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Nutritional Ketosis

Glossary -

Glossary -

Alternative Hypothesis Obesity is a growth disorder, just like any other growth disorder, and fat accumulation is determined not by the balance of calories consumed and expended but by the effect of specific nutrients on the hormonal regulation of fat metabolism. Calorie A calorie is a unit of measurement for energy. Thats it, really. By formal definition, a calorie is the amount of energy required to raise one gram of water from 14.5 to 15.5 degrees Celsius at atmospheric pressure. One-thousand calories = 1 kilocalorie, or a kcal, for short. Heres where it gets a bit tricky. Most people use the term kilocalorie and calorie interchangeably. So when someone says, A gram of fat has 9 calories, they actually mean 9 kcals. The important thing to remember is that a calorie (or kcal) tells you in the case of food how much energy you get by burning the food. Literally. In the old days this is how folks figured out the energy content of food, using a device called a calorimeter. As a general rule, carbohydrates have approximately 3.4 kcal per gram; proteins also have approximately 3.4 kcal per gram; fats have approximately 9 kcal per gram. Carbohydrate Carbohydrates are one (of three) classes of what we call macromolecules, the other two being fats and proteins. [Some argue alcohol is a fourth class.] They are organic compounds consisting of carbon [C], hydrogen [H], and oxygen [O] atoms, and they fit together (almost always) in the form of Cm(H2O)n, where m and n are integers, either the same or different. For example, glucose, which is a very simple carbohydrate consisting of a single ring of 6 carbons has the formula C6H12O6. The more important point is that carbohydrates can be simple, as in the case of glucose, which is just one ring of six carbons (one ring, gives it the Continue reading >>

Reversing Type 2 Diabetes With Nutritional Ketosis

Reversing Type 2 Diabetes With Nutritional Ketosis

Virta is a science-based online specialty medical clinic using continuous remote monitoring and intensive coaching to help our patients reverse type 2 diabetes and prediabetes. A unique contributor to our success in this is harnessing and sustaining the metabolic benefits of nutritional ketosis. Admittedly, reversing diabetes is a rather bold goal. By way of contrast, the American Diabetes Association defines type 2 diabetes as a progressive disease whose course at best can be slowed by lifestyle change and medication. Based upon solid sciencesome old and some newwe beg to differ. Perhaps its time for a paradigm change. There are few times in the lives of medical scientists where we have the opportunity to change the course of a major medical disease; and even fewer cases where we actually succeed in doing so. In 1920, Bantings discovery that injected insulin could control type 1 diabetes (T1D) was such an event. As a result, over the last century, millions of people with T1D have achieved long and productive lives; whereas before 1920 most of them would have succumbed to this insulin-deficiency disease within less than a year. Young insulin patient circa 1920s, before insulin, and 4 months after beginning treatment. Type 2 diabetes (T2D), on the other hand, is a very different disease that affects hundreds of millions of people. It responds very poorly to injected insulin. Whereas T1D patients cannot make insulin, people with T2D typically make lots of insulin but are resistant to insulins effects across a variety of cellular functions. Despite these facts having been known for 5 decades, we are taught that the core components of T2D management are to force the body to make even more insulin or to inject more insulin to overcome the insulin resistance that characteriz Continue reading >>

What Is Ketosis? Benefits, Side Effects & How To Get In Ketosis

What Is Ketosis? Benefits, Side Effects & How To Get In Ketosis

Odds are youve heard the word ketosis at some point. You likely know it has something to do with eating low amounts of carbohydrates. However, many people dont grasp what exactly ketosis means from a physiological standpoint, nor do they understand the vast benefits it can have. We will cover all the pertinent science of ketosis in this article. We will give you an overview of how to reap the benefits of ketosis in your daily life ! Ketosis is a natural metabolic process that your body uses to survive during times of food restriction (especially carbohydrate restriction). Technically, this type of ketosis is referred to as nutritional ketosis; people with type-1 diabetes may achieve ketosis by not using sufficient insulin. If ketones build to a critical point in the body in diabetics, a condition called diabetic ketoacidosis may result (which usually requires medical attention). Its crucial to understand that diabetic ketoacidosis is not the same as nutritional ketosis. The former can be a life-threatening condition if left uncontrolled as it makes the blood very acidic. Nutritional ketosis is safe and means having a healthy amount of ketones in the body, which imparts many benefits. Normally, your body thrives on glucose (sugar), which is why carbohydrates provide bursts of energy. In fact, this is why athletes, especially endurance runners, stock up on carbohydrates before sporting events. Moreover, the brain typically uses glucose to function. Its important to note that pretty much all the carbohydrates you consume (regardless of the food source), aside from a select few, are broken down to glucose in the body. The process of breaking down carbohydrates to produce ATP (the energetic currency of cells) is called glycolysis. However, when glucose isnt readily availabl Continue reading >>

