Is Dietary Ketosis Harmful To The Liver?
The mild dietary ketosis, such as that which is experienced during the Weight Loss phase of the Lean for Life program, is not harmful to individuals with a normal, healthy, functioning liver. Here is some information about ketosis that may help you to understand its role in weight loss: The carbohydrates you eat are converted to glucose, which is the body’s primary source of energy. Whenever your intake of carbohydrates is limited to a certain range, for a long enough period of time, you’ll reach a point where your body draws on its alternate energy system, fat stores, for fuel. This means your body burns fat and turns it into a source of fuel called ketones. (Ketones are produced whenever body fat is burned.) When you burn a larger amount of fat than is immediately needed for energy, the excess ketones are discarded in the urine. Being in ketosis means your body has burned a large amount of fat in response to the fact that it didn’t have sufficient glucose available for energy needs. Dietary ketosis is among the most misunderstood concepts in nutrition because it is often confused with ketoacidosis, which is a life-threatening condition most often associated with uncontrolled insulin-deficient Type 1 diabetes. In the Type 1 diabetic, the absence of insulin leads to a toxic build-up of blood glucose and an extreme break-down of fat and muscle tissue. This condition doesn’t occur in individuals who have even a small amount of insulin, whether from natural production or artificially administered. Dietary ketosis, however, is a natural adjustment to the body’s reduced intake of carbohydrates as the body shifts its primary source of energy from carbohydrates to stored fat. The presence of insulin keeps ketone production in check so that a mild, beneficial ketosis Continue reading >>
Is Ketosis Really Bad For You?
A patient recently asked me how bad being in nutritional ketosis was for her. I responded that the worse problem I’ve seen recently is the patient that broke his toe when he slipped on bacon grease. Are there risks with a ketogenic diet? Yes, but these usually only occur when you cheat or fall off the wagon. What problems can arise? Lets talk about them individually. First, as I stated above, make sure you don’t slip on bacon the grease. It really can be an issue if you’re not used to using increased amounts of fat in your kitchen. So, be prepared for how to cook and use fat. Grandma understood this well, we could learn a great deal from her if you ask her about using bacon grease. Second, let’s define the difference between ketosis and keto-acidosis and try to clarify the misinformation that is being spread around the blogosphere. A ketone is a molecule the body produces from the breakdown of fat (specifically triglycerides) and some proteins (amino acids). There are specifically three types of ketones: beta-hydroxybutyric acid, acetoacetic acid and acetone. If ketosis was “bad,” then why would our bodies produce these molecules? They are not bad, and in fact, multiple studies show that the body is often more efficient in weight loss, inflammatory reduction, bowel function, epigenetic influence and maintenance of lean body mass more effectivly when it functions on ketones rather than glucose as its primary fuel source. You can see these studies here, here, here and here. The body can only supply a limited amount of sugar or glucose for fuel. If you talk to runners, marathoners or triathletes, they will tell you that after about 45-90 minutes of continuous endurance exercise the glucose supply runs out and they will experience what is termed a “bonk” (ha Continue reading >>
Are Ketogenic Diets Bad For People With Kidney And Liver Issues?
There is an international organization of doctors and other professionals who have clinical experience with ketogenic diets. It's called the International Ketogenic Diet Study Group. They publish guidelines for safe use of ketogenic diets. The guidelines include a list of medical conditions (contraindications) which would make a ketogenic diet unsafe. At least one of the conditions on the list (carnitine deficiency) can cause liver dysfunction. You don't say exactly what sort of liver problem you have in mind. If you personally have a disease that affects the liver, maybe you should look at the list of contraindications carefully. Another condition on the list, beta-oxidation defects, can cause the liver to lack the ability to oxidize fatty acids. Regarding this condition the guidelines say, "An inborn metabolic error at any point along this pathway can lead to a devastating catabolic crisis (i.e., coma, death) in a patient fasted or placed on a [ketogenic diet]." Ketogenic diets increase the risk of kidney stones. Doctors often prescribe potassium citrate to people on medical ketogenic diets as a prophylactic measure against kidney stones. Here is a link to the full text of the guidelines. Contradindications are in Table 2. The title says "children" because virtually all clinical experience with ketogenic diets has been with kids. If you want to read more about the risks of ketogenic diets, click here to see a bibliography on my website (with many links to full text) of articles about risks and prevention. Some people seem to believe that ketogenic diets are harmless, risk-free, totally wonderful things. This isn't true. Ketogenic diets are like medications. They bring benefits but they also bring risks and harmful side effects. They involve tradeoffs. I'm not against Continue reading >>
Ketosis: What Is Ketosis?
