Ketosis

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Kellyfitness128
Kellyfitness128 Posts: 194 Member
edited October 2014 in Health and Weight Loss
I really want to further discuss the topic of ketosis from the other thread (which appears to have been closed). A lot of you thought that I was wrong when I said that it is unhealthy to be in a state of ketosis. Here is some information that I'd like to share that is straight from my nutrition text book titled "Perspectives in Nutrition: A Fundamental Approach" by Carol Byrd-Bredbenner, Gaile Moe, Donna Beshgetoor, Jacqueline Berning, and Danita Kelley...published in 2014.

"Most of the digestible carbohydrates in our diets are broken down to glucose. As glucose, they provide a primary source of energy, spare protein from use as an energy source, and prevent ketosis.

The main function of glucose is to act as a source of energy for body cells. In fact, red blood cells and cells of the central nervous system derive almost all of their energy from glucose. Glucose also fuels muscle cells and other body cells." (Hence, carbs are important.)

"The amino acids that make up dietary protein are used to build body tissues and to perform other vital functions only when carbohydrate intake provides enough glucose for energy needs. If you do not consume enough carbs to yield glucose, your body is forced to break down amino acids in your muscle tissue and other organs to make glucose. However, when dietary carb intake is adequate to maintain blood glucose levels, protein is "spared" from use as energy." (However, most of us consume enough protein so sparing proteins isn't necessarily an important role of carbs, but I wanted to include this for some of us who might not be eating enough).

"A minimal intake of carbs (50-100g per day) is necessary for the complete breakdown of fats to CO2 and H2O. When carb intake falls below this level, the release of hormone insulin decreases, resulting in the release of large amount of fatty acids from adipose tissue to provide energy for body cells. These fatty acids travel in the bloodstream to the liver. The subsequent incomplete breakdown of these fatty acids in the liver result in the formation of acid compounds called ketone bodies.

The brain and other cells can adapt to use ketones for energy when carb intake is inadequate. This is an important survival mechanism during starvation.

Many low-carb/high-fat weight-reduction diets (Atkins, South Beach) and fasting regimens promote ketosis as a beneficial state for successful weight loss. Ketosis can suppress one's appetite, resulting in a lower calorie intake. It also can cause increased loss of water from the body, which may be reflected in lower body weight. However, over time, ketosis can lead to serious consequences, such as dehydration, loss of lean body mass, and electrolyte imbalances. If severe, ketosis can even cause coma and death."


If you're eating low-carb and feel great, then I'm not saying you should change that. I just want to make people aware of the potential risks if you're doing it for too long, not drinking enough water, not maintaining body protein mass, etc. The low-carb diet just seems like another fad diet to me... Sure, you will absolutely lose weight (and lots of water weight) but is it healthy? Well, I provided you with this information, so now it's up to you to decide.
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  • baconslave
    baconslave Posts: 6,961 Member
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    Here is some information to consider as well:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/

    "The present study shows the beneficial effects of a long-term ketogenic diet. It significantly reduced the body weight and body mass index of the patients. Furthermore, it decreased the level of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol. Administering a ketogenic diet for a relatively longer period of time did not produce any significant side effects in the patients. Therefore, the present study confirms that it is safe to use a ketogenic diet for a longer period of time than previously demonstrated."
  • stroutman81
    stroutman81 Posts: 2,474 Member
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    Ketoacidosis = dangerous

    Ketosis not so much
  • Kellyfitness128
    Kellyfitness128 Posts: 194 Member
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    MrM27, The information I provided above may be exaggerated, you're right. I'm sure it would take a long time for the body to actually be at risk, but still.... if that is what ketosis eventually can lead to, it doesn't sound healthy to me. One can still achieve weight loss in a healthy way and avoid ketosis by eating only 50g of carbs a day :) Can I ask then why you aren't a fan of keto?

    baconslave, I'm assuming those positive results are merely from the weight loss itself rather than being in a ketogenic state...and 6 months isn't exactly long-term. Interesting info though. At least we know it's safe for a 6 month period of time!
  • TheSatinPumpkin
    TheSatinPumpkin Posts: 948 Member
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    safe after 14 months on my WOE.
  • baconslave
    baconslave Posts: 6,961 Member
    edited October 2014
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    Something else interesting:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2129159/

