More and more people are interested in trying keto to see if it can help them lose weight or resolve other health issues. It’s so popular, in fact, that the term “keto diet” took the number one spot for the most searched diet in 2020.(1) While it’s exciting that more and more people are turning to lower-carb diets to live healthier, unfortunately, many don’t realize that there are different types of ketogenic diets. Understanding this and which version of keto is right for you can often be the determining factor in if you’ll find success with this nutritional approach or not.  

In general, “keto” is short for “ketosis,” a metabolic state where your body burns fat for fuel instead of sugar. It’s attractive from a weight loss perspective because the breakdown of fat creates ketones, replacing glucose as the primary energy source for the body and the brain.
But again, it’s essential to recognize that there are different ways to enter and maintain this metabolic state. Versions of a keto approach include:

• Standard ketogenic diet (SKD)
• Cyclical ketogenic diet (CKD)
• Targeted ketogenic diet (TKD)
• High protein ketogenic diet
• Nutritional ketogenic diet
• Low carbohydrate diet
• Fasting

While all of these versions may help you lose weight, some nuances and subtleties make each of them more appropriate, depending on your overall goals. Cyclical and targeted keto diets have not been studied closely and are typically used by bodybuilders or athletes.(2) The more commonly known standard keto diet calls for approximately 70% fat, 20% protein, and 10% carbs. Unfortunately, eating such a large amount of fat for too long can have many adverse effects on your body, including low blood pressure, kidney stones, constipation, nutrient deficiencies, and an increased risk of heart disease.(3) The high protein version of the diet typically includes 60% fat, 35% protein, and 5% carbs.(2) Out of all of these approaches, nutritional ketosis offers a more balanced approach overall.

What makes nutritional ketosis different?  

The specific macro breakdown of 55% protein, 30% fat, and 15% carbs in nutritional ketosis enable your body to burn stored body fat while maintaining lean muscle mass. It is also a temporary metabolic state, meaning you eat this way only until you lose the desired amount of weight. Once you’ve reached your goal, you should move to an all-whole-foods meal plan. When you work with us, your coach will help you during this transition to create a low-to-moderate carb plan with personalized macros that work for you.

What are the benefits of nutritional ketosis?  

Nutritional ketosis has a wide range of potential benefits in conditions such as neurological disorders, cancer, diabetes, and more.(4)

Weight Loss

Like other keto approaches, nutritional ketosis can effectively enable the body to use its own stored fat as fuel. By reducing the amount of sugar and carbs in your diet, your liver begins to produce ketones from stored body fat that provide your body and brain with an efficient source of energy.  

With less sugar to process, the pancreas is no longer required to produce copious amounts of insulin. This gives this often-overworked organ a welcomed break, giving it a chance to rest and ultimately reset. Consuming less glucose also makes you less susceptible to blood sugar highs and lows, resulting in more stable blood sugar. Once glucose is reintroduced into the body (in complex carbohydrates), the pancreas will once again produce insulin. However, the body will be much more likely to use the food you eat as energy and not store it as fat.   

Another benefit of nutritional ketosis is that even though you consume fewer calories in food, your body will compensate by burning stored body fat to make up the difference. This means you’ll be less hungry throughout the day while eating fewer calories.  

Cognition

Chronic high blood sugar can weaken blood vessels and lead to mini-strokes in the brain, increasing your risk of various forms of dementia. Increased simple sugar intake can also make all cells, including those in the brain, insulin-resistant, causing them to die.(5) By keeping blood sugar levels low, nutritional ketosis also lowers your risk of cognitive decline in the process.

Carrying excess body fat is harmful to the brain. This fat releases inflammatory proteins (hormones and cytokines) that can contribute to cognitive deterioration as inflammation levels continue to rise.(5) For example, it has been shown that obesity doubles a person’s risk of having elevated amyloid proteins in the brain, a trademark trait of Alzheimer’s disease.   

Research conducted by the Mayo Clinic showed that older people who eat a predominately carb-heavy diet have almost four times the risk of developing mild cognitive impairment (MCI). MCI is thought to be a strong indication of developing Alzheimer’s disease. Signs of MCI include things like forgetfulness, losing your train of thought, feeling overwhelmed at making decisions, trouble finding your way around familiar environments, and showing poor judgment. This study also found that those who ate the healthiest fats—particularly unsaturated fats like omega-3 rich fish, walnuts, and flaxseeds—were 42 percent less likely to experience MCI.(6)  

Diabetes  

There can often be some confusion when it comes to diabetes and ketosis. It’s critical to understand the type of diabetes when discussing the metabolic state of ketosis.   
When it comes to type-1 diabetes, it’s vital to understand the state of “diabetic ketoacidosis.” This state occurs in people with type-1 diabetes who don’t regulate their insulin levels.(7) When there is not enough insulin to process the glucose in the body, it causes the body to use fat instead, which, as we know, produces ketones. This can be a good thing for some people. Still, unfortunately, with diabetic ketosis, these ketones are created in hazardous amounts and become toxic as they build up in the blood. To make matters worse, a significant loss of bicarbonate happens as well, which causes a considerable drop in the body’s pH levels (aka “acidosis”).  