Ketosis is a normal metabolic process. When the body does not have enough glucose for energy, it burns stored fats instead; this results in a build-up of acids called ketones within the body. Some people encourage ketosis by following a diet called the ketogenic or low-carb diet. The aim of the diet is to try and burn unwanted fat by forcing the body to rely on fat for energy, rather than carbohydrates. Ketosis is also commonly observed in patients with diabetes, as the process can occur if the body does not have enough insulin or is not using insulin correctly. Problems associated with extreme levels of ketosis are more likely to develop in patients with type 1 diabetes compared with type 2 diabetes patients. Ketosis occurs when the body does not have sufficient access to its primary fuel source, glucose. Ketosis describes a condition where fat stores are broken down to produce energy, which also produces ketones, a type of acid. As ketone levels rise, the acidity of the blood also increases, leading to ketoacidosis, a serious condition that can prove fatal. People with type 1 diabetes are more likely to develop ketoacidosis, for which emergency medical treatment is required to avoid or treat diabetic coma. Some people follow a ketogenic (low-carb) diet to try to lose weight by forcing the body to burn fat stores. What is ketosis? In normal circumstances, the body's cells use glucose as their primary form of energy. Glucose is typically derived from dietary carbohydrates, including: sugar - such as fruits and milk or yogurt starchy foods - such as bread and pasta The body breaks these down into simple sugars. Glucose can either be used to fuel the body or be stored in the liver and muscles as glycogen. If there is not enough glucose available to meet energy demands, th Continue reading >>
Fatty Liver Is More Dangerous Than You Might Realize. Here’s How To Heal It
“My doctor says I have a fatty liver and I should stay away from fat,” writes this week’s house call. “Are high-fat foods the culprit here? Any tips to help with a fatty liver?” Indeed, your doctor is right to feel concern: Fatty liver is a dangerous yet misunderstood disease. In America, it affects 90 million of us and 17 percent of our children. Think about foie gras, the French delicacy made from duck or goose liver. It is made by force-feeding the animals a combination of sugar with corn and starch (a really sad, horrible practice), intentionally creating a fatty liver. So if you’re gorging on sugar and starch, you’re essentially doing the same thing with your own liver. Fatty liver literally means your liver fills with fat, paving the path for chronic disease and inflammation. You might be surprised to learn the primary culprit here. Research shows that carbs (and not fat) produce more fat in your belly and liver. Sugar switches on fat production in your liver, creating an internal process called lipogenesis, which is your body’s normal response to sugar. Fructose, the most detrimental sugar that heads directly to your liver, actually ramps up lipogenesis. That explains why sugar, especially fructose, becomes the chief cause of liver disease and the leading cause of liver transplants. What’s so bad about having a fatty liver? Well, among its numerous repercussions include inflammation, which triggers insulin resistance and pre-diabetes, meaning your body deposits fat in your liver and organs including your belly (called visceral fat). It gets worse. Excess sugar and starch creates more serious problems including high triglycerides, low HDL (“good” cholesterol), and high amounts of small LDL (dangerous cholesterol particles that cause heart att Continue reading >>
Paleo Diet: Ketosis And Liver Disease
I know what you’re thinking “jeeze, Barry’s been really anti-low-carb recently….what’s the deal!?”. Well, let me be clear that I’m really not against low-carb at all. In fact, I think low-carb or ketogenic Paleo is hands down the best way for a person to lose some body-fat, and reign-in any autoimmune or metabolic issues they may have. But, as I encountered recently with my own diet, staying very-low-carb or ketogenic long-term just doesn’t seem to be a good idea. For some reason, at some point, people began believing that Paleo is by default a low-carb diet…..which it really is not. It can be if fat-loss is desired, but it certainly doesn’t have to be by any stretch of the imagination. As I’ve mentioned in earlier articles, being very-low-carb for a very-long-time can wreak havoc on a person’s Thyroid function, and according to a short but sweet blog post by Peter of Hyperlipid, Ketosis could eventually cause a certain type of liver disease. On February 13th 2012, Peter posted a blog article titled “NASH on a Ketogenic Diet”. Firstly, what on earth is “NASH”? “Nonalcoholic steatohepatitis or NASH is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly. NASH affects 2 to 5 percent of Americans. An additional 10 to 20 percent of Americans have fat in their liver, but no inflammation or liver damage, a condition called “fatty liver.” Although ha Continue reading >>
The Ketogenic Diet Plan. Is It Good For Liver Disease?
