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Metabolic Effects Of The Very-low-carbohydrate Diets: Misunderstood

Metabolic Effects Of The Very-low-carbohydrate Diets: Misunderstood "villains" Of Human Metabolism

Go to: The Ketone Bodies are an Important Fuel The hormonal changes associated with a low carbohydrate diet include a reduction in the circulating levels of insulin along with increased levels of glucagon. This activates phosphoenolpyruvate carboxykinase, fructose 1,6-biphosphatase, and glucose 6-phosphatase and also inhibits pyruvate kinase, 6-phosphofructo-1-kinase, and glucokinase. These changes indeed favor gluconeogenesis. However, the body limits glucose utilization to reduce the need for gluconeogenesis. In the liver in the well-fed state, acetyl CoA formed during the β-oxidation of fatty acids is oxidized to CO2 and H2O in the citric acid cycle. However, when the rate of mobilization of fatty acids from adipose tissue is accelerated, as, for example, during very low carbohydrate intake, the liver converts acetyl CoA into ketone bodies: Acetoacetate and 3-hydroxybutyrate. The liver cannot utilize ketone bodies because it lacks the mitochondrial enzyme succinyl CoA:3-ketoacid CoA transferase required for activation of acetoacetate to acetoacetyl CoA [3]. Therefore, ketone bodies flow from the liver to extra-hepatic tissues (e.g., brain) for use as a fuel; this spares glucose metabolism via a mechanism similar to the sparing of glucose by oxidation of fatty acids as an alternative fuel. Indeed, the use of ketone bodies replaces most of the glucose required by the brain. Not all amino acid carbon will yield glucose; on average, 1.6 g of amino acids is required to synthesize 1 g of glucose [4]. Thus, to keep the brain supplied with glucose at rate of 110 to 120 g/day, the breakdown of 160 to 200 g of protein (close to 1 kg of muscle tissue) would be required. This is clearly undesirable, and the body limits glucose utilization to reduce the need for gluconeogenesis Continue reading >>

What Is Ketosis

What Is Ketosis

Ketosis is a metabolic reaction that occurs in your body, when following the OPTIFAST® VLCD™ Program Intensive level. This means your body shifts from using primarily carbohydrates to using fats as an energy source resulting in a reduction of body fat stores. Ketones are by-products that are created when your body has to switch to fats for energy. It means your stores of glycogen or carbohydrates have been depleted. One of the consequences of ketosis is a decrease in appetite, which helps make following the OPTIFAST® VLCD™ Program Intensive level much easier. As the OPTIFAST® VLCD™ Program causes only a mild ketosis; it is a very safe approach to weight loss. Before your body transitions into ketosis, you will most likely feel hungry and you may experience some side-effects such as: Fatigue Lack of concentration Nausea & Headaches These side-effects should only last about 3 days and most symptoms usually pass by days 4-6. This is what we refer to as the 3 day challenge. Following the initial 3 day challenge you will experience an increase in energy and reduction in appetite which, in the Intensive level, will result in a consistent and successful weight loss. It is important to know that these are typical symptoms and you should try to stick to the program as prescribed or otherwise you will simply pro-long these first few days of the OPTIFAST® VLCD™ Program. Of course, if you are concerned about your symptoms or if they persist, speak to your doctor, dietitian or pharmacist as they can advise how to overcome or correct these before coming off the program. Once your body is in ketosis, any excess ketones that your body does not use for energy are excreted via your urine and breath (thus the incidence of bad breath in some cases). This therefore allows you to Continue reading >>

Ketonuria, What Causes It?

Ketonuria, What Causes It?

