Low carb diets are attracting more and more interest. Among them, the keto or ketogenic diet. There is often a lot of talk about its effects and benefits, but the fundamental process, ketosis, still raises many doubts. Liliana Cabo, dietitian-nutritionist and member of the Spanish Academy of Nutrition and Dietetics, helps us clear them up.
What is ketosis?
Ketosis is a metabolic process that occurs when the body does not have enough carbohydrates for energy. Instead, it oxidizes fat and produces ketones, which can be used as energy fuel.
How do you get into ketosis?
To enter ketosis, the body must deplete its carbohydrate reserves in the form of glycogen and begin using fat as an energy source. This is generally achieved in three situations:
- During the prolonged fastthat is, beyond the 12-hour overnight fast.
- Low carbohydrate diets (generally less than 50 grams a day), such as the ketogenic diet.
- he prolonged strenuous exercise.
How long does it take to get into ketosis?
Being an unknown process, it is common to ask when you enter ketosis. Although it depends on the individual, generally, «following a strict low-carbohydrate diet, this process usually begins in 2-4 days,» says the expert. «Factors such as basal metabolism, amount of exercise and type of diet (carbohydrate content) influence this time,» she points out.
Does drinking sugar-free soda affect the ketosis process?
As absurd as it may seem, one of the questions that dietitians-nutritionists hear the most is yes. drinking sugar-free cola breaks ketosis. Liliana Cabo recognizes that drinking this soft drink “generally does not affect the process, since it does not contain sugars or carbohydrates, the main nutrients that the body must avoid to stay in ketosis.”
Now, “some people may be sensitive to artificial sweeteners, such as aspartame and sucralose, found in sugar-free colas. “These sweeteners, in some cases, could trigger an insulinemic response or affect ketosis, although this is not common.”
Just in case, he suggests consulting with a dietician-nutritionist specialized in ketogenic diets for personalized advice.
How do protein foods affect the state of ketosis?
When reducing carbohydrate consumption, it is usual to increase protein intake. This ‘extra’ contribution does not accelerate or modify the ketosis process. «Proteins have a moderate impact on ketosis. However, higher protein consumption can lead to a conversion of amino acids into glucose, a process known as gluconeogenesis, which could reduce the production of ketones,» Cabo infers.
You can enter ketosis in three ways: through prolonged fasting, with very low carbohydrate diets or after periods of strenuous and very long exercise.
When entering ketosis, is it necessary to take nutritional supplements?
This depends on the individual diet and how ketosis is practiced. «Some people may need supplements to ensure adequate intake of nutrients and electrolytesespecially of fiberthat may be missing in a strict ketogenic diet,» says the expert.
Depending on the variety of foods included in the diet, for example, the type of vegetables, fish, meat or nuts, the nutritional contribution will also be different.
The entire diet and supplementation should be consulted and supervised by a dietitian-nutritionist specialized in this type of diet.
Can you maintain ketosis for life?
The million dollar question is how long you can stay in ketosis. Although for the expert the most important thing is “that the person is under the supervision of a professional to control side effects and ensure that all nutritional needs are met.”
“There is no set time limit to be in ketosis safely», which can vary between weeks and months or even years. The important thing is to pay attention to the signs and symptoms of the body and be accompanied by a professional specialized in these diets.
Is it bad to enter ketosis?
In principle, entering ketosis is not dangerous. Now, Cabo distinguishes between nutritional ketosis, ketoacidosis and optimal ketosis. «The nutritional ketosis It is a safe and desired metabolic state during low-carbohydrate diets, where ketone levels are much lower and do not pose a health risk. «It is achieved in a controlled manner and does not lead to the dangerous acidification of the blood seen in ketoacidosis.»
The ketoacidosis is a serious complication, often associated with type 1 diabetes. “It is an emergency medical condition where the buildup of ketones in the blood causes it to become too acidic.”
On the other hand, associated with the beneficial effects of ketosis, is the concept known as optimal ketosiswhich refers to «the range of ketone levels in the blood that is considered effective and safe. This level – indicates the expert – can vary between individuals, but is generally in the range of 1.5 to 3.0 mmol/L.»
How do I know if I am in ketosis?
There are a series of signals that appear when the body enters this process. Among them, «bad breath, greater satiety, or the feeling of silk or dry mouth.» We will have total confirmation by «measuring ketones, mainly in the blood, or in the urine. High levels are a clear sign of ketosis.»
These are the unequivocal symptoms that the body is producing ketones:
- bad breath. It is caused by the release of ketones, which are excreted through breathing and urine.
- Fatigue. It is due to the body’s adaptation to using fats as the main source of energy instead of carbohydrates. As the body adapts, this fatigue usually decreases.
- Muscle cramps. It may be a result of the loss of minerals and electrolytes (such as magnesium and potassium) that accompanies the transition to ketosis, especially if adequate hydration is not maintained.
- Constipation. It may be due to decreased fiber intake from restricted carbohydrates such as whole grains.
- Lack of appetite. The cause may be that fats are more satiating and that ketones themselves have an appetite suppressing effect.
Cabo emphasizes that «not all people experience all of these symptoms and they can occur with varying intensity. Some, such as constipation, can be avoided with good planning of the dietary regimen by the dietitian-nutritionist.»
What health benefits does ketosis have?
It can help with weight loss, contribute to an improvement in triglyceride and cholesterol levels, as well as increased appetite control, and potentially, better blood glucose control.
In addition, «ketosis has been shown to have benefits in neurological situations such as epilepsy,» he adds.
Does it promote blood sugar control?
One of the positive effects associated with ketosis is that «it can help improve blood sugar control and reduce dependence on diabetes medication. In fact, it can affect the management of diabetes, especially type 2 ”.
Now, in the case of type 1 diabetes, ketosis must be managed carefully to avoid ketoacidosis, since this can be one of the consequences of poorly managed pathology.
All of the above leads Cabo to highlight the need for medical follow-up to ensure safe management of diabetes in relation to ketosis.
Does entering ketosis help you lose weight?
Because it reduces appetite and increases fat burning, «ketosis may help you lose weight and therefore would be a way to lose weight for some people.» Now, «as with any diet, its suitability and health depend on how it is implemented and whether it adjusts to individual health needs and conditions. In addition, its long-term maintenance is quite difficult,» warns the dietician-nutritionist. . In normal clinical practice, after weight loss, the supply of carbohydrates in the diet is gradually restored.
Are intermittent fasting and ketosis compatible?
Both intermittent fasting and ketosis are often used as part of a weight loss plan. Now, can they be applied at the same time? What’s more, does its effectiveness increase if we do it in unison? The answer is overwhelming: intermittent fasting and ketosis are not only compatible, they are also two strategies that usually complement each other. «Intermittent fasting can help the body enter ketosis more quickly, since both processes involve periods of reducing or eliminating carbohydrate intake,» Cabo clarifies.
The entry Ketosis: the 13 questions that nutritionists answer the most was first published in Nutriiendo.