Ketogenic Nutrition

Ketogenic Nutrition

“Nutritional ketosis is an amazing tool for reversing disease processes including inflammation, diabetes type 2, autoimmunity, and even cancer growth. It is a serious medical tool which can be used to improve health while allowing the patient to be their own manager.” Dr. Toni Bark, M.D. If you haven’t heard of the ketogenic lifestyle, you probably will very soon. This diet is the most beneficial not just for weight loss, but for health and disease prevention and reversal as well. So, what is the ketogenic – or “keto” – diet? It’s fairly simple. Most people fuel their bodies with carbohydrates, sugar and (usually) too much animal protein. With keto, that fuel comes from fatty acids and ketones. 75-85% of caloric content comes from good fats. Basically, once you achieve ketosis by depleting your body of available glycogen and using macros that consist of low or no carb, average protein and high fats. This trains your body to burn fat instead of carbs. All of our cells, excluding red blood cells, have a furnace called mitochondria which can use glucose or fats to produce energy for the cell. Glucose molecules contain twice the amount of oxygen as ketones or fatty acids, they also create half the amount of energy. Therefore, using fats for energy allows more energy production with greatly reduced oxidative byproducts. For endurance athletes, ketosis allows you to have great amounts of available stored energy in the form of free fatty acids for muscle and ketones for the brain. There is no “hitting the wall” after reaching the 2000 calories of stored glycogen. No matter how many carbs one eats prior to a race, only 2000 calories of glycogen can be stored. But, in ketosis, the average slim athlete has 40,000 calories of stored fats for burning. The benefi Continue reading >>

10 Tips For Getting Into Nutritional Ketosis For Weight Loss

10 Tips For Getting Into Nutritional Ketosis For Weight Loss

10 Tips For Getting Into Nutritional Ketosis For Weight Loss What is Nutritional Ketosis? Ketosis is an eating plan where the body uses ketones to fuel the brain and body instead of glucose like most people use when on the SAD (standard American diet). It can be very helpful for blood sugar and consistent energy because fat is a very stable source of fuel. We all have a few million calories of fat we would gladly burn off, right? It takes a while to get into ketosis and it can be elusive if you are not paying close attention. It can be very safe for a period of time (even forever) but each person has to decide what feels compatible with their own lifestyle. Some experts do not think it is an optimal state for athletes but others experts disagree. I think we all have bio hack ourselves to see what feels right. Of course, I believe that the paleo template is good starting place for optimal health but ketosis can be an add-on or tweak for people who get stuck or feel hopeless. It can be a powerful and effective way to lose weight without hunger and many of my friends have had success with it. Always ask your doctor before beginning any new nutrition or weight loss plan. Here are some ways to make it work for you: 1. Eat Less Protein I have a made a handy dandy chart here for figuring out the right amounts for you. Most average ladies need about 50-100 grams, no more, fyi. You have to self experiment a little to find what is right for you. The idea is that protein can turn to sugar if someone eats more than they need, then the sugar spikes blood glucose encouraging fat storage. 2. Eat More Fat I used to see this all the time in clients, I say add more fat and people add a tsp of evoo to their salad, NO!!! I am talking about seeing fat as a food group not a side item. Avocad Continue reading >>

Ketosis Advantaged Or Misunderstood State? (part I)

Ketosis Advantaged Or Misunderstood State? (part I)

Ketosis advantaged or misunderstood state? (Part I) In part I of this post I will see to it (assuming you read it) that youll know more about ketosis than just about anyone, including your doctor or the majority of experts out there writing about this topic. Before we begin, a disclaimer in order: If you want toactuallyunderstand this topic, you must invest the time and mental energy to do so. You really have to get into the details. Obviously, I love the details and probably read 5 or 6 scientific papers every week on this topic (and others). I dont expect the casual reader to want to do this, and I view it as my role to synthesize this information and present it to you.But this is not a bumper-sticker issue. I know its trendy to make blanket statements ketosis is unnatural, for example, or ketosis is superior but such statements mean nothing if you dont understand the biochemistry and evolution of our species. So, lets agree to let the unsubstantiated statements and bumper stickers reside in the world of political debates and opinion-based discussions. For this reason, Ive deliberately broken this post down and only included this content (i.e., background) for Part I. Ketosis is a metabolic state in which the liver produces small organic molecules called ketone bodies at sufficient levels, which Ill expand upon later. First, lets get the semantics correct. The first confusing thing aboutketosisis thatketone bodiesare not all technically ketones, whose structure is shown below. Technically, the termketonedenotes an organic molecule where a carbon atom, sandwiched between 2 other carbon atoms (denoted by R and R), is double-bonded to an oxygen atom. Conversely, the term ketone bodies refers to 3 very specific molecules: acetone, acetoacetone (or acetoacetic acid), and Continue reading >>

