“Ketosis” is an intimidating word for many. Like with a low-carbohydrate diet, a high-fat diet, or a diet with increased fatty acids, you may have heard of keto dieting and have some reservations about sending your body into this state without fully comprehending what it is or even how it works. And, let’s face it, anything that sounds like a medical diagnosis can be a bit scary for all of us. However, ketosis is actually the beginning of a true lifestyle change with a myriad benefits. Whether you simply want to lose weight, feel more energetic and alert, or improve gut health and enjoy better sleep, ketosis can help lead you closer to those goals and more.
The challenge in convincing most people to try ketosis and keto dieting is getting them to accept that a long-term gain will indeed come with some short-term discomfort. The bottom line is that ketosis is can seem like a true shock to your system; your body will feel this radical change and it will react accordingly. But like exercising for the first time after a prolonged period of not doing any exercise, your body adapts over time and ultimately benefits from the change. If you are prepared in advance and know what to expect, you will have a much easier time managing ketosis and then realizing and enjoying the many health benefits of the keto lifestyle. There are numerous ways to mitigate the initially unpleasant side effects and arming yourself with this important information will make the entire process more palatable. Speaking of palatable, now is a good time to dispel one myth: keto does not mean saying goodbye to carbohydrates forever! You may not enjoy the same amount of carbs as before but, in time, you will find that you do not miss them as much as you may think you will. You will retrain your body in the way that it processes food for energy and that bakery you pass on the way to work each morning will not lure you in with its tempting muffins and croissants. You will feel full and satisfied with much healthier choices and, in turn, you will experience more energy. It's time to break the carb addiction! All of this happens when you retrain your body in ketosis. Let's walk through what it is and how it works.
What Is Ketosis?
First and foremost, ketosis is a normal process in our bodies: it happens naturally when the body does not have enough carbohydrates to burn for energy. When there is a lack of available carbs, the body shifts into the mode of burning fat for energy instead. Our bodies are naturally equipped to react to a lack of carbohydrates in this way and fat becomes our alternative energy source.
Eating carbohydrates is how we introduce glucose into the body and you may know that glucose, or blood glucose, is used interchangeably with the term “blood sugar.” This brings us to an important point, as you have undoubtedly heard of a diabetic stating “My blood sugar is low.” Ketosis and ketogenic dieting should be discussed with a physican for anyone who is managing diabetes. While ketosis is a natural process that can be managed safely for most, those with diabetes run the risk of a more dangerous state called ketoacidosis. This occurs when there are too many ketones in the blood and the blood then turns acidic. However, this is most likely to occur in those with type 1 diabetes. It can still happen in individuals with type 2 diabetes, although is it quite rare. Under the care of a medical professional ketosis can often be used effectively to help treat and reverse symptoms of those that have type 2 diabetes. Ketoacidosis is a condition that can be deadly if left untreated and, therefore, diabetics should always work in consultation with their physicians to manage a healthy and appropriate diet for their circumstances. Ketoacidosis can also occur with an overactive thyroid, in conjunction with alcoholism, or in cases of true starvation (we are talking extreme poverty and malnourishment here, NOT a healthy and nourishing keto diet).
For those managing the process effectively, having “too many ketones” in the blood will not be an issue. Ketones are not a bad thing—they represent a fuel source for our body. They are produced from fat once we stop burning carbs for fuel, and they power our body and brain. This conversion from fat-to-ketone happens in the liver and then the ketones enter our bloodstream. The cells in our body will then use the ketones as fuel similarly to how they would have previously used glucose for fuel.
Some are reluctant to try ketosis and keto dieting based on the misconception that we must consume carbs to fuel our brains. In fact, our brains can and do thrive when powered by ketones. Many people feel significantly more alert and focused after going through the initial process of ketosis and maintaining a keto diet. While weight loss is a primary goal for many who try this diet, the increased mental alertness is often a most welcome change and something that keeps individuals committed to the keto diet and lifestyle.
So How Do I Get into Ketosis? Where Do I Start?
If you are reading this article, you have already started a very important first step in the process: educating yourself and getting prepared. Keto diets are heavily hyped these days and there is a danger in people jumping on board to try them without getting educated first! You need to understand how to manage the process safely in order to get the best results and realize all of the fantastic benefits of ketosis. Just “cutting carbs”and going on a low-carb diet is not going to cut it. You must be prepared for the initial side effects of ketosis and how to mitigate them. (We’ll have some more specific tips on that later in the article!)
