >>

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  1. datums

    Unfortunately, biochemistry is not the kind of topic that can be easily researched online without formal training. There are a number of points you make that are incorrect. I keto myself, so don't think I am trying to attack your general position here.
    Starvation and the keto diet are actually nearly identical from a biochemical perspective. The key pathway is fat mobilization, where fatty acid chains are broken down two carbons at a time to produce energy. When this process starts to happen faster than your body can manage it, some of the chemical constituents of the process actually break down to become the ketones that can be detected in the urine and breath. In other words, ketones are a side effect, rather than a major player.
    The idea that a calorie deficit, ie starvation, is somehow bad, is incorrect. Anybody who is using diet and exercise to become more lean is doing the same thing. There is no magic method to lose weight without some form of starvation. The reason why the keto diet does not cause significant lean tissue loss is that the starvation involved is not sufficiently severe.
    An important point that you bring up is the idea that the keto diet stabilizes insulin levels. This is basically correct. Insulin signals cells to take up glucose from the blood, and also tells the liver to begin glycogenesis - the process of packing glucose into glycogen. High blood sugar triggers this. These effects are basically reversed by adrenaline, which tells the liver to start breaking glycogen down to make glucose.
    Part of the difficulty with this is that with a normal diet, blood sugar spikes after meals. This leads to cyclic variance in levels of glucose, insulin and adrenaline. As the cycle progresses toward the adrenaline end, you start to get cravings for foods that will once again spike your blood glucose.
    However, when you are relying on fat mobilization to make glucose, these spikes are greatly reduced. Fat mobilization is not efficient, and is not able to provide sudden bursts of glucose. It is more constant. This makes athletic activity much more difficult aswell.
    But this is the real reason why the keto diet works - it mitigates the cycle of spiking and lowering blood sugar, providing a more level and constant supply. This reduces the propensity for craving food.
    In essence, the keto diet is not unique in terms of the basic biochemistry of metabolism. It simply makes 'starvation' more tolerable, and easier to manage. For many of us, that is exactly what we need.
    Edit - swapped 'gluconeogenesis' with 'glycogenesis'.

  2. gogge

    Insulin signals cells to take up glucose from the blood, and also tells the liver to begin gluconeogenesis - the process of packing glucose into glycogen. High blood sugar triggers this. These effects are basically reversed by adrenaline, which tells the liver to start breaking glycogen down to make glucose.
    Insulin inhibits gluconeogenesis (creation of new glucose), you probably meant glycogenesis (conversion of glucose to glycogen)?

  3. datums

    You are right on that one. The word I was looking for was glycogenesis. It can be a little tricky to remember that between glycolysis, glucogenesis, and gluconeogenesis, one means glycogen synthesis, and the other two mean glycogen breakdown.

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