Programming Your Ketogenic Diet
Ketogenic diets are all the rage as they have been shown in studies to reduce inflammation, improve metabolism and enhance brain function. Many individuals do not know how to successfully enter into and maintain ketosis. Natural ketosis is an incredible physiological state that can be measured and cycled or maintained for excellent health.
Many people continue to confuse natural ketosis with the pathological ketoacidosis. Ketoacidosis is due to an extreme insulin deficiency such as in Type I diabetes and advanced type II diabetes. In this condition the concentration of ketones are ten times higher than in natural ketosis. In ketoacidosis, the blood sugar is also extremely high while in natural ketosis the blood sugar is stable and low (1).
How Are Ketones Formed:
The body has two major energy sources, it burns glucose or ketone bodies. The majority of people burn glucose primarily because they are constantly supplying a steady form of sugar, starches and proteins that can be turned into blood sugar. When one either fasts or goes on a low-carb, moderate protein and high fat diet they switch their energy source to fat.
In particular, the fatty acids are broken down into ketone bodies. The three major forms of ketones produced in the body include Acetoacetate, Acetone and Beta-HydroxyButyric acid. These are released into the blood from the liver when insulin levels are low and hepatic liver metabolism is increased (2).
Measuring Ketone Levels:
There are three ways to measure ketone body formation: breath, urine and blood. Breath testing measures acetone, urine measures acetoacetate levels and blood looks at beta-hydroxybutyric acid. Blood measurements are the most accurate but the testing is more expensive. All three areas can help guide you to understand how to maintain ketosis with your unique biochemistry.
The skin prick blood spot test is the most accurate way to measure ketosis. Most people will enter into a light nutritional ketosis (between 0.5-1.0 mmol/L on the meter) within two or three days. It typically takes two to three weeks to get into a stable optimal ketosis of 1.5-3.0 mmol/L (3).
Urine ketosis shows the amount of ketones that are not being used through metabolism. Some people will be in ketosis, yet only show low levels of ketones on their urine strips. Others will show higher levels. The more energy you are expending (exercise, physical work, etc.) the more you will use ketones as an energy source and the less ketones will be in your urine. However, if you were relatively sedentary you may very well notice more ketones in your urine.
The Ketogenic Nutrition Plan:
The body stores protein as lean muscle tissue and carbohydrates in the form of glycogen. During ketosis the body is primarily burning fatty acids in the form of ketosis and it is preserving protein and glycogen stores. This creates a physiological state of fat adaption where the body is burning through fat stores.
The result of fat adaption is improved lean body tissue, better brain function, improved energy and more restful sleep among other things. You become fat adapted by building all your meals around good fats sources such as avocados, coconut oil, olive oil, pastured butter, nuts and seeds and organ meats.
I try not to make too big a deal about macronutrient percentages and personally, I do not measure my own. I just intentionally look to avoid high carbohydrate foods and consume as much good fat as I can. Some individuals want to measure and track and so the best strategy is to have your nutrition plan contain good fat sources making up 60-80% of total calories.
Protein makes up 10-25 percent of calories based on physical demands. Someone who is exercising more intensely will need about 20-25 percent of calories from protein whereas someone is sedentary or doing lighter forms of exercise who should be on 10-15% of calories from protein. Carbohydrates make up around 5-15% of total calories.
Sources For This Article Include:
- Manninen AH. Metabolic Effects of the Very-Low-Carbohydrate Diets: Misunderstood “Villains” of Human Metabolism. Journal of the International Society of Sports Nutrition. 2004;1(2):7-11.
- Veech RL.The therapeutic implications of ketone bodies: the effects of ketone bodies in pathological conditions: ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism. Prostaglandins Leukot Essent Fatty Acids. 2004 Mar;70(3):309-19. PMID: 14769489
- Mitchell GA, Kassovska-Bratinova S, Boukaftane Y, Robert MF, Wang SP, Ashmarina L, Lambert M, Lapierre P, Potier E. Medical aspects of ketone body metabolism. Clin Invest Med. 1995 Jun;18(3):193-216. PMID: 7554586