The Ketogenic Diet: Does It Live Up To The Hype? The Pros, The Cons, And The Facts About This Not-so-new Diet Craze.
If you believe the buzz, ketosis — whether via the almost-zero-carb ketogenic diet or via ketone supplements— can curb appetite, enhance performance, and cure nearly any health problem that ails you. Sound too good to be true? It probably is. Want to listen instead of read? Download the audio recording here… ++++ Wouldn’t it be awesome if butter and bacon were “health foods”? Maybe with a side of guacamole and some shredded cheese on top? “I’m doing this for my health,” you could purr virtuously, as you topped your delectably marbled, medium-rare steak with a fried egg. Well, many advocates of the ketogenic diet argue exactly that: By eating a lot of fat and close to zero carbohydrates you too can enjoy enhanced health, quality of life, performance, brain function, and abs you can grate that cheese on. So, in this article, we’ll explore: What are ketones, and what is ketosis? What, exactly, is a ketogenic diet? What evidence and scientific research supports the ketogenic diet? Do ketone supplements work? Is the ketogenic diet or ketone supplementation right for me? How to read this article If you’re just curious about ketogenic diets: Feel free to skim and learn whatever you like. If you want to change your body and/or health: You don’t need to know every detail. Just get the general idea. Check out our advice at the end. If you’re an athlete interested in performance: Pay special attention to the section on athletic performance. Check out our advice for athletes at the end. If you’re a fitness pro, or interested in geeking out with nutritional science: We’ve given you some “extra credit” material in sidebars throughout. Check out our advice for fitness pros at the end. It all started with the brain. If you’ve called Client Care at Pr Continue reading >>
Ketoacidosis Versus Ketosis
Some medical professionals confuse ketoacidosis, an extremely abnormal form of ketosis, with the normal benign ketosis associated with ketogenic diets and fasting states in the body. They will then tell you that ketosis is dangerous. Testing Laboratory Microbiology - Air Quality - Mold Asbestos - Environmental - Lead emsl.com Ketosis is NOT Ketoacidosis The difference between the two conditions is a matter of volume and flow rate*: Benign nutritional ketosis is a controlled, insulin regulated process which results in a mild release of fatty acids and ketone body production in response to either a fast from food, or a reduction in carbohydrate intake. Ketoacidosis is driven by a lack of insulin in the body. Without insulin, blood sugar rises to high levels and stored fat streams from fat cells. This excess amount of fat metabolism results in the production of abnormal quantities of ketones. The combination of high blood sugar and high ketone levels can upset the normal acid/base balance in the blood and become dangerous. In order to reach a state of ketoacidosis, insulin levels must be so low that the regulation of blood sugar and fatty acid flow is impaired. *See this reference paper. Here's a table of the actual numbers to show the differences in magnitude: Body Condition Quantity of Ketones Being Produced After a meal: 0.1 mmol/L Overnight Fast: 0.3 mmol/L Ketogenic Diet (Nutritional ketosis): 1-8 mmol/L >20 Days Fasting: 10 mmol/L Uncontrolled Diabetes (Ketoacidosis): >20 mmol/L Here's a more detailed explanation: Fact 1: Every human body maintains the blood and cellular fluids within a very narrow range between being too acidic (low pH) and too basic (high pH). If the blood pH gets out of the normal range, either too low or too high, big problems happen. Fact 2: The Continue reading >>
Ketoacidosis During A Low-carbohydrate Diet
To the Editor: It is believed that low-carbohydrate diets work best in reducing weight when producing ketosis.1 We report on a 51-year-old white woman who does not have diabetes but had ketoacidosis while consuming a “no-carbohydrate” diet. There was no family history of diabetes, and she was not currently taking any medications. While adhering to a regimen of carbohydrate restriction, she reached a stable weight of 59.1 kg, a decrease from 72.7 kg. After several months of stable weight, she was admitted to the hospital four times with vomiting but without abdominal pain. On each occasion, she reported no alcohol use. Her body-mass index (the weight in kilograms divided by the square of the height in meters) was 26.7 before the weight loss and 21.7 afterward. Laboratory evaluation showed anion-gap acidosis, ketonuria, and elevated plasma glucose concentrations on three of the four occasions (Table 1). She had normal concentrations of plasma lactate and glycosylated hemoglobin. Screening for drugs, including ethyl alcohol and ethylene glycol, was negative. Abdominal ultrasonography showed hepatic steatosis. On each occasion, the patient recovered after administration of intravenous fluids and insulin, was prescribed insulin injections on discharge, and gradually reduced the use of insulin and then discontinued it while remaining euglycemic for six months or more between episodes. Testing for antibodies against glutamic acid decarboxylase and antinuclear antibodies was negative. Values on lipid studies were as follows: serum triglycerides, 102 mg per deciliter; high-density lipoprotein (HDL) cholesterol, 50 mg per deciliter; and calculated low-density lipoprotein (LDL) cholesterol, 189 mg per deciliter. The patient strictly adhered to a low-carbohydrate diet for four Continue reading >>
What Is The Difference Between Exogenous Ketosis, Nutritional Ketosis, And Diabetic Ketoacidosis?