Ketonuria is a condition of an abnormal quantity of ketones and ketone bodies in urine. It indicates a possible presence of malignant diabetes mellitus. A diabetic with the risk of ketonuria requires regular urine monitoring to watch out for the buildup of ketone for prompt treatment to prevent sliding into unmanageable condition. Ketonuria is also known as ketoaciduria or acetonuria. KETONURIA CAUSES The human body requires carbohydrates for energy, but the presence of diabetes causing abnormal carbohydrates metabolism is responsible for ketones to build up and accumulation in the blood and passed out in urine. The conditions responsible for Ketones accumulation are acidosis and coma in diabetics. Other enabling factors may include Starvation, Digestive disturbances, Dietary imbalance, Eclampsia, Glycogen storage diseases, Severe, prolonged exercise, Fever, Prolonged exposure to cold temperatures. Ketones are toxic and disrupt uric acid excretion. The cause mild depression of the central nervous system and acidosis. FOOD DIGESTION AND INSULIN In food digestion, the body breaks fat, proteins and carbohydrates into nutrients for the body use. Proteins are converted to amino acid, fat to fatty acid and glucose. All these nutrients get into the blood stream to begin the work of sustenance and nourishment of the body. In food digestion, the body turns proteins, fats, and carbohydrates into nutrients that sustain and nurture it. It converts Fats into fatty acids, Proteins into amino acids and Carbohydrates into glucose (sugar) that enters the bloodstream. Although the body requires glucose to power it, the glucose is only available through insulin. Insulin is the hormone responsible for supplying the body its glucose needs, and it is produced by the pancreas. It is when gluc Continue reading >>

Escaping The Fat Trap

Escaping The Fat Trap

Once you’ve been heavy for some time, your high insulin levels can make it hard to succeed in losing weight. Trying diet after diet and failing on each and every one is depressing. But when you discover the perfectly natural bodily process called lipolysis, hope can replace despair. To a person longing to lose weight, Nirvana is the definition of lipolysis: the process of dissolving fat. When you burn fat, it breaks down into glycerol and other fatty acids. How does the process actually work? Are there any drawbacks? There are plenty of laypersons and even physicians who think there must be. Burning off one’s fat sounds like a faddish trick. These folks give a skeptical shrug and say, "I’m sure people lose some weight with the Atkins approach, but don’t they gain it right back again?" The interesting thing is that if you adhere to the four phases the Atkins approach—which includes finding your Atkins Carbohydrate Equilibrium (ACE), meaning the amount of carbohydrates you can still consume and neither gain nor lose weight—you won’t regain the weight. The phase known as Lifetime Maintenance, though more indulgent, evolves naturally from the three weight-loss phases, thereby gradually teaching you a permanent way of eating that still moderates carbohydrate intake to the degree that is necessary for your individual metabolism. Many controlled carbohydrate regimens have been proposed over the years. They work with some degree of effectiveness for some people. However, many of them do not bring carbohydrate intake down to a level that will permit lipolysis. For people who suffer from metabolic obesity and have great difficulty losing, that is a grave weakness. Atkins, on the other hand, starts you off consuming 20 grams of carbohydrates. You then proceed at your Continue reading >>

Metabolic Disorders

Metabolic Disorders

Metabolic Disorders Metabolic disorders are illnesses that occur when the body is unable to process fats (lipids), proteins, sugars (carbohydrates) or nucleic acids properly. Most metabolic disorders are caused by genetic mutations that result in missing or dysfunctional enzymes that are needed for the cell to perform metabolic processes. Most metabolic disorders are inherited, which means they are passed down through families. Prognosis and treatment vary, depending on the type and severity of the disorder. At Lehigh Valley Health Network, we have a pediatric endocrinologist on staff who can help you navigate the treatment path for a metabolic disorder. Patients who have genetically inherited metabolic disorders or are carriers of certain disorders may wish to receive genetic counseling. A counselor will provide information and answer questions about the risk for passing the disorders on to their children. Patients with metabolic disorders should take their medications exactly as prescribed and/or strictly follow their diets in order to help prevent complications. Types of diseases: Jump to: Adrenoleukodystrophy (ALD) Alkaptonuria Cystinosis DIDMOAD (Wolfram) syndrome Glucose 6-phosphate dehydrogenase (G6PD) deficiency Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) Inborn errors of urea synthesis Kearns-Sayre syndrome Maple syrup urine disease (MSUD) McArdle's disease MELAS syndrome Metabolic syndrome Phenylketonuria (PKU) Pyruvate carboxylase deficiency (hyperalaninemia) Subacute necrotizing encephalopathy Tay-Sachs disease (TSD) Trimethylaminuria Adrenoleukodystrophy (ALD) Adrenoleukodystrophy is a rare and fatal genetic disorder that is passed down among families. Patients with ALD accumulate high levels of saturated, very long-chain fatty acids (VLCFA) in Continue reading >>