In this article I am going to give you details about a Ketogenic Diet, the dangers of low carb diets and some of the benefits. Remember low carb diets can be very good for liver disease sufferers. Just a quick word of CAUTION. You should always check with a medical professional/dietician before deciding to start a diet like this! Whilst low carb diets were all the rage at one time nowadays, based on the research gathered, the high levels of stimulant hormones created can cause thyroid issues, heart irregularities and blood pressure issues for some, whilst the rest of us simply feel more healthier. The objective of a ketogenic diet is to get the bodies metabolic system into a state of ketosis. This is where you start to burn fat cells for all your energy needs. Ketosis is a proven process that encourages the body to survive during times when no food is available to you. It has been shown to improve disease conditions such as Autism, Epilepsy , Alzheimer’s, Cancer and a few others. So how does a Ketogenic diet help with liver disease? Glad you asked. When you read on you will see that this type of diet trains the body to burn fat as opposed to sorting it and placing it around the body and then storing any access in the liver which causes liver disease. Read this article first so you have a better understanding of non-alcoholic fatty liver disease. Do I need to be concerned about the “dangers of low carb diets”? Firstly, you need to be aware that most trained doctors don’t really understand the effects that eating different foods have on the body, so you may be told that ketosis is dangerous. This is because many doctors confuse ketosis with ketoacidosis which are two different conditions. In my honest opinion the “dangers of low carb diets” are really just hyp Continue reading >>
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Everything You Should Know About The Ketogenic Diet
Recently I had a client tell me that she and her husband were eating more than 2 pounds of bacon a week—usually three strips for breakfast and one or two with a salad for dinner. I’ve been a dietitian for almost 20 years. Few things surprise me. But I had to ask: “Why?” She told me that her husband had heard about a new diet on TV, the keto diet, and they decided to try it. Six months and countless packages of bacon later, her husband had lost 20 pounds and said he felt more energetic. I’m beginning to hear more and more people lecture me about the benefits of the ketogenic diet. “Keto burns fat fast! It turbo-charges your energy! It fights disease! You can eat all the bacon you want!” But as is so often the case with diets, underneath all the initial excitement, there’s a gut check. Here’s everything you should know about the ketogenic diet and whether or not you should try it for yourself. Ketogenesis has existed as long as humans have. If you eat a very low amount of carbohydrates, you starve your brain of glucose, its main fuel source. Your body still needs fuel to function, so your brain signals it to tap its reserve of ketones. It’s like a hybrid car that runs out of gas and reverts to pure electricity. Okay, but what are ketones? They’re compounds created by your liver from your fat stores when blood insulin is low. “Your liver produces ketones all the time, but the rate depends on carbohydrate and protein intake,” says Jeff Volek, Ph.D., R.D., a professor of human sciences at Ohio State University. Eat a normal amount of carbs and protein, and ketogenesis idles. Cut carbs and protein back, and you push to half throttle. This takes about three days to induce. A ketogenic diet requires that fat comprise 60 to 80 percent of your total calo Continue reading >>
Not to be confused with Ketoacidosis. Ketosis is a metabolic state in which some of the body's energy supply comes from ketone bodies in the blood, in contrast to a state of glycolysis in which blood glucose provides energy. Ketosis is a result of metabolizing fat to provide energy. Ketosis is a nutritional process characterised by serum concentrations of ketone bodies over 0.5 mM, with low and stable levels of insulin and blood glucose. It is almost always generalized with hyperketonemia, that is, an elevated level of ketone bodies in the blood throughout the body. Ketone bodies are formed by ketogenesis when liver glycogen stores are depleted (or from metabolising medium-chain triglycerides). The main ketone bodies used for energy are acetoacetate and β-hydroxybutyrate, and the levels of ketone bodies are regulated mainly by insulin and glucagon. Most cells in the body can use both glucose and ketone bodies for fuel, and during ketosis, free fatty acids and glucose synthesis (gluconeogenesis) fuel the remainder. Longer-term ketosis may result from fasting or staying on a low-carbohydrate diet (ketogenic diet), and deliberately induced ketosis serves as a medical intervention for various conditions, such as intractable epilepsy, and the various types of diabetes. In glycolysis, higher levels of insulin promote storage of body fat and block release of fat from adipose tissues, while in ketosis, fat reserves are readily released and consumed. For this reason, ketosis is sometimes referred to as the body's "fat burning" mode. Ketosis and ketoacidosis are similar, but ketoacidosis is an acute life-threatening state requiring prompt medical intervention while ketosis can be physiological. However, there are situations (such as treatment-resistant Continue reading >>
Is The Keto Diet Safe? 10 Myth-busting Arguments For The Safety Of Ketosis
