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Ketosis is a potentially serious condition during which there are raised levels of chemicals called ketones in the blood. It occurs when the body needs energy and there is not sufficient glucose available. This is often caused by a diet that is very low in carbohydrate, which is the main food group required by the body for producing energy and it plays a key part in a healthy, balanced diet. The so called Ketogenic diet (Keto Diet) has attracted interest in the recent years especially regarding weight loss. In this week’s article find out what happens in your body during ketosis, how this diet works and whether it is effective and safe.

Fat metabolism

Carbohydrates are normally broken down into glucose, which is then converted into energy and transported to the body’s muscles and organs. However, if there is a lack of glucose, or if it is not possible for glucose to be broken down the body has to break down stored fat in order to convert it into energy. This process is known as fat metabolism and it inevitably causes a build-up of ketones in the blood, resulting in ketosis.

What are ketones?

As your body starts to break down fat instead of glucose, the levels of ketones in your blood will begin to rise. Ketones are acidic chemicals and therefore they increase the acidity of the blood, which can affect urine and may eventually cause serious damage to the liver and kidneys.

The ketogenic diet

The ketogenic diet is high in fat, low in carbohydrate and has an adequate amount of protein. It was first designed in the early 1900s for treating children with epileptic seizures. It is a strict diet that works by stimulating the biochemical effects of starvation. The low amount of carbohydrate in the diet leads to the build-up of ketones in the blood, the calorie intake is restricted and usually calcium and vitamin supplements are necessary to avoid deficiencies.

High-protein, low-carbohydrate diets have been widely promoted in recent years as an effective approach for weight loss. According to these diets 30% to 50% of the total calorie intake should come from protein. However, other recommendations from the American Heart Association, the National Cholesterol Education Program, etc promote a diet in which a smaller percentage of calories are derived from protein, and almost 50% should come from carbohydrates.

How Do Low-Carb Diets Work?

By restricting carbohydrates drastically to a mere fraction of that found in the typical western diet, the body goes the metabolic state of ketosis, whereby it burns its own fat for fuel. As a result, your body changes from a carbohydrate-burning engine into a fat-burning engine. So instead of relying on the carbohydrate-rich items you might typically consume for energy, and leaving your fat stores unchanged, your fat stores become the primary energy source. Additionally, during ketosis people tend to feel less hungry, and are likely to eat less than usual. The result, of course, is weight loss.

Are there any health risks?

Apart from ketosis which is considered an unhealthy metabolic state, high protein/low-carb diets can cause a number of health problems, including:

• High cholesterol due to the increased consumption of red meat, whole dairy products, and other high fat foods, which is also linked to an increased risk of developing heart disease, stroke, and cancer.
• Large quantities of calcium in the urine. Over a prolonged period of time, this can increase a person’s risk of osteoporosis and kidney stones.
• Kidney failure due to the very high protein intake which puts a strain on the kidneys.
• Cancer due to the low consumption of carbohydrate-containing foods which are rich in vitamins, minerals, antioxidants and fiber. It is therefore important to obtain your protein from a diet rich in whole grains, fruits, and vegetables. Not only are your needs for protein being met, but you are also helping to reduce your risk of developing cancer.

The NHS describes ketosis as a potentially serious condition, whereas a number of popular diets cite ketosis as being an essential part of weight loss. Ketosis is described as being potentially dangerous as very high level of ketones can make the blood acidic, a state known as ketoacidosis, which can lead to serious illness in a relatively short space of time. Maintaining relatively high levels of ketones over a long period of time, such as by being on a ketogenic diet for a long time, has had questions asked over long term safety. Although some studies found ketogenic diets to be relatively safe over a period of 8 months, the evidence of safety over the longer term and in older groups is not so well known. Most health professionals regard restricting a diet from all carbohydrates as unhealthy and dangerous. However, it is not necessary to completely eliminate all carbohydrates from the diet in order to achieve a state of ketosis. Other scientists regard ketosis as a safe biochemical process that occurs during the fat-burning state.

The anti-ketosis conclusions have been challenged by a number of doctors and advocates of low-carbohydrate diets, who argue that the body doesn’t have a preference for glucose and that there are no significant dangers associated with ketosis. While it is believed that carbohydrate intake after exercise is the most effective way of replacing depleted glycogen stores, studies have shown that, after a period of 2–4 weeks of adaptation, physical endurance is unaffected by ketosis, as long as the diet contains high amounts of fat.

Undoubtedly, it is a rather controversial subject and it comes down to the individual whether to try and adopt a specific diet plan, especially if it’s a tightly controlled diet plan such as a ketogenic diet. It is always wise to consult a GP or a Nutritionist before starting a new diet. Moreover, keep in mind that in order to achieve permanent weight loss you must change your lifestyle. This means following a lower calorie diet that includes lean meat, fruits, vegetables, whole grains, legumes, combined with participating in regular physical activity.

By Kleio Bathrellou
Associate Nutritionist & ISSN Certified Nutritionist

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