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Ketogenic Lifestyle

YOUR KETOSIS UNDERSTANDING ESSENTIALS

Forgotten history of “ketogenic diet”

 

Fasting has been used to help manage “epileptic seizures” during the last 2,500 years of human history. However, fasting is “not” a long term solution to control epilepsy, since the body will eventually run out of body fat stores leading to starvation.

The ketogenic diet, a high-fat, low-carbohydrate diet, was designed in the 1920’s by Dr. R.M. Wilder of Mayo Clinic, Minnesota to manage epilepsy in patients who did not respond to anti-epileptic medications by instigating a metabolic state similar to fasting, “ketosis,” in the “absence” of body’s preferred energy source, “carbohydrates.”

Dr. Wilder mimicked starvation by limiting dietary carbohydrate to a minimum level, while providing high amounts of dietary fat. He discovered that the body remained burning body fat for fuel –like in the state of fasting–  as long as the low carb diet was strictly maintained. The “ketogenic diet” was born.

The ketogenic diet was widely used to manage epilepsy throughout the 1930’s. It fell out of favor in the late 1930’s when a new class of anti-epileptic drugs was introduced.

The ketogenic diet use declined, and eventually seized until 1994 when the epileptic son of Hollywood film director Jim Abrahams, Charlie, was treated seizure-free through ketogenic diet which was still offered at Johns Hopkins University, Maryland. Abrahams started the Charlie Foundation to raise awareness of the ketogenic diet and in 1997, he directed the movie “First Do No Harm” starring Meryl Streep, a movie about a boy who develops intractable epilepsy that is successfully managed with the ketogenic diet.

Since mid 1990’s, public interest in the ketogenic diet has reemerged steadily. Today, the ketogenic diet offers hope for 30% of epilepsy patients, and is offered at nearly all children’s epilepsy centers in the US and across the world.

Ketosis a.k.a. Ketogenic State or Metabolic State of Ketosis

Ketosis, (also referred to as ketogenic state or metabolic state of ketosis), is the metabolic state of the body at which the quantity of ketone bodies (ketones) in the blood has reached higher-than-normal levels.

Ingested and stored fats as alternative energy source.

For energy, our body mainly uses …

      Carbohydrates (pasta, rice, sugars …)
      AND/OR
      Fats (butter, fatty meats, oils …).

During ketogenic diet program, glucose is by design in short supply; only measured low amounts of carbs from green leafy vegetables are consumed; among other carbohydrates, bread, grains, beans, starches, gluten, processed foods, sweeteners, beverages, and alcoholic drinks, as well as sugar are entirely eliminated from the diet.

In the ketogenic state, our lipid energy metabolism is in action. The liver switches from processing glucose (sugar) to breaking down the ingested and stored fats as alternative energy source.

Ketosis is basically the other method utilized by our body to fuel our cells with the necessary ATP (adenosine triphosphate a.k.a. energy).

Being in ketosis simply means that we’re burning our fat stores and using them as our primary source of fuel.
The metabolic state of ketosis simply means that the quantity of ketone bodies in the blood have reached higher-than-normal levels.

Ketone test strips provide a fast, convenient way of testing urine for the presence and concentration of ketones (acetoacetic acid). Ketones, when found in the urine, provides information on the state of the fat metabolism by changing its color; with other words, the color codes indicate whether a person is in ketosis or not.

Use of ketone test strips inform us whether we are in ketosis or not and which adjustments we need to make, if any, in our diet. Ketone presence in our urine means that we are burning fat.

Establishing the metabolic state of ketosis —even for a short period of time— has great benefits.

