Ketosis: Definition, Benefits, Downsides, and More

Written by Resurchify | Updated on: July 13, 2022

Food is our body's fuel, with the three main elements- carbohydrates, fats, and protein. The body then slowly breaks the carbohydrates, then the fats, and the protein, which provides energy to our body. In all these bodily processes, ketosis is one such process.

Ketosis is a procedure that takes place when there are not many carbohydrates in the body to produce energy. Thus, the body burns the fats, and substances such as ketones are produced.

Ketosis is a word that is often associated and linked up with diabetes or weight reduction, as diabetic ketoacidosis and Ketosis sound similar. Usually, our body produces energy by using our blood sugar, that is, glucose, but during ketosis, our body receives much of the energy from ketones which are obtained when the body burns fats. This does not happen overnight or instantly; there are a few steps in the process. It is a metabolic condition during which the blood in our bodies has higher concentrations and quantities of ketones, which are otherwise known as beta-Hydroxybutyrate. Ketosis occurs when our body uses fuel due to its limited reach to glucose and blood sugar, which occurs mainly when one starves fast or undergoes a very low-carb diet.

The body cells favor using glucose for energy, which we get from the food we eat. When we eat 12- 14 times a day, which people usually do as per the studies conducted by the Salk Institute, our blood glucose level never tends to come down. It remains artificially elevated as we are eating all the time. This leads to the extra energy getting stored as fat. Here there are a couple of hormones that play a role- insulin and glucagon. When we tend to eat all the time, we keep our blood sugar level high which increases the insulin level too, when our body can not use all this stored energy.

So to reach ketosis, you need to fast, which decreases the high glucose level in the body. When the body doesn't possess much glucose to provide energy to these cells, there is a decrease in the level of insulin hormone, which causes fatty acids to come out from the body fat stores in bulk quantities.

The fatty acids in bulk quantities are transported to the liver, where the process of oxidization occurs, also referred to as the ketone bodies. These ketone bodies are substitute energy bodies. Ketones, unlike fatty acids, can overcome the blood-brain barrier and, without glucose, can release energy for the brain.

Ketosis And Ketogenic Diet

In a ketogenic state or when one wants ketosis to occur, one should consume no more than 50 grams of carbs per day or 20 grams per day. The carb intake varies from person to person as every person has a different body type.

Foods rich in carbohydrates should not be consumed and should be greatly cut off from the diet. The carbohydrate-rich foods like potatoes, grains, legumes, soft drinks and sugary sweetened beverages, ketchup, and sugar barbecue sauce. Most people undergo keto-diets to reduce their weight, keep their sugar levels under control, or reduce the seizures relating to epilepsy.

Symptoms After Following Ketogenic Diet

If one undergoes a ketogenic diet, one might undergo or experience the following symptoms, foul breath, which happens due to acetone or ketone, loss of weight, consumption of less food, headache, nauseated feelings, and fatigue all over the body. A person who undergoes ketosis for the very first time experiences a pyramid of symptoms like nausea, bad breath, tiredness, and fatigue all over the body.

One can get aware that he/she is in ketosis by using a blood or a urine measurement device. If the blood levels are between 0.5-3.0 millimoles per liter, then one has attained ketosis.

Is Ketosis Helpful?

The Keto diet can be helpful as well as can have several health benefits. It makes the body immune and less risky to cardiovascular diseases, diabetes, and metabolic syndrome. It increases the amount of lipoprotein and "healthy" cholesterol more profoundly than other moderate-carb diets.

Researchers are investigating to see if a keto diet is healthful in matters of-

metabolic syndrome
Alzheimer's disease
acne
cancer
polycystic ovary syndrome

Epilepsy

Epilepsy is a malfunction of the brain caused by consecutive seizures. It's a condition occurred in the brain, and 50 million people around the world get diagnosed with it. Many people often use medications to control their seizure attacks, but this treatment method does not work for around 30% of the affected people.

In the early 1920s, the ketogenic diet was initiated for the people with epilepsy on whom the treatment was not affecting. The children are often asked to follow this diet with epilepsy. Most research has shown that both children and adults affected and undergoing epilepsy have reported that it can reportedly, and to a large extent, bring down seizures and can occasionally cause suspension.

The ketogenic diet is usually very difficult to follow for a long duration of time and is only followed by people for whom the treatment is ineffective.

Weight Loss

In recent past years, ketosis has often elevated in its fame for the reduction in weight among the people, which has often proved to be healthful. When the body consumes a low-carb diet, our body depends on ketones which are derived from fats that are released in the liver to produce energy and refuel itself. With time, it can lead to a humongous loss of weight and fat.

The interesting thing is people who follow a ketogenic diet often are less hungry and more satisfied and full, and the credit often goes to ketosis. For this prime reason, it's usually unnecessary to keep a count of the calories when the ketogenic diet is strictly followed.

However, it is widely known that strict following is essential for success for a long period. Some people often find it very comfortable to follow the ketogenic diet, while others often find it very difficult as there are food restrictions. A point to be noted is that some researchers suggest that following a keto diet does not help in the reduction of weight and often fails.