    And also, there are varying levels of ketosis which correspond to different levels of ketones in the blood.

    blood concentration (millimolar)
    < 0.2 not in ketosis
    0.2 - 0.5 slight/mild ketosis
    0.5 - 3.0 nutritional ketosis
    2.5 - 3.5 post-exercise ketosis
    3.0 - 6.0 starvation ketosis
    15 - 25 ketoacidosis

    The majority of fat-adapted people in nutritional ketosis couldn't reach starvation ketosis if they tried. And I know people who have tried to get above 4 mmol/L. Ketoacidosis occurs mainly in diabetics whose diabetes has been uncontrolled to the point that the body no longer produces insulin AT ALL. Also it's found in severe alcoholics. You'll also note that the gap between "starvation ketosis" and ketoacidosis is quite large. A great number of conditions must be met for these extreme conditions to occur.

    So you might want to research the difference between nutritional ketosis, starvation ketosis, and genuine ketoacidosis. Ketoacidosis is the extreme side of the ketosis spectrum and is bad news. But as I said, it is usually only found under extreme circumstances. Not the run-of-the-mill low-carb diet.
  • yarwell
    yarwell Posts: 10,477 Member
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    kellyb28 wrote: »
    "Most of the digestible carbohydrates in our diets are broken down to glucose. As glucose, they provide a primary source of energy, spare protein from use as an energy source, and prevent ketosis.

    The main function of glucose is to act as a source of energy for body cells. In fact, red blood cells and cells of the central nervous system derive almost all of their energy from glucose. Glucose also fuels muscle cells and other body cells." (Hence, carbs are important.)

    "The amino acids that make up dietary protein are used to build body tissues and to perform other vital functions only when carbohydrate intake provides enough glucose for energy needs. If you do not consume enough carbs to yield glucose, your body is forced to break down amino acids in your muscle tissue and other organs to make glucose.


    Glucose also inhibits the use of fats for energy, and "When carb intake falls below this level, the release of hormone insulin decreases, resulting in the release of large amount of fatty acids from adipose tissue to provide energy for body cells." is precisely why people choose to restrict carbs.

    Why would the amino acids from food not be used in glucose production in the absence of dietary carbs ? I suggesting it will break down muscles and organ tissue just FUD ?
  • parkscs
    parkscs Posts: 1,639 Member
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    If you're eating low-carb and feel great, then I'm not saying you should change that. I just want to make people aware of the potential risks if you're doing it for too long, not drinking enough water, not maintaining body protein mass, etc. The low-carb diet just seems like another fad diet to me... Sure, you will absolutely lose weight (and lots of water weight) but is it healthy? Well, I provided you with this information, so now it's up to you to decide.

    I can make the argument that IIFYM or even general "healthy eating" can result in loss of lean body mass, kidney problems, liver problems, and the like - and that would be a true statement. IIFYM or even "healthy eating" do not ensure adequate protein (although most people recommend you set your protein macro at such a level as a starting point), nor do they require resistance training. As neither requires a strict minimum protein intake, you can thus you can see an elevated loss of lean body mass from such a diet. But just because it's possible, that doesn't mean it will necessarily happen and there are definitely steps you can take to prevent it. If you want to talk about a loss of lean body mass though, you realize you quoted 80/10/10 in the other thread, and that sort of diet is almost certain to lead to an increased loss of lean body mass relative to a standard IIFYM recommendation or a low carb diet... but I digress.

    On the other hand, someone that is predisposed to kidney or liver problems may be exposed to a greater risk of kidney or liver problems if their protein intake is on the high side, and the average protein intake recommended for a healthy individual on these forums and pretty much in any fitness community would expose that the individual predisposed to kidney/liver problems to a higher degree of risk. Thus, one could conclude that even the recommended IIFYM protein intake can (in some rare situations) lead to a greater risk of kidney and liver failure.

    My point is... you can concoct such general arguments about any way of eating. But there's a difference between something being true for the average person and something being true for a very small subset of individuals. Add to that, you also have to account for things that can be mitigated (e.g., electrolytes can be supplemented as necessary on a ketogenic diet, which is actually pretty common). You need a bit more specificity to your language if you're going to accurately critique any particular diet (or really anything for that matter).
  • psuLemon
    psuLemon Posts: 38,404 MFP Moderator
    edited October 2014
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    Correct me if i am wrong but aren't most keto diets have protein levels equivalent to around 1g per lb of lean body mass? Most keto macros i have seen are 5/65/30.