The main difference between these three types of ketosis is the level of ketones in your blood. With both nutritional ketosis and exogenous ketosis, blood BHB levels usually remain below 8 mM. By contrast, during diabetic ketoacidosis BHB levels in the blood are more than twice as high (over 20 mM). Diabetic ketoacidosis usually only occurs in Type I diabetics who produce no insulin. Blood glucose rises very high but because there is no insulin released, glucose cannot enter the cells, and the body wrongly believes it is starving. This leads to uncontrolled ketone production and should be treated as a medical emergency. Continue reading >>
What's A Keto Diet?
What is a ketogenic diet and how does it work? The process was initially developed in 1924 by Dr. Russell Wilder as an effective, non-pharmacological treatment for intractable childhood epilepsy. The process works when the body is put into a metabolic state called Ketosis, where ketones become the main source of energy for the brain and body to function. The ketogenic diet plan is high in fat and low in carbohydrates while supplying adequate protein to the body. This specific combination changes the manner in which your body uses energy. Additionally, while reducing epileptic seizures, this process lowers glucose levels while improving the body’s resistance to insulin. So I know a lot of you are probably wondering "what is Ketosis?" am I right? By definition, it is when your body goes through a metabolic state in which the body transforms ketones created from fat into energy, instead of energy created from converting carbohydrates. What are they exactly did you ask? Biochemically speaking, ketones are organic, carbon-based compounds that contain a central carbon atom double-bonded to an oxygen atom and two carbon-containing substituents, denoted by “R.” Ketones are considered simple compounds because they do not contain chemical groups that are readily reactive. Fatty acids in the body are oxidized by the liver for energy production. There are 3 different ketone bodies produced in mitochondria of the liver: acetone, acetoacetic acid and beta-hydroxybutyric acid. Some of these fatty acids are oxidized by the liver for energy production while others can be partially oxidized to form the substrate acetoacetate, which is then converted to beta-hydroxybutyric acid; collective. These bodies produced in the liver are referred to as endogenous ketone bodies and are those Continue reading >>
Why Dka & Nutritional Ketosis Are Not The Same
There’s a very common misconception and general misunderstanding around ketones. Specifically, the misunderstandings lie in the areas of: ketones that are produced in low-carb diets of generally less than 50 grams of carbs per day, which is low enough to put a person in a state of “nutritional ketosis” ketones that are produced when a diabetic is in a state of “diabetic ketoacidosis” (DKA) and lastly, there are “starvation ketones” and “illness-induced ketones” The fact is they are very different. DKA is a dangerous state of ketosis that can easily land a diabetic in the hospital and is life-threatening. Meanwhile, “nutritional ketosis” is the result of a nutritional approach that both non-diabetics and diabetics can safely achieve through low-carb nutrition. Diabetic Ketoacidosis vs. Nutritional Ketosis Ryan Attar (soon to be Ryan Attar, ND) helps explain the science and actual human physiology behind these different types of ketone production. Ryan is currently studying to become a Doctor of Naturopathic Medicine in Connecticut and also pursuing a Masters Degree in Human Nutrition. He has interned under the supervision of the very well-known diabetes doc, Dr. Bernstein. Ryan explains: Diabetic Ketoacidosis: “Diabetic Ketoacidosis (DKA), is a very dangerous state where an individual with uncontrolled diabetes is effectively starving due to lack of insulin. Insulin brings glucose into our cells and without it the body switches to ketones. Our brain can function off either glucose or fat and ketones. Ketones are a breakdown of fat and amino acids that can travel through the blood to various tissues to be utilized for fuel.” “In normal individuals, or those with well controlled diabetes, insulin acts to cancel the feedback loop and slow and sto Continue reading >>
Ketoacidosis (dka) Vs Ketosis What’s The Difference?
