Most of us have heard about this diet called the ketogenic diet. When you look at the results people have gotten following this diet, they are tremendous, that too, in a very short amount of time! However, there are some doctors out there who do not recommend such diets for weight loss as they maybe harmful to an extent that they may result in death of a person. They have their own reasons.

So before you try out this ketogenic (ketone generating) diet, let us try and understand what ketones are and how they are generated (without the diet).

When your body goes into an extreme starvation mode or a very low carbohydrate diet mode, hormone sensitive lipase mobilises the triglycerides stored in your body from the adipose tissue.

For all the biomedical students out there, you understand what I am trying to say. For the people who are not aware of the terms I am using in the underlined statement and are screaming “English please!”, let me put it in simpler words.

So whenever you eat food, it will be used for your metabolic activities but when you eat that extra slice of pizza and top it up with some chocolate ice cream, your body will store it for the day you plan on fasting. So this excess fat is stored in the form of triglycerides. As all processes require a mediator, our storing mediator here is the enzyme called lipoprotein lipase (lipo means fat). Now, let’s go to the day you plan to starve your body. As your body needs energy to function, it will use the enzyme called hormone sensitive lipase to mobilise the triglycerides from your adipose tissue (fat tissue).

The triglycerides are broken down into fatty acids and glycerol which enter the liver.

In the liver:

  • Glycerol is used for gluconeogenesis (Gluco- glucose; Neo- new; Genesis- generation). This means the body is forming new glucose using the mediator oxaloacetate. Remember this only happens when your body has not consumed carbs for more than 24 hours. Within 24 hours of not consuming carbs, the body will utilise the carbs it already has using glycogenolysis (breaking down glycogen)
  • Fatty acids undergo a process called beta oxidation and generates acetyl coA. This compound, using oxaloacetate, enters the TCA cycle (Citric acid cycle) to form energy (ATP- Adenosine triphosphate)

The oxaloacetate stores in the body are very less. In such cases of starvation, the body prefers gluconeogenesis. Most of the oxaloacetate will be used for gluconeogenesis and there will be very little of it left for the TCA cycle to run. As a result of this, the TCA cycle comes to a halt and normal energy production stops. We still have acetyl coA which is now diverted to produce ketone bodies!

These ketone bodies provide high amounts of energy. There are three types of ketones: Acetoacetate, Acetone and beta-hydroxy butyrate. These are considered harmful because acetoacetate and beta-hydroxy butyrate are strong acids that deplete the body’s bicarbonate stores (bicarbs balance acidity) lowering the pH of the blood. Acidity in the blood can collapse the lungs.

The normal limit of ketone bodies in the blood is 1 mg/dl. If it exceeds this limit, it can cause ketonemia (keto-ketones; emia- in blood) and ketourea (keto-ketones; urea- in urine). At this stage, the body is said to have entered the stage of ketoacidosis. Such a person’s breath is fruity due to acetone. This is a dangerous stage and can lead to death if not taken care of.

After reading this you might not want to do the diet. Do not worry. The ketogenic diets (most of them) are created in such a way that the body enters a state called nutritional ketosis. A ketogenic diet primarily consists of high-fats, moderate-proteins, and very-low-carbohydrates. The dietary macronutrients are divided into approximately 55% to 60% fat, 30% to 35% protein and 5% to 10% carbohydrates. Specifically, in a 2000 kcal per day diet, carbohydrates amount up to 20 to 50 g per day. The way these diets function is by reducing the insulin secretion blocking glucose and fat storage. Gluconeogenesis and ketogenesis start and eventually, acetone and beta-hydroxy butyrate are the ketones that are sustained throughout your ketogenic diet. As long as the body is deprived of carbs, the metabolism remains in the ketotic state causing weight loss by not storing fats and using up excess fats. These fats continue the cycle of ketosis. The nutritional ketosis state is considered quite safe, as ketone bodies are produced in small concentrations without any alterations in blood pH. It greatly differs from ketoacidosis, a life-threatening condition where ketone bodies are produced in extremely larger concentrations, altering blood ph to an acidotic state (NCBI, 2018)

So now that you know what ketones are and what is the difference between ketoacidosis and nutritional ketosis, make sure you are doing the right kind of ketogenic diet. I would still recommend this only to the people who have tried various exercise methods and diets and have not received any results. To reduce the risks of obesity, you may try this diet. For the people who just want to lose a few pounds to look fitter, exercise and balanced diet is the best way to do so.

For the people who are doing a ketogenic diet, please do not do it for more than 2 months consistently. Take a break of a month after 2 months and then start again if required. Understanding what you are doing brings in a sense of responsibility and makes it more fun to do so I hope you found this article useful!

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