Ketosis In An Evolutionary Context

Ketosis In An Evolutionary Context

Humans are unique in their remarkable ability to enter ketosis. They’re also situated near the top of the food chain. Coincidence? During starvation, humans rapidly enter ketosis; they do this better than king penguins, and bears don’t do it at all. Starvation ketosis Humans maintain a high level of functionality during starvation. We can still hunt & plan; some would even argue it’s a more finely tuned state, cognitively. And that’s important, because if we became progressively weaker and slower, chances of acquiring food would rapidly decline. Perhaps this is why fasting bears just sleep most of the time: no ketones = no bueno..? Animals with a low brain/carcass weight ratio (ie, small brain) don’t need it. Babies and children have a higher brain/carcass weight ratio, so they develop ketosis more rapidly than adults. Is this a harmful process? No, more likely an evolutionary adaptation which supports the brain. The brain of newborn babies consumes a huge amount of total daily energy, and nearly half comes from ketones. A week or so later, even after the carbohydrate content of breast milk increases, they still don’t get “kicked out of ketosis” (Bourneres et al., 1986). If this were a harmful state, why would Nature have done this? …and all those anecdotes, like babies learn at incredibly rapid rates… coincidence? Maybe they’re myths. Maybe not. Ketosis in the animal kingdom Imagine a hibernating bear: huge adipose tissue but small brain fuel requirement relative to body size and total energy expenditure. No ketosis, because brain accounts for less than 5% of total metabolism. In adult humans, this is around 19-23%, and babies are much higher (eg, Cahill and Veech, 2003 & Hayes et al., 2012). For the rest of this article and more, head over to Pat Continue reading >>

Can I Reach Nutritional Ketosis Through Diet Alone?

Can I Reach Nutritional Ketosis Through Diet Alone?

Can I Reach Nutritional Ketosis Through Diet Alone? Can I Reach Nutritional Ketosis Through Diet Alone? In short, yes, I absolutely think so! And Im living proof of it. But I know you like to know the reasons behind my reasons Give your body the choice and it will first go for glucose and sugar to fuel itself, then fatty acids (ketone bodies) second. If you keep fuelling your body with carbs (in the form of pastry, bread, pasta, grains etc.) then your body will rarely get to burn fat and you will remain overweight. But, when you reduce the amount of carbs you give your body to a minimal level, your body has no choice but to look for alternative fat sources and those include the fatty acids that have built up in your cells. Once you start burning these off, you really become a fat burning machine! Having spikes of insulin in your bloodstream and lots of fat in your diet is one sure fire way to never lose the weight youre after. What we really want is for our bodies to start burning fat for fuel instead of sugar. The production of endogenous ketones is what makes this a reality. Many people now measure their blood ketones through urine, breath and/or blood. Nutritional ketosis is a range of .5 to 3.0 mmol/L. Most people who eat the Standard American Diet (SAD) will measure in at a .2 or .3. Getting to .5 and up only requires fewer carbohydrates (and those chosen to be from quality sources), a moderate amount of protein and a good amount of healthy fats. Thats when the body will start to burn fat for fuel. Personally, I usually measure at .8 mmol/L and have a body fat percentage of 17%. This is a tough one to answer for everyone. We all work so differently and one defined amount of carbs is not going to have the same effect on each of us. It also looks different for someo Continue reading >>