Type 2 Diabetes

Every 5 out of 10 people have diabetes; it is a chronic and long-lasting condition that affects the way our body converts food into energy. The ketogenic diet, if followed strictly, can help lower blood sugar levels in diabetic people.

Research has outlined the fact that people affected with type 2 diabetes who follow a ketogenic diet have well-refined blood sugar levels.

But also, sticking to the ketogenic diet may be a very wayward process on a long-term basis, so it is not helpful for people who do not follow this plan and cannot follow this plan for a longer time. Further, it can also put one at a higher risk of hypoglycemia or sugar levels that are low in the body.

At the end of the day, it is beneficial and often better to work with the consultation of a medical professional. They often can suggest and advise ways to control diabetes that adapts to one's health, lifestyle, and ways of living and choices.

Ketoacidosis

People affected with diabetes who act in accordance with a keto diet need to keep a check on their ketone levels and follow up very conscientiously. If ketone levels in the body get too higher, then a condition called ketoacidosis occurs. DKA is a state where the measures of ketones increase all of a sudden, which causes harm to the body. It is a very fearful and critical state that can occur spontaneously, sometimes within the time frame of 24 hours.

There are certain provocation points and triggers that often lead to ketoacidosis. Significantly, it resultantly occurs due to illnesses that cause hormones in higher levels that do not go well with and often result against insulin. It can also occur from issues occurring with therapies taken from insulin, either through scheduled treatments, which often go missing, or not intaking insulin.

Some less common triggers of ketoacidosis include:

misuse of drugs
trauma on an emotional basis
trauma on a physical basis
stress
surgery

People with type 1 diabetes often undergo the problem of ketoacidosis. It can also be caused by people who have been diagnosed with type 2 diabetes.

Usually, people who have very large amounts of ketones in the urine and high levels of sugar in their blood are often affected by ketoacidosis. A person can test for ketoacidosis by using a kit at home and can come to know whether he is affected or not.

Some early symptoms of ketoacidosis include:

pain in the abdomen
confusion and shift of focus, and difficulty in concentrating
skin which is flushed
deep thirst and mouth which is dry
bad breath
urinating frequently
vomiting and nauseated feelings
shortness of breath or panting

Ketoacidosis Treatment And Prevention

Ketosis does not usually happen in people who take balanced diets and proper nutritious meals. Reduction of calories and intakes of carbs, exercising for a long period of time, or pregnancy may induce ketosis. Although some people often prefer to put the body in a ketosis mode, the danger of large amounts of acid levels can be risky in those who are not suppressing it.

In people who are affected with diabetes, ketosis and subsequently DKA or Diabetic ketoacidosis can happen if they do not make use of a large amount of insulin and if they do not take meals, or if a reaction is caused by insulin occurs. An insulin reaction often results when one is sleeping or in deep slumber.

Doctors think DKA to be a state of crisis, as it can lead to a state of unconsciousness and even cause fatality. Emergency healthcare workers will usually treat people and admit them people if necessary to the hospital.

For the people who are affected with diabetes, the hospital team will take the following steps-

Fluid replacement: Doctors often detoxify the body, and sugar in the blood is often removed.
Electrolyte replacement: A person with this treatment balances heart, muscle, and nerve cell function. In the absence of insulin, levels of blood pressure drop.
Insulin therapy: Insulin is secreted by our liver and helps the sugar we intake to reach the cells and produce energy. Insulin therapy is a good way to treat ketosis. The doctors often alter and reverse the way of ketoacidosis. Healthy people who often follow a balanced diet and exercise regularly help to alter ketosis.

Prevention

There are a number of ways a person can avoid ketoacidosis is, by the following ways :

They should check their blood sugar levels at least three to four times per day, check the insulin dosage with a medical practitioner, and practice a diabetes treatment plan. The people who are diagnosed with diabetes should keep a kit to keep an eye on their ketone levels.

Nutritional Ketosis Vs. Ketoacidosis

Nutritional ketosis and diabetic ketoacidosis are totally different things. On the one hand, nutritional ketosis is safe and is good for health, and ketoacidosis is a serious condition that requires medical supervision. Unfortunately, many medical professionals do not understand the way these two are different from each other.

Ketoacidosis happens mostly in people who are diagnosed with type 1 diabetes if they aren't provided with insulin to come up to their demands. In diabetic ketoacidosis (DKA), blood sugar and ketones accelerate to levels that are often dangerous and cautious and which disturb the blood's fragile balance between acid-base.

In nutritional ketosis, BHB levels are typically as low and below 5 mmol/L. On the other hand, people diagnosed with diabetic ketoacidosis often have BHB levels above 10 mmol/L, which is somehow related to their inability to generate and procreate insulin.

Other people who are often affected with ketoacidosis are those diagnosed with type 2 diabetes undertaking medications such as SGLT-2 inhibitors, which constitute empagliflozin, canagliflozin, dapagliflozin, and ertugliflozin.

In certain rare phenomena, women who do not possess diabetes can be detected with ketoacidosis while breastfeeding. But for people who are most capable of producing insulin, it's next to impossible to have ketoacidosis.

