Today, in an attempt to lose weight, many people are following low-carb diets like the ketogenic diet – low carb, high-fat, and adeqaute protein.
Due to the low intake of carbs, the need for the body to produce insulin is reduced causing a reduction in insulin levels. A body naturally low on insulin incapable of using blood glucose (diabetics) or not supplied with enough carbs seeks the next best source of energy – fat. The increase in fat intake, characteristic of a ketogenic diet, further supports this adaptation.
Ketosis results from the increase in free fatty acids from fat cells, promoting the synthesis of ketone bodies (or simply ketones) in the liver. Ketones do not need insulin to enter the cells of your body and can, thus, be easily used for energy.
Ketosis Vs. Ketoacidosis
When your body produces normal to high levels of ketones, your body is in a state of ketosis. At very high levels, the excess ketones may make your blood acidic causing a serious complication called ketoacidosis.
Most Prominent Signs Of Ketosis
Here are some indicators that you are in a state of ketosis. Note that it does not necessarily imply ketoacidosis and may just be an essential part of your weight loss journey, particularly when switching to low-carb diets.
1. Fruity Or Nail Polish Remover Breath
Acetone, a type of ketone found in nail polish removers, is primarily responsible for giving you fruity breath if you’re ketotic.1 This is not permanent and the smell fades with time.
While resorting to gums and drinks to mask your breath, be careful about high-sugar products as they will bring your ketone levels down. Anything rich in sugar may deprive you of the weight loss benefits of ketones. Consider sugar-free options only.
2. Lethargy And Fatigue
When a body used to getting huge supplies of energy from high-carb foods is suddenly deprived, it is bound to display withdrawal symptoms. Craving glucose for energy and not yet capable of using fat for energy, ketosis makes you feel lethargic and fatigued.2
While exercising, you may feel like you’re having to put in a lot more effort, more than usual, for exercises that seemed easier before. This, however, is only short term, that is till your body gets used to the idea of producing and using ketones.
3. Loss Of Appetite
High levels of ketones in your blood curb your hunger and leave you feeling full for longer. The exact mechanism by which ketones affect hunger is still under investigation. Some studies hint at reduced levels of the hunger-promoting hormone ghrelin.3
4. Digestive Problems
Even the smallest change in diet will have some sort of impact on digestion. Pre-existing gastritis or fat intolerance may worsen the side effects of ketosis. Ketosis sometimes take its toll on the digestive system causing nausea, vomiting, diarrhea, or constipation.4
5. Insomnia Or Disturbed Sleep
Diets that are very low in carbs like the ketogenic diet adversely affect sleep quality in the short term.5 So, ketosis may leave you feeling deprived of restful sleep even after you’ve slept a good number of hours. This is because of the reduction of REM sleep (dreaming sleep).
Some people may not be able to sleep at all or may have very disturbed sleep, waking up often through the night. This, again, is a consequence of the adjustment period.
6. Visible Weight Loss
Not all signs of ketosis are negative. It is with good reason that ketogenic diets are popular for their weight loss effects, both short-term and long-term.6 Noticeably visible results are achieved in the first week after adopting the diet itself. Most people think this is die to fat burn. In reality, the reduction in weight is due to the depletion of stored carbohydrate and water in the body.
7. Improved Focus And Memory
Another positive, ketosis has been associated with improved brain function. While transitioning to depending on ketones for energy is exhausting, once you’re well adapted, you will see an improvement in your ability to focus.7 You will soon also notice a very welcome improvement in your memory.8
Ketogenic Diets: Words Of Caution And Promise
As excess ketones are removed from the body by the kidneys and liver, its important not to overburden these organs. If you’re suffering from a kidney or liver disease, avoid a ketogenic diet all together and take any signs of ketosis very seriously. Ketosis may also adversely affect your bone health by interfering with calcium and phosphorus absorption.9
The ketogenic diet has been used in the medical treatment of epilepsy for over 80 years now. Building from this use of ketone bodies, researchers have found that certain ketone bodies can protect nerve cells from various types of damage.10 Imagine the implications in the treatment of neurodegenerative diseases like Alzheimer’s!
A ketogenic diet should ideally be followed anywhere between 2–3 weeks and 6–12 months. The weaning off of such a diet to a normal diet should be gradual. Most signs of ketosis crop in this transitional phase and are not permanent.
|↑1||Musa-Veloso, Kathy, Sergei S. Likhodii, and Stephen C. Cunnane. “Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals.” The American journal of clinical nutrition 76, no. 1 (2002): 65-70.|
|↑2||White, Andrea M., Carol S. Johnston, Pamela D. Swan, Sherrie L. Tjonn, and Barry Sears. “Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study.” Journal of the American Dietetic Association 107, no. 10 (2007): 1792-1796.|
|↑3||Paoli, Antonio, Gerardo Bosco, Enrico M. Camporesi, and Devanand Mangar. “Ketosis, ketogenic diet and food intake control: a complex relationship.” (2015).|
|↑4||Duchowny, Michael S. “Food for thought: the ketogenic diet and adverse effects in children.” Epilepsy currents 5, no. 4 (2005): 152.|
|↑5||Afaghi, Ahmad, Helen O’Connor, and Chin Moi Chow. “Acute effects of the very low carbohydrate diet on sleep indices.” Nutritional neuroscience 11, no. 4 (2008): 146-154.|
|↑6||Bueno, Nassib Bezerra, Ingrid Sofia Vieira de Melo, Suzana Lima de Oliveira, and Terezinha da Rocha Ataide. “Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials.” British Journal of Nutrition 110, no. 07 (2013): 1178-1187.|
|↑7||D’Anci, Kristen E., Kara L. Watts, Robin B. Kanarek, and Holly A. Taylor. “Low-carbohydrate weight-loss diets. Effects on cognition and mood.” Appetite 52, no. 1 (2009): 96-103.|
|↑8||Krikorian, Robert, Marcelle D. Shidler, Krista Dangelo, Sarah C. Couch, Stephen C. Benoit, and Deborah J. Clegg. “Dietary ketosis enhances memory in mild cognitive impairment.” Neurobiology of aging 33, no. 2 (2012): 425-e19.|
|↑9||Frommelt, Lena, Maximilian Bielohuby, Barbara JM Stoehr, Dominik Menhofer, Martin Bidlingmaier, and Ellen Kienzle. “Effects of low-carbohydrate, high-fat diets on apparent digestibility of minerals and trace elements in rats.” Nutrition 30, no. 7 (2014): 869-875.|
|↑10||Gasior, Maciej, Michael A. Rogawski, and Adam L. Hartman. “Neuroprotective and disease-modifying effects of the ketogenic diet.” Behavioural pharmacology 17, no. 5-6 (2006): 431.|