Ketosis is a natural metabolic state.
It involves the body, via the liver, producing ketone bodies from fat and using them for energy instead of glucose derived from carbohydrates.
You can get into ketosis by starving the body of glucose. This is most conveniently done by following a very low carb, high fat ketogenic diet.
A ketogenic diet can help you lose weight and often leads to transformative weight loss.
In the short term, you can lose weight quickly, because it reduces the body’s stores of glycogen and water.
In the long term, it satiates your appetite meaning your body tells you are fully and require no more food and this leads to a lower calorie intake.
Apart from weight loss, research proves ketosis has several health benefits, including reducing seizures in children with epilepsy.
Ketosis is complex, but in this article, we seek to explain what it is and how it can benefit you.
What Is Ketosis?
Ketosis is a metabolic state in which there’s a high concentration of ketones in the blood.
This happens when fat provides most of the fuel for the body, and there’s limited access to glucose. Glucose (blood sugar) is the preferred fuel source for many cells in the body.
Ketosis is most often associated with ketogenic diets, aka very low carb, high fat diets. It also happens during pregnancy, infancy, fasting and starvation.
That’s right, babies are in ketosis in the womb!
For ketosis to start, you generally need to eat fewer than 5% of your total caloric intake from carbohydrates. This can range from 50 grams per day to sometimes as few as 20 grams per day.
However, the exact carbohydrate intake that will cause ketosis varies between individuals.
To do this, you may need to remove certain food items from your diet, such as:
- grains
- candy
- sugary soft drinks
You also have to cut back on:
- legumes
- potatoes
- fruit
When eating a very low carbohydrate diet, levels of the hormone insulin go down and fatty acids are released from body fat stores in large amounts.
Many of these fatty acids are transported to the liver, where they oxidize and turned into ketones (or ketone bodies). These molecules can provide energy for the body.
Unlike fatty acids, ketones can cross the blood-brain barrier and provide energy for the brain in the absence of glucose.
Summary: Ketosis is a metabolic state where ketones become the primary source of energy for the body and the brain. This happens when carbohydrate intake and insulin levels are low.
Ketones can supply energy for the brain
It is a common misunderstanding that the brain doesn’t function without dietary carbohydrates.
It is true that glucose is preferred and that some cells in the brain can only use glucose for fuel.
However, a large portion of your body and brain can use ketones for energy, such as during starvation or when your diet is low in carbohydrates.
In fact, after only three days of starvation, the brain gets 25% of its energy from ketones. During long-term starvation, this number rises to around 60%.
In addition, your body can use protein or other molecules to produce the glucose the brain still requires during ketosis. This process is called gluconeogenesis.
The body is, via ketosis and gluconeogenesis, perfectly capable of fulfilling the brain’s energy needs.
Summary: In ketosis, the body provides the perfect amounts of ketones and glucose to fuel the energy needs of the brain via the process of gluconeogenesis.
Ketosis Is Not Ketoacidosis
People often confuse ketosis and ketoacidosis.
Ketosis is normal, natural metabolic state.
Ketoacidosis is a dangerous metabolic condition where the bloodstream is flooded with extremely high levels of glucose (blood sugar) and ketones.
When this happens, the blood becomes acidic, which is seriously harmful and can be fatal if left untreated.
Ketoacidosis is most often associated with uncontrolled type 1 diabetes. It may also occur in people with type 2 diabetes, although this is less common.
In addition, severe alcohol abuse may lead to ketoacidosis.
Summary: Ketosis is normal, natural metabolic state. Ketoacidosis is a serious medical condition most often seen in type 1 diabetes that’s not well managed.
Effects on Epilepsy
Epilepsy is a brain disorder characterized by recurring seizures.
It is a very common neurological condition, affecting around 70 million people worldwide.
Most people with epilepsy use anti-seizure medications to help manage seizures.
However, around 30% of people continue to have seizures despite using these medications.
In 1924 the ketogenic diet was developed by Dr. Russell Wilder at the Mayo Clinic as a treatment for epilepsy and it is still used as a means of therapy for those who have a pharmacological resistance to epilepsy.
It has primarily been used in children, with some studies showing benefits. Many children with epilepsy have seen significant reductions in seizures while following a ketogenic diet, and some have seen complete remission.
Summary: Ketogenic diets are used to effectively manage epilepsy, especially in children who don’t respond to drug treatment.
Effects on Weight Loss
The ketogenic diet is a popular weight loss diet because research and anecdotal evidence clearly demonstrates how effective it can be, if implemented correctly.
Some studies have found that ketogenic diets are more helpful for weight loss than low fat diets.
One study reported 2.2 times more weight loss for people on a ketogenic diet, compared to those on a low fat, calorie restricted diet.
What’s more, people tend to feel less hungry and more satiated on a ketogenic diet, which is attributed to ketosis. For this reason, it is generally not necessary to count calories on this diet.
However, it is widely recognized that adherence to the diet is critical for long-term success.
Some individuals may find it easy to adhere to the ketogenic diet, while others may find it unsustainable.
Some research suggests the keto diet may not be the best way to lose weight. The authors of a 2019 review concluded that it was not better than other diets at helping people lose weight, and it may not have specific advantages for people with metabolic disorder.
Summary: The ketogenic diet is popular for weight loss in the main but might not have specific advantages for people with metabolic disorders.
Other Health Benefits of Ketosis
Some scientists have suggested that ketosis and ketogenic diets may have other therapeutic effects, although it is worth noting that not all experts agree on this.
- Heart disease:Some older studies suggest that reducing carbohydrate intake to achieve ketosis may improve heart disease risk factors such as blood triglycerides, total cholesterol, and HDL cholesterol.
- Type 2 diabetes:The diet may improve insulin sensitivity and various risk factors that can lead to type 2 diabetes, including obesity.
- Parkinson’s disease:A small study found that symptoms of Parkinson’s disease improved after 28 days on a ketogenic diet.
Does Ketosis Have Any Negative Health Effects?
While a ketogenic diet has many benefits for health and weight loss, it can also trigger some side effects.
Short-term effects include headache, fatigue, constipation, high cholesterol levels, and bad breath, but these usually disappear within a few days or weeks of starting the diet.
Also, there may be a risk of developing kidney stones.
People who are taking blood sugar lowering drugs should consult with a doctor before trying a ketogenic diet, because the diet may reduce the need for medication.
Some versions of ketogenic diets are low in fiber. For this reason, it is common sense and good practice to eat plenty of high fiber, low carbohydrate vegetables while using a keto diet.
The following tips can help you stay healthy during ketosis:
- Drink plenty of fluids, particularly water with a pinch of sea salt
- Talk to your doctor before starting the diet and follow their advice.
- Monitor your kidney function while following the diet.
- Seek help if you have concerns about negative effects.
Summary: Ketosis has demonstrated health benefits for many people, however you should consult your doctor before switching to a keto diet, in case it is not suitable for you.
The Bottom Line
Ketosis is a natural metabolic state that can be achieved by following a ketogenic diet.
It may have a variety of health benefits, including:
- weight loss
- lower blood sugar levels
- reduced seizures in epileptic children
However, following a strict diet to induce ketosis can be difficult, and there may be some negative side effects. In addition, not all researchers agree that a keto diet is the best way to lose weight.
Ketosis is not for everyone, but it has demonstrated health benefits for many people.
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