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 >>
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 >>
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 >>
Nutritional ketosis is a normal, physiological response to carbohydrate and energy restriction. A ketogenic diet is an effective weight loss strategy for many. Ketoacidosis, on the other hand, is a pathological condition caused by insulin deficiency. The common theme is low insulin; however, in ketoacidosis, blood glucose levels are very high. Ketone levels are elevated in both states, although are 10-20x higher in ketoacidosis (~0.5-2 vs. > 20 mM). Nutritional ketosis and ketoacidosis should not be confused with one another, and a ketogenic diet doesn’t cause ketoacidosis. In ketoacidosis, gluconeogenesis occurs at a very high rate and the lack of insulin prevents glucose disposal in peripheral tissues. Skeletal muscle protein breakdown contributes gluconeogenic substrates, exacerbating the problem. This can cause blood glucose to reach pathological levels, exceeding 250 mg/dL. Brownlee, 2005 (technically, this figure shows the theoretical mechanisms underlying the pathology of the long-term effects of moderate hyperglycemia [<180 mg/dL]; not the acute effects seen in ketoacidosis…) In people on a ketogenic diet, blood glucose levels are not increased. This is an important aspect differentiating nutritional ketosis from ketoacidosis. Yes, gluconeogenesis is modestly elevated to partially compensate for the reduced carbohydrate intake… it only partially compensates for the reduced carbohydrate intake because some tissues decrease their glucose utilization, relying in fats and ketones instead (ie, less glucose is ‘needed’). From: Sumithran & Proietto, 2008 Ketone bodies are produced when glycolysis is low & hepatic fatty acid oxidation is high. Low glycolysis is important because certain byproducts of glucose metabolism inhibit fatty acid oxidation; eg, citrate Continue reading >>
What Is “nutritional Ketosis”?
IN A NUTSHELL: Nutritional ketosis is a state of health in which your body is efficiently burning fat as its primary fuel source instead of glucose. When undergoing a ketogenic diet you are essentially converting yourself from a “sugar burner” to a “fat burner”. This is accomplished by reducing your consumption of carbohydrates, increasing your intake of fat, and consuming only an adequate amount of protein to meet your body’s needs. The term nutritional ketosis is claimed to have been coined by Dr. Stephen Phinney & Jeff Volek, two of the leading experts and researchers in the field of low carbohydrate dieting (Check out this informative video to hear a talk from Dr. Phinney). Ketosis is achieved by following a “ketogenic diet” which is high in fat, very low in carbohydrates, and adequate in protein (Please Note: It is “adequate” in protein, NOT “high” in protein. More on this later). By consuming more lipids you are enhancing your body’s fat burning function by up-regulating the enzymes and other “metabolic machinery” needed to burn fat more efficiently, therefore making it easier for your body to tap into stored adipose tissue as an energy source (i.e. you turn yourself into a fat-burning machine!). But don’t we NEED carbohydrates? While it’s true that our red blood cells and a small percentage of brain cells and kidney cells are exclusively glucose dependent, the body can actually GENERATE carbohydrates in a process called gluconeogenesis in which certain non-carbohydrate substrates like proteins (amino acids) and certain constituents of fatty acids (glycerol) can be converted into glucose. The quantities of glucose produced by the body are sufficient to meet the needs of these particular cells and also help to balance the body’s bl Continue reading >>
- Reversing Type 2 Diabetes with Nutritional Ketosis
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
Is Keto Healthy? Ketosis Vs Ketoacidosis
Is Keto Healthy? Ketosis vs Ketoacidosis When looking at a ketogenic diet and ketosis, it’s common for some people to confuse the process with a harmful, more extreme version of this state known as diabetic ketoacidosis. But there are a lot of misconceptions out there about ketosis vs ketoacidosis, and it’s time to shed some light on the subject by looking at the (very big) differences between the two. An Overview of Ketosis A ketogenic, or keto, diet is centered around the process of ketosis, so it’s important to understand exactly what ketosis is first before we get into whether or not it’s safe (spoiler: it is): Ketosis is a metabolic state where the body is primarily using fat for energy instead of carbohydrates. Burning carbohydrates (glucose) for energy is the default function of the body, so if glucose is available, the body will use that first. But during ketosis, the body is using ketones instead of glucose. This is an amazing survival adaptation by the body for handling periods of famine or fasting, extreme exercise, or anything else that leaves the body without enough glucose for fuel. Those eating a ketogenic diet purposely limit their carb intake (usually between 20 and 50 grams per day) to facilitate this response. That’s why the keto diet focuses on very low carb intake, moderate to low protein intake, and high intakes of dietary fats. Lower protein is important because it prevents the body from pulling your lean muscle mass for energy and instead turns to fat. Ketone bodies are released during ketosis and are created by the liver from fatty acids. These ketones are then used by the body to power all of its biggest organs, including the brain, and they have many benefits for the body we’ll get into later. But first, let’s address a common mi 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 >>
Low Carb Ketogenic Diet & Diabetes: Is It Safe?