An equally important step while educating yourself on the process of ketosis is to discuss this change with your physician. It is always a good idea to tell your doctor about dietary changes, especially if you consider introducing any supplements (as many people do with keto dieting). If you are taking any prescription medications, your doctor will be able to advise you if you can expect to have any complications or side effects based on how those medications may interact with supplements. Additionally, your doctor may be able to provide additional guidelines on how ketosis can be managed effectively and safely with your own unique health concerns and history.
Once you have done that, it is time to take stock of your food supply. Your pantry and refrigerator may need a thorough overhaul before you begin a new keto diet. If you are used to a daily diet that consists primarily of carbohydrates, you will need to restock with plenty of fresh vegetables, proteins, and, yes, fat! If you haven’t used real butter in a while, it is about to change.
And here is a quick feel-good tip in terms of getting rid of those unwanted carbs: new and unopened packaged foods may be donated to a local food bank rather than thrown out completely. While you may feel sad to say goodbye to that favorite box of breakfast cereal, you can take some comfort in passing it along to a program that serves the needy in your local community.
For some keto dieters, getting rid of all the carbs can be problematic if you have children in your household. Just because you are trying a keto diet does not mean your whole family is signing up for it and you may need to find ways to manage your food cravings with the presence of your children’s snacks constantly tempting you. Try rearranging the pantry to keep some of these items out of view, or perhaps even make a shelf dedicated to “kids only” and begin to think of that as your “no” shelf. Arrange and display fresh and healthy options for yourself in your pantry and refrigerator. We are all visual when it comes to food and an attractive display of healthy snacks will begin to become much more tempting for you. In time, that fresh avocado will be calling your name much more than those sugary snack bars ever did.
The initial stages of ketosis are going to find you feeling tired and weak. Therefore, if you are not getting adequate sleep before starting a keto diet, try to change your routine. It is best to start from a place of feeling well rested; this can certainly have an impact on your emotional state as well. Saying goodbye to favorite foods may leave you feeling down. For some, it may actually feel as if you have lost a friend! Do not underestimate both the physical and emotional toll this process may have on you in the beginning and get yourself prepared with plenty of good rest beforehand. Try to adopt healthy sleep habits as much as possible, such as going to bed at the same time every evening, turning your phone to “do not disturb” mode, and turning off the television before you go to bed. Try blackout shades to eliminate distracting exterior light that may keep you awake and, for some, a soothing sound machine also promotes restful sleep.
Now, it is time to begin! Follow these steps and guidelines to get your body into ketosis:
Step 1: Cut Down on Carbs!
A common misconception about keto dieting is that you must cut out all carbs. Think of it more like a very low-carbohydrate diet. While you will need to cut down on your carbohydrate intake, you will not need to cut them out completely. Individual needs will vary, but for most people, the ideal range to get into ketosis is to limit net carbs to 20 to 40 grams per day. Net is an important distinction here and you will need to consider this as you review the information provided on all food packaging.
The net carb number comes from subtracting the grams of fiber per serving from the grams of carbohydrates per serving in that particular item. In other words, if the information on the package suggests that the product contains 25 grams of carbohydrates per serving and 10 grams of fiber per serving, your net carb number is 15 grams. (Remember that this is per serving. We can often overlook this important distinction and many of us are guilty of consuming an entire package of a particular snack only to discover later it was intended as four servings.)
Not all carbs are equal, nor are they received by every individual body in the same way. We can divide them into two primary types, based on the glycemic index: High GI carbs and Low GI carbs. Foods that rank higher on the glycemic index will introduce glucose into the bloodstream rapidly. And, unless you have run a marathon or participate in seriously strenuous daily workouts, there is no way you will burn off all the glucose from a High GI carb before it turns into fat. On the other hand, Low GI carbs will release glucose at a slow and steady pace into the bloodstream. We are better equipped to burn off these types of carbs through moderate activity. This is why, for example, sports drinks should truly only be used for recovery periods from strenuous exercise. Consuming sports drinks daily if you don’t engage in strenuous activity will undoubtedly backfire on any weight loss goals. (Remember: water is your best friend in ketosis!)
High GI carbs are the ones most often associated with the “bad carb rap.” Think white bread and sugary cereals! But there are plenty of Low GI carbs that are much better and healthier choices for daily intake to get yourself into ketosis. Low GI carb choices include non-starchy vegetables (you will want to avoid corn and potatoes) as well as berries, which are by far the best fruit choice for a keto diet.
For those who will miss pasta while keto dieting, a popular alternative is to use a spiralizer to turn zucchini into “noodles.” These kinds of tricks may help get you over the hump if you suffer from a starchy carb addiction!
Step 2: Load Up on Fat! The Good Kind!
