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  • Writer's pictureDenise Reese, RN

Ultimate Guide to Keto

Updated: Mar 19, 2022

Unless you've been living under a rock, or honestly just didn't care, the Ketogenic Diet has rocked the weight loss and health industry like no other.



But First, the Obesity Crisis...

Many people are struggling with their weight. In fact, in the United States, over 70% of the population are overweight or obese. The scary thing about this, is that the surge of weight problems happened shortly after the war on "fat" began in the 70's. It was said that fat was the reason for strokes and heart attacks. Since then, foods advertised as low-fat became popular, and the consumption of fat free, but sugar-laden foods became acceptable. Slowly but surely, we see a rise in metabolic disorders, such as Diabetes, metabolic syndrome, insulin resistance, which all contribute to obesity.


The scientific, nutritional and dietary industries have been grappling with this effect, and not wanting to bail on the mainstream, heavily sponsored and regulated oversight, will continue to say that fat is the reason for disease. Well, thanks to social media, community sponsorship, many doctors, scientists and the like have stepped away from the mainstream and have been doing the work to disprove these flawed theories.


Too Many Carbohydrates

Lets think about this: Most of us were raised on foods that consisted mainly of carbs, some proteins, and if following mainstream dietar


y advice, low quantities of fat. A lot of these foods contain added sugars, which are always ultra processed, and are easily passed into the bloodstream, which causes the hormone insulin to respond to the rising blood sugar levels. The sole purpose of insulin, is to take this sugar from the bloodstream, and put it into cells for our bodies to use as energy. The problem with this is that many of us are not only eating carbohydrates as the main source of energy, we are OVEREATING carbohydrates, which lead to overproduction of insulin, and therefore, overuse of this insulin/cell process. Blood sugar, or glucose, is stored in the skeletal muscle, liver, and are then converted into fat in the fat cells if the liver and muscle are already at capacity for storage. Overtime, overeating excess carbs leads to fat gain because they have no where else to go. In addition, the more we stuff fat cells with glucose, the cells stop responding to insulin an pancreas works harder to make more insulin in an effort for loses its ability to store the glucose because the fat cells have become even more resistant, and therefore the sugar is left in the blood stream, creating high blood sugar levels (Diabetes).


Ketogenic Diet

The Ketogenic diet was originally used as a therapeutic method to control neurological disorders such as epilepsy, due to the metabolic pathways that influence brain activity. It involves the consumption of primarily fats, moderate proteins, and a very low amount of carbohydrates to switch the metabolism into burning fat and fat byproducts as fuel, as opposed to carbohydrates. One outcome that was noted, was that this type of diet not only improved their neurological symptoms significantly, but also improved their metabolic profiles.


The Ketogenic diet focuses on priming the body to be a fat burner, which offer amazing benefits such as weight loss (if needed), reduction in hypertension, reversal of high blood sugar, reduction in inflammation, and regulation of hormones. How it works is, a person begins to consume their calories in a ratio of 70% fat, 25% protein, and 5% carbs. For a person who eats about 2000 calories per day, this will be 1400 calories in fat, 500 calories in protein, and 100 calories in carbs. This translates to 156 grams of fat, 125 grams of of protein, and 25 grams of net carbs. Meals typically contain a meat/poultry/seafood source, low carb veggie such as broccoli or zucchini with some delicious butter or olive oil, and seasoned and herbed how ever you like. It allows for dairy, such as cheese, heavy cream, sour cream, nuts in moderation.


Over time, your body will start to favor burning fat for energy. The cool thing about keto, especially for weight loss, is that once your body is used to using fat as the primary source of energy, it will begin eating body fat if you reduce your caloric intake. Generally keto should be started in a particular way of the goal is weight loss:


Get Started

Step 1: Get into Ketosis (7 days). Lower your carbohydrate intake to 25 or less net carbs (carbs minus fiber= net carbs) so the body can burn through the carbohydrates (glucose) stored in the body, and start eating healthy fats such as avocado, coconut, grass-fed beef and butter. Make sure to also be eating healthy low carb veggies such as broccoli, zucchini, green beans, cabbage, salads. For the first day or two, your body will still be burning sugar (glucose) as fuel because it is relying on the glucose stores in the liver & muscle. Once the stored glucose in the liver becomes very low, the liver will start to convert dietary fat into ketones, the fuel source that makes the metabolism "ketogenic". When this happens, you are in ketosis. Ketosis is a safe, stable metabolic state. In fact, when you are sleeping, exercising, or sick and not eating much, the body easily switches to burning fat and using the ketones for energy.