  1. In the metabolic state of ketosis, our body becomes increasingly efficient at mobilizing fats as our energy source. Once in ketosis, our body indeed prefers ketoacids over glucose as fuel. Hence, ketosis increases our body’s ability to utilize fats as our primary energy.
  1. During ketosis, lipid energy metabolism is in action. In absence of glucose, our body turns to our stored body fat as our fuel.
  1. Ketoacids, along with appropriate amount of protein intake, suppress appetite. Dietary fat holds nine calories per gram compared to four calories held by one gram of sugar; fat is a much denser food in terms of energy content.
  1. Ketosis has a protein sparing effect. As we have abundant amount of stored fat, there is no need for our body to oxidize protein from our muscle tissues to generate glucose (gluconeogenesis).
  1. Insulin has a lipolysis-blocking effect, which can inhibit the use of fatty acids as energy. Low levels of insulin in our body cause greater lipolysis and free-glycerol release compared to a typical high-carb diet when our insulin level is around 80 – 120. Low levels of insulin in the body also cause release of beneficial hormones.
  1. Individuals following the ketogenic diet will experience a drop in “bad” cholesterol levels, and “good” cholesterol levels will increase.
  1. A high-carbohydrate diet, on the other hand, increases hunger levels. Because we consume ample fat on a ketogenic diet, which holds nine calories per gram, we do not need much food in terms of volume. We do not go hungry on a reduced-calorie ketogenic diet.
  1. Once our body gets used to producing ketoacids as our main energy substrate, we will actually have more balanced energy. We won’t be fighting through low-blood-sugar crashes set off by high-carb meals.

How does ketosis work?

  1. During ketogenic diet programglucose is by design in short supply.
  2. During metabolic state of ketosis, the liver switches from sugar metabolism (processing/digesting sugar/carbs) into fat metabolism (breaking down the ingested and stored fats). The process of fat digestion is called “beta-oxidization.”
  3. Our fat stores accumulate fat as “long” fatty acids called triglycerides.
  4. During beta-oxidization the stored or ingested fatty acids are broken down in our liver into our alternative energy source.
  5. While sugar (glucose) is in short supply, the triglycerides are broken down into “short” ketoacids. These short molecules are able to penetrate our cells as fuel.
  6. These ketoacids are utilized (burned) by many of our tissues, including the brain.
  7. The brain operates just as well on a diet of ketoacids as it does on glucose.
  8. What’s left (the incompletely burned fragments) are called ketones (most notably; beta-hydroxybutyrate). They are what spill into the urine to be removed from the body.

How long does it take our body to shift from “sugar energy metabolism to “lipid energy metabolism“?

It may take somewhere between four days to two weeks for the body to shift from sugar energy metabolism to lipid energy metabolism (using fat as primary fuel). The rate of this shift depends on the metabolic resistance of the individuals.

Is it reasonable to go in and out of ketosis?

No, it is not reasonable to go in and out of ketosis.

We need to recognize fact that our body is conditioned to use sugar as our primary energy source due to decades of high-carb diet. In consequence of our poor dietary choices, our idle lipid energy metabolism has become ever more sedate.

In order to reactivate our lipid energy metabolism, and stay on ketosis, we need to establish a “long-term” dietary environment which largely excludes ingestion of carbohydrates and all types of sugar (including fructose from fruits). As long as we stick to this cardinal rule, we will remain on ketosis.

While we are on ketosis …

  1. Once sugar (from fruits, high carb foods or hidden added sugar in processed foods) is introduced to our digestive system while we are on ketosis, our body instantly reacts to it by secreting insulin.
  2. The instant this happens, our body at once puts our lipid energy metabolism on hold and reverts to sugar energy metabolism “temporarily” –or if you decide to go back to SAD diet, “permanently.”
  3. The “ketosis-interrupters,” the carbs and sugar we ingest are broken down into glucose, and shuttled to our cells as energy source.
  4. At this stage, our ketoacid production is on hold.
  5. Our cells do not have a say-so on which type of energy source they get delivered. They will use any form of energy, glucose or ketoacids, to support cell functions, growth and cellular repair.
  6. Having been delivered glucose, our cells will automatically revert to sugar energy metabolism with the help of insulin from our pancreas.

 

Once we are out of ketosis, it will take anywhere between four to 14 days –depending on our present overall metabolic response rate– to get back on ketosis.

Even if the above situation happens after several months of uninterrupted ketogenic regimen, we will need to reset anew to get back into ketosis. This will sadly mean that our weight loss progress will stall and we will not burn our stored fat –for four to 14 days until we get back on ketosis.

One other reason to avoid going out of ketosis is that sugar induces dopamine secretion and a quick feel-good rush, which may set off the sugar cravings of the past. The reawakened sugar cravings may continue during the entire shift-back period until we get back on ketosis again.

