- What Ketosis is and how it relates to fat metabolism.
- How to structure your diet in such a way as to create a healthy state of ketosis for fat loss, massively improved energy levels and many other health benefits.
What is Ketosis?
Ketosis /kɨˈtoʊsɨs/ is a metabolic state where most of the body's energy supply comes from ketone bodies in the blood, in contrast to a state of glycolysis where blood glucose provides most of the energy. It is characterised by serum concentrations of ketone bodies over 0.5 millimolar with low and stable levels of insulin and blood glucose. It is almost always generalized, with hyperketonemia, that is, an elevated level of ketone bodies in the blood throughout the body. Ketone bodies are formed by ketogenesis when liver glycogen stores are depleted. The main ketone bodies used for energy are acetoacetate and β-hydroxybutyrate, and the levels of ketone bodies are regulated mainly by insulin and glucagon. Most cells in the body can use both glucose and ketone bodies for fuel, and during ketosis free fatty acids and glucose synthesis (gluconeogenesis) fuel the remainder.
During the usual overnight fast the body's metabolism naturally switches into ketosis, and will switch back to glycolysis after a carbohydrate-rich meal. Longer-term ketosis may result from fasting or staying on a low-carbohydrate diet, and deliberately induced ketosis serves as a medical intervention for intractable epilepsy.  In glycolysis higher levels of insulin promote storage of body fat and block release of fat from adipose tissues, while in ketosis fat reserves are readily released and consumed. For this reason ketosis is sometimes referred to as the body's "fat burning" mode.
What do I have to know before I try to do a Ketogenic Diet?
Bile is an alkaline liquid soap/salt that your liver makes and your gall bladder stores and concentrates. When you eat any meal, the food first goes into the stomach where, ideally, stomach acid sterilizes the food and helps to breakdown proteins into usable amino acids. The stomach does it's work, it passes the (ideally) acidified food into the start of the intestinal tract (the duodenum). This is where the concentrated bile that the gall bladder has been holding onto is then secreted into the acidic food sludge. The bile's role here is to neutralize the pH of the food, further sterilize the food, and also to breakdown (emulsify) the fats in the food. Bile breaks down the fats and turns them into usable nutrition for energy and cellular construction.
Without bile, you cannot breakdown (emulsify) the fats you eat. Think of anytime you've had oil on your hands. You can try to wash it off with water, but it doesn't really work. Likewise, you can try to eat a high fat, low carb, moderate protein diet to get into fat burning mode (ketosis), but if your bile isn't flowing well then all that fat you eat is potentially going to make you extremely nauseous, gassy, tired, sick, breakout in acne and even get fatter. These negative effects of fat consumption will befall you if you do not have good bile flow because anything that you eat that your body is not good at digesting is really only going to give you problems and drain you of energy as your body struggles to deal with the problematic food.
So before you try out a ketogenic diet, you may want to evaluate your digestive power and see if you have good bile flow or not. You can assess your bile flow in a number of ways via self tests and observations...
Indications of good bile flow
Indications of poor bile flow
There is also a more definitive test you can order to determine with great accuracy if your bile is flowing properly or not. This test detects the presence of bile acid sulfates in the urine - which are present if the bile is refluxing back into the bloodstream instead of exiting the body through the colon the way it is supposed to. Many clinical studies have verified the validity and accuracy of this test.
One provider of this test can be found at this site:
If you run any of those tests on yourself or notice any of those digestive symptoms of poor bile flow and think that you may have bile flow issues, then I highly recommend you take yourself through our Free Digestive Issues Course to help get your bile working well first. Attempting a ketogenic diet without very strong bile flow is a bad idea. Pretty much anyone who tried and failed at the Atkin's Diet will attest as to how uncomfortable, frustrating and nauseating such an experience can be.
Not Recommended for Hypothyroid Body Chemistries
This accelerated rate of tissue breakdown (catabolism) is precisely why the ketogenic diet can in many cases lead to such tremendous fat loss - for the adipose tissue is being catabolised (turned into energy for fuel) BUT this can in some very significant ways be seen simultaneously be seen as an accelerated aging process. As such, someone who is just trying to be healthy or who is dealing with an under active thyroid may do much better on a diet that provides more readily available direct forms of glycogen (most beneficial sources typically being fructose rich carbohydrates from fruits and fruit juices.)
So what exactly is the Ketogenic Diet?
