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ketosis

QUESTION: “Can you please explain how ketosis works? For example, how to get your body into a state of ketosis and what it does exactly. Thank you and have a great day!”

Thank you for your question and thank you for listening to the show.

Ketosis is a term used to describe a phenomenon that can happen in the body. This phenomenon is the build-up of these compounds called ketones.

I’m sure you are familiar with one type of ketone already: nail polish remover (aka acetone). Acetone is just one type of ketone. There are many others. When our bodies are in a state of “ketosis”, it means blood levels of ketones, like acetone, have increased to a higher than normal level. In fact, a common symptom of someone that is in a state of ketosis is how they smell.

They often smell like acetone, or nail polish remover.


Listen to Dr. Neal address this topic on Episode 1190 of the podcast Optimal Health Daily.


How Does Ketosis Happen?

I realize this doesn’t sound all that healthy. But, I should mention that our bodies produce ketones naturally all the time. They just get excreted. But, producing too many ketones can lead to some side effects, such as smelling like nail polish remover.

Now what causes the body to produce too many ketones and ultimately fall into a state of ketosis?

There are some pre-existing conditions that can lead to this. For example, if someone has diabetes and they aren’t controlling their blood sugar levels all that well. That could lead to a life-threatening situation. But, ketosis can also happen based on the type of diet consumed. When we consume a low-carbohydrate diet for example, our body ends up producing lots of ketones. This is a natural process and not life-threatening.

When we consume a diet that’s low in carbohydrates, like Atkins, Paleo, South Beach, and of course the Ketogenic diet, we find that the body produces more ketones. What ends up happening is, because there’s very little carbohydrate around, the body will turn to another source of energy. That source of energy is fat. But, there’s a side effect to burning fat for energy when we don’t have a lot of carbohydrates or sugar available at the same time. This side effect is ketone production.

So, if we follow a low-carbohydrate diet for weeks or months at a time, the body will burn fat for energy, but without a supply of carbohydrates or sugar, ketones will start to build up in the bloodstream.

But, again, when ketosis is caused by eating a low-carbohydrate diet, it’s not life-threatening. In fact, this is considered to be a mild state of ketosis.

How Low is Low-Carbohydrate?

Now, you might be wondering, how low is “low-carbohydrate”? Meaning, if someone were to follow a low-carbohydrate diet, how many servings or grams of carbohydrates per day are we talking about?

Well, there is no strict definition for low-carbohydrate.

Usually, consuming less than 50 g of carbohydrates each day will increase the body’s production of ketones, leading to a state of ketosis. Fifty grams of carbohydrate would be equivalent to 2-3 slices of sandwich bread.

So, if someone were to eat 2 slices of toast for breakfast and wanted to put their body in a state of ketosis, they would basically be done with their carbohydrate allowance for the day. That means, they could not have any fruit, potatoes, corn, peas, pasta, rice, or cereal for the rest of the day.

Is Ketosis Harmful?

So, now we have to ask ourselves, is mild ketosis harmful? Last year, I attended 5-day nutrition conference… no scratch that… I attended THE nutrition conference. In every profession, there’s that one yearly conference that everyone knows about and tries to attend. This was it.

I noticed that some of the most widely attended sessions were those that discussed the topic of… guess what… ketosis! Heck, those were the ones I attended!

And, when it comes to whether being in a state of long-term ketosis here’s what I learned: we are nowhere close to having definitive answers about whether being in a state of mild ketosis over the long-term is helpful or harmful.

Why not? The problem is that most published studies have looked at whether long-term, mild ketosis diet is good for athletes, or for those with diabetes, or those that want to manage their body weight.

So, what about the rest of us?

That’s where we need more research. It is possible that following a low-carbohydrate diet may not provide consumers with enough B-vitamins, Vitamin C, calcium, zinc, phosphorus, and dietary fiber.

We’re also learning that following a low-carbohydrate diet may lead to a less diverse microbiome. The term microbiome refers to the good bacteria found in the gut. These bacteria help keep us healthy. A nice, diverse microbiome has been associated with improved health outcomes.

If a low-carbohydrate diet limits the diversity of the microbiome, then it may lead to unintended health consequences.

The Bottom Line

So, here’s my bottom line: right now, we simply don’t know whether being a long-term state of mild ketosis is safe over the long-term.

It may be fine in the short-term, but it’s possible that nutrient deficiencies can arise and other unforeseen health effects are possible.

If someone is willing to try it and they feel great and are able to perform at their best, then more power to them! But, I would want to monitor them closely over the long-term to be sure that they continue feeling their best.

Again, that’s because we simply don’t know how a person’s body will respond to being in a state of mild ketosis over the longer term.

Listen to Dr. Neal address this topic on Episode 1190 of the podcast Optimal Health Daily.

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Neal Malik

Dr. Neal Malik ("Dr. Neal") is currently a professor at California State University, San Bernardino. Before this, he served as Department Chair at Bastyr University California. Dr. Neal has also published peer-reviewed scientific research and presented at national conferences. Send in your health related question and Dr. Neal will answer it on the Optimal Health Daily show!
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