Wednesday, October 17, 2012

My Nutritional Ketosis Disaster

With all of the talk about Ketosis going on lately, I couldn’t help myself. I just had to take a peek at the latest low-carb craze called Nutritional Ketosis. At first, I used the excuse that I needed to know what it was in case I wanted to write about it and suggest it to my low-carb blog readers, but I got a bit bowled over and distracted by the success that many people are having following this way of eating.

22-ounce Porterhouse Steak
Many Low-Carb Dieters Eat Too Much Protein
(Photo by MoToMo)

What is Nutritional Ketosis?

If you just type “Nutritional Ketosis” into a search engine, the number one result is going to send you to a blog written by someone who doesn’t believe that eating too much protein can cause the liver to go crazy with gluconeogenesis. The reason why that blog’s author doesn’t believe in the theory is because there are no scientific studies to back up the notion, and because when they ate too much protein, their blood sugar didn’t rise excessively.

For those with metabolic syndrome, we all have different degrees of insulin resistance or sensitivity. Not everyone has metabolic syndrome, so blood glucose reactions are extremely individual – even among pre-diabetics and diabetics. The degree of insulin resistance you have and the amount of beta cells that function correctly plays a large role in the way your liver handles the protein you eat. For those who don’t have a normal insulin response or don’t respond to glucose properly, you can end up with too much glucose in the blood from eating a low-carb diet.


Because of gluconeogenesis. Restricting carbohydrates lowers your body’s carbohydrate stores. When those stores get too low, the liver pulls fat out of your fat cells to fuel the conversion of protein into glucose to feed the brain, kidneys, heart and other organs and body tissues. Some of the fat pulled out of your fat stores is also used for fuel.

Ordinarily, the body will also release some insulin along with the protein you eat in order to help the glucose made by the liver get into your cells. If you’re insulin resistant or you don’t make enough insulin to handle the excess glucose, that blood sugar will back up in your blood. That’s what happens to me when I eat very low carb (20 net carbs per day, or less). My blood sugar goes through the roof.

Nutritional Ketosis is similar to what Dr. Atkins called Dietary Ketosis. It simply means that you are in Ketosis due to dietary means, rather than Ketoacidosis. However, most people who have gone to the expense and effort of checking their blood for Ketones, rather than their urine, have discovered that they are not in Ketosis! Using a blood ketone meter for data, these individuals have played around with the amount of protein, fats, and carbohydrates they eat. During these experiments, they have discovered that there is a close relationship to the amount of protein they eat and being in Ketosis.

What to Eat to Get Into Nutritional Ketosis

The theory behind the fact that most low-carb dieters are not in Ketosis is that gluconeogenesis is interfering with Ketosis. If you eat too much protein, your body will convert that protein into glucose and you’ll predominantly burn glucose for fuel rather than fats. If your insulin response to protein is normal, your body will release enough insulin to handle the protein, so you won’t see a rise in blood sugar. The glucose will be escorted into your cells where it will be burned for fuel or stored in your fat cells if there’s more than you immediately need. This is what makes the “gluconeogenesis isn’t the problem” argument faulty.

Pile of Fatty Pork Ribs
Nutritional Ketosis is a High-Fat Low-Carb Diet That Limits Protein
(Photo by Rex Roof)
The idea behind a Nutritional Ketosis program is to lower your protein and raise your fats. Basically, it’s a high-fat, low-carb, moderate-protein diet, but far lower in protein than most low-carb dieters realize. In our super-size society, we have taken our overly-large portions with us into our low-carb diets and the result is that eventually, the amount of calories we’re eating will catch up with us. Many low-carb dieters also believe they can eat all of the low-carb foods they want and still lose weight. When calories catch up with us, however, we begin to maintain.

But we can also throw ourselves out of Nutritional Ketosis by continuing to eat the large amount of meat, cheese and eggs we could when we first started our low-carb program. Most low carbers who have tried this plan have found they can only eat between 50 and 72 grams of protein a day (a large man such as Jimmy Moore can eat closer to 84), or it will kick them out of Ketosis. It’s being in Ketosis that gives you the benefits of burning fatty acids for fuel. It’s also being in Ketosis that drops your cravings for carbohydrates and significantly lowers your appetite.