While ketoacidosis can also occur in those with type-2 diabetes, it is much less common. Type 2 diabetics tend to lose weight with a keto-style diet, decrease their A1C levels, and reduce or stop insulin altogether. In one study, all ketosis participants were able to discontinue sulfonylureas, a common medication for diabetics. These participants did have continuous monitoring and supervision by a health coach and a doctor, which may also play an essential role in these results.(8)  

Nervous System Disorders  

According to Dr. David Perlmutter in his book Grain Brain (2018), “It has been discovered that the brain can also produce ketones…These ketone bodies are profoundly neuroprotective.” These ketones reduce free radical production in the brain while simultaneously increasing antioxidants. In other words, they block the pathway that would lead to the self-destruction of brain cells.(7)  

The late Harvard Medical School professor George F. Cahill stated, “Recent studies have shown that beta-hydroxybutyrate, the principal ketone, is not just fuel, but a super fuel, more efficiently producing ATP energy than glucose. It has also protected neuronal cells in tissue cultures against exposure to toxins associated with Alzheimer’s or Parkinson’s.”(9)

How do I get the benefits of nutritional ketosis?  

Your body enters a ketogenic state when you significantly reduce the number of carbohydrates you consume daily. This restriction causes your body to search for an alternative fuel source as it begins depleting the glucose stores in your body. First, your body will try to break down your muscle to use as energy. But, if you’re eating enough protein, the body spares your muscle and quickly moves on to using your stored body fat for fuel. This is why working with a knowledgeable health coach to ensure you are getting enough protein is so important. They can monitor your levels using a scale with body composition analysis capabilities to determine fat, muscle, and even hydration levels.

How do I know it’s working?  

While transitioning into ketosis, it’s common to experience some symptoms due to carbohydrate withdrawal as your body is quite literally switching its metabolic process. Symptoms can include headaches, fatigue, irritability, light-headedness, dizziness, and hunger. However, the good news is that these are temporary, and most can be mitigated, if not skipped altogether if you are working with a professional.  

In addition to the transition period—which can last five days up to a few weeks—you know you’re in nutritional ketosis when you start to feel better than before. We’re talking about feeling better than before you started this health journey. You may notice yourself with more energy, better quality sleep, enhanced mental focus, and of course, a suppressed appetite!   
To be 100% certain you are in nutritional ketosis, there are evidence-based tools that can provide concrete proof. These include:

• Blood tests test your blood for levels of beta-hydroxybutyrate. Some common brands include CareTouch, Keto-Mojo, Nova Max Plus, and Precision Xtra.  
• Breath tests measure the levels of acetone in your breath. Some common brands include Biosense, Ketonix, and LEVL.  
• Urine strips test the levels of acetoacetate in your urine. Some common brands include Kiss My Keto, Nurse Hatty, and EZ Keto. It’s important to note that this method may not be as accurate, considering there are no concrete numbers associated with test results. Urine test strips provide a color range which you match to the color options on the bottle.   

Takeaway  

It’s important to understand that nutritional ketosis is best used in combination with supervision from a trained health coach or doctor to hold you accountable and provide continuous support. Most importantly, this guidance also comes with individualization—the ability to take the nutritional ketosis outline and tailor it specifically to you. Contact us to learn more about what nutritional ketosis can do for you!
 
References

1. Gans, K. (2020, December 30). 10 Most Searched Diets of 2020 on Google. U.S. News.   https://health.usnews.com/health-news/blogs/eat-run/slideshows/10-most-searched-diets-of-2020-on-google?slide=2  
2. Mawer, R. (2020, October 22). The Ketogenic Diet: A Detailed Beginner’s Guide to Keto. Healthline. https://www.healthline.com/nutrition/ketogenic-diet-101#diet-types
3. Helms, N. (2019, June 20). Ketogenic diet: What are the risks? UChicagoMedicine.  https://www.uchicagomedicine.org/forefront/health-and-wellness-articles/ketogenic-diet-what-are-the-risks 
4. Mikstas, C. (2021, April 21). What’s a Ketogenic Diet? WebMD. https://www.webmd.com/diet/ss/slideshow-ketogenic-diet  
5. Perlmutter, D. (2018). Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar – Your Brain’s Silent Killers. (pp. 84-85). Little, Brown Spark. 
6. Roberts, R. O., Roberts, L. A., Geda, Y. E., Cha, R. H., Pankratz, V. S., O’Conner, H. M., Knopman, D. S., & Petersen, R. C. (2012). Relative Intake of Macronutrients Impacts Risk of Mild Cognitive Impairment or Dementia. Journal of Alzheimer’s Disease, 32(2), 329-339. 10.3233/JAD-2012-120862  
7. Perlmutter, D. (2018). Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar – Your Brain’s Silent Killers. (pp. 158–159). Little, Brown Spark. 
8. Hallberg, S. J., McKenzie, A. L., Williams, P. T., Bhanpuri, N. H., Peters, A. L., Campbell, W. W., Hazbun, T. L., Volk, B. M., McCarter, J. P., Phinney, S. D., & Volek, J. S. (2018). Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study. Diabetes Therapy, 9(2), 583-612. 10.1007/s13300-018-0373-9  
9. Cahill, G. F. Jr., & Veech, R. L. (2003). Ketoacids? Good Medicine? Transactions of the American Clinical and Climatological Association, 114, 149 – 163. PMID: 12813917 PMCID: PMC2194504