Being Fat Adapted Versus

Being Fat Adapted Versus "in Ketosis" (pt.1/3)

UPDATE!! (9/20/2017) I have a new post that explains how and why the body produces ketones, It will help you understand much better the difference between burning fat and having a fat-based metabolism, versus being "in ketosis." It's very long, but I think it's worth reading if you'd really like to understand this -- and if you want to stop freaking out about your ketone levels. (If you click over to that post and want to read only the section that explains the difference between ketosis and running on fat, scroll way down to where it says Ketogenesis: How and Why Do We Make Ketones? Also: Fat Adaptation versus Ketosis.) Happy reading! If I never hear or read those six words, in that order, ever again, I’ll be one happy individual. Based on what I come across on low-carb forums, blogs, and videos, there is a lot of confusion about the correct use of urine ketone test strips (which I’ll sometimes refer to as ketostix, since “ketone test strips” is a mouthful, even when you’re only reading). So allow me to ‘splain a little bit about how to interpret these things, and what role they should play—if any—in your low-carb life. First and foremost is the most important thing you will read in today’s post. (And it is so important that I will likely repeat it in all the posts to follow in this little series. Plus, you can tell it’s important because it’s red, bold, in italics, and all caps, hehheh.) You can be in ketosis and not lose body fat, and you can lose body fat without being in ketosis. Here is an exhaustive, comprehensive list of everything urine ketone test strips tell you: There is acetoacetate in your urine. That’s it. Nothing more. Nada más. Game over. Finito. The fat lady has sung, and Elvis has left the building. Your worth as a human being Continue reading >>

Exogenous Ketones For Fat Burn

Exogenous Ketones For Fat Burn

OVERVIEW Exogenous ketones are the newest scientific breakthrough in the world of health and wellness, making the job of achieving ketosis, the state in which the body is burning fat/ketones as fuel rather than glucose, much easier. They come in powder form and are ingested exogenously (a fancy word for outside the body). Exogenous ketones are comprised of beta-hydroxybutyrate salts, which flood your bloodstream with ketones and put the body in ketosis within 30-60 minutes. This means that you can reap all the amazing health benefits of being in ketosis in a simple and effective way (just mix the exogenous ketones with water & drink!). Research is now linking exogenous ketones to a multitude of benefits, including more efficient weight loss, athletic performance enhancement, cancer prevention, cognitive improvement, neuroprotection and anti-inflammatory properties. (See research links below.) In addition, exogenous ketones are an extremely useful tool to easily transition to the ketogenic diet. When taken daily, they can reduce carb/sugar cravings, turn on your fat burners, give you more energy, and keep "low-carb flu" at bay. So bottom line, exogenous ketones are perfect for anyone looking to improve their health and wellbeing. WHY USE THEM Reason #1 - Fat Burning Exogenous ketones for fat burn. Taking exogenous ketones will get you into ketosis quickly. Once your body is done using the exogenous ketones you ingested as fuel, then it will start looking for other places to get ketones from. And lucky for you, ketones are made from the fat stored in your body! So as your body produces more of these ketones as fuel, you end up burning fat. Reason #2 - Energy Our bodies use ketones via our mitochondria to generate energy. They are an alternative fuel source to glucose and Continue reading >>

What Is Ketosis?

What Is Ketosis?

