Ketosis and Ketogenic Diet

Introduction:

The human body needs glucose for energy. When the body does not receive enough glucose, it uses stored fats for energy. The burning of stored fats leads to a build-up of acids called ketones in the body. The metabolic process involved in the formation of ketones is called ketosis. Some people follow a diet that is low in carbohydrates and calories to promote ketosis in the body. This diet is called a keto diet or ketogenic diet. Excess ketosis can lead to problems in diabetics, causing a condition called diabetic ketoacidosis (DKA) that requires emergency treatment.

What Is Ketosis?

Typically, the body uses glucose from carbohydrates and starchy foods for energy. It breaks down the complex carbohydrates into simple sugars that form glucose. Glucose is sent into the cells of body tissues with the help of the hormone insulin. Excess glucose that remains in the bloodstream gets converted into glycogen which is stored in the liver and muscles for use when the body falls short of glucose. This is the normal mechanism that occurs in the body.

Sometimes when the body does not receive enough glucose from carbs, it uses stored fats for energy. The metabolic process which occurs during the breakdown of fats releases acids called ketones into the body. This process is called ketosis. A small number of ketones in urine indicates ketosis occurring in the body.

What Is a Keto Diet?

A keto diet or ketogenic diet is high in fat. Typically, calories in a keto diet are 20 percent protein, 10 percent carbohydrates, and 70 percent fats. More calories are obtained from fats and proteins when compared to easily digestible carbohydrates. However, the nutrient proportions depend on the type of diet followed.

A keto diet is usually followed by people who would like to reduce weight. Fewer calories are consumed without feeling hungry, which can help in short-term weight loss. To achieve a state of ketosis, a person must consume a diet that has less than 50 grams of carbohydrates per day. The carbohydrates that need to be considerably reduced or removed from the diet include:

• Potatoes.

• Candy.

• Sweetened foods or beverages.

• Legumes.

• White bread or pasta.

• White rice.

• Sauces that contain sugar.

For many reasons, people choose a keto diet to reduce weight, maintain blood sugar levels, and control or reduce seizures related to epilepsy.

Is Keto Diet Healthy?

The keto diet, when followed for the short term, has many benefits in reducing the risk of developing health conditions like:

• Diabetes.

• Cardiovascular diseases.

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• Metabolic syndrome (a group of health conditions that lead to an increase in the risk of heart diseases).

• Improving levels of “good” cholesterol or high-density lipoprotein (HDL).

• Decrease of seizures in children with epilepsy.

Research is also being done on other health conditions that can benefit from a keto diet, which include:

1. Acne.

2. Cancer.

3. Polycystic ovary syndrome (PCOS) is a hormonal imbalance that affects ovaries in women of childbearing age.

4. Alzheimer’s disease is a brain disorder that causes problems in thinking, behavior, and memory.

5. Lou Gehrig’s disease is a neurological disorder that causes weak and deformed muscles.

What Are the Signs and Symptoms of a Ketogenic Diet?

A person who follows a keto diet may have the following signs and symptoms, that include:

• Bad breath or a fruity smell that occurs due to a ketone called acetone.

• Decreased appetite.

• Loss of weight.

• Nausea.

• Headache.

• Brain fog.

• Tiredness.

People new to the keto diet can develop a group of symptoms known as keto flu which causes nausea, headache, fatigue, and stomach upset. Blood or urine tests help to know whether the body has achieved ketosis. Blood ketone levels measure between 0.5 to 3 millimoles per liter (mmol/L).

What Are the Benefits of a Ketogenic Diet?

• Weight Loss: A keto diet is helpful in weight loss when followed for the long term as it promotes the use of fewer carbohydrates and more fat to obtain energy. The keto diet is considered a healthy way of weight loss as it makes the person feel full by decreasing the amount of food consumed.

• Epilepsy: Epilepsy is a disorder of the brain that causes frequent seizures affecting about 50 million people around the world. The keto diet has helped people with epilepsy, especially children, in reducing the frequency of seizures. It is generally recommended by doctors for people who do not respond to epilepsy treatments. However, following a long-term keto diet is found to be difficult for some people.

• Type 2 Diabetes: A ketogenic diet has been found to be useful in both type 1 and type 2 diabetics to control their blood sugar levels within ranges. However, complications like hypoglycemia (low blood sugars) can occur in a few cases.

What Are the Risks of a Ketogenic Diet?

All kinds of diets have benefits as well as drawbacks; similar is the case with a keto diet as well. Side effects that occur include:

• Tiredness.

• Headaches.

• Bad breath.

• Constipation.

• Dehydration.

• Kidney stones.

• High levels of bad cholesterol (LDL or low-density lipoprotein).

• Deficiency of nutrients.

A keto diet is not suitable for people with a history of disordered eating because of the restrictive nature of the diet. Following a strict keto diet can cause social isolation, as it offers fewer options. Breastfeeding mothers and people with diabetes have to consult a dietitian before starting a keto diet to prevent complications.

Vegetables that are low in carbs and high in fiber promote digestion and prevent constipation related to the keto diet.

What Is the Relationship Between Diabetes and Ketosis?

Ketosis develops in diabetic patients who have poorly controlled blood sugars, as the body does not have enough insulin to process the glucose. An increase in the ketone levels in urine indicates uncontrolled sugars that require monitoring.

Sometimes, doctors may prescribe a keto diet in patients with type 2 diabetes, as the diet aims to reduce the intake of dietary carbs.

What Is Diabetic Ketoacidosis?

Diabetic ketoacidosis (DKA) is a serious condition that causes the build-up of extremely high levels of ketones in 24 hours. It affects people with type 1 diabetes more commonly when compared to people with type 2 diabetes. Uncontrolled blood sugars and high levels of ketones in urine are the indicators of DKA.

Problems in insulin therapy, not receiving adequate insulin, or missing scheduled treatments are the possible triggers for developing DKA. Less common triggers may include:

• Physical trauma.

• Mental trauma.

• Misuse of drugs.

• Stress.

• Surgery.

Symptoms of ketoacidosis include:

• Increased thirst.

• Dry mouth.

• Frequent urination.

• Fruity breath.

• Nausea and vomiting.

• Abdominal pain.

• Confusion.

• Difficulty concentrating.

• Difficulty breathing.

• Dry skin.

People can test for DKA with test kits at home.

How Is Diabetic Ketoacidosis Treated?

DKA is an emergency condition that requires immediate medical attention. The patient may require hospitalization to prevent complications like diabetic coma (a life-threatening complication of diabetes that causes unconsciousness) and death.

The emergency medical team performs the following treatments to reverse DKA, which include:

• Fluid replacement helps the body rehydrate and dilute the excess blood glucose.

• Electrolyte replacement helps in maintaining heart, nerve, and muscle functions. Electrolyte levels normally drop in cases of insufficient insulin.

• Insulin therapy helps doctors reverse DKA occurring due to uncontrolled blood sugars.

How Is Diabetic Ketoacidosis Prevented?

Diabetic patients can prevent developing DKA, especially when ill or under stress, by following the below steps, which include:

1. Monitor blood sugar levels at least three to four times a day.

2. Following a strict diabetes treatment plan.

3. Following insulin dosage prescribed by a specialist.

Conclusion:

Ketosis is a condition in which the body starts receiving energy from stored fats instead of carbohydrates. A low carb or keto diet has proven to be effective in helping weight loss, except in people with conditions like diabetes. A keto diet can be safely followed by healthy people. However, consulting a doctor or dietitian is preferable, especially for people with underlying health conditions. Ketoacidosis is a serious complication of diabetes that can be managed by emergency treatment.