ketosis

Could someone give me the dumbed down definition of ketosis?

Doug, As I understand it. It's when your body is and has been totally depleted of glycogen, and you do not repleni**** by consuming less than 20 grams/day of any carbohydrate for a couple weeks.  At that point, you body turns to burning fat instead of the glycogen. The problem is, slip once and go above the 20 grams, and you have to start over.  You can still stay in ketosis up to about 40 grams, but it's very easy to slip out. Guy

Ok, here is where I'm going to sound really stupid, but do we need to be in ketosis to loose weight? Or is ketosis something to be avoided? I'm thinking ketosis is a bad thing, am I right?  

Ketosis is a process in which your body converts fats into energy.  Your body normally uses glucose to meet its energy needs. Glucose comes from the carbohydrate in your diet. A healthy, balanced diet should provide you with all the glucose your body needs, so that ketosis does not take place. However, if your body does not have enough glucose, perhaps because your diet is very low in carbohydrates or you are starving yourself, it will begin ketosis to obtain energy from its stored fats instead. As a result of this, the ketone levels in your blood will rise. Prolonged severe ketosis can be dangerous as it can change the acidity of your blood, which may eventually lead to serious damage to your liver and kidneys.

Recently, diets that recommend you eat lots of protein and very little carbohydrate have become popular. These high protein-low carbohydrate diets - known as ketogenic diets - are intended to work by forcing your body to begin ketosis to burn fats and create quick weight loss. Because long periods of ketosis can be dangerous to your kidneys and liver, ketogenic diets are never recommended by health professionals for more than short-term use, typically no longer than 14 days. Many nutritionists warn their patients - especially women in the early stages of pregnancy - against following them at all

Hi Doug,

Good to see you. They've pretty much got it pegged. However, there are a few diets that allow 60-70 grams to limit overall insulin output to make us a little more "like the French", who supposedly have the same calorie intake as us Yanks, but are much leaner.

Best Wishes,

Dave

Ketosis is the accumulation of "ketone bodies" in the blood and urine as a result of the preferential metabolism of fats over carbohydrates for energy.  Ketone bodies are what's left over from fat metabolism when there are few carbohydrates available.  These leftovers are mainly acetone (yup, the same chemical found in nail polish remover), acetoacetate, and beta-hydroxybutyrate.  These are excreted in the urine, and in the case of acetone, a volatile chemical, also via the lungs.  That's one reason you can get really bad breath when you're in ketosis (the other reason is dehydration). Ketosis occurs in diabetics because their lack of (or resistance to) insulin prevents glucose from entering the cells and being metabolized for energy, so cells have to resort to burning fat.  Low carbohydrate diets first cause the liver to be depleted of glycogen (so-called "animal starch"), and once that source of carbs is gone, produce a state of ketosis.  Since glycogen stores hold on to a remarkable amount of water as well, a low-carbohydrate diet will produce a deceptively large initial weight loss, compared to a more typical weight loss diet which doesn't restrict carbs. /Steve

What I still do not understand is why this condition in diabetics results in neuropathy, necrosis, organ failure, blindness and a whole host of other nasty health consequences issues but it's apparently great for dieting.  Both my kids were diagnosed very young and we have been told ever since that ketosis doesn't just burn fat, it burns tissue indiscriminately and is the cause of the accumulated damage that eventually results in all the diabetic complications you hear about.  High blood sugar is just the symptom but ketosis is what is supposed to cause all the actual damage as it ravages tissues and organs to provide energy.  So my kids use Ketostix as an early warning and bolus insulin when we see any keytones.  But dieters use Ketostix as a sign that things are going well.  I haven't heard of anyone going blind from the South Beach or Zone diets though.  What am I missing here?  Is it a matter of degree?  Keytosis starts with fat and only burns off organs and tissue if it is allowed to go to extremes?  Or are these really different processes? -- T.Rob

> What I still do not understand is why > this condition in diabetics results in > neuropathy, necrosis, organ failure, > blindness and a whole host of other > nasty health consequences issues > but it's apparently great for dieting. Good question, but it's based on faulty assumptions.  Ketosis isn't the cause of any of these deleterious effects of diabetes, high blood glucose is.  However, ketosis in a diabetic is usually a marker indicating that there is inadequate insulin available to allow glucose to enter cells to be burned for energy.  Usually, this is also associated with elevated blood glucose levels.  Furthermore, in a diabetic, severe ketosis, the lack of insulin and high blood glucose can rapidly spiral out of control, causing ketoacidosis and coma, and possibly death. A non-diabetic only goes into ketosis by radically reducing their intake of carbohydrates (through fasting/starvation or by following a low-carbohydrate diet like Atkins and others).  The elevated levels of ketone bodies are handled easily by someone otherwise healthy.  (Plus, a really strict low-carb diet is very difficult to adhere to in the long-term.) A diabetic can go into ketosis whenever glucose is unable to enter cells.  It's the lack of insulin, or a resistance to insulin, which prevents glucose from entering the cells.  So even though their bodies are swimming in too much glucose, it's unable to enter cells to be metabolized for energy.  That's why you see the "ketosis": a sign of "starvation" or "extreme low-carb dieting".  An uncontrolled diabetic is literally "starving" even though their bodies are full (too full) of glucose.  But it's the chronic, long-term elevations of blood glucose which are believed to be responsible for the devastating consequences of the disease, some of which you've mentioned above. I suspect the phrase "ketosis burns off organs" is just a really loose unscientific phrase designed to emphasize that a diabetic with high levels of ketones in their urine is a poorly controlled diabetic.  In that sense, it's a useful statement, even if it fudges with some of the details. Does this help?  /Steve

Hi Steve, Thanks, that helps a lot.  I've been wondering about this for some time as the low-carb diets have become popular and I keep reading about intentionally causing a state of keytosis.  My kids are grown now and I don't get to talk to the endocrinologist any more.  In fact, thanks to HIPAA, I *can't* talk to their endocrinologist any more unless I get a note.  -- T.Rob

TRob, are you sure you aren't referring to "Ketoacidosis" ?  (think I spelled that correctly) From what I know, that's where you have too many ketones in your body and it causes major issues like you mentioned.