What is ketosis?
Ketosis is a metabolic state which our bodies can go in and out of typically as an adaptation to varying food sources and carbohydrate availability. The process gives us metabolic flexibility and the ability to use multiple food sources as fuel.
The trigger, or switch, to ketosis is determined by the balance of two hormones, insulin and glucagon. The levels of these hormones constantly fluctuate throughout the day and are heavily influenced by diet. The levels can also be affected by some metabolic health conditions and endocrine disorders.
Blood glucose levels, which are correlated heavily with dietary carbohydrate intake, will affect the insulin and glucagon balance. As dietary carbohydrates are removed from the diet, insulin levels start to drop.
As insulin goes down, free fatty acids (FFA) are released from fat stores and can be used by most of the body as an alternate fuel source. Some of the FFAs are transported to the liver, where they are converted into ketone bodies. The ketone bodies then serve as another source of fuel, or energy, in the absence of dietary carbohydrates.
What is a ketogenic diet?
Ketogenic diets provide a set of diet macros where the amount of dietary carbohydrates is low enough to decrease insulin enough to trigger a metabolic shift into ketosis. To support the metabolic shift, more calories from fat are consumed to offset the decrease in dietary carbohydrates and provide a dietary source of fuel or energy.
Ketogenic diets geared at weight loss are also lower in calories but still maintain a higher percent of calories from fat than traditional diets. This means they tend to be very satisfying and people aren’t as hungry. The drop in insulin and blood sugar also tends to decrease hunger and people find it easier to break sugar cravings.
What is keto adaptation?
Keto adaptation is the process of making the metabolic switch from burning primarily carbs for fuel, to burning fat. The transition period can last anywhere from 3 days, up to 10 days for some people. During the transition several symptoms are common:
- A loss of electrolytes during the first week of a ketogenic diet due to changes in renal function can result in headaches. Electrolyte supplementation may be recommended to alleviate this for some patients.
- Muscle cramping:
- Like headaches, muscle cramping is due to a loss of electrolytes. This is a strong sign of a dietary imbalance and it’s common for a lot of people to restrict their sodium intake on ketogenic diets, which isn’t recommended and can further this issue.
- Glucose levels are low, cells are making the transition to using FFAs and ketones for energy. During the week of keto adaptation, the process hasn’t caught up with the need, and some fatigue is common. Vitamin B12 in its methylated form can be helpful for a lot of clients
Ketogenic diet macros
Keto macros can vary in protein, fat and carbohydrates. We recommend starting the calculation with protein requirements based on age/height/weight/gender/activity level. This ensures that muscle won’t be lost which is a common fault of many ketogenic diets.
Net carbohydrate intake can be anywhere from 0-100g per day to meet the requirements of ketosis. For practical purposes 10-30 grams per day of net carbohydrates is a typical range for most ketogenic diets. This amount needs to be adjusted based on exercise type and intensity.
Fat intake makes up the largest percent of a ketogenic diet and is the primary source of dietary fuel or energy. It’s important to consume the higher fat content to maintain normal energy levels and mental clarity. This needs to be adjusted based on weight loss goals and activity or exercise levels.
What to eat on a ketogenic diet
Protein can be of any type. Typically, fattier cuts of meat are preferred as an easy way to hit diet macros which are high in fat to begin with. This makes options like bacon, sausage, and full fat dairy can easily be incorporated.
Low starch high fiber vegetables can be eaten in very large quantities on ketogenic diets and help with feeling satisfied. This can include:
- Bell Pepper
- Salad Greens
- Green Beans
- Brussel Sprouts
- Yellow Squash
Ketogenic Diets and Exercise
Any level of exercise can be performed on a ketogenic diet. For athletes and anyone doing high intensity exercise or extensive endurance training some diet modifications will be necessary to maintain maximum performance along with preserving muscle mass.
Ketone test strips
These can be used but are not recommended. Urinary ketone test strips are specific, but not always sensitive. Meaning if they are positive you are in ketosis, but if they are negative its possible your serum ketones would still be positive.
Additionally, most people will have a drop in urinary ketone output once they get further ketoadapted and maintain a state of ketosis. This makes the test strips more inaccurate the longer you stay in ketosis.
Appetite Suppressants for Fat Loss Keto Plans
Appetite suppressants help patients control cravings and increase energy. Prescription appetite suppressant supplements are available from Diet Doc in non-stimulant and stimulant options.
- Non-Stimulant Option
- Our prescription non-stimulant, Craving Control 2, is designed to control hunger and cravings without any jittery or stimulated feelings. It can help break the cycle of emotional and stress eating and is not addictive.
- Stimulant Option
- Our prescription stimulant SlimPhen (non phentramine/phentermine) is designed to control hunger and increase energy. It has a stimulating effect and is not for those sensitive to caffeine or with cardiac or mental health conditions.
Diet Doc Keto Plan
The Diet Doc Keto Plan builds on all the information above through customized diet macros, which make sure you have enough fuel for performance, weight loss, and maintain muscle mass. Our nutrition specialists are standing by to help you adjust and fine tune your keto plan to get to your goals faster and with less obstacles. Get started today by scheduling a free, no-obligation consultation with one of our medical weight loss doctors!