Although ketosis and ketoacidosis may sound the same, they are two distinct things. We are going to be talking about the difference between ketoacidosis and ketosis and what makes the two diverse from one another. In order to provide a good explanation of what these conditions are and how they affect the body, we must talk about their main common denominator, the ketones. These are organic compounds that the body will provide when it starts to burn stored fat instead of burning glucose or sugar when it requires energy. What is Ketoacidosis? DKA applies to diabetic ketoacidosis and is a complication of type 1 diabetes. Ketoacidosis is a very dangerous condition that makes it difficult for your body to be able to produce a good level of insulin. Your levels of ketones can rise to very dangerous levels, which will also increase your blood sugar. The ketones create a very acidic environment inside your body, and the function of certain organs will be affected severely. It becomes a life-threatening situation when presented with high levels of ketones and excess blood sugar. Anyone not given proper treatment for DKA could end up in a coma and even die. The kidneys and liver are affected more than most other organs, and this can create a very serious health issue. Once a person develops what is known as diabetic ketoacidosis, they will show severe symptoms within as little as 24 hours. When a person has type one diabetes, they are in great danger of developing diabetic ketoacidosis. What is ketosis The best way to explain ketosis is to consider it a very mild form of ketoacidosis, and the truth is that this is not going to be harmful most of the time. In your lifestyle, if you’re on a ketogenic diet nutrition plan or any long-term low-carb diet, you might be experiencing ke Continue reading >>
Is There A Difference Between Nutritional Ketosis Vs. Ketosis?
Just to be clear, “nutritional ketosis” is a biological state in which your body is generating ketone bodies to feed your brain in a well-fed state. Your body will also switch to ketone bodies as a primary food source during starvation. But nutritional ketosis is different in a number of ways from starvation. So if you are not starving and you are not taking exogenous ketones and you are getting measurable blood ketone levels, then you are in “nutritional ketosis”. Awesome. Nutritional ketosis is not at all something you would experience from taking exogenous ketones as another answerer suggests. Continue reading >>
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 sometimes this occurs in very late-stage, insulin-dependent, Type II diabetics) fail to receive enough insulin, they go into an effective state of starvation. While they may have all the glucose in the world in their bloodstream, without insulin, they can’t get any into their cells. Hence, they are effectively going into starvation. The body does what it would do in anyone – it starts to make ketones out of fat and proteins. Here’s the problem: the diabetic patient in this case can’t produce any insulin, so there is no feedback loop and they continue to produce more and more ketones withou Continue reading >>
Tweet Ketosis is a state the body may find itself in either as a result of raised blood glucose levels or as a part of low carb dieting. Low levels of ketosis is perfectly normal. However, high levels of ketosis in the short term can be serious and the long term effects of regular moderate ketosis are only partially known at the moment. What is ketosis? Ketosis is a state the body goes into if it needs to break down body fat for energy. The state is marked by raised levels of ketones in the blood which can be used by the body as fuel. Ketones which are not used for fuel are excreted out of the body via the kidneys and the urine. Is ketosis the same as ketoacidosis? There is often confusion as to the difference between ketosis and ketoacidosis. Ketosis is the state whereby the body is producing ketones. In ketosis, the level of ketones in the blood can be anything between normal to very high. Diabetic ketoacidosis, also known as DKA, only describes the state in which the level of ketones is either high or very high. In ketoacidosis, the amount of ketones in the blood is sufficient to turn the blood acidic, which is a dangerous medical state. When does ketosis occur? Ketosis will take place when the body needs energy and there is not sufficient glucose available for the body. This can typically happen when the body is lacking insulin and blood glucose levels become high. Other causes can be the result of being on a low carb diet. A low level of carbohydrate will lead to low levels of insulin, and therefore the body will produce ketones which do not rely on insulin to get into and fuel the body’s cells. A further cause of ketosis, less relevant to people with diabetes, is a result of excessive alcohol consumption. Is ketosis dangerous? The NHS describes ketosis as a pote Continue reading >>
What Is Ketosis, And How Long Does It Take To Get Into Ketosis?