What is ketosis? Being in ketosis is truly a magical thing. Ketosis happens when your body starts producing ketone bodies instead of utilizing carbohydrates as energy. Both can be used as energy sources, but I find that converting to a fat-burner over a carbohydrate-burner to be most favorable. Signs of being in ketosis There are a few signs that could suggest you’re in ketosis: a metallic taste in mouth strong smelling urine random bursts of happiness (it’s weird, but it’s true!) decreased appetite How to get into ketosis The best way to get into ketosis is to immediately drop all major carb sources in your diet and focus on high-quality fats. Some find that going extremely low carb for a couple days will jumpstart ketone production and ultimately reaching a state of ketosis. Initially when you first remove a majority of carbohydrates from your diet, most people experience signs of lethargy and flu-like symptoms. This is what people consider the “low carb flu.” The low carb flu could last anywhere from a couple days to a couple weeks. It’s important to stay extremely hydrated on a ketogenic diet, so much make sure you’re getting enough water and electrolytes. If you’re one of the lucky ones, you won’t experience any low carb flu symptoms at all. Carbohydrate tolerance varies from person to person to maintain a ketogenic state. Some report that they can eat up to 80 grams and still be in ketosis. A safe spot for most people seems to be between 20-30 grams. Benefits of being in ketosis You will find it hard to believe that an array of benefits can be obtained from following a ketogenic diet, but the proof is in the research! Some of these include: Effortless weight loss Awesome blood sugar regulation Reduced blood pressure Reduced inflammation Appetite Continue reading >>

High Blood Sugar Emergencies

High Blood Sugar Emergencies

Blood sugar levels that are too high (hyperglycemia) can quickly turn into a diabetic emergency without quick and appropriate treatment. The best way to avoid dangerously high blood sugar levels is to self-test to stay in tune with your body, and to stay attuned to the symptoms and risk factors for hyperglycemia. Extremely high blood sugar levels can lead to one of two conditions—diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS; also called hyperglycemic hyperosmolar nonketotic coma). Although both syndromes can occur in either type 1 or type 2 diabetes, DKA is more common in type 1, and HHNS is more common in type 2. Diabetic Ketoacidosis (DKA) Ketoacidosis (or DKA) occurs when blood sugars become elevated (over 249 mg/dl, or 13.9 mmol/l) over a period of time and the body begins to burn fat for energy, resulting in ketone bodies in the blood or urine (a phenomenon called ketosis). A variety of factors can cause hyperglycemia (high blood glucose), including failure to take medication or insulin, stress, dietary changes without medication adjustments, eating disorders, and illness or injury. This last cause is important, because if illness brings on DKA, it may slip by unnoticed, since its symptoms can mimic the flu (aches, vomiting, etc.). In fact, people with type 1 diabetes are often seeking help for the flu-like symptoms of DKA when they first receive their diagnosis. Symptoms of diabetic ketoacidosis may include: fruity (acetone) breath nausea and/or vomiting abdominal pain dry, warm skin confusion fatigue breathing problems excessive thirst frequent urination in extreme cases, loss of consciousness DKA is a medical emergency, and requires prompt and immediate treatment. A simple over-the-counter urine dipstick test (e.g., Keto Continue reading >>

Ketones During Pregnancy – Causes And Preventions

Ketones During Pregnancy – Causes And Preventions

Presence of ketones in urine especially during pregnancy poses a serious impact on the health of a woman. Moreover, it is one such problem that many of the pregnant women are facing. Though, it is a not a matter of serious complication, it could turn alarming at a certain point. What Are Ketones? Ketones are elements derived from the breakdown of fat which the body utilizes to produce energy during emergency concerns like starvation or glucose deficiency. The body receives essential energy from the consumption of food and it gets converted into glucose and blood sugar. The access with blood sugar is obtained through insulin. When you are faced with detecting Ketones in Pregnancy, you must understand that the pregnancy hormones boost the body hormones against insulin. This indicates that the cells of body do not acquire sufficient glucose from blood and consequently a pregnant woman is not able to gain enough energy through breaking down of carbohydrates. The body attempts to search for alternative energy sources, like the fat reserves and ketones are the by-product of this process. Causes for the presence of ketones There are various factors that lead to ketone’ presence in the urine, and they are as listed below: You have been dehydrated. A bad diet or a diet that is not nutritious may result in your body breaking down fat instead of carbohydrates for energy. It is possible that you do not get sufficient calories from the diet or the time space between meals may be too long. Other possibilities are that you may be skipping meals or snacks. You must be careful to have your meals on time to avoid ketones and other problems, especially during pregnancy. Some of the natural signs of pregnancy, such as nausea, throwing up could also make you feel DE-energised and pose you Continue reading >>