Ketoacid production during high- and low-carb diets

When we are on a typical high-carbohydrate diet
  1. On a typical high-carbohydrate diet (such as the Standard American Diet-SAD), our body uses solely the ingested sugar as fuel.
  2. As a result of the continual availability of sugar in our high-carb diet, our body gets conditioned to expect the sugar to keep on entering our system as the primary energy.
  3. With time, our body becomes increasingly lethargic to mobilize fats as energy.
  4. As long as we continue feeding our body with high-carb foods and sugar keeps on entering our system, the liver does not produce ketoacids.

 

 

KETO Food-PyramidWhen we are on a low-carb/high-fat diet …
  1. In contrast, during a typical low-carb/high-fat diet regimen (such as ketogenic diet), we consume with every meal only a measured low amount of carbs from green leafy vegetables and select dairy products.
  2. Sugar, bread, grains, beans, starches, gluten, sweeteners, beverages, processed foods, most high fructose fruits, and alcoholic drinks are entirely eliminated from our diet.
  3. The purpose of avoiding the above listed foods is to intentionally starve our body of sugar.
  4. In this state, by design glucose is in short supply; the liver switches to breaking down the ingested and stored fats as alternative energy source.

 

Does the liver produce ketoacids all the time?

The liver produces a traceable small amount of ketoacids from ingested fats at all times. These are consumed by the brain rapidly. However, this state is not ketosis due to the availability of sugar (glucose) as our primary fuel.

The liver reverts to steady ketoacid production from stored body fat and ingested dietary fat, only if there is a “continuous” shortage of sugar in our diet (glucose from breakdown of carbs and added sugar).

The liver does not shift from sugar energy metabolism to lipid energy metabolism as long as our diet is based on a constant supply of carbohydrates and added sugars.

Ketones and ketosis are no mysteries thanks to ketone testing strips.

They are called KetoStix (the first brand name), Urine Test Strips, Reagent Strips, Ketone Testing Strips, or Lipolysis Test Strips.

Quick look at ketosis and ketones

  1. During ketogenic diet program, glucose is by design in short supply; in this state the liver switches to breaking down the ingested and stored fats as alternative energy source. This process is “beta-oxidization,” and the metabolic state is called ketosis.
  2. Ketoacids are the product of beta-oxidization process in our liver. During beta-oxidization the stored or ingested fatty acids are broken down in our liver into our alternative energy source.
  3. Our fat stores accumulate fat as “long” fatty acids called triglycerides. While sugar (glucose) is in short supply, the triglycerides are broken down into “short” ketoacids. These short molecules are able to penetrate our cells as fuel.
  4. These ketoacids are utilized (burned) by many of our tissues, including the brain. The brain operates just as well on a diet of ketoacids as it does on glucose.
  5. What’s left (the incompletely burned fragments) are called ketones. They are what spill into the urine to be removed from the body.
Being in ketosis simply means that we’re burning our fat stores and using them as our primary source of fuel.
How do ketone test strips work?

The test strips provide a quick, private and cost effective way to determine if we are in ketosis at any given time and at what rate. Most of us feel more secure with such a simple way to test, and get instant answer. All we need to do is to simply dip the reagent end of the strip into our urine specimen and remove immediately. Alternatively we can wet reagent area of the strip in our urine stream. We check the color of the reagent area within 10-15 seconds against the color chart on test strip bottle.

ketone chartA beige or cream color indicates that NO KETOSIS was detected. Any shade of pink/purple indicates some level of ketones in the urine. We are all different. Some of us lose better (and feel better) at lighter or darker levels. You’ll soon learn what feels right for you.

The preferred zone for optimal ketosis is between 30-55 mg/dl  of ketones in the urine.

If your reading is over 30 mg/dl, this means you are in starvation mode, thus instead of losing fat, you will gain weight. This is because your body in the starvation mode will store rather than using fat as fuel.

Caution: If we let the test strip sit for longer than 15 seconds after being exposed to urine, the reagent area will turn totally dark, which is a false reading.

Attention! Danger zone: Any value over 55 mg/dl is truly dangerous to your health and medical assistance should be sought.

 

KETONE ZONEHow do blood and urine values compare?

The blood and urine values may differ slightly. This is due to the possibility that urine may have been sitting in the bladder for a while. On the other hand, the blood ketone reading reflects the real time value.

Blood ketone values are in milimol/liter while urine ketone values are in miligram/deciliter. So how do the correspond to each other?