Ketosis is a natural state of the body in which it is fueled almost solely by fat. This happens when a person fasts or adheres to a very low carbohydrate diet. The exciting thing about ketosis and ketogenic diets is that you can lose a lot of weight while eating a normal quantity of food. You don’t have to suffer through skimpy portions. There are other benefits of keeping a ketogenic diet as well. These will be explained in the following article. An Explanation of Ketosis The root “keto” in the word ketosis comes from the type of fuel that the body produces when blood sugar is in low supply. The small molecules that are used as fuel are called “ketones.” If you consume very few carbohydrates and only a moderate amount of protein, then the body begins to produce ketones. Ketones are made by the liver from fat. Both the body and the brain can use them as fuel. The brain cannot directly function from fat. It must convert the fat into ketones. Legionella Testing Lab - High Quality Lab Results CDC ELITE & NYSDOH ELAP Certified - Fast Results North America Lab Locations legionellatesting.com When you go on a ketogenic diet, your body almost solely runs on fat. Your insulin levels become rather low as well. Since you are burning so much fat, this is a great way to lose weight. Studies show that ketogenic diets result in greater weight loss. The fastest way to get into ketosis is by fasting. However, you cannot fast for very long, so you need to start a low carb diet. The Brain and Ketones Many people think that the brain needs carbohydrates to function. This is not really true. The brain can work well simply by burning ketones. The reality is that many people feel like they have even more energy and focus when they are fueled by ketones. Benefits of Ketosis There ar Continue reading >>
Acute Nutritional Ketosis: Implications For Exercise Performance And Metabolism
Go to: Dietary intake influences metabolism An ancient Spanish proverb ‘Diet cures more than the lancet’ suggests that the importance of diet in maintaining good health is an age-old concept. Mechanisms by which the body uses the fuels we eat to sustain life, or in the case of excess, store the surplus energy, have fascinated generations of scientists. Carbohydrates, fat, protein and, for some, alcohol are the fundamental sources of dietary energy. Whilst the numbers of dietary macronutrients (food groups) are limited, the particular composition and relative contribution of these dietary groups to our calorific needs vary widely. Until recently, little was known of the metabolic systems that linked diet with human function. In 1937, Krebs made arguably the most important breakthrough in biochemistry , describing a cycle of enzymatic reactions uniting dietary fuel combustion with cellular energy provision. This final common pathway for substrate metabolism has allowed the detailed study of the flow of energy transformation (energetics) from dietary sources to the ‘energy currency’ adenosine triphosphate (ATP). Exercise the litmus of metabolic performance Over the last century, our understanding of the fundamental processes underlying human performance has expanded greatly. At the intersection of elite sport and substrate, metabolism lays the potential to investigate the processes that define the limits of human physiology. The onset of acute exercise triggers a rapid increase in demand for substrate and oxygen (mediated via an increase in cardiac output), with metabolic rate raised up to 100-fold above resting conditions during high-intensity exercise . Depending on the relative intensity of exercise, durations of physical effort may last for minutes, hours Continue reading >>
The Effects Of Fasting Ketosis
Understanding ketosis and muscle loss during fasting. The process of ketosis is one of the physiological effects of fasting in which the brain (and some other bodily processes) uses ketones produced from fatty tissues as a fuel instead of the usual glucose. This is called "muscle sparing". When glucose isn't readily available via the diet (in the form of carbohydrates) and the glycogen stores in the liver become depleted, the body could break down muscle to get it. But ketosis is an adaptation that will spare muscle during times of shortage by instead breaking down fat stores and manufacturing ketones for brain fuel. It is said this state is attained at approximately 48 hours of a water fast for women and closer to 72 hours for men. The effects of fasting ketosis have become a more popular and controversial subject in recent years due to low-carb, high-protein dieters relying on it long-term to "burn the fat". Where ketosis was once considered a "crisis response" of the body and fine only for short durations, there are some doctors who now contend ketones are an acceptable alternative fuel, produced and used by the body any time glucose is scarce, which can happen even in non-fasting, non-dieting individuals, such as during intense exercise or during sleep. They are considering it a natural metabolic process where ketone production and use fluctuates constantly in response to the body's needs. What is so controversial about the low-carbers use of ketosis is the long term, artificially produced, use of it. Over long periods of time, their high-protein diet produces excess protein by-products that become a strain on the kidneys to eliminate. Ketosis also creates a mild acidosis of the blood, which, over a long period of time is considered detrimental to our health. One ef Continue reading >>
Is Ketosis Dangerous? No, Because Ketosis Is Not Ketoacidosis.
