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Ketosis, The Ketogenic Diet and Ketones might be trendy right now, but it is nothing new. Ketosis is a perfectly normal metabolic state our bodies can be in as opposed to using glucose metabolism. Being in ketosis is a metabolic state where your body uses fat as the primary source of energy instead of relying on carbohydrates. 

While it is true that our bodies use carbs to function, it is also true and even more beneficial to use ketones as energy. You may be thinking, okay, but where do I get these ketones as energy? 

It is quite simple. Ketones are produced as you restrict carbs. Being in ketosis is a metabolic state your body goes into when you limit carbs. 

Think of it as a fail-safe mechanism of your body. Imagine a time of starvation or food scarcity.  We don’t fall over and die if we go without food for prolonged periods of time. Your body automatically produces the energy it needs to survive by switching to a state of ketosis. Although being in ketosis is a perfectly normal state of metabolism, we rarely experience being in ketosis because we eat carbohydrate-rich diets, and we eat too often.

Being in ketosis is a metabolic state where your body uses fat as the primary source of energy instead of relying on carbohydrates. 

Understanding Ketone Terminology

In this table are some of the key terminology referred to when discussing ketogenic metabolism. 

KetonesEnergy containing elements derived from fatty acid that provides fuel to the body.
KetosisThe biochemical process where ketone bodies are produced. Keto – molecule and genesis – beginning. The beginning of ketone production or the making thereof
KetoacidosisA dangerous side effect of Type 1 Diabetes where ketone production reaches levels above 10 mmol/L. This does not happen to non-diabetics
Nutritional ketosisThe process of accelerating production of ketones through restriction of dietary carbohydrates
Keto-adaptationThe process the body goes through when it is exposed to limited amounts of carbohydrates and continuously elevated ketone levels. It is a change or shift in which the body uses fat for fuel and takes 3 days to 3 weeks to fully develop

Side Note: Understanding Carbs, Sugar And Glucose

When we talk about carbs, you need to know that carbs also refer to sugar or glucose. All carbs are broken down into sugar and stored in our bodies as glucose. Anywhere where we mention carbs, also think of it as sugar or glucose.

Common carb food sources:

  • Breads
  • Pasta
  • Cereal
  • Sodas/Fruit juices
  • Vegetables
  • Fruit 

In the post covering macronutrients, you can read more about the function of each of the three macronutrients found in food. Carbohydrates are one of the three macronutrients, and its primary role is to provide our bodies with energy. For this section though it is perhaps the easiest to firstly know that carbs are broken down into sugar and stored in our bodies as glucose which is then used as fuel. You can also think of your body as either being a “carb burner” or a “fat burner”. You either use carbs as fuel/energy, or you use fat as fuel/energy. More on this to follow.

What are Ketones?

By now you’ll understand that ketosis is a normal metabolic state where your body produces ketones in the absence of carbs. It is also interesting to understand (although not that important) that our bodies produce different types of ketones. These ketones are:

  • Acetoacetate (AcAc)
  • Beta-Hydroxybutyrate (BHB)
  • Acetone

How are Ketones Formed?

In the absence of glucose, body fat aka fatty-acids, are broken down in your body. These fatty acids are too large to be taken up directly as energy and flows through your bloodstream to your liver. In your liver, these fatty acids convert into ketone molecules. Ketone molecules are very small and also water-soluble, making it more accessible to be taken up by all your major organs as well as your brain.

This Process Where Ketones Are Formed Is Called Ketogenesis.

Acetoacetate is the first ketone created by breaking down fat, followed by the formation of the second type of ketone body, called Beta-hydroxybutyrate. Acetone is then formed directly as a side product of acetoacetate (this process is called decarboxylation). Beta-hydroxybutyrate is the ketone body found in your blood, while Acetone which is expelled through your lunges and Acetoacetate is found in your urine and has that fruity smell you commonly associate with the first few days of being in ketosis.

Why We Use Ketones

Although purposefully restricting carbohydrates to below 20g per day has become a popular dietary choice as part of the low-carb, high-fat movement. It is essential to understand why increased ketones and being in ketosis, are so crucial for initial brain development and then later peak brain function. To best understand that, we will look at the vital role it plays in our development inside the womb.

Ketones are present during gestation and in early infancy. This period of development is crucial and relies heavily on ketones. 

Soon after birth, human babies are in ketosis and remain so while breastfeeding irrespective of the mother’s diet. It is as if God (creation, evolution … whatever your view may be) has placed a mechanism in place to ensure that babies stay in ketosis, despite the diet of the mother. They use ketones and fats for energy and brain growth. It is clear that ketones are an essential fuel source for brain function and development. It is sad to see that as soon as we stopped breastfeeding and left to our own devices, we moved away from primarily using this intended fuel source. When looking at the benefits of ketosis, you will note that this move away from ketosis has dire consequences. 

The fact is ketones are always present in our bodies. However, it is when glucose is not available that the liver produces more ketone bodies. Ketones can also increase during fasting and prolonged exercises. 

Being in a state of ketosis is a normal physiological function and vital for peak mental performance; as it was intended to be from birth.

“In human fetuses at mid-gestation, ketones are not just an alternative fuel but appear to be an essential fuel because they supply as much as 30% of the energy requirement of the brain at that age.”

(Adam et al., 1975)

Is Ketosis Safe?

Being in ketosis is a normal metabolic process (even though most of the human race, unfortunately, hardly ever reap the benefits of being in ketosis). Is ketosis safe? 

Firstly, it is, in fact, a type of “fail-safe mechanism” for starvation periods, in other words, ketosis protects the body during severe starvation. Secondly, ketosis is an essential process in utero development.  Even with these hard facts, people will still ask if being in ketosis is safe. 

It is worth noting that being in ketosis is also sometimes (illogically) confused with diabetic ketoacidosis as I’ll explain in the section below.

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