Is ketosis safe? The truth is that we can’t say for certain that it is 100% safe. Humans don’t understand everything under the branch of nutritional science and probably won’t for a very long time. As an individual, the only thing you can do is take a look at the research yourself and form your own conclusion. Personally, through the reading I’ve done and the experience I’ve had with the Keto diet, I’ve formed my own conclusion that ketosis is safe. Could I be wrong? Absolutely. But I could also be right. I’m willing to take that risk in order to follow a diet which could maximize longevity, well being and function. My personal conclusion shouldn’t matter to you though. You need to do your own research and come to your own conclusion. I’ve put together this post to organize all of the issues surrounding the safety of ketosis so that you can make your own decision. In trying to prove something to be safe there are two ways to go about it. Disprove the claims of danger Show evidence which may be correlated with safety This article will dispel the top 10 claims people make in an argument to label ketosis as dangerous. Like I said, the science on ketosis is still quite immature. The following data is not meant to 100% prove or disprove the safety of ketosis. It’s merely the information we have available today which can help us form a nutritional strategy we feel is best for ourselves. I’m not a doctor or a researcher. The following information is material I’ve collected in my attempt to feel confident following a Keto diet indefinitely. Most of it is sourced from doctors or authors although I have also included anecdotal accounts from experiences posted on message boards and Reddit. I know, much of the information here isn’t sourced directly from s Continue reading >>
Research Review: Lean Liver With A Low-carb Diet
Note to readers: We wrote this article in 2011. Since then, based on the latest scientific research and lots of client experience, we’ve updated and refined our position on low carb diets. To read our most recent thoughts on this topic, check out: Carb controversy: Why low-carb diets have got it all wrong. Generally people are suspicious of low-carb diets — not because of the carbs, but because of the fat. They worry: Fat makes you fat! My triglycerides and cholesterol will go up! My arteries will clog! The food pyramid says I should cut down on fat and eat more grains! Your doctor, mother, grandmother, next door neighbour and even governments have been telling you that fat is bad and a low-carb/high-fat diet might help you lose weight now, but you’re putting your health at risk. Once, even I thought that although people could (maybe, temporarily) lose weight on low-carb diets, they’d be harming their health in the process. So let’s answer this question definitively: Are you putting yourself at risk by going on a low-carb diet? No. In fact, there’s a good chance you’re making yourself healthier. The truth about low carbohydrate (aka high fat) diets Over the last decade, many studies have found that if you eat a diet that is lower in carbohydrate and higher in fat: You will lose weight. Your triglycerides will go down. Your HDL (“good”) cholesterol will go up. Your cardiovascular health will improve. Not convinced? I’m not surprised. It seems that every week there’s a new “healthy” way to eat. It’s normal to feel suspicious. Let’s look more closely at how a diet higher in carbohydrates leads to fat gain, and how that results in higher blood triglycerides. Fat doesn’t make you fat; carbohydrates make you fat For years you’ve heard “fat Continue reading >>
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Ketones, Ketosis, And Ketogenic Diets
An understanding of ketones and ketosis is essential for understanding how some high protein-low carbohydrate diets (also called Ketogenic Diets) such as Atkins diet works. Ketones are mild acids, a sort of reserve fuel released from burned fats for survival under conditions of starvation. When we go without food for even a few days our bodies begin living off our stored fats, and these release ketones. During ketosis, the body switches from using glucose for energy (sufficient dietary carbohydrates are not available) to using fat. Fatty acids are then released into the bloodstream and converted into ketones. The ketones themselves are produced by the metabolism of fat. Ketosis refers to the process of the conversion. The ketones are used by your muscles, your brain, and other organs as an energy source. Excess ketones are then eliminated during urination. Ketosis occurs when the amount of carbohydrate fuel- the fuel that is needed to run the body - drops below a critical level, forcing the body to turn first to protein and then to fat reserves to do the work carbohydrates normally do. When protein is deflected in this manner, it releases nitrogen into the blood stream, placing a burden on the kidneys as they try to excrete excessive urinary water due to sodium loss. When fat is likewise deflected, the breakup releases fatty acids, or ketones, into the bloodstream, further burdening the kidneys. If ketosis continues for long periods of time, serious damage to the liver and kidneys can occur, which is why most low-carbohydrate, or ketogenic diets recommend only short-term use, typically 14 days. Many nutritionists caution their patients-especially women in the early stages of pregnancy-against following them at all. Fasters experience a sensation of improved well-being a Continue reading >>