It seems to go against all we have ever heard about healthy dieting, but now is the time to increase your fat intake to transform your body into a fat-burning machine. Remember that is the true point of ketosis. Most ketogenic diets intended for weight loss and improved athletic performance will derive 60–80% of calories from fat. That means it is time to introduce more healthy fats into your daily routine, including olive oil, coconut oil, butter, and lard. Additionally, you should plan to include avocados, nuts, meat, cheese, and fish in your meals and snacks. Opt for fatty fish like salmon. In addition to the fact that it will help you get into ketosis, salmon is often associated with improved mental health and decreases the risk of disease. Perhaps “a salmon a day” will keep the doctor away?
Not everyone has a taste for fish, however, and if this is the case for you, try a variety of meats and eggs. Omelets can serve as a very satisfying keto meal! And, as a splurge, you can even indulge in small amounts of dark chocolate, which has a high fat content (but be sure to check the carb and sugar content as well to stay within your daily keto guidelines).
Step 3: Get Up and Move!
This may be the toughest part of ketosis for many. The decreased carb consumption may leave you feeling weak initially, but it is important to stay active in order to get your body into ketosis. Think of the physical activity as the kickstart your body needs to retrain itself to burn the fat you are consuming once its glucose is depleted. Your liver will produce ketones to burn as alternative energy and physical activity will ramp up the production of ketones. Your workout is a direct instruction to your body to produce the ketones so think of it as a critical and necessary step in this process. It is important to remember that you should not overexert yourself with exercise that is way beyond the scope of your normal routine. For example, if you are used to taking three 30-minute walks each week, now is not the time to try a 10-mile run. Try gradually and safely increasing your workout frequency and times and consider trying something new for variety—perhaps you can sign up for a yoga class, swim laps in a local pool, or join a local dance studio. Staying active will also help you stay focused on something other than how much you miss that old friend, your sugary breakfast cereal! In addition to physical activity, stay engaged in anything that keeps you in good spirits—read a book, work on a home improvement project, or spend time with family and friends. Just be open with them about your dietary changes so they will avoid offering you sugary snacks…and so they will understand that you may be feeling a bit down or irritable! Having the support and encouragement of family and friends or a community of other keto dieters can make a big difference in the process for you.
Step 4: Measure Your Ketones
As we mentioned earlier, this is not a one-size-fits-all program and different bodies will respond differently to the reduction of carbs. Some may need to stick with 20 net grams daily while others may be able to get into ketosis while consuming 40 net grams of carbs daily. The best way to keep track of your ketosis progress is by measuring your ketones, which can be done with blood tests, urine tests, or breath tests. All of these are available in local pharmacies and they are relatively inexpensive. If your ketone levels are not high enough, you may need to make adjustments to your diet in order to get into ketosis. There is some degree of trial and error here, and you will need to be patient until you find what works best for you!
A Word about the Dreaded Keto Flu…
Speaking of patience, this is where you will need it most: if you are struck with keto flu. And, let’s face it, everyone will have some degree of unpleasant side effects in the initial stages of ketosis. Even the healthiest among us are not immune to this when a drastic change takes place in our bodies.
You are going to feel weak and possibly dizzy. Your muscles may cramp and you may have nausea, diarrhea, constipation, or even vomiting. You may feel irritable (not surprising considering the side effects we have already spelled out) and you may also have difficulty sleeping.
During this time period, you must stay focused on the fact that these effects are temporary: do your best to stick with the diet and power through!
To ease some of these symptoms, the best thing you can do is stay hydrated and also increase your electrolyte intake. Most of the effects are actually a direct result of the loss of electrolytes. When your insulin decreases in ketosis, your kidneys are going to release excess sodium from the body. In order to feel better, you need to replace it. Ensuring you are getting enough sodium (as well as calcium, potassium, and magnesium) will go a long way toward helping you feel better and help you get through the toughest part of ketosis. See additional information about replenishing electrolytes in another article Keto Electrolytes: The Importance of Electrolytes in the Keto Diet
You may also want to supplement with exogenous ketones to help you get through the initial keto flu phase.
Remember that sports drinks may not be your best friend as far as replacing electrolytes as the carb content may prevent you from getting into ketosis. So, unless you have run a marathon, stick with water instead. For those who prefer flavored beverages, try keeping a pitcher of infused water on hand. Citrus fruits and cucumbers can pack a lot of punch in plain old water, and this may help you resist the temptation to reach for the sodas or other sugary beverages you used to drink.
Remember that ketosis is about short-term pain for long-term gain. If you can stick it out through the process, you will enjoy not only the benefits of weight loss but you will simply feel better overall!