Nutritional ketosis is a natural metabolic state in which your body is fueled mainly by fats and ketones, instead of carbohydrates (glucose).
Nutritional ketosis happens when dietary carbohydrates are significantly reduced (<50 grams per day) and the body’s production of ketones increases to maintain a blood level at or above 0.5 mM.
Ketone production in the body is a very natural process that can be measured at home by a medical device such as the Precision Xtra meter or Keto-Mojo meter.
When we say ketones, we are referring to the primary circulating fatty acid metabolites beta-hydroxybutyrate (βOHB) and acetoacetate (AcAc)
When maintained for several consecutive weeks, nutritional ketosis fundamentally changes the way cells work.
This term is often used synonymously with keto-adaptation, and commonly used to describe low-carb adapted athletes.
A ketogenic diet that is restricted in carbs and moderate in protein results in increased production of ketones.
There are plenty of delicious high-fat, low-carb options available, and you can eat out or cook at home.
When you consume sugar or carbohydrates (which get absorbed as blood sugar), this triggers an insulin response by your body.
Carbohydrate tolerance varies among individuals.
On Virta, we recommend counting total carbohydrates, with the most of your food coming from real, whole foods.
We humans are a very diverse lot, and there is no known diet that is perfect for everyone.
The ”flu-like” symptoms that some individuals experience when starting the ketogenic diet is due to the body’s response to carb restriction.
It is well known that whole foods should be emphasized over dietary supplements because essential vitamins and minerals found in foods are usually better absorbed than those found in supplements.
In short, 3000-5000 mg of sodium and 2000-3000 mg of potassium on average are needed as part of a well-formulated ketogenic diet.
Most healthy humans maintain lean body mass and function during a ketogenic diet providing between 1.5 and 1.75 grams of protein per kg of ‘reference body weight.’
Xylitol is among the better choices because it is a dental protectant, and because it provides usable energy.
Absolutely! While 10-20% of your daily energy need should be coming from protein, you can meet this need by consuming high protein, vegetarian and keto friendly foods.
Achieving nutritional ketosis while being a vegan is possible but this style of eating will be restrictive and require a large amount of pre-planning.
There is no need for people to avoid dairy products unless they have specific symptoms brought on by their consumption (e.g., lactose intolerance).
A ketogenic diet is naturally very low in gluten, but if you do not have gluten intolerance or celiac disease, there is no need to avoid gluten.
In addition to getting fiber, there are many other reasons to consume vegetables.
There are clear benefits from fiber consumption for bowel function and blood sugar control in people consuming a diet high in carbohydrates.
Whey protein is a double-edged sword: it has a very high biological value score, but it also causes higher insulin secretion.
You can ask for steamed versions of some dishes and then add soy sauce, which fits within the guidelines of a well-formulated ketogenic diet.
Insulin resistance improves promptly for most people when they begin a ketogenic diet, and the effect appears to be attributable to the ketones.
We have many anecdotes of reversal of neuropathy, retinopathy, and nephropathy in people with T2D following a well-formulated ketogenic diet.
In contrast to this normal physiology of ketosis, pathologic ketoacidosis manifests with serum ketone levels of 15-25 mM (three- to ten-fold higher than in nutritional ketosis).
Insulin resistance is the hallmark of type 2 diabetes and manifests as carbohydrate intolerance.
In the context of a well-formulated ketogenic diet (high fat, low carb, moderate protein), the intake of fat is not only safe, but imperative for long-term success.
For most people, a ketogenic diet leads to improvements in cholesterol, but there are sometimes transient rises in cholesterol levels during weight loss.
A ketogenic diet typically leads to a broad range of improvements in blood lipids as well as other cardiovascular risk factors such as blood pressure and inflammation.
Triglycerides are among one of the most predictable changes when one adapts to and maintains a well-formulated ketogenic diet.
There are no known problems associated with combining statin use with a well-formulated ketogenic diet.
Nutritional ketosis, achieved by following a well-formulated ketogenic diet is a safe and beneficial metabolic state for most people.
This is a distinct pathologic state that happens when insulin levels are extremely low, such as in a person with type 1 diabetes who cannot produce insulin.
In the setting of a well formulated ketogenic diet, a modest increase in salt intake is safe, and does not raise blood pressure (Hallberg 2018).
This is an excellent question for which there is no solid scientific answer.
While there are many anecdotes of women nursing while following a ketogenic diet, there are no published large prospective studies demonstrating safety and effectiveness of this practice.
The gallbladder is a storage organ for bile, which (among other functions) helps with the digestion of dietary fat.
In general terms, taking thyroid medication can fully replace what the thyroid gland normally does.
The topic of Lyme disease is very complex, involving both an infectious cause and often a prolonged inflammatory response after the infection is eradicated.
Our clinical experience is that kidney stones are rare during a well-formulated ketogenic diet.
There is a short-term increased risk of gout flares when initially entering into nutritional ketosis due to the competitive inhibition of ketones on kidney excretion of uric acid.
Any regimen involving fasting beyond 24-hours has not been proven effective in sustaining weight loss long term.
Being in nutritional ketosis will accelerate the rate at which the body burns fat, and this is a fundamental key to the short- and long-term benefits of a ketogenic diet.
For regular dietary fats, once they are digested, they enter the circulation and participate in what is called ‘fatty acid turnover’.
Losing central fat (belly fat) is one of the many benefits of a well-formulated ketogenic diet.
Cramps may occur for a variety of reasons. A mineral imbalance may manifest in physical symptoms like cramps and is often resolved by magnesium supplementation.
Diarrhea is not a common side effect of a well-formulated ketogenic diet. If it occurs, it likely due to well-intentioned but incorrect food choices.
Many people assume that constipation while following a well-formulated ketogenic diet is due to inadequate fiber.
Hair loss is not commonly seen with a well-formulated ketogenic diet. Here are a few causes of hair loss.
In our experience, ‘keto rash’ is relatively rare. In the cases we’ve seen, it tends to occur early in the course of a ketogenic diet.
Individuals vary in their blood ketone levels (i.e., beta-hydroxybutyrate – aka BOHB) over the course of a day and from day to day.
Intermittent breaks in adherence to ketogenic diets has not been studied carefully in humans.
The use of continuous glucose monitors (CGM) serves a variety of purposes and depends on the individual.
On a well-formulated ketogenic diet where 70-80% of your daily energy comes from fat, the majority of your dietary fat should be from sources of monounsaturates and saturates.
Sources of saturated and monounsaturated fats should provide the majority of your dietary fat intake.
In general, people don’t tolerate high amounts of polyunsaturated fats (PUFAs) as part of a high fat diet.
Every oil or fat has a temperature range within which it performs best and a point at which it begins to breakdown (smoke point).
Satiety is very subjective, so it’s hard to measure it precisely.