Testing Your Ketones

Testing Your Ketones

diabetes, weight loss For long-term health, it is essential that both type 1 and type 2 diabetics monitor their blood sugar levels regularly. While this is often done through self-monitoring of blood glucose levels, urine ketone testing can also be used to avoid the dangers of Diabetic Ketoacidosis (DKA). What are ketones? The body usually uses glucose as a source of energy by breaking down carbohydrates from the foods we eat. However, when your body doesn’t have enough glucose, or insulin to use the glucose, your body then starts to break down fat for energy. Ketones are the by-products of this breakdown of fats in the liver. They can accumulate to dangerous levels in the body and also appear in urine. People with type 1 diabetes are at a higher risk for making ketones, it rarely occurs in people with type 2. Ketones make your blood acidic and put you at risk of DKA. It is also related to hyperglycaemia. Having high levels of ketones requires medical assistance and as such diabetics are encouraged to check their urine for ketones regularly. Symptoms of high ketones If you are a diabetic, you need to be aware of the symptoms of having too many ketones in your body. Early symptoms that occur include: A dry mouth Strong thirst Frequent urination High blood sugar readings If left untreated, the symptoms can progress leading to: Extreme fatigue Confusion Flushed skin Sweet acetone smelling breath (similar to nail polish remover) Trouble breathing Abdominal pain Nausea Vomiting How to test for ketones Urine tests are an easy way to assess the level of ketones in the body. They are available without a prescription. The testing strip contains a special chemical that will turn a specific colour if it detects ketones in the urine. Many of them can indicate that there are no ke Continue reading >>

Reasons For Ketones In Urine

Reasons For Ketones In Urine

What are ketones? Everybody has ketones. The body produces ketones when there is not enough insulin that will convert sugar into energy. Ketones are chemicals produced by the liver from fatty acids. The liver then sends ketones into the bloodstream, so the tissues and muscles can utilize them as fuel. People without diabetes don't have an issue with this process. However, people with diabetes can have too much buildup of ketones in the blood, which can be life-threatening. If you have type 1 diabetes, you might need a ketone test. In type 1 diabetes, a person's immune system attacks the pancreas, which produces insulin. Without enough insulin, the levels of blood sugar rise. Individuals who have type 2 diabetes can also experience high ketone levels, but not as common as with those who have type 1 diabetes. Signs to Test for Ketones Your doctor will probably ask for a ketone test when you have the following conditions: A blood sugar of more than 250 mg/dl for two consecutive days Excessive thirst Vomiting You have an illness You have an injury You are pregnant Tests for Ketones Ketones are tested through a urine analysis. You can purchase a ketone test kit at your local drugstore and test your urine at home. A ketone test can also be done in your doctor's clinic. To test for ketones in your urine, you have to pee in a sterile container to get a urine sample. After collecting the urine sample, do the following steps: Dip the test strip into the urine sample. You can also hold the strip under your urine stream. Gently shake off excess urine from the test strip. You will notice that the test strip will change in color. the directions will tell you how long that takes. Follow the instructions and check the strip color against the provided chart in your test kit. The corresp Continue reading >>

