Chapter 5.

Nutritional ketosis

by Grant Schofield

Is the keto diet safe?
Nutritional ketosis refers to the state where your brain and most of your body runs on ketones for energy. There are two other types of ketosis you may have heard about; however, they are very different from nutritional ketosis and can be quite dangerous. In this chapter, we will explore nutritional ketosis.

What is nutritional ketosis?

Nutritional ketosis refers to the state where your brain and most of your body runs on ketones for energy, as opposed to glucose. This is sustainable and achievable long-term and provides your body with all of the energy and nutritional requirements for optimal health and wellbeing. There are two other types of ketosis you may have heard about – fasting (or starvation) ketosis and pathological ketosis. These are very different from the type of ketosis we are aiming for and can be quite dangerous.

Fasting ketosis is a short-term, evolutionarily adapted response to cope with shortages of food – but is not sustainable. While I wholeheartedly advocate intermittent fasting as a fantastic complement to a well-managed ketogenic diet, extreme fasting can be dangerous. When you refrain from eating for a long period of time (such as several days), your glycogen stores become depleted and your body will look for alternative sources of fuel – namely fat or protein from muscle. Unfortunately, when fasting ketosis becomes severe enough, it can result in lean muscle mass loss.

Starvation or long-term fasting ketosis can also be very dangerous for people with low blood sugar (hypoglycemia) or for those who are taking blood pressure medication. People with a history of disordered eating should also be very wary of long periods of fasting, as attempting to push your body into ketosis through long-term fasting can trigger harmful relapses. To clarify, skipping a meal here and there, or intermittent fasting such as a 5:2 diet, can be a healthy way to cycle in and out of nutritional ketosis and does not create fasting ketosis.

Pathological ketosis is an entirely different state again and is induced by illness, not design. Diabetic ketoacidosis is one example, where the blood’s natural acid-base balance is disrupted to dangerous levels through extremely high blood ketone levels. In a diabetic person whose body is not able to make insulin to shut down ketone production, this can be fatal.

Nutritional ketosis differs immensely from other forms of ketosis in that it is safe and sustainable.
In just a few days, your body will have cleaned out glucose stores and learnt to use fat as its primary energy source. Over time, you will experience the full range of benefits ketosis provides while maintaining adequate nutrition to keep your body healthy – without dangerous blood sugar lows or battles with willpower!

How to get into nutritional ketosis?

Getting into nutritional ketosis requires you to restrict carb intake to less than 50 g per day, forcing your body to use glucose stores and begin producing ketone bodies. Reducing your carb intake can be as simple as swapping your burger bun for crisp lettuce or trying zoodles instead of pasta. Embarking on a keto diet is a wonderful opportunity to explore new tastes and textures with your food: would you have ever tried delicious cauliflower rice otherwise? There is one proviso to reducing your carb intake – in order to achieve healthy nutritional ketosis, you need to INCREASE your fat intake. You need to ditch the fat-phobia and embrace good fats such as coconut oil, olive oil, avocado, full-fat dairy and animal fats.

Be patient, it may take 3-4 weeks for your body to fully adapt to this mild ketogenic state, but after this time you will be operating on what I like to call ‘metabolic flexibility’ and will reap the benefits of nutritional ketosis. In a nutshell, this refers to the ability to switch in and out of nutritional ketosis depending on whether carbohydrate is available or not. A metabolically flexible individual can be a carb burner OR a fat burner. Maintaining your health goals at this point will be much easier.

If you are new to nutritional ketosis, quantifying your efforts with keto sticks or blood ketone test strips to check your ketone levels may be useful in checking where you are at. No matter what though, stick with it and don’t succumb to those cravings. Get your family on board, surround yourself with support and don’t be afraid to request exactly what you want when you are out and about. In time, those sweets won’t look so tempting!

The Ultimate Keto Diet Guide

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The Ultimate Keto Diet Guide

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Meet the Keto Guide Authors

Jaxon Calder
Jaxon has been one of Australia’s leading health and weight loss coaches for the last 11 years, he is a second-generation personal trainer, director of Lean for Life which is ranked in Australia’s top 3 weight loss companies ad founded KetoLean Australia's first Keto Product Range.
Grant Schofield
Grant Schofield is Professor of Public Health at Auckland University of Technology and Director of the University’s Human Potential Centre (HPC), Grant lead's Australia and New Zealand in science-based healthy living and specialises in Keto dieting.