Written by Hrefna Palsdottir, MS — Medically reviewed by Grant Tinsley, PhD, Nutrition — Updated on October 13, 2020
Ketosis is a natural metabolic state.
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It involves the body producing ketone bodies out of fat and using them for energy instead of carbs. You can get into ketosis by following a very low carb, high fat ketogenic diet (1).
A ketogenic diet can help you lose weight. In the short term, you can lose weight quickly, because it reduces the body’s stores of glycogen and water.
In the long term, it can suppress your appetite leading to a lower calorie intake.
As well as contributing to weight loss, ketosis may have several health benefits, such as reduced seizures in children with epilepsy (2).
Ketosis is quite complex, but this article explains what it is and how it can benefit you.
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What is ketosis?
Ketosis is a metabolic state in which there’s a high concentration of ketones in the blood. This happens when fat provides most of the fuel for the body, and there’s limited access to glucose. Glucose (blood sugar) is the preferred fuel source for many cells in the body.
Ketosis is most often associated with ketogenic and very low carb diets. It also happens during pregnancy, infancy, fasting and starvation (3, 4, 5, 6).
For ketosis to start, you generally need to eat fewer than 50 grams of carbs per day and sometimes as little as 20 grams per day. However, the exact carb intake that will cause ketosis varies between individuals.
To do this, you may need to remove certain food items from your diet, such as:
grains candysugary soft drinks
You also have to cut back on:
When eating a very low carb diet, levels of the hormone insulin go down and fatty acids are released from body fat stores in large amounts.
Many of these fatty acids are transported to the liver, where they’re oxidized and turned into ketones (or ketone bodies). These molecules can provide energy for the body.
Unlike fatty acids, ketones can cross the blood-brain barrier and provide energy for the brain in the absence of glucose.
Ketosis is a metabolic state where ketones become an important source of energy for the body and brain. This happens when carb intake and insulin levels are low.
Ketones can supply energy for the brain
It’s a common misunderstanding that the brain doesn’t function without dietary carbs.
It’s true that glucose is preferred and that some cells in the brain can only use glucose for fuel.
However, a large portion of your brain can also use ketones for energy, such as during starvation or when your diet is low in carbs (7).
In fact, after only three days of starvation, the brain gets 25% of its energy from ketones. During long-term starvation, this number rises to around 60% (8, 9).
In addition, your body can use protein or other molecules to produce the glucose the brain still requires during ketosis. This process is called gluconeogenesis.
Ketosis and gluconeogenesis are perfectly capable of fulfilling the brain’s energy needs.
Here is more info about ketogenic diets and the brain: How Low-Carb and Ketogenic Diets Boost Brain Health.
When the brain isn’t getting enough glucose, it can use ketones for energy. The glucose it still needs can be produced from protein or other sources.
People often confuse ketosis and ketoacidosis.
While ketosis is part of normal metabolism, ketoacidosis is a dangerous metabolic condition that can be fatal if left untreated.
In ketoacidosis, the bloodstream is flooded with extremely high levels of glucose (blood sugar) and ketones.
When this happens, the blood becomes acidic, which is seriously harmful.
Ketoacidosis is most often associated with uncontrolled type 1 diabetes. It may also occur in people with type 2 diabetes, although this is less common (10).
In addition, severe alcohol abuse may lead to ketoacidosis (11).
Ketosis is a natural metabolic state, while ketoacidosis is a serious medical condition most often seen in type 1 diabetes that’s not well managed.
Epilepsy is a brain disorder characterized by recurring seizures.
It’s a very common neurological condition, affecting around 70 million people worldwide (12).
Most people with epilepsy use anti-seizure medications to help manage seizures. However, around 30% of people continue to have seizures despite using these medications (13).
In the early 1920s, the ketogenic diet was introduced as a treatment for epilepsy in people who don’t respond to drug treatment (14).
It has primarily been used in children, with some studies showing benefits. Many children with epilepsy have seen significant reductions in seizures while following a ketogenic diet, and some have seen complete remission (15, 16, 17, 18).
Ketogenic diets can effectively reduce epileptic seizures, especially in epileptic children who don’t respond to conventional treatment.
The ketogenic diet is a popular weight loss diet, and research has shown it can be effective (19).
Some studies have found that ketogenic diets are more helpful for weight loss than low fat diets (20, 21, 22).
One study reported 2.2 times more weight loss for people on a ketogenic diet, compared to those on a low fat, calorie restricted diet (23).
What’s more, people tend to feel less hungry and more full on a ketogenic diet, which is attributed to ketosis. For this reason, it is generally not necessary to count calories on this diet (24, 25).
However, it’s widely recognized that adherence to a diet is critical for long-term success. Some individuals may find it easy to adhere to the ketogenic diet, while others may find it unsustainable.
Some research suggests that the keto diet may not be the best way to lose weight. The authors of a 2019 review concluded that it was not better than other diets at helping people lose weight, and it may not have specific advantages for people with metabolic disorder (26).
More details here: A Ketogenic Diet to Lose Weight and Fight Disease.
Some studies show that ketogenic diets lead to more weight loss than low fat diets. In addition, people feel less hungry and more full.