    I dont do low carb because my body doesnt respond well. If i go below 200gs of carbs i am very sluggish and struggle to exercise. And cutting foods cause me to binge.

  • blktngldhrt
    blktngldhrt Posts: 1,053 Member
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    kellyb28 wrote: »
    "A minimal intake of carbs (50-100g per day) is necessary for the complete breakdown of fats to CO2 and H2O. When carb intake falls below this level, the release of hormone insulin decreases, resulting in the release of large amount of fatty acids from adipose tissue to provide energy for body cells. These fatty acids travel in the bloodstream to the liver. The subsequent incomplete breakdown of these fatty acids in the liver result in the formation of acid compounds called ketone bodies.

    There are people who are unable to consume 50-100g of carbs a day and would also benefit from a decrease in insulin. They have to eat low carb in order to be healthier. That doesn't mean they're doomed to suffer from dehydration, loss of lean body mass, and electrolyte imbalances (which can actually occur from any diet if the person isn't taking proper care of their body).

    "If you do not consume enough carbs to yield glucose, your body is forced to break down amino acids in your muscle tissue and other organs to make glucose." This is exactly why the keto diet gives specific protein amounts that a person must consume..to avoid this. If you aren't getting you're protein and fat in the necessary amounts you're not properly following the diet.

    People on keto also closely pay attention to their sodium, magnesium and potassium levels on top of watching their macros. Or at least they should be.
  • baconslave
    baconslave Posts: 6,961 Member
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    psulemon wrote: »
    Correct me if i am wrong but aren't most keto diets have protein levels equivalent to around 1g per lb of lean body mass? Most keto macros i have seen are 5/65/30.

    I dont do low carb because my body doesnt respond well. If i go below 200gs of carbs i am very sluggish and struggle to exercise. And cutting foods cause me to binge.

    That is correct.
  • MelRC117
    MelRC117 Posts: 911 Member
    edited October 2014
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    Thank you for preaching about something that most doing keto/low carb for longer than a month already researched.

    You should probably consider doing more research before you decide to tell people that they shouldn't be eating a certain way...even to go out of your way to create a whole thread about it. People that do keto diets learn that drinking water and marking sure they get in enough magnesium, calcium, sodium, and potassium.
  • baconslave
    baconslave Posts: 6,961 Member
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    kellyb28 wrote: »

    baconslave, I'm assuming those positive results are merely from the weight loss itself rather than being in a ketogenic state...and 6 months isn't exactly long-term. Interesting info though. At least we know it's safe for a 6 month period of time!

    But the study also said that "Administering a ketogenic diet for a relatively longer period of time did not produce any significant side effects in the patients."

    I'll agree that the weight loss itself could have produced the good results. But this also shows, since the diet did produce good results in those areas, that the ketogenic diet did not make those factors worse nor kept the usual improvements from occurring. The study determined that ketogenic diets were SAFE. Not specifically better than anything else. As far as a more extended time period, the piece said they are working on longer term studies. I'm approaching the 6 mo mark soon myself so time will tell. Though there are many people who have done it for a year or more.



  • parkscs
    parkscs Posts: 1,639 Member
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    psulemon wrote: »
    Correct me if i am wrong but aren't most keto diets have protein levels equivalent to around 1g per lb of lean body mass? Most keto macros i have seen are 5/65/30.

    I dont do low carb because my body doesnt respond well. If i go below 200gs of carbs i am very sluggish and struggle to exercise. And cutting foods cause me to binge.

    That's on the higher end of keto macros, but yes. And personally I find this criticism a bit comical. On one hand, we've got a suggestion that you will lose lean body mass in this thread, yet studies show that LBM retention is predominantly controlled by protein intake and resistance training (assuming a calorie deficit that isn't extreme) and 1/g per lb of LBM is a perfectly adequate protein recommendation - carb intake is simply not on the list. Yet, her suggestion that you are likely to lose lean mass on such a diet appears to suggest she thinks you don't get enough protein on a low carb diet. On the other hand, we just came from a now-locked thread where the "deadly diet" was reputed to cause kidney and liver damage, presumably because of the protein intake which can adversely affect people that are predisposed to kidney and liver problems. The implication there is that you get too much protein on a low carb diet... yet I thought we were losing lean body mass because of inadequate protein?