You might be surprised to know that the ketogenic diet has been around for over 80 years. It was originally used to treat people with epilepsy. The ketogenic diet is very high in fat, extremely low in carbohydrate with a moderate amount of protein. The severe restriction of carbohydrate resulted in improvements in the seriousness and frequency of seizures. The diet is also associated with weight loss, improvement in risk factors for diabetes and enhanced brain health. How the Ketogenic Diet Works Carbohydrate is the body’s primary source of energy. When following a very low carbohydrate diet, the body is forced to burn stored fat for energy. But fat isn’t clean fuel: it leaves an acidic waste in your blood stream called ketones. Your body can get rid of some, but not all, of the ketones by excreting them in the urine. This process is known as nutritional ketosis. It is not the same as diabetic ketoacidosis, which can be fatal. In diabetic ketoacidosis, ketones build up to much higher levels than those found with nutritional ketosis. The blood glucose levels are also extremely high in diabetic ketoacidosis due to insufficient insulin. Research shows when the body is in a state of nutritional ketosis there is a decrease in hunger and longer satiety after eating, resulting in weight loss. Are Low Carb Ketogenic Diets Safe? Before the discovery of insulin therapy in the early 1920s a ketogenic type diet was used for people with diabetes. However, after the discovery of insulin therapy and oral hypoglycemic medications, recommendations for carbohydrate intake gradually increased. Today the question about how much carbohydrate is a source of controversy. Some diabetes experts say limit carbohydrate for better diabetes control and others say higher carbohydrate—noting co Continue reading >>
A Preventable Crisis People who have had diabetic ketoacidosis, or DKA, will tell you it’s worse than any flu they’ve ever had, describing an overwhelming feeling of lethargy, unquenchable thirst, and unrelenting vomiting. “It’s sort of like having molasses for blood,” says George. “Everything moves so slow, the mouth can feel so dry, and there is a cloud over your head. Just before diagnosis, when I was in high school, I would get out of a class and go to the bathroom to pee for about 10–12 minutes. Then I would head to the water fountain and begin drinking water for minutes at a time, usually until well after the next class had begun.” George, generally an upbeat person, said that while he has experienced varying degrees of DKA in his 40 years or so of having diabetes, “…at its worst, there is one reprieve from its ill feeling: Unfortunately, that is a coma.” But DKA can be more than a feeling of extreme discomfort, and it can result in more than a coma. “It has the potential to kill,” says Richard Hellman, MD, past president of the American Association of Clinical Endocrinologists. “DKA is a medical emergency. It’s the biggest medical emergency related to diabetes. It’s also the most likely time for a child with diabetes to die.” DKA occurs when there is not enough insulin in the body, resulting in high blood glucose; the person is dehydrated; and too many ketones are present in the bloodstream, making it acidic. The initial insulin deficit is most often caused by the onset of diabetes, by an illness or infection, or by not taking insulin when it is needed. Ketones are your brain’s “second-best fuel,” Hellman says, with glucose being number one. If you don’t have enough glucose in your cells to supply energy to your brain, yo Continue reading >>
What’s The Difference Between Ketosis And Diabetic Ketoacidosis?
Ketosis and ketoacidosis sound similar and are sometimes confused, but don’t mistake these conditions for one another. These involve two different sets of circumstances with considerably different outlooks. Both are triggered by an increase of ketones in the body, which are acids released into the bloodstream when the body burns fat for energy instead of carbohydrates. But it’s how the body responds to this increase that sets ketosis and ketoacidosis apart from each other. RELATED: How to Tell the Difference Between Good and Bad Carbs What Is Ketosis and How Does the Process Work? “Ketosis is a natural state that occurs when you start to metabolize fat instead of sugar,” says Michael Greenfield, MD, endocrinologist and chief medical officer at El Camino Hospital in Palo Alto, California. “It occurs often when people fast and use up the stores of sugar in their body." To understand ketosis, it helps to understand how the body burns energy. Carbohydrates and fat are both energy sources, and the body typically burns carbs (sugar or glucose) first, and then fat. If there aren’t enough carbohydrates in your system, it begins to break down fat for energy, which puts your body into a state of ketosis. While in this state, the body becomes a fat-burning machine. For this reason, ketosis is the goal of many diets, particularly those that restrict carbohydrate intake and rely on fat for energy, such as the ketogenic diet. Understanding the Relationship Between the Ketogenic Diet and Ketosis “The ketogenic diet is a high-fat (60 to 80 percent of your total daily calories), moderate-protein (10 to 15 percent of your total daily calories), and low-carbohydrate diet (less than 10 percent of your total daily calories) that forces your body into ketosis, where it burns fa Continue reading >>
Does Ketosis Cause Kidney Damage?