Adverse Reactions To Ketogenic Diets: Caution Advised

Adverse Reactions To Ketogenic Diets: Caution Advised

As the ketogenic diet gains popularity, it’s important to have a balanced discussion regarding the merits of this diet. Let me emphasize right out of the gate that this is not a diet without merits (excuse the double negative); in fact, it has significant therapeutic potential for some clinical pathologies. However, it is also a diet with inherent risk, as evidenced by the extensive list of adverse reactions reported in the scientific literature—and this has not yet been a thorough enough part of the public discussion on ketogenic diets. The AIP Lecture Series is a 6-week video-based, self-directed online course that will teach you the scientific foundation for the diet and lifestyle tenets of the Autoimmune Protocol. This is the first of a series of articles discussing various facets of a ketogenic diet with an inclination toward balancing the discussion of the pros and cons of this high-fat, low-carb, low/moderate-protein diet. My interest in this topic stems from concerns I have over its general applicability and safety, simultaneous with its growing popularity. I feel a moral and social obligation to share what I understand of these diets, from my perspective as a medical researcher. The dangers of a ketogenic diet was, in fact, the topic of my keynote presentation at Paleo F(x) this year (links to video will be provided once available). This series of articles will share the extensive research that I did in preparation for this presentation, including all of the topics covered during my talk as well as several topics that I didn’t have time to discuss (also see the free PDF Literature Review at the bottom of this post). For every anecdotal story of someone who has regained their health with a ketogenic diet, there’s a counterpoint story of someone who derai Continue reading >>

Exogenous Ketones Vs. Nutritional Ketosis

Exogenous Ketones Vs. Nutritional Ketosis

Exogenous Ketones vs. Nutritional Ketosis There is a distinct difference between nutritional ketosis and taking exogenous ketones. Nutritional ketosis is the state of your body using fat as a source of fuel. Most of us are accustomed to using glucose or sugar as fuel because our diets contain more of those ingredients. And that is what our body uses for energy. When we switch to a low carbohydrate, moderate protein, high fat diet; this allows our body to transition from using that sugar, to know using fat for a source of fuel or energy. That is how our body moves into nutritional ketosis, and this is called a ketogenic diet. For some people to become keto-adapted, or move into nutritional ketosis, it can takes weeks. Other people it can take months, depending on the individual. Exogenous ketones allow you to ingest ketones orally to elevate blood ketone levels as if you were in a state of nutritional ketosis, but without having to follow the strict guidelines of being on a ketogenic diet. These ketones will stay in your system anywhere from 3 6 hours. Exogenous ketones can be a great way to propel and assist your body into nutritional ketosis while starting a ketogenic diet. The best exogenous ketone supplement that we endorse and recommend is called, KETO//OS . It is known to have the highest concentration of ketones of any other keto product on the market, and will no doubt get you those therapeutic ketone levels needed to get into ketosis. Dont take our word for it, feel free to test your ketone levels . Continue reading >>

Why Dka & Nutritional Ketosis Are Not The Same

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 >>

Glucose Ketone Index (gki) – What Ratio Do I Need For Nutritional Ketosis Benefits?

Glucose Ketone Index (gki) – What Ratio Do I Need For Nutritional Ketosis Benefits?

Generally these blog posts are a result of scratching my own itch (answering my own question), and this post is no different. At the time of writing this, I’m doing a 5-day fast, and wanted to understand the readings I’m getting for my blood glucose and blood ketone levels. Initially I thought that blood ketones were all that mattered, and certainly a lot of people only talk about that reading. But looking at Dr Thomas Seyfried’s paper on treating brain cancer (glioblastomas). It suggests that its important to take into account blood glucose also. In their study, they acheieved optimal results when their patients maintained what they called ‘nutritional ketosis’. And as part of the paper, they included a formula for what this means. The chart below describes visually what they mean by nutritional ketosis, and how it affected the tumour growth. The red is an increase in ketones as a fictional patient goes deeper into ketosis. The black line represents blood glucose, that decreases to a plateau, as carbohydrate sources are removed from the diet, and glycogen stores decrease. So that sweet spot they reach at the end is an optimum level of nutritional ketosis. Now… obviously in our case we are (hopefully) not trying to slow the growth of a glioblastoma. But by getting into ketosis we’re hoping to achieve a number of benefits including: Reduced IGF-1 Immune system rejuvenation (perhaps mainly lymphocytes) Increased cellular autophagy Reduced inflammation (often measured by improved C-reactive protein levels) The extent of these benefits will depend if you’re eating a keto diet, or doing a water fast/fast mimicking diet. But all 3 should improve the biomarkers such that you have a reduced risk of major diseases such as diabetes, cancer and cardiovascular disea Continue reading >>

Should Endurance Athletes Go Keto? Ketosis And Ketogenic Diets For Endurance Athletes

Should Endurance Athletes Go Keto? Ketosis And Ketogenic Diets For Endurance Athletes