My own Nutritional Ketosis Experiment

None of this is new to me. I’ve tried several ketogenic and zero-carb diets before. Always, with bad results – but none of my zero-carb experiments ever monitored the amount of protein grams I was eating. I always ate to hunger. Since Kimkins, an hHCG diet, and Lyle McDonald’s Rapid Fat Loss Plan (protein-sparing modified fast) all limit the amount of protein you eat, I thought I’d give protein restriction a try. The only difference between those diets that worked well for me and Nutritional Ketosis is the amount of fat you eat.

Sliced Avocado
Nutritional Ketosis Includes High Fat Fruits
(Photo by A Machine)
I gave the program a two-week trial. Although statistically speaking I was only supposed to eat 52 grams of protein, or less, since I have more lean body mass than the average woman my age, I raised that to 60. I ate 1200 calories per day, or more, to make the test fair, 20 grams of carbohydrates, and I ate the excess fats even though they played severe havoc with my digestive system. Fats included avocados, extra-virgin coconut oil, grapeseed oil, real butter, cream cheese, and hard cheddar. I even ate peanut butter to test out the Fat Bomb craze as well.

The results were a disaster! I gained five pounds during that two-week trial, which my body decided to store around my abdomen. It was one of the worst two weeks of my life. The gastrointestinal repercussions from eating all of that fat was extremely uncomfortable. I spent far too much time in the bathroom, and I found myself craving real food!

What Does Nutritional Ketosis Look Like?

Sixty grams of protein isn’t very much. It’s about nine ounces of meat, cheese, or eggs per day. If you eat extra-fatty meat, you can eat a little more. Although Weight Watchers' Original Exchange Program only allows you that same amount, with Weight Watchers you also get to eat 2 servings of starches, 3 fruits, and 2 servings of milk. Subtract the starches, fruit, and milk, as well as the extra 550 calories for extras, and you're left with very little food. Just 9 ounces of protein and 20 carbs worth of veggies. Most of your diet is fat.

To meet that low level of protein, most people only eat once or twice a day. Those who eat more, are living on what’s called Fat Bombs, avocados, salads with no protein added, and homemade protein shakes where the protein powder is drastically reduced or totally eliminated.

Block of Cream Cheese
Fat Bombs are Cream Cheese, Butter, and Peanut Butter
(Photo by Alisha Vargas)
Fat Bombs are basically cream cheese, butter, and peanut butter mixed together and frozen into small cubes. Some people add coconut oil, unsweetened chocolate, or dark cocoa powder and some add sugar substitute to that mixture as well. Others are eating straight butter or coconut oil right off the spoon or slices of cream cheese in order to get the amount of calories and dietary fats they need to get through the day.

Surprisingly, it’s working quite well for a lot of people, but for me, that two weeks was all I could stand. At the very least I can honestly say that I gave it an honest try. Granted, I didn't go to the expense of buying a blood ketone meter and blood test strips, but even if I had, that wouldn't have stopped me from gaining the weight I did. Nor would it have made the diet any more tolerable. Now the only problems is – How do I get rid of the extra five pounds I gained in my belly from eating all of that dietary fat???

The obvious answer is to return to what works for me!

However, if your experience differs from mine, I'd love to hear from you. Just leave a comment below or pop on over to my low-carb blog: What is Nutritional Ketosis? and leave me a comment there.


  1. Hmm. Similar issues with me and a history of using high protein, low everything else diets for weight loss. I'm guessing this primes your body for gluconeogensis.

    I think that once you've adapted (and I've lost 100 pounds using high protein diets) to protein burning, that it can be harder and take longer to adapt to ketosis.

    I would also suggest that you weren't getting enough saturated fat.

    Additionally, for me, I can't do coconut oil. Especially virgin. It messes me up.

    I stick with fatty meat (ribeye cooked in butter for example) and eggs cooked in butter with cream cheese, sausage, bacon, etc. etc. Liverwurst is a special treat, too.

    I would move away from the veggie sources of fat (especially peanut butter), and embrace saturated fat. Especially from high quality pastured butter and grass fed meats.