Step 2: Become Fat Adapted (2 weeks-3 months). Continuing to eating fat as a primary source of fuel gives allows your body to start building and creating the right types of cells to process and breakdown fat and convert it into energy. This is especially important if you want your body to eventually burn its own bodyfat when you lower calories or decrease the amount of dietary fat you are eating. See, your metabolism has been used to processing carbohydrates, glucose as its source of energy, and particular cells called mitochondria are responsible to converting these cells into usable energy. Although we also burn fat at any given time, we have way more glucose supportive mitochondria than we have fat supportive mitochondria. So, when you begin eating more fat and less carbs, the body will start to make more of these fat supporting mitochondria. It takes time, and the longer you stick to keto, the more your body makes. Once your body has made enough mitochondria to support a robust fat metabolism, you are fat adapted. This means, that your body is prepared to consume fats, break it down into ketones, and use those ketones for energy. Yay!


Step 3: Sustained Fat Loss (until goal). Some people get into ketosis, and become fat adapted faster than others. It is what it is, but once it happens, the magic really begins. I'm going to take this opportunity to tell you something that a lot of people miss during the early phases of keto: The role of insulin. So you think, that as long as you keep your carbohydrates low, that this will put you into ketosis, and eventually, into fat adaptation, right? Well you are 10% there. Insulin, as we now know, is a hormone that has the task of taking sugar within the blood stream and then into cells for energy. Once these cells, (liver, muscle) are full, insulin can shove the excess glucose into fat cells, and that glucose is converted INTO fat once in these cells. When insulin is present in the bloodstream at a certain level, meaning floating around and responding to glucose levels, it signals the body that it does not need to burn its own fat for energy, because energy is coming IN. Insulin brings glucose INTO the cells for energy, so there is no need to burn bodyfat when energy is being delivered. Essentially, when insulin is present, you will NOT burn body fat. The only way the body can start to burn and release its own body fat is when the body needs more calories than your diet is providing (calorie deficit), and insulin is low. Insulin is low when we don't eat foods that cause an insulin response, such as a significant amount of carbs. When insulin is low, there is therefore no signal to not burn bodyfat.

Don't eat foods that cause insulin to rise (sugars, starches, etc)

Eat less calories than your body needs to maintain your current weight (caloric deficit)

Body will get the remaining calories it needs from your body fat (fat loss)

Since your body is now fat adapted, the bodyfat that is broken down for energy is easily processed just like the fat you eat, for energy.


Other things to know:


Did you know that glucose is bound to 3 grams of water? So as you burn glucose, the water is released and urinated out. You will lose a lot of water, sodium and a little potassium in the beginning. This is why people lose 10 lbs in 2 weeks. You are losing some fat too, but the majority of this insane loss is water. Week 4-6, your body is rebalancing the water, so it may seem like you are no longer losing fat, but you still are. The body is just bringing some water back on at the same time. This is not a stall, not a plateau, but it DOES suck to see the scale go up or not move. Don't worry. This takes about 2 weeks to settle, and once the water is back on, you'll see the scale move again! Just trust the process please!! During this time, add salt to your foods and take a multivitamin.


When you are fat adapted, you have way more fat supportive mitochondria, but you still have some carbohydrate mitochondria. This is needed to still use the 25 or so grams of carbs you'll be eating.


If you have a cheat day, your body will quickly use up that glucose first, and go right back to burning fat once those carbs are burned off.


The more carbs you eat, or the more cheat days you have, you will start to make more carbohydrate supportive mitochondria, and less fat supportive mitochondria. This takes days in a row to do, so limit those higher carb days to 1 per week to allow your body to stay a fat burning metabolism.


Fat and proteins illicit a small insulin response, but the insulin levels drop fast (since there's no glucose), and allows your body to go right back into fat burning mode.


You will be less hungry naturally, because your body is constantly getting calories from your food, or your body. Hunger hormones are usually activated when your body needs to be given calories because it doesn't have access to fat stores because insulin is always present. This happens in a carbohydrate metabolism.


Lowering your calories, while eating carbs all day, is how you lower your metabolism. If you are eating lots of carbs, and insulin is around all day trying to process these carbs, but you are not eating enough calories to fuel the body, how will the body manage? It slows down the metabolism. You may not gain weight, but you certainly won't lose any.


Focus on nutrition. Since the ketogenic diet cuts out food groups that have a wide variety of vitamins and minerals, its important to eat veggies! Prioritize healthy foods and not keto junk!






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