Ketosis is a normal metabolic process. When the body does not have enough glucose for energy, it burns stored fats instead resulting in a build-up of acids called ketones within the body.
Ketosis can occur naturally, or encouraged through various diets or starving the body of calories and carbohydrates. Many diets limit carbs, but most recently a diet called the Ketogenic Diet has gained popularity. The aim of the diet is to burn unwanted fat by forcing the body to rely on fat for energy, rather than carbohydrates.
Several diets are low-carb, or limit “bad carbs”, in order to slow down the metabolism from quickly storing calories into fats. For example, the South Beach Diet doesn’t count grams of carbs, but encourages dieters to go for low-sugar carbs, or those with a low glycemic index (they don’t cause the blood sugar levels to rise and fall as quickly). How the Keto is unique is its goal of having a more prolonged or ongoing ketosis in the body by drastically reducing your carbohydrate intake.
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.
Fast facts on ketosis
- 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?
Normally your body’s cells use glucose as their primary form of energy. Glucose is typically derived from dietary carbohydrates, including:
- sugar – can be in sweets, but also natural foods such as fruits and milk or yogurt
- starchy foods – processed foods such as bread and pasta, or naturally starchy foods such as potatoes and corn
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.
Your liver and muscles can only store a limited amount of glycogen. Once you’ve reached that limit it gets stored in the body as fat. If there is not enough glucose available to meet energy demands, the body will adopt an alternative strategy in order to meet those needs. Specifically, the body begins to break down fat stores to provide glucose from triglycerides.
Ketones are a by-product of this process.
Ketones are acids that build up in the blood and are eliminated in urine. In small amounts, they serve to indicate that the body is breaking down fat, but high levels of ketones can poison the body, leading to a process called ketoacidosis.
Ketosis describes the metabolic state whereby the body converts fat stores into energy, releasing ketones in the process.
The ketogenic diet
By exploiting ketosis, the ketogenic diet is used by many as a way to lose weight. Ketosis breaks down fats when you starve the body of glucose (sugar and starch), so the ketogenic diet works to create an ongoing state of ketosis.
Ketosis diets are also referred to as:
- ketogenic diets
- keto diets
- low-carbohydrate diets
The ketogenic diet is often confused with diets like Atkins and South Beach diets. However, the distinction is how the keto diet is continually starving the body of starches, whereas South Beach or Atkins allows natural starch to be eaten almost unlimited.
The ketogenic diet is sometimes thought of as a high-fat diet, since over 70 percent of calories are derived from fats. In contrast, around 20 percent and 5 percent of calories are gained from proteins and carbohydrates, respectively.
Adhering to the ketogenic diet can lead to short-term weight loss. A study conducted in 2008 and published in the American Journal of Clinical Nutrition found that obese men following a ketogenic diet for 4 weeks lost an average of 12 pounds during this time.
The participants were able to consume fewer calories without feeling hungry while following the diet. This is, of course, due to high fat diets relax your body and give you the feeling of being satiated even when limiting calorie intake.
Is ketosis healthy?
The ketogenic diet could have a healthful effect on serious health conditions such as:
- cardiovascular disease
- metabolic syndrome
It may also improve levels of HDL cholesterol (high-density lipoproteins, also known as “good” cholesterol) better than other moderate carbohydrate diets.
These health benefits could be due to the loss of excess weight and eating of healthier foods, rather than a reduction in carbohydrates.
The ketogenic diet has also been used under medical supervision to reduce seizures in children with epilepsy who do not respond to other forms of treatment. Some studies have suggested that the diet could also benefit adults with epilepsy, although more research is required to confirm these findings.
However, longer-term adherence to the ketogenic diet does not appear to yield great benefit.
The American Heart Association (AHA), American College of Cardiology, and the Obesity Society have concluded that there is not enough evidence to suggest that low-carbohydrate diets such as the ketogenic diet provide health benefits to the heart.
Other conditions are also being studied to see if a ketogenic diet might be beneficial; these include:
- metabolic syndrome
- Alzheimer’s disease
- polycystic ovary disease (PCOS)
- Lou Gehrig’s disease
Ketosis and diabetes
In diabetic patients, ketosis can occur due to the body not having enough insulin to process the glucose in the body. The presence of ketones in the urine is an indicator that a patient’s diabetes is not being controlled correctly.
Some dietitians recommend a ketogenic diet for individuals with type 2 diabetes, also known as non-insulin dependent diabetes (NIDDM). With type 2 diabetes, the body still produces some insulin but is unable to properly use the insulin to transport glucose into cells for use as fuel.
The ketogenic diet focuses on the reduction of dietary carbohydrate intake. Individuals with type 2 diabetes are recommended to reduce carbohydrate intake as carbohydrates are converted to glucose and increase blood sugar levels.
Patients with diabetes who follow a ketogenic diet need to carefully monitor their ketone levels. A serious condition called ketoacidosis can occur if these levels get too high, and although it is most prevalent in individuals with type 1 diabetes, people with type 2 diabetes can also develop ketoacidosis.