Let’s Talk About Ketosis

What is ketosis? Is ketosis a good or bad thing? If it’s good, how do I get into a state of ketosis?

…All very good questions that we hear from many people these days as the ketogenic diet is becoming more well-known, and the science proving its efficacy continues to build, and many like yourself are in search for answers, possibly for a better, happier, healthier, and more fulfilling way of life.

• Nutritional Ketosis Basics
• Nutritional Ketosis Is NOT Ketoacidosis
• Achieving and Maintaining a State of Ketosis
• The Many Facets of Ketosis and Keto Adaptation
• Signs Of Being In Ketosis
• Possible Problems with Ketosis

Nutritional Ketosis Basics

First, let’s define nutritional ketosis, which is the body process or state that results from following a ketogenic diet and leads to fat-burning, weight loss, and many other health benefits that we’ll talk about.

Dr. Peter Attia, describes it this way on his blog Eating Academy:

Ketosis – also known as keto-adaptation, fat-adaptation, and ketogenesis – is a state, achieved through significant reduction of carbohydrate intake (typically to less than 50 grams per day), at which point the body makes a fundamental change from relying on glycogen as its main source of energy to relying on fat as the primary source of energy. In particular, the brain shifts from being entirely dependent on glucose, to being primarily dependent on beta-hydroxybutyrate – a so-called “ketone body.” Ketone bodies are chemical structures made by the liver (also somewhat in the kidney) out of fatty acids, primarily.

…This is a normal metabolic process, one that actually gives us quite a biological advantage should we ever go without food, which likely happened quite often in our not-so-distant ancestral past.

If our bodies relied totally on glucose for fuel, we would die if we ever encountered any shortage of food or periods of fasting/starvation, because the average person burns 2000 calories per day, while the body can only store 1000-1600 calories of glucose in the form of glycogen in the muscle and liver cells. (Ketogenic-Diet-Resource)

In those situations, where glucose is depleted, the process of ketosis kicks in, creating ketone bodies from stored fats, and our muscle cells & brain can live just as well (or better) on those ketone bodies. And, whenever carbohydrates are consumed again, the body quickly kicks over to converting them into glycogen.

Nutritional Ketosis IS NOT Ketoacidosis

Any time we discuss ketosis with someone new to the concept, it’s wise to make a key distinction between nutritional ketosis and ketoacidosis (DKA). Many dietitians and doctors, still today, get the two confused.

I go into more detail on the differences between the two here, but for the sake of brevity on this post, know that they are completely different; while ketoacidosis IS very dangerous, nutritional ketosis is harmless and proven to have many health benefits.

Keto Terms:

• Ketones – small substances derived from fatty acids that contain energy the body can use as fuel
• Ketosis – a metabolic state where ketone production is increased, usually marked by blood levels of ketones greater than 0.5 mmol/L
• Nutritional Ketosis – the process of accelerating the production of ketones via restriction of dietary carbohydrates
• Ketoacidosis – a dangerous side effect of Type 1 diabetes where ketone production reaches level above 10 mmol/L. This does not happen in non-diabetics
• Keto-adaptation – the process the body goes through when it’s exposed to limited carbohydrate and continuous elevated ketone levels. It is characterized by a shift to using predominately fat for fuel, and takes at least several weeks, if not months, to fully develop

If you would like to dive into some of the research that shows the benefits of the ketogenic diet & ketosis, check out these:

• Ketone bodies, potential therapeutic uses – Richard Veech
• Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets – Paoli, Rubini, Volek, Grimaldi
• The Ketogenic Diet as a Treatment Paradigm for Diverse Neurological Disorders – Stafstrom, Rho
• The use of ketogenic diet in special situations: expanding in intracable epilepsy and other neurologic disorders – Lee

Achieving And Maintaining A State Of Ketosis

Here’s a great video from a legend in the ketogenic diet arena, Dr. Stephen Phinney on the topic of getting into, and staying in, a state of ketosis…

The Many Facets Of Ketosis and Keto-Adaptation

The ketogenic diet has really begun gaining awareness and acceptance as a successful way not only to lose weight, but also to improve overall health, reduce cardiac risks, and as a treatment for many medical conditions, including diabetes, metabolic syndrome, Alzheimer’s, Parkinson’s, and more.

When you follow a ketogenic diet correct – consuming about 80% of your daily calories from fat, 15% from protein, and less than 5% from carbohydrates – your body will enter into a state known as ketosis, where it adapts from burning carbs/glucose/sugars for energy to burning fats for fuel.

In that “fat burning” state of ketosis, the liver turns fats into ketone bodies, which is the actual fuel source for the body’s cells.

Many people do their research on how to properly change their diet to a high-fat low-carbohydrate ketogenic diet, learning which foods to eat and which not to eat. They set out on the new plan, confident they’ll be in ketosis and losing weight in no time…but then find themselves wondering, “How do I know if I’m in ketosis or not?“.

Sound familiar? If that’s you, don’t worry, you’re not alone!

Let’s talk about some of the signs you can watch for to know if you’re successfully adapting into ketosis…

What Are The Signs Of Being In Ketosis?

While every single person’s body is different, and each has its own unique way of adapting from a standard diet to the fat-burning state of ketosis, there are some common signs & symptoms many people experience when they first get started on a keto diet.