The ‘Lean for Life’ program is mildly ketotic, and only for a brief portion of the program. It has not been associated with kidney damage or disease in individuals who have normally functioning kidneys. Concerns regarding undue stress on the kidneys are often aimed at very low carbohydrate, very high protein ketogenic diets. Few studies have shown any actual damage, however. (Note: Although the Weight Loss portion of the ‘Lean for Life’ program is mildly ketogenic, it is not considered to be exceptionally “high protein” for most individuals.) Dietary ketosis is among the most maligned and misunderstood concepts in nutrition medicine. Particularly among researchers who don’t actually treat patients, ketosis (the presence of ketone bodies in the urine) is often confused with ketoacidosis, which is a life-threatening build-up of ketone bodies due to muscle wasting and dehydration as in states of shock or uncontrolled 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. Whereas patients in ketoacidosis are closely monitored in Intensive Care Units, individuals in ketosis are amongst the healthy, active population. Dietary ketosis 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 is achieved. Blood glucose levels are stabilized within a normal range and there is no break-down of healthy muscle tissue. It would be diffi Continue reading >>
Ketosis & Measuring Ketones
Generally, ketone concentrations are lower in the morning and higher in the evening. Whatever time you pick to measure ketone levels, make sure to keep it consistent. Also, do not measure your ketone levels right after exercise. Ketone levels tend to be lower while your glucose levels higher so you won't get representative numbers. Keep in mind there are daily fluctuations caused by changes in hormone levels. Don't get discouraged! Another aspect that affects the level of ketones is the amount of fat in your diet. Some of you may show higher concentration of ketones after a high-fat meal. Coconut oil contains MCTs that will help you boost ketones. To easily increase your fat intake on a ketogenic diet, try fat bombs - snacks with at least 80% fat content. Ketone levels tend to be higher after extensive aerobic exercise as your body depletes glycogen stores. Exercise may help you get into ketosis faster. ketogenic "fruity" breath is not pleasant for most people. To avoid this, drink a lot of water, mint tea and make sure you eat foods rich in electrolytes. Avoid too many chewing gums and mints, as it may put you out of ketosis; there may be hidden carbs affecting your blood sugar. Increase your electrolyte intake, especially potassium. You are likely going to lose some sodium and potassium when switching to the keto diet. Finally, if you find it hard to lose weight on a ketogenic diet, there may be plenty other reasons than the level of ketone bodies: Not Losing Weight on Low-Carb Ketogenic Diet? Don’t Give Up and Read Further. Continue reading >>
Ketosis Vs Ketoacidosis
Ketosis vs ketoacidosis: Are they both safe? What’s the difference between them. You may have read warnings about the dangers of putting your body into ketosis. Often , the danger of having ketones in the blood is limited to those who have pre-existing metabolic disorders. When you’re following a very low-carb diet, you’ll experience dietary ketosis. Ketosis is a natural physiological state where your body starts burning fat for energy when glucose isn’t easily available and you body has depleted its glycogen stores. This is a normal metabolic process, with a number of proven health benefits ranging from weight loss to managing seizures to improving symptoms of degenerative diseases like Alzheimer’s or Parkinson’s. It’s also the basis of low-carb diets like keto, paleo, and Atkins. However, those with Type 1 Diabetes can sometimes produce excessive amounts of ketone bodies, the compounds that your body creates when you’re metabolizing fats. The boost in the amount of ketones in the blood can be dangerous when a couple of other factors are also present. The result is a life-threatening condition called ketoacidosis. It’s important for you to know the difference between nutritional ketosis and diabetic ketoacidosis. What is Nutritional Ketosis? Studies have proven that ketone body metabolism can provide natural relief from symptoms associated with a variety of health issues, and can result in a significant reduction in body fat. Ketosis can even help decrease your appetite and support lean muscle mass, which are just a couple of the important benefits available to people who follow a low-carb diet. Nutritional ketosis is the body’s natural response to the low-carb diet. Any time you slash your carbs and keep them under 50g to 70g a day then replace tho 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 >>
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 >>