The keto diet is one that is high in fat and low in carbs, with moderate amounts of protein. The ketogenic diet shifts the body’s fuel source away from using glucose, and instead toward using ketones for energy, into a state of ketosis. Put simply, being in ketosis means that the body relies on ketones to function.
But what are ketones, and why are they so beneficial? A significant body of research points to the anti-inflammatory, anti-aging, and anti-cancer benefits of a ketogenic diet, along with the results of lower blood sugar, and a decreasing risk for developing type 2 diabetes and other conditions. Throughout this article, we’ll delve into the nitty-gritty science of ketosis, discuss tips for a successful ketogenic diet, and explain myths about the diet that often surface in the media.
See the following articles for more “Keto Guide”
[Keto Guide for a Beginner]
- A Beginner’s Guide to the Keto Diet
- The Top Benefits of the Keto Diet
- What is Ketosis?: The Top Signs of Ketosis
- The Keto Flu: How to avoid and cure it
- Debunking the Myths About the Keto Diet
- Dieting Do’s and Don’ts: The Top Keto Mistakes to Avoid
[Life Tips for Keto]
The Battle of Glucose and Ketones: What are ketones and why do they win?
The human body requires fuel for energy. Many believe that glucose is the preferred source of energy for the body. This, however, is a myth. But what even is glucose? Glucose is a simple sugar derived from the breakdown of all carbohydrates and proteins. The body also stores glucose in the form of glycogen in the muscles and liver.
Whenever there is glucose or glycogen available within the body, it is used first as a fuel source. Particularly, when humans consume excess carbohydrates, glucose is used rather than fat. This is due to the fact that the body can hold at maximum of 5 grams of glucose in the blood. Thus, after consuming a high carb meal, the body will burn the glucose first in an attempt to avoid blood toxicity from excess glucose in the blood. While glucose is often consumed by the body for energy, it is not necessarily meant to be the body’s primary source of energy. In fact, without excess carbohydrates (and therefore excess glucose), some have found that the body prefers fat over glucose.
When the body runs out of glucose, it turns to fat being either consumed or stored within the body. Fat is broken down by the liver into two compounds called glycerol and fatty acids. These fatty acids are then entered into the fuel-making process called ketogenesis, with the end product being ketone bodies. This process can happen when a person is fasting, after prolonged exercise, during starvation, or it can be induced within the body by a person consuming a low carbohydrate, ketogenic diet.
What’s the difference between ketones and ketone bodies? A ketone body is a water-soluble compound that results from the breakdown of fatty acids; these include acetoacetate, acetone, and beta-hydroxybutyrate. A ketone, rather, is the distinctive chemical structure of a carbon molecule double bonded to an oxygen. All of the ketone bodies have this same chemical structure, called a ketone group.
Although the body’s process of converting glucose to energy is quicker, it is far less efficient than using ketones. Also, the research has shown that higher blood sugar, and therefore higher levels of circulating glucose, correlate with increased cell damage, inflammation, and increased disease risk. Ketones are more efficient for the body to use and studies have shown ketogenic diets to decrease inflammation, especially in the brain, improve cognitive function, and help with weight loss.
When the body is in ketosis, physiological insulin resistance occurs, which can have positive results. In the absence of carbohydrates on the ketogenic diet, cells receive less glucose and adapt to these changes accordingly, resulting in insulin resistance. But just what is insulin resistance? Insulin resistance occurs when the body becomes less sensitive to the hormone insulin. Insulin is the messenger that signals to the cells to uptake glucose, so insulin resistance means that the body is no longer turning immediately to glucose for fuel. This means the body instead looks to other sources of fuel, like fats.
Let’s take a look at this part of the metabolic cycle in ketosis: The mitochondria (where energy is made) begin to run off of fat and ketones. Pyruvate dehydrogenase is deactivated, which is the enzyme that is usually needed to shuttle pyruvate (a glucose metabolite) into the mitochondria. Without this shuttle, the cells lose sensitivity to insulin so that glucose is not allowed in as readily as before. In other words, this is the cell saying it prefers fat and ketones to glucose. Myth busted. The body does not prefer glucose as a fuel source. Ketones for the win.
How the body produces ketones
When glucose is not available, the liver instead breaks down fat into glycerol and fatty acid molecules. The fatty acid is then broken down further, in a process called beta-oxidation, and then ketones are formed. These ketones then travel from the liver to circulate back into the bloodstream and are used by the muscles and other tissues to fuel metabolism and create energy. There are three different ketones that are produced: acetoacetate, beta-hydroxybutyrate, and acetone.