For now, the essentials of the Ketogenic Diet can be easily recalled through the help of the K.E.T.O acronym, which I learned through the fantastic book Keto Clarity by Jimmy Moore. A big thank you to Jimmy for all of the excellent research and clear presentation of the ketogenic diet. Jimmy's book is available in written and audiobook format (links below...)
Keep Carbs Low
(under 20 grams per day)
Eat Lots of Fat
(especially saturated fats: butter, ghee, coconut oil, MCT oil, eggs and fatty meats.)
Test Your Ketone Levels Often
(at first urine test strips will do, but after a few weeks on the diet blood or breath
tests are in order and urine testing may not be as insightful.)
Overeating Protein Is Bad
(Usually about 1/2 your body weight in grams is appropriate. E.g. a 200 lb man
would eat 100 grams or less of protein per day on a ketogenic diet.)
Keep Carbs Low
Some people will be able to eat more carbohydrates than others and still remain in ketosis, but the general rule of thumb that seems to be effective for most people is to consume 20 or less grams of total carbohydrates per day. That is a very, very small amount. Even eating fibrous, low starch vegetables a couple times a day will yield about that many grams of fiber and trace amounts of sugar and starch.
If you stick to the left side of this Veggie Carb Chart as far as carbs go you'll be ok eating these foods freely.
Let me restate that bile is essential for the proper digestion of fat and that you need sufficient bile for every bit of fat that you consume, so over eating on fat, even on a ketogenic diet, can cause you problems if you don't have enough bile to handle the amount of fat you consume. That being said, given that you have good bile flow or have done the work to fix your bile flow and now can properly digest fats, eating predominately fats will encourage your body to use fat as its primary fuel source (provided carbohydrates are minimized and protein rich foods are consumed in moderation.)
Saturated and medium chain triglyceride (M.C.T.) fats are generally the best sources of fat, but omega 9 rich foods like cold-pressed olive oil, as well as freshly ground flax seed and avocado can also be good fats to include. Which fats are best for you to really emphasize will depend somewhat on whether or not you are in an anabolic or catabolic imbalance, but in general this diet works best with saturated fats (e.g. butter, cream, ghee, egg yolks, fatty cuts of meat) and medium chain triglycerides (MCT oil, coconut oil). Be cautious of some of those overpriced MCT oils out there made of vague combinations of palm and coconut oil. There are better quality, less expensive ones out there that are much easier on your wallet and stomach, like Buried Treasure Coconut MCT Oil. Go slow with MCT oil at first though - too much can cause stomach distress and diarrhea. Start with just 1 tsp per day and gradually build up to 1 teaspoon to 1 tablespoon per meal.
When you first start off on a ketogenic diet, if you're body is taking to it well, you'll be able to detect ketones in your urine - moreso later in the day, but somewhat in the morning also. Urine Keto Test Strips are easy to use, inexpensive and easy to find at your local pharmacy.
As your body gets better at using ketones for energy, you'll stop peeing them out and start using them up, so you won't be able to detect them using urine ketone strips. At that point, to know if you're actually in ketosis you'll either have to test your blood or your breath. Breath analysis is a fancy new technology that, in my opinion, is much more fun than pricking my finger every day. The blood ketone meter is less expensive but the strips you have to buy for each test are quite expensive, so in the long run the breath meter is cheaper and less painful and more fun to use...
Ketonix Breath Ketone Analyzer
Precision Xtra Blood Glucose & Ketone Meter
The general rule of thumb here is to divide your bodyweight by 2 and eat that many grams or less of protein per day. E.g. a 200 lb person would eat 100g or less protein per day. Individual metabolisms may be able to eat more or less - the only way to know what's right for you is to test your ketones via blood or breath and make sure you're actually in ketosis. If you're not, reduce your protein intake, check your carbohydrate intake, and increase your fat intake, especially MCT oils and saturated fats.
More than Fat Loss
Jimmy Moore does an excellent job enumerating the many benefits of the Ketogenic Diet in his above mentioned book Keto Clarity. It's not necessarily right for everyone, due to differences in individual metabolism as well as differences in physique goals and athletic performance goals, but it may be a very good approach for you for a period of time.
I hope you found this article helpful. For more health and fitness info please check out my other blog articles or click on the link below to listen to my partner Tony and I on our free podcast: Kick It Naturally.
Thanks for reading! Catch ya next time :)
Will Wolfgang Schmidt