Ketosis Status Urine ketone reading Blood ketone reading
No traceable ketosis less than 5 mg/dl less than 0.6 mmol/liter
Small to moderate ketosis between 5-15 mg/dl between 0.6 – 1.5 mmol/liter
Moderate ketosis between 15-30 mg/dl between 1.6 – 3.0 mmol/liter
Large ketosis between 30-55 mg/dl between 3.0 to 4.5 mmol/liter
Dangerous level of ketosis over 55 mg/dl over 4.5 mmol/liter

 

Which brand should you get?

There are a number of brands to chose from. The original Ketostix by Bayer is the most common and easiest to find one. It is sold in most pharmacies and health stores. Shop for price first though because they can be bought for anywhere from $6.00 to $16.00 in different stores and online sites.

It doesn’t matter which Ketone Testing Strips you use, avoid switching brands because it can get confusing with slightly differing colors.

 

What are the challenges of ketosis?

 

While the benefits of the ketogenic diet outweigh the downsides, there are a few challenges which need our attention:

 

  1. During the first few weeks of the ketogenic diet, our body will go through the “metabolic shift.”

 

  1. While going through the “metabolic shift” period, we may experience a small degree of …
  • fatigue, headache, and
  • brain fog.

KETO flu symptomsThis is a temporary condition which may last up to a full week. The condition is called “keto flu” and is a direct effect of the “metabolic shift” process.

As we address under the next bullet point, ketosis induces increased release of water through urination. With that comes inadvertent loss of salt. Lack of salt in our system hinders several micro-cellular functions in our body and causes flu like symptoms.

 

  1. KETO dehydration-and-water-retentionWhile going through the “metabolic shift” period, we may experience a noticeable degree of …
  • dehydration due to increased water loss associated with ketoic-induced diuresis, and
  • water loss from depletion of glycogen

Staying hydrated is very important during the ketogenic diet regimen, especially before, during, and after physical exercise.

 

  1. Blood-lipid profile may be a concern for some individuals on the ketogenic diet due to the rather high amounts of saturated fats in the diet. To counteract any possible concerns, we consume a balanced blend of healthy unsaturated fats like olive oil, avocados with tasty saturated fats from animal sources such as eggs, cheese, butter, bacon, etc.

 

  1. KETO chiaKetogenic diet can cause sporadic constipation. Supplementing our ketogenic diet with chia seeds will eliminate this negative aspect entirely.

 

  1. Micronutrients such as thiamin, folate, calcium, potassium, and magnesium are typically inadequate in low-carb diets. As ketogenic diet stipulates consumption of restricted amounts of carbohydrates, micronutrient deficiencies may occur.

To handle this potential problem, we designed My KetoPal recipes with high-quality micro-nutrients from whole foods to ensure that we consume as much as 100 percent of the daily need.

 

 

Practical Tips to Ease Your Way into Ketogenic Lifestyle…

Not long ago, you were energetic and determined to start your healthy lifestyle. Starting with enthusiasm and hope, you watched your food intake diligently, exercised like it was going out of style, and even avoided the temptation that seemed to lurk around every corner. You were confident that you were going to reach your goals once and for all!

KETO fat people eating sweet stuffThen certain tragedy struck! You ate an extra piece of birthday cake. Realizing you had “blown” your diet; you ate another and another and couldn’t get it together the next day either. Or worse, you missed one workout, and that turned into a whole week away from the gym. After that, your momentum to start over again was gone, and your gym bag hasn’t left the closet since.

Every time you misstep on your healthy journey, you have two choices:

  • to keep walking backwards, which will surely take you even further away from your goals; or
  • to accept your lack of perfection as normal and forgivable, and take not one, but two positive steps down the path that brings you closer to the future you want.

If you’re reading this, you might have been walking backwards for a while. But instead of waiting for the next day, week, month or even year to overhaul your habits, start TODAY.

Start small.

You can’t go from the recliner to running …

or

… from sugar, pasta and bread to avocados in an afternoon. But you can do one, two or even a handful of small things that will help you regain your momentum for healthy living.

KETO stuffed-avocadoWith healthy eating and exercising, as long as you’re consistently out-stepping your steps back, you’re ahead of the game. If you expect perfection (and many of us do) though, you’re setting yourself up for disappointment and guilt.

Always remember. It’s progress not perfection that counts.

When you feel like getting back on track is overwhelming, then try several of these small steps each day for two weeks.