At this point, I consider myself pretty immune to what internet trolls say to me. I have a pretty tough skin, usually laugh off nonsensical comments, and carry on with my day. This last time was different. When checking the social media account for my ketosis supplement company, Perfect Keto, I noticed a rather ridiculous comment. To the best of my memory, the comment said something like this: “How dare you promote ketosis?! I HATE KETOSIS! My daughter is a diabetic and had to be brought to hospital the other day because she was in ketoacidosis! Shame on you and everyone like who you recommends a dangerous diet that kills people! You are killing people! AGHHH!” Not only is this comment wildly misinformed and ignorant, I think comments like this are more dangerous than the promoting the ketogenic diet. When people make comments like this, they use the same scare tactics and lack of facts that have recently overtaken our political system to influence people in not using very beneficial tools to their advantage. Sometimes you just have to use your brain. The unfortunate truth is that this lady isn’t the only delusional and misinformed one instilling fear into people who are trying to gain benefit from their nutritional choices. Plenty of mainstream doctors also think the ketogenic diet is life threatening. I’ve recommended the ketogenic diet to many of my patients trying to fix weight and metabolic issues they haven’t been able to correct for years. One of them mentioned this change to their primary care physician, who was reviewing the statins and several other medications they have this patient on, who reacted with disbelief. Ketosis! How could I recommend such a life threatening intervention?! They were told not to see such a quack like myself any more before Continue reading >>
Ain’t That Nutritional Ketosis Thing Just Another Way Of Saying Atkins?
If I had a dollar for every time I heard some variation of the title of this column, I’d be a very rich man. Ever since I started on my n=1 nutritional ketosis experiment in May 2012 (read my four 30-day update posts: Day 1-30, Day 31-60, Day 61-90 and Day 91-120), I have seen interest that is near-unprecedented in my eight years of blogging about low carbohydrate diet and health. It just goes to show you that despite the best efforts by the media and all the so-called health “experts” trying to discredit healthy low carb living, countless numbers of people who want to lose weight and attain optimal health still believe in its amazing benefits. There’s certainly something there that warrants a closer look for those who have been struggling in their nutritional health goals. Being In A Ketogenic State If you’ve been following a low carb lifestyle for any length of time, you probably already understand the importance of being in a ketogenic state, where your body switches from using carbohydrates to fat — both dietary and stored body fat — and ketone bodies as its primary fuel sources. The late, great Dr. Robert C. Atkins made this key concept the centerpiece of his bestselling books. Unfortunately, dietary ketosis has been severely maligned by Dr. Atkins detractors as somehow being a “dangerous” state. “Ketosis” has a mistaken negative association with the truly dangerous and potentially fatal “diabetic ketoacidosis” that most frequently occurs in people with Type 1 diabetes. I encourage you to go listen to my podcast with Mark Sisson from the “Mark’s Daily Apple” blog in Episode 5 of “Ask The Low-Carb Experts” where we take on this misconception about ketosis. Another problem with using the term “ketosis” alone, as Dr. Atkins did Continue reading >>