- Acetoacetate: This is the first ketone that is created from the breakdown of fatty acids, and can then be converted into either of the other two (beta-hydroxybutyrate or acetone). Along with beta-hydroxybutyrate, acetoacetate is responsible for transporting energy from the liver to other parts of the body.
- Beta-hydroxybutyrate: BHB is technically not a ketone due to its chemical structure, but for all intents and purposes, and in the context of the ketogenic diet, it’s considered to be one of the three ketones.
- Acetone: This is the most simple ketone and is created as a byproduct of the production of acetoacetate. When acetone isn’t needed for energy it will be excreted from the body as waste via sweat, breath, or urine. Although it is the least abundant ketone body, it may be produced in higher quantities when first starting the ketogenic diet.
How the body uses ketones
Once ketones are circulating in the body, they become the preferred source of fuel. As a result, the body begins burning fat as its basic form of energy.
But how exactly is this happening? To better understand the how, let’s take a step back and first look at what happens with high blood sugar (hyperglycemia):
With high blood sugar, the release of insulin is triggered, which promotes glucose to be transported into fat cells which therefore promotes lipogenesis, the storage of fat. Insulin is promoting an anti-lipolytic effect, meaning it’s not doing the body any good when it comes to fat burning.
With low blood glucose (hypoglycemia) which occurs with a ketogenic diet, this is what happens:
With lower blood sugar and therefore less glucose available in the cell, lipogenesis is suppressed, meaning less fat is being stored. Additionally, lower levels of insulin help to favor the breakdown of fat, allowing for a flow of free fatty acids into the bloodstream. Low levels of glucose are therefore stimulating fatty acid oxidation, which again, is the process that forms ketones.
As the body’s cells adapt to carbohydrate restriction, the brain and muscle cells start using beta-hydroxybutyrate as their primary fuel source, as it is the predominant ketone body found in the blood.
Eventually, the body will become keto-adapted, a process the body goes through as it changes from using primarily glucose to using primarily fat. This process can take different amounts of time for different people. The amount of time it takes also depends on specific ratios of macronutrients consumed, physical activity level, and physical make-up. However, the body can only store enough glucose to last a couple days. If implementing a calorie-restricted ketogenic diet, the body may create more ketone bodies quicker than if calories were not restricted on the diet. Complete keto-adaptation may take anywhere from one to three weeks, however, ketosis will begin kicking in after about 3-4 days. Once the body becomes keto-adapted, ketones can supply a significant portion of the body and brain’s energy needs. When in ketosis, the use of ketones can replace most of the glucose required by the brain.
The body uses oxygen more efficiently when using fat and ketones. Due to metabolic changes, it has been found that the VO2 max increases on a ketogenic diet. This suggests that ketosis induces a more efficient use of oxygen. According to the free radical theory of ageing, the ageing process is the result of the presence of free radicals. These free radicals come as a by-product of energy production in mitochondria. When glucose is burned as a fuel, more free radicals are produced compared to when ketones are used. Implementing a ketogenic diet means that fewer free radicals are produced, meaning decreased stress on the body, and a slowed ageing process.
A ketogenic diet emphasizes fat while minimizing carbohydrates. Remember, the goal here is to have the body run off of fat. This means glycogen stores should be depleted. For obvious reasons, it’s important to minimize carbohydrates. When it comes to protein, while the human body requires it to function, it is important to not go overboard. This is because several amino acids (the backbone of all proteins) are glucogenic, meaning that they can be converted to glucose through a process called gluconeogenesis.
Here are some key foods to focus on for a ketogenic diet:
- Fats and Oils: avocado, coconut oil, coconut butter, olive oil, flaxseed oil, avocado oil, sesame oil, grass-fed butter, ghee
- Proteins: grass-fed meats and poultry, bacon, beef, duck, lamb, chicken, sausage, ham, seafood, and especially fatty fish like tuna and salmon, eggs
- Dairy: cream, full-fat greek yogurt, cheese from 100% grass-fed animals
- Veggies: non-starchy, low-carbohydrate vegetables such as asparagus, kale, spinach (and other leafy greens), broccoli, mushrooms, onions, peppers, and tomatoes
- Nuts and seeds: almonds, walnuts, pecans, and macadamia nuts
In order to do the ketogenic diet right, make sure to minimize unhealthy fats. Ensure you get most fats from monounsaturated fats, and don’t consume too many polyunsaturated fats. It is also important to ensure adequate ratios of macronutrients. Typically, the ratios that work best are 4:1 fat to carb and protein. This means for every 4 grams of fat consumed, 1 gram of carbohydrate and/or protein is consumed.