Protein's Effect On Ketosis

Although having protein in any diet is essential for the loss of muscles and fats, a lot of questions have been asked about protein's effect on levels of the ketone. During the digestion process, protein is converted into amino acids, which provokes the genesis of insulin. Even if the quantity of insulin needed to shift these amino acids into muscles is less but when there is an intake of large quantities of protein, the rise in insulin might affect and lessen the intensity of ketone production.

Due to this cause, ketogenic diets for epilepsy are not allowed protein and carbs for consumption which makes sure that ketone levels remain increased in bulk, often at regular intervals.

Diet Doctor Bjarte Bakke conducted several "n of 1" researches to examine how much protein he could consume and still have ketosis, and he realized that maintaining a net carb intake below 20 grams per day was what the real importance was and the amount of protein intake did not matter.

Suppose one wants to remain in ketosis and still consume a lot of protein and remains worried about the ill effects. In that case, it might be a great idea to undergo some kind of experiments in order to find out one's personal doorway of protein. Sometimes, it is higher than one imagines.

What Is Optimal Ketosis?

Getting into ketosis on a ketogenic diet includes a wide range of events, and one can undergo different kinds of ketosis. The term "optimal" ketosis is most widely used, but it is very imperfectly defined. For example, those undergoing treatments for seizures or Alzheimer's disease may enhance by keeping their ketone level above 1.5 mmol/L; on the other hand, for weight reduction or blood sugar reduction, the degree of elevation does not matter at all.

Below 0.5 mmol/l is not considered "ketosis," although a value of, say, 0.2 demonstrates that you're getting close. At this level, you may not be at your maximum fat-burning zone.

The value occurring within 0.5 – 3 mmol/l is nutritional ketosis which benefits a person by receiving a positive effect on one's food habits and metabolic improvements.

The range between 1.5 – 3 mmol/l is referred to as "optimal" ketosis by some people. However, the concept of optimal ketosis is way too wayward, and it is not clear if it provides any important benefits over the 0.5-1.5 level. Some altercations can be included in the treatment of seizures or people who are inclined towards gain in maximum mental and physical performance.

The range of 3 mmol/l is way too higher than required. It will mostly reach nearly neither better nor worse effects than remaining at the 1.5–3 level. Bigger numbers can also sometimes indicate that one is not receiving enough food ("starvation ketosis"). People undergoing type 1 diabetes have ketone levels of more than 3.0 mmol/L, which can be caused by an acute shortage of insulin that requires medical attention.

Over 8–10 mmol/l: It's nearly impossible to reach the level just by consuming a keto diet. It indicates that a lot of things are wrong.

Conclusion

Each human body is different in its way and undergoes various changes while accepting a new type of diet. So before trying to attain ketosis, it is recommended to consult the doctor and then take any steps. In the above article, we discuss ketosis in this process, where the body goes from burning glucose or sugar to burning fat as fuel. We also understood that this process does not happen automatically and that it takes certain steps. When the body uses fats as fuel, you ultimately get rid of all the unnecessary fats by going through the long desert of no food. You don't have to go for it suddenly, as it may affect digestion. Go slow and allow your body to take the whole ketosis process.

Frequently Asked Questions

What does it mean to be in a state of ketosis?

Being in a state of ketosis indicates that your liver is creating higher levels of ketone bodies in order to supply energy to the brain, heart, and muscles. To get this done, carbohydrate intake needs to be significantly restricted, and the protein intake checked at a specific level. A state of ketosis can occur and go through any day, but with time you'll learn how to stay ketotic for longer.

What is nutritional ketosis, and how to get into it?

Nutritional ketosis is a natural metabolic body process in which the body starts burning instead of carbohydrates (glucose) for energy. It takes place when the carbohydrate consumption from the food gets significantly low, that the person's liver starts to convert adipose tissue and dietary fats into a fatty acid which is otherwise called ketones, then burn the ketones to produce energy.

Nutritional ketosis takes place when the carbohydrates we intake are reduced by <50 grams per day, after which the body's ketone production increases to hold a blood level at or above 0.5 mM.1 When carbs are restricted below 50 grams, and protein consumption becomes moderate, it is normal to have ketone levels of 0.5-3.0 mM. It is a fact that every person's body is different from one another; hence it is very natural that every person's capacity to get into nutritional ketosis is distinct. Some people will notice an increased ketone level within just a few days of limiting carbs intake, while others will take 1 or 2 weeks before their ketones begin to increase, especially if they are on some medication for diabetes (mainly type-2). Thus, it is suggested to work with someone who is an expert on a ketogenic diet, so you are guided through the whole process.

Should I take vitamins or supplements on a ketogenic diet?

It is better to go with whole foods over dietary supplements as all the essential vitamins and minerals found in foods are absorbed better than those found in dietary supplements. A natural ketogenic includes all whole foods like grains and processed food as well. All of these meet the nutritional need of the body. Hence it is better to go for all the naturally occurring foods instead of dietary supplements if you're on a ketogenic diet.

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