1. Altered Breath – Many in the media who report on the keto diet, but personally unfamiliar with it, will refer to it as “having bad breath”, but it’s not strong enough for others to smell ketones in your breath. It’s usually an experience of having a lingering metallic taste in the mouth, and sometimes everything eaten tastes funny or off just a bit. Type 1 Diabetics often develop a fruity breath.

2. Appetite Reduced & Cravings Eliminated – This takes a different amount of time to set in for everyone, but if you find yourself much less hungry, able to go without meals without much thought, you’re very likely in ketosis. When you’re fat-adapted, your body can sustain itself purely burning excess fat in your body – no need for a meal or snack to give a surge of energy, like on a typical high-carb diet.

You will still get hungry, close to meal times and such, but you won’t have that feeling that starving feeling, that you need to eat or else you’ll crash.

Biological cravings diminish or are totally eliminated in ketosis, as the body is getting all the energy it needs from fat. However, if you have cravings stemming from psychological issues like habits & conditioning, or for stress avoidance, those may continue and need to be worked on with discipline.

Note: As you get closer to your goal weight you will want to maintain at, the hungrier you will get, as excess fat stores are depleted. But, for most, that point will be a ways down the road.

3. Strong Urine Smell – This one’s a bit hard to explain, but this is a sign you’ll notice very quickly after your body goes into ketosis.

4. Increased Energy – You may experience fatigue in the very beginning, as your body is adapting from being a “sugar burner” to a “fat burner”, especially if you had a poor standard American diet before…but a very common sign people experience is an immediate increase in energy once they do get into ketosis. Along with the increase in energy and motivation to get up and be active, people find they have more stamina and endurance, without the typical highs & lows that accompany a standard higher-carbohydrate diet.

5. Mental Clarity – This varies greatly for everyone. I personally never experienced much in the way of “brain fog” issues before the ketogenic diet, but many who have, claim that brain fog is lifted and they experience much more mental clarity when their brain is using ketones for fuel.

6. Ketones in the Blood, Urine, and Breath – If you’re the tracking/testing/measuring type, and want more accurate evidence that you really are in ketosis, then you’ll want to physically test for ketone levels present in your blood, urine, or breath. Check out this post to learn more about how to do this, which ways are best, and what tools to use to measure.

7. Weight Loss – The main goal for starting the diet in the first place for most people…Initially the weight loss will come from water loss, as the body is releasing excess fluids that had been retained on the diet you had before. Once you’re keto-adapted, the fat burning will commence and weight loss from fat burning can happen quite rapidly.

Not Always An Easy Transition For Everyone…

While getting into a state of ketosis is easy & painless for many, some do experience some negative symptoms in the process of becoming fat-adapted. They are generally:

• Fatigue – a lack of energy since the body is accustomed to having glucose as a fuel source, and hasn’t yet adapted to tapping into fat reserves as a fuel source
• Nausea
• Headache
• Shakiness or Dizziness

You’ll often hear this group of symptoms referred to as the “keto flu” – not the real influenza kind of flu, but just symptoms that are similar to what you would experience with the real flu.

It’s understandable this happens, especially if you’ve been on a standard American, high-carb, diet for years, having prolonged higher blood glucose levels. It will naturally take some time for the body to adjust and adapt to a new, healthier state…and when it does so, these negative symptoms will go away.

These symptoms often are the result of an electrolyte imbalance. When your body first goes into ketosis, it will flush out a lot of excess fluids (high carb diets cause the body to retain fluid), and salts/electrolytes along with that fluid.

If that’s the case, add a quarter teaspoon of salt to a glass of water and drink it…if it’s an electrolyte imbalance you’re experiencing, the symptoms should go away in less than 30 minutes.

Just like you need to embrace fat on a ketogenic diet, you also need to embrace salts, adding them to foods. And, be sure to drink more water!

However, I don’t believe there is a one-size-fits-all solution. A ketogenic, low-carb high-fat diet may not be for everyone. Above all else, listen to your body, pay attention to the signs it gives you and act accordingly.

Other Resources On This Topic:

• Kickin’ Carb Clutter – How Do I Know If I Am In Ketosis?
• Ketogenic Diet Resource – Low Carb Diet Side Effects
• Ketogenic Diet Resource – Ketosis Symptoms

Some Problems That Can Possibly Arise In Ketosis

Ketosis has countless benefits, but as with anything involving health, fitness, dieting and nutrition, there is no one-size-fits-all prescription that will work for every single person. We all react differently to things based on our genetics, environment, diet, history, current prescription medications, and activity & lifestyle. Hence, you hear the typical disclaimer that you should always first consult your physician before pursuing something like the ketogenic diet, to know how it can effect your personally and for issues to be aware of and prepared for.

There are a handful of problems that can arise for some people going into a state of ketosis (not to be confused with ketoacidosis), of which we’ve listed below:

• Ketosis Headaches
• Ketosis & Alcohol
• Weight Loss Plateau

Some People Experience ‘Ketosis Headaches’

More to come soon…thanks for your patience!

Can You Be In Ketosis & Consume Alcohol?

More to come soon, we apologize for disappointing you with nothing here!

Many People Experience Weight Loss Plateaus

More to come