There are some myths regarding the ketogenic diet, which is why it’s important to stick to the research.
- People on the ketogenic diet can eat any type of fat
- The ketogenic diet is a high fat and high protein diet
- The ketogenic diet is a quick-fix for weight loss
- You don’t need to exercise when on the ketogenic diet
Myth 1: People on the ketogenic diet can eat any type of fat
One myth is that people on the ketogenic diet can eat any type of fat. However, the keto diet is definitely not a fat free-for-all. It’s important to focus on getting a significant amount of fat from sources of omega-3 anti-inflammatory fats including from fish, olive oil, nuts, seeds, and avocados, for example.
Myth 2: The ketogenic diet is a high fat and high protein diet
Another myth is that the ketogenic diet is a high fat and high protein diet. This is completely false, as it is not a diet high in protein by any means. Protein intake on the ketogenic diet must be moderate, to avoid kicking the body out of ketosis. Some recommendations say to stick to the following macronutrient breakdown: 75% fat, 5% carb, and 20% protein.
Myth 3: The ketogenic diet is a quick-fix for weight loss
Many people may be jumping on the keto bandwagon thinking that it’s a quick fix for weight loss. While there’s no doubt that the ketogenic helps with weight loss, the effects are not always immediate. Additionally, the ketogenic diet does much more than just that in terms of improving health. Other benefits include regulating hormone function, decreasing inflammation and overall disease risk, and improving cognition and energy.
Myth 4: You don’t need to exercise when on the ketogenic diet
Is exercise important on the ketogenic diet? Absolutely! It has been shown that the ketogenic diet can be used alongside resistance and weight training to cause favorable changes in body composition including increased muscle mass, decreased fat mass, and improved hormonal profiles.
The difference between nutritional ketosis and diabetic ketoacidosis
It’s important to understand the difference between nutritional ketosis and diabetic ketoacidosis. When insulin is not available or not working correctly, as in those individuals with type 1 and type 2 diabetes, diabetic ketoacidosis can occur. Uncontrolled diabetes can lead to ketosis, which is a sign that the body is not properly using or receiving insulin. Diabetes poses a risk for developing diabetic ketoacidosis, a situation where ketone levels continue to rise and reach unhealthy and dangerous levels, creating a pH that is much too low for the blood. In this scenario, ketosis can become dangerous, and the extremely high levels in diabetics can lead to dehydration and alter the chemical balance of the blood. However, very low carbohydrate ketogenic diets have been shown to be extremely beneficial for those with diabetes, for both type 1 or type 2. Improvements in glycemic control, insulin sensitivity, weight loss, and decreased cardiovascular disease risk have been shown as results of drastically decreasing carbohydrate content.
Diabetic ketoacidosis is very different from nutritional ketosis. For individuals without diabetes, it is highly unlikely to experience ketoacidosis, as the balance of insulin, glucagon, and other hormones occur naturally to handle normal ketone production. In certain cases, however, ketoacidosis can occur. Generally, however, ketoacidosis is a result of alcoholism, starvation, or an overactive thyroid. In most cases, with a healthy low carb ketogenic diet, ketoacidosis should not pose a problem.
Help to become “keto adapted” or “fat adapted”
Want to start your keto journey, but not sure where to begin? Here are some tips to start you on the right track!
9 Tips for Becoming Fat Adapted
- Choose the correct goals
- Learn to cut carbs right away
- Don’t create a calorie deficit too soon
- Consume a lot of electrolytes
- Eat the right amount of protein
- Eat the right kind of protein
- Be wise with the use of MCT oils
- Sift through the supplement jargon
- To monitor ketones check blood, not urine
Choose the correct goals
Set an overall goal to be healthier and feel better, not necessarily simply to lose weight. This will help you place an emphasis on the types of foods you eat, rather than trying to strictly hit macronutrient targets. Focus on more omega 3 fats, lots of non-starchy vegetables, and high-quality meats like 100% grass-fed and pastured. Maintaining the proper vision is key. With the overall goal of better health, choosing more targeted goals will become easier, and you’ll feel more inspired to hit those goals.