When it comes to weight loss and endurance performance, dietary ketosis is the strategy everyone is asking about this year. On the surface, ketosis or a ketogenic diet offers everything an endurance athlete could dream of: endless energy, freedom from bonking, and an efficient pathway to weight loss. The diet has been all over mainstream magazines, it’s the subject of several new books, and the supplement companies have already jumped in with new products and a ton of marketing dollars. So, is it time for cyclists, triathletes, and runners to go Keto? First, a refresher course on what a ketogenic diet is. To achieve dietary or nutritional ketosis you need to severely restrict carbohydrate intake (fewer than 50 grams of CHO/day) so the body transitions to using ketones for fueling muscles and the brain. Ketones are produced from fat, which is why nutritional ketosis is so appealing to sedentary people as a weight loss solution. It’s appealing to athletes because we have a virtually unlimited reserve of fat calories to pull from but can only store 1600-2000 calories worth of carbohydrate in muscles, blood, and the liver. An athlete fueled by ketones would be theoretically “bonk-proof”, since bonking is the result of running low on blood glucose. [blog_promo promo_categories=”coaching” ids=”” /] Dietary ketosis for athletes is one of the most hotly contested subjects right now. Proponents point to the metabolic advantage of relying on fat instead of carbohydrate, and critics point out the physiological limitations of eliminating carbohydrate as a fuel for performance. You’ll find bias in both groups, either because scientists and coaches (including me) have been in the high-carbohydrate camp for many years, or because there’s a lot of money to be made b Continue reading >>

Nutritional Ketosis, Treating Type 2 Diabetes And Morea Q&a With Dr. Stephen Phinney

Nutritional Ketosis, Treating Type 2 Diabetes And Morea Q&a With Dr. Stephen Phinney

Nutritional Ketosis, Treating Type 2 Diabetes and MoreA Q&A with Dr. Stephen Phinney Is type 2 diabetes reversible? Is intermittent fasting good for you or dangerous? Is nutritional ketosis possible for vegetarians? Virta co-founder and Chief Medical Officer Dr. Stephen Phinney answers these questions and a lot more in this Q&A. Thanks again to everyone who joined our recent Facebook Live session with Dr. Phinney and for submitting great questions. Well be doing it again soon, and well announce our next live event on Virtas Facebook page . In the mean time, Dr. Phinney took it upon himself to answer many of the questions that didnt get answered. If you dont see your question, it was probably answered live. Enjoy! Q: Interested in reversing type 2 diabetes is a ketogenic diet recommended?? Thx! Dr. Phinney: Insulin resistance is the hallmark of type 2 diabetes and manifests as carbohydrate intolerance. Like other food intolerances, the most logical and effective approach to managing carbohydrate intolerance is to restrict sugars and starches to within the individuals metabolic tolerance. A well-formulated ketogenic diet can not only prevent and slow down progression of type 2 diabetes, it can actually resolve all the signs and symptoms in many patients, in effect reversing the disease as long as the carbohydrate restriction is maintained. Q: Appreciated your article on the concerns about prolonged fasting. Could you comment on the utility and safety of shorter durations of fasting (i.e. 16 hrs of fasting/8 hrs of eating or 20 hrs of fasting/4 hrs of eating over a period of 1 day)? Dr. Phinney: I do not have major concerns with either time-restricted feeding or intermittent fasting for durations less than 24 hrs as long as: There are adequate protein and vegetable intake Continue reading >>

Are There Different Types Of Ketosis?

Are There Different Types Of Ketosis?

Before reading this, if you haven’t already, I suggest reading What is a Ketogenic Diet and Understanding Ketosis so you will have a stronger understanding of what it means to be in a state of ketosis. The next step necessary in comprehending the ketogenic diet is learning the different types of ketosis that can occur. For this article, we will refer to three different forms of ketosis: fasting ketosis, nutritional ketosis, and pathological ketosis. The different types of ketosis vary in their degree of ketone production as well as their method of induction. Fasting Ketosis The idea of fasting has been around for hundreds of years and played a major part in the origins of the ketogenic diet. In fact, many great philosophers, such as Hippocrates, Socrates, and Aristotle, all praised the many benefits of fasting. Paracelsus, physician and father of toxicology, was quoted saying, “Fasting is the greatest remedy—the physician within.” While these early scientists and philosophers were definitely ahead of the game in recognizing the potential of fasting, the mechanisms were still yet to be understood. Ketosis tends to occur when insulin and blood glucose levels decrease to an extent that allows for increased fat oxidation, which is ultimately followed by greater ketone production. A minor state of ketosis can occur following periods of complete food restriction, such as an overnight fast. This may produce ketone levels around 0.1 mmol/L to 0.03 mmol/L. Shorter duration fasts typically will not raise ketone levels above these levels because the rate of ketone metabolism matches ketone synthesis. As the fast continues, the rate of ketone production exceeds ketone clearance, resulting in an increase in blood ketone levels (1). While a minor state of ketosis can occur du Continue reading >>

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