Metabolism And Ketosis

Metabolism And Ketosis

Dr. Eades, If the body tends to resort to gluconeogenesis for glucose during a short-term carbohydrate deficit, are those who inconsistently reduce carb intake only messing things up by not effecting full blown ketosis? If the body will still prefer glucose as main energy source unless forced otherwise for at least a few days, is it absolutely necessary to completely transform metabolism for minimal muscle loss? Also, if alcohol is broken down into ketones and acetaldehyde, technically couldn’t you continue to drink during your diet or would the resulting gluconeogenesis inhibition from alcohol lead to blood glucose problems on top of the ketotic metabolism? Would your liver ever just be overwhelmed by all that action? I’m still in high school so hypothetical, of course haha… Sorry, lots of questions but I’m always so curious. Thank you so much for taking the time to inform the public. You’re my hero! P.S. Random question…what’s the difference between beta and gamma hydroxybutyric acids? It’s crazy how simple orientation can be the difference between a ketone and date rape drug…biochem is so cool! P.P.S. You should definitely post the details of that inner mitochondrial membrane transport. I’m curious how much energy expenditure we’re talkin there.. Keep doin your thing! Your Fan, Trey No, I don’t think people are messing up if they don’t get into full-blown ketosis. For short term low-carb dieting, the body turns to glycogen. Gluconeogenesis kicks in fairly quickly, though, and uses dietary protein – assuming there is plenty – before turning to muscle tissue for glucose substrate. And you have the Cori cycle kicking in and all sorts of things to spare muscle, so I wouldn’t worry about it. And you can continue to drink while low-carbing. Continue reading >>

Ketosis And The Hcg Diet

Ketosis And The Hcg Diet

Ketosis The HCG diet is a ketogenic diet, meaning that it brings the body into a state where it burns fat in order to supply its energy needs. Ketones are used by the muscles, the brain and other parts of the body as energy, and they are derived from fat when fat is metabolized. When carbohydrate levels are low, the body must break down fat stores to provide sufficient energy. Carbohydrates are converted the most easily into energy by the body, and when we eat excess carbohydrates they are stored as fat. When dietary carbohydrate levels are low, such as with the HCG diet or low carb diets like the Atkins diet, fat is metabolized for energy. When the body is in ketosis it is constantly burning fat for energy and any diet with a net consumption of less than 100 grams of carbohydrates per day is considered to be ketogenic. The HCG diet usually results in a metabolic state of ketosis The HCG diet has about 60 to 80 grams of carbohydrates per day on average, and as a result it causes the body to enter into a state of ketosis. Ketosis will begin during the first week of the HCG diet, and you can test for ketosis by using urine strips that can be purchased at a local pharmacy. The strips test for ketones in the urine, but testing for ketosis is not necessary as a part of the diet. The strips also show the quantity of ketones in the urine, but the level of ketones in the urine are not considered to be a good indicator of the level of ketosis, so this can mostly be ignored unless otherwise advised by a medical professional. Ketosis is not harmful for the body Some people think that ketosis is somehow dangerous or bad for the body because of some misconceptions about ketogenic diets. The truth is that ketogenic diets have been used for several decades without major medical proble Continue reading >>

Type 1 Diabetes Mellitus

Type 1 Diabetes Mellitus

Pathophysiology This section reviews the consequences of insulin deficiency resulting from loss of beta cell mass and function. The earliest abnormalities of beta cell function, detectable before clinical onset, include loss of pulsatile insulin secretion and loss of the first-phase insulin response (FPIR) to intravenous glucose. Insulin secretion declines rapidly before and following onset of symptoms, and reduced insulin action results in increased glucose output by the liver and reduced glucose uptake by insulin sensitive tissues including muscle and fat. Blood glucose rises and spills into the urine, producing an osmotic diuresis. Glucose deprivation in other tissues triggers breakdown of fat and structural proteins, causing rapid weight loss. These changes account for the three leading symptoms of uncontrolled diabetes: thirst, polyuria and weight loss. The underlying metabolic abnormalities are largely − but incompletely − reversed by standard insulin therapy. In the absence of insulin, the 'accelerated starvation' of uncontrolled diabetes is followed by overproduction of acidic ketone bodies, and culminates in the metabolic emergency of diabetic ketoacidosis, the hallmark of type 1 diabetes. Changes in insulin secretion The beta cells within each islet are linked into a single functional mass by junctions between the membrane of one cell and the next. This allows depolarization of the cell membrane to propagate throughout the beta cell mass such that the beta cells of each islet release insulin in unison. A neural network links the million or so islets scattered though the pancreas to a putative 'pancreatic pacemaker', enabling them to secrete insulin in synchronous pulses. These pulses, which account for ~70% of insulin production by the liver, were initiall Continue reading >>

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