Learn to cut carbs right away
Enter into ketosis thoughtfully and correctly. Carb moderation is not the goal for keto dieters, which is why carbohydrates should be cut right away. That said, be sure to do so in a way that does not create an energy deficit. If you fail to give the body enough fuel, the body may respond with stress and create complications for your keto journey.
Don’t create a calorie deficit too soon
Creating a calorie deficit before your body is keto-adapted may lead to muscle loss and slowed metabolism. This may be the result of the body not getting enough protein due to the lack of calories consumed in efforts to achieve ketosis. A review of the literature uncovers the importance of differentiating between fat loss and weight loss. Ideally, fat loss is the ultimate goal. If an energy deficit is created too early, however, lean body mass can be affected.
Consume a lot of electrolytes
While the body transitions its primary fuel source from glucose to ketones, low energy is a common complaint. By consuming adequate electrolytes, especially during the transition, very often the issues resolve. With the loss of glycogen, water is released. Much of the initial weight loss may, in fact, be water weight. However, with the loss of water comes the loss of electrolytes, such as potassium losses, which can cause the fatigue that some early keto dieters experience.
Eat the right amount of protein
Too much protein can be the kicker that keeps you from entering ketosis, or it can be what helps you get into it. Many amino acids, as discussed earlier, are glucogenic, meaning that they can be converted to glucose in the body, inducing a release of insulin. Recommendations for the amount of protein to consume vary from person to person, depending on lifestyle, physical activity, and body size. A recent study found that consuming 25% of calories from protein on a very low carbohydrate diet resulted in a preservation of muscle mass.
Eat the right kind of protein
Where possible, it’s important to strive to eat only 100% grass-fed beef, 100% pastured poultry, 100% pastured eggs, and 100% pastured pork. Why? Animals that are fed predominantly grass have meat that is higher in omega-3s, and may also have increased precursors for both vitamin A and vitamin E, as explained here. Ensuring that you are consuming more omega-3s compared to omega-6s ensures a favorable balance that enables anti-inflammatory pathways. Foods that contain a lot of omega-3s includes (but are not limited to): salmon, sardines, trout, flaxseed oil, walnuts, pumpkin seeds, avocados, and leafy green vegetables. Foods that are a high source of omega-6s include (but again, are not limited to): dairy and eggs, poultry, and vegetable oil.
MCTs, or medium chain triglycerides, are a type of fatty acid that is absorbed directly into the portal circulation and transported to the liver for rapid oxidation in the mitochondria. They can be used for energy right away. Unlike long-chain fatty acids, which make up the majority of fats consumed, MCTs are an extremely efficient source of fat. MCT oil is a great tool for beginning keto dieters to help kick the body into ketosis. Consuming MCTs may also help with weight loss, especially for those with type 2 diabetes. However, once the body becomes keto-adapted, MCT oil may prevent the body from burning fat, stalling potential weight loss. MCTs are found in high concentrations in coconut oil, but also can be found in the supplemental form. When supplementing with MCT oil, it is important to not go overboard with the dosage. Increase gradually to lower risk of complications, which may include inhibition of weight loss or gastrointestinal disturbances.
Sift through the supplement jargon
There are tons of supplements targeted to keto dieters. Just because it says “keto” on the label does not mean it’s good to consume. Use supplements sparingly and wisely to maintain health. Exogenous ketones are a practical and efficient way to help achieve ketosis. A recent study showed that exogenous ketones increase beta-hydroxybutyrate.
To monitor ketones check blood, not urine
When testing your ketone levels, take the time to use the correct method. Urine strips can be very inaccurate, particularly once the body is keto-adapted. Monitoring the blood level is the best and most accurate method, but breath tests have also proven effective. Studies have found that testing urine is less effective than blood testing for ketones. Additionally, urine testing is less effective.
Ketones and ketosis for a healthy life
Understanding how ketones affect the body is the first step towards a healthier you. Once you understand the benefits of ketone production and a ketogenic diet, it’s difficult to not want to jump on board. Research is continually being conducted supporting the efficacy and vast health benefits of implementing a ketogenic diet. Some of the health benefits include decreased inflammation, slowed ageing, decreased disease risk, improved blood glucose control and decreased risk for developing type 2 diabetes, increased mental clarity, improved energy levels, and weight loss. With the proper knowledge of ketones and how to properly implement the diet, a healthier life is at your fingertips.