    Hopefully in the next thread baby bear's protein intake will be just right, but in the meantime it seems a bit contradictory to me.
  • psuLemon
    psuLemon Posts: 38,404 MFP Moderator
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    parkscs wrote: »

    That's on the higher end of keto macros, but yes. And personally I find this criticism a bit comical. On one hand, we've got a suggestion that you will lose lean body mass in this thread, yet studies show that LBM retention is predominantly controlled by protein intake and resistance training (assuming a calorie deficit that isn't extreme) and 1/g per lb of LBM is a perfectly adequate protein recommendation - carb intake is simply not on the list. Yet, her suggestion that you are likely to lose lean mass on such a diet appears to suggest she thinks you don't get enough protein on a low carb diet. On the other hand, we just came from a now-locked thread where the "deadly diet" was reputed to cause kidney and liver damage, presumably because of the protein intake which can adversely affect people that are predisposed to kidney and liver problems. The implication there is that you get too much protein on a low carb diet... yet I thought we were losing lean body mass because of inadequate protein?

    Hopefully in the next thread baby bear's protein intake will be just right, but in the meantime it seems a bit contradictory to me.

    Well technically all diets will have some level or lean body mass loss because one inherently doesnt need to have as much when they are smaller. But that is besides the point.

    The main point of my question was that these levels of protein are equivalent to many plans. So this would suggest a program like IIFYM would inherently have the same potential kidney issues.
  • Alisha_countrymama
    Alisha_countrymama Posts: 821 Member
    edited October 2014
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    I lost all my weight by being in a state of ketosis, low carbohydrate, moderate protein, high fat. and I was for almost 3 1/2 years. It worked for me.
  • parkscs
    parkscs Posts: 1,639 Member
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    psulemon wrote: »
    parkscs wrote: »

    That's on the higher end of keto macros, but yes. And personally I find this criticism a bit comical. On one hand, we've got a suggestion that you will lose lean body mass in this thread, yet studies show that LBM retention is predominantly controlled by protein intake and resistance training (assuming a calorie deficit that isn't extreme) and 1/g per lb of LBM is a perfectly adequate protein recommendation - carb intake is simply not on the list. Yet, her suggestion that you are likely to lose lean mass on such a diet appears to suggest she thinks you don't get enough protein on a low carb diet. On the other hand, we just came from a now-locked thread where the "deadly diet" was reputed to cause kidney and liver damage, presumably because of the protein intake which can adversely affect people that are predisposed to kidney and liver problems. The implication there is that you get too much protein on a low carb diet... yet I thought we were losing lean body mass because of inadequate protein?

    Hopefully in the next thread baby bear's protein intake will be just right, but in the meantime it seems a bit contradictory to me.

    Well technically all diets will have some level or lean body mass loss because one inherently doesnt need to have as much when they are smaller. But that is besides the point.

    The main point of my question was that these levels of protein are equivalent to many plans. So this would suggest a program like IIFYM would inherently have the same potential kidney issues.

    Well the implication was that we're talking about a greater amount of LBM loss (a conclusion which the majority of relevant studies do not support) since she's critiquing a particular way of losing weight relative to other weight loss programs, but of course there will be some lost regardless. And yes, IIFYM's default protein macro are typically at least as high as low carb macros and I stated as much in my first post in this thread - yet it's pretty rare to see people warning flexible dieters about how deadly their diet is. Actually I think the average low carb'er eats quite a bit less protein than the average lifter, since the supplement companies have convinced a lot of 160 lb guys they need to eat 250g-300g of protein per day for gains, which is way beyond the level any non-enhanced lifter will benefit from... but I digress.
  • agrasso88
    agrasso88 Posts: 33 Member
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    So much misinformation in the OP.
  • ladymiseryali
    ladymiseryali Posts: 2,555 Member
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    I've been doing keto for over a year. I'm still alive and healthy and doing great. Am I just an anomaly? Are the others who are also still alive and healthy just anomalies?