    Also, couldn't hurt to try adding some enzymes to your diet until you adapt to high fat. And maybe some liver supplements. Milk Thistle is a good one.

  2. It's interesting that you could eat enough to gain weight. When I'm in ketosis I have to force myself to eat anything above about 1000 calories. I'm just not hungry, which is a plus as I don't like being hungry.

    It's amazing how different we all are.

  3. Have you read "Art and Science of Low Carbohydrate" or "Art and Science of Low Carbohydrate Performance" by Volek and Phinney

    Also, try Paleo first it might work well for you then once your adjusted to that then try Nutritional Ketosis as describe by Volek and Phinney

  4. If you haven't yet I couldn't recommend Jack Kruse more highly.

    His blogs on Leptin, Epi-Paleo, CT, and myriad of other health issues are very interesting and informative.

    I wouldn't doubt there is something in his blogs or on his forum that might help you. Either with whatever issue you had or something else. He also has an attached forum where you can post about various things if your interested.

    Good luck

  5. Cody,
    Thank you so much for your comments. I haven't thought about how high-protein diets like Atkins could prime you for gluconeogenesis, but that would definitely make sense, since I've been doing low-carb diets of one form or another since 1972.

    You don't think I was eating enough saturated fats?

    I only tried the peanut butter one day because I wanted to understand "how" those eating this way were making it work for them. The majority of the time, I ate bacon, eggs cooked in bacon grease, full-fat cheese, cream cheese, pork chops, steak, hamburger, dark meat chicken with the skin, and a little bit of mayo in my homemade salad dressing. Grass fed meat is not available here, but I do eat grass-fed butter.

    I don't have a gall bladder, so I don't know if I would ever "adapt" to high-fat eating. I was testing the high-protein theory, but find that it's more complex of an issue than just protein.

    Milk Thistle is a good idea.

  6. Craig,
    I have always gained weight from eating fat, even when I've kept my calories very low. I've read that most people with celiac disease have fat malabsorption issues due to the inflammation. I don't know how true that is, but I seem to fit that pattern.

    1. I think this is very true as I have some issues with my gut and have been on many forums related to celiac and crohn's. Possibly you could use a very good fat focused digestive enzyme like Lypo Gold, or you might have to use a different option.

  7. Butch,
    I have not read those books myself. I've just been following several other people who have read them and are doing the diet.

    I've tried Atkins, Protein Power, Kimkins, PSMF, Paleo, the old Weight Watchers' Exchange Program, SugarBusters and several diets of my own making.

    Diets that include a high amount of fats, grass fed or otherwise, have always caused me to stall or gain weight. Always.

    1. I was on a stall too for a long time, like 6 months or so. Until I read that book. Apparently needed to bring down the carbs to about 25 to 35 and protein to 75-100.

      Also,I started to used a software called Fitday to track my carbs and protein exactly, NOT necessarily counting calories, I also bought a food scale because my eyeballing was way way off. And yes I have to up the ante on fat from 75% to 82%-85%

      Result in 4 weeks after the tweaks to the carbs and protein - lost 5 pounds.

    2. I'm glad to hear you found something that works for you. That's basically what I tried for several years: about 35 carbs per day and protein somewhere around 90 or less. For me, the fat content of my diet really matters. The only time I've been able to lose anything has been when I've taken my calories and fat grams extremely low. Your experience matches many, many others though. Congratulations on the weight loss!

  8. Jonathan,
    Thanks for the link to Jack Kruse's website. My Leptin levels do crash fairly quickly whenever I try to diet anymore. After losing over 100 pounds on various forms of low carb, my body started to defend itself pretty violently. I'll definitely check it out.

  9. I added a link to my Nutritional Ketosis post at my low-carb blog at the end of this post. My zero-carb attempts haven't faired any better than this experiment did, and I was on zero-carb long enough to adapt. I just kept getting fatter and fatter. I was hoping the problem was too much protein, but I was obviously wrong.

  10. Have you ever done Zero Carb or VLC without the dairy? That can make a big difference.

    1. Yes. When I did zero carb it was without the dairy, and I gained quite a lot back then too.