Here are some practical tips to ease in to your ketogenic lifestyle

1.            Try MyKetoPal’s Recipes for Self-healing. Cooking whole foods is fun and our recipes are always exciting flavor explosions.

KETO Eggs baked ommelet

2.            Eat a healthy ketogenic breakfast. Your morning meal sets the stage for the rest of your day, it is time to break your overnight fast. Start off right with a great self healing breakfast recipe.

3.            Try a short simple exercise early in the morning. Even a start with a short and simple five minutes exercise is better than nothing. For easy lead-in to simple exercises, browse our “Sound Body“section.

4.            Drink your water. Aim for 14 to 16 cups each day and you’ll feel the difference!

KETO Drink water

5.            Prepare for your journey to recovery. Visit our “Courage” and and “Prepping for Success” sections.

6.            Consider using My FitnessPal (by UnderArmour) to record and monitor your progress. This app allows you to monitor/record your food intake in terms of calories, and percentage of macros you consume.

You can download the app on your phone. You only need the free services. No need for paid services. We will soon publish practical My FitnessPal tips.

KETO My Fitness Pal app screen shot

7.            Also sign up online with Map My Walk (synchronizes well with My FitnessPal ). This app allows you to monitor/record your walks, bike rides, and how many calories you burn during these activities.

You can download free app which logs your burned calories, distance, speed, steps taken, time and route map. Start playing with the app, get familiar with it.

8.            From today on, start tracking your food on My FitnessPal (by UnderArmour). No matter how it adds up, you’ll learn from it.

9.            Join MyKetoPal’s Shout Group on Facebook (Ketopedia). Start sharing your fat burning journey with fellow fat burners. Post your food, activity and progress pictures and remarks on the Shout Out Group. It’s a visual way to track your ups and downs, but also your progress. When you post your progress on our Shout Out Group or share them with with fellow fat burners, you’ll be more accountable.

10.          Exercise for 10 minutes. Start with marching in place, do some mini jumping Jack’s or some crunches. Small amounts do add up to something big!

KETO Exercise

11.          Connect with friends at MyKetoPal’s Shout Group on Facebook (Ketopedia), whether you need support or someone to listen, give you ideas or encouragement.

12.          Take a walk. Don’t worry about how long or far you go — just get out there!

13.          Go shopping for healthy whole foods.  Use your shopping list generated by MyKetoPal Recipes for Self-healing.

14.          Before you go out to eat, check the nutrition facts online on Restaurant Nutrition Index by My FitnessPal. That way, you can make an informed choice.

15.          Ride your bike. Even a leisurely ride has benefits for your body and mind. If you don’t have one, get one.

KETO UA sneakers

16.          Work in the yard. Gardening and yard work is a great way to add activity to your day.

17.          Take the stairs. Even if this is the only thing you do all day, you’ll feel stronger for it.

18.          Listen to an inspirational song. Better yet, make a playlist of them so you can turn to it whenever you need a boost.

19.          If you have stalled with your program before, restart. Sometimes it’s easier to get back on track when you have a clean slate.

20.          Measure your portions based on your MyKetoPal Recipes for Self-healing diet plan. It’s a comfortable way to monitor how much you’re eating.

21.          Slow down during meals. You’ll be less likely to overeat and more likely to enjoy your meal.

KETO Eat-Slower-Clock

22.          Play! What kids call “play,” we call “exercise.” Play a sport, a game, or use the playground equipment to bring the fun back into fitness.

23.          Learn something new about how your body works. Simply reading an article on MyKetoPal website about ketogenic nutrition, fitness, or health can change your mindset and get you back on track.

Welcome (back) to ketogenic lifestyle!

Dr. Eric Berg explains Ketosis

We trust Dr. Berg and find that his informative videos are easy to understand. If you would like to learn more about how a ketogenic lifestyle could help you beat your illness, we suggest that you check out Dr. Berg’s site at www.drberg.com and his Youtube Channel.

 

Here are some further research studies on ketogenic diet.

Neuroprotective and disease-modifying effects of the ketogenic diet

Cholesterol & Long term ketosis: Long-term effects of a ketogenic diet in obese patients

Acne, cognitive, heart, diabetes, cancer, lung, heart, etc.: Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets

The effect of a low-carb ketogenic diet on glycemic control in type 2 diabetes

What Causes Heart Disease?