Keto: The Best Fatty Liver Diet
Fatty liver disease is exactly what the name suggests – a disease characterized by the build up of fat in the liver. There are two main types of fatty liver disease: Nonalcoholic fatty liver disease Alcoholic fatty liver disease (also called alcoholic steatohepatitis) Both types of fatty liver disease are diagnosed when fat makes up at least 10% of the liver, but the cause of the fat build up is different for each type. The cause of alcoholic fatty liver disease is obvious. The amount of alcohol it takes to cause fatty build up in the liver, however, is not so obvious. The Liver Foundation suggests consuming no more than 14 drinks a week for men and 7 drinks a week for women. Anything more than may cause fat to build up in the liver. The treatment for alcoholic fatty liver disease is simple enough — stop drinking alcohol. Studies confirm that cessation of alcohol consumption can reverse alcoholic fatty liver disease. However, the cause and treatment of nonalcoholic fatty liver disease are not as obvious. This is because many different factors (other than alcohol) can cause fat to build up in the liver. The Truth About Nonalcoholic Fatty Liver Disease Nonalcoholic fatty liver disease affects 20-30% of adult populations in developed countries, but the mechanisms underlying its cause are incompletely understood. We can, however, take some clues from other common diseases to figure out why this happens. In epidemiological studies including people with type 2 diabetes, 62 to 69% of them also had nonalcoholic fatty liver disease. Another study found that 50% of patients with dyslipidemia (abnormally elevated cholesterol levels) had nonalcoholic fatty liver disease. Obesity, metabolic syndrome, and heart disease are also closely linked with nonalcoholic fatty liver disease Continue reading >>
Fatty Liver Disease And Ketogenic Diets
Fatty liver disease is a condition in which the liver becomes clogged with excess fat due to elevated triglyceride levels within the body. The condition is strongly linked to insulin resistance, metabolic syndrome and prediabetes. When the fat stored in the liver accounts for more than 10% of the liver’s weight, the function of the liver becomes compromised, and the liver can't metabolize insulin and fine tune blood sugar levels as it would normally. This type of liver disease is called non-alcoholic fatty liver disease (NAFLD) or hepatic steatosis and if left untreated, it can result in liver damage or liver cancer. What Causes NAFLD? High Triglycerides High blood triglyceride levels associated with high carbohydrate and fructose consumption. The elevated triglycerides which cause fatty liver disease are a direct result of a diet which is high in carbohydrates, and specifically, high in fructose. Studies have shown that fructose consumption elevates blood pressure, sky rockets triglyceride levels and increases inflammation and insulin resistance in the liver. Insulin resistant body systems. A high carb consumption and lack of exercise is strongly associated with the development of overall body insulin resistance and high triglycerides levels. See this study, and this study shows that a high carbohydrate diet is linked to liver dysfunction. Vegetable Oil Consumption High levels of vegetable oil consumption. Vegetables oils contain omega-6 polyunsaturated fats which are inflammatory when consumed in large amounts. In addition, they are often hydrogenated to solidify them, and this introduces trans-fats which can also damage the liver. The most prevalent are corn, canola, and soybean oil. These oils are commonly found in commercial mayonnaise and salad dressings. Altern Continue reading >>
Paleo For Liver Health
Liver isn’t just something that you eat (although that’s important too, and you can read about it here). It’s also something that you have, and your own liver is definitely an organ you want to take care of: it’s responsible for crucial functions like cholesterol synthesis, detoxification, and fat metabolism. Without a healthy liver, none of us would last very long, so learn how to keep yours humming along smoothly. One way of doing this is to think about problems you’d like to avoid. There are a few different types of liver problems: Alcoholic hepatitis: fat deposits on the liver and liver breakdown caused, as the name implies, by excessive alcohol consumption Non-alcoholic fatty liver disease (NAFLD): accumulation of fat deposits on the liver in people who don’t drink. Non-alcoholic steatohepatitis (NASH): a more severe form of NAFLD. Autoimmune hepatitis: liver inflammation caused by an autoimmune attack on liver cells. Liver problems don’t get a lot of press, except as an occasional footnote on the complications of obesity or alcoholism, but that’s not because they don’t exist. This paper estimates the prevalence of NAFLD alone at 20-30% in developed countries! In the overweight and obese, rates are even higher. But these patients often fly under the radar because subclinical liver problems develop slowly and often show no symptoms until the disease is very far advanced. The implication of this is that even if you don’t notice anything wrong, you might still be having liver trouble on the inside. So what causes all these inflammatory conditions, and how can diet affect them? How does Fat Get in the Liver? Fat can accumulate on the liver from 3 different sources: Release of fatty acids from body fat deposits Dietary fat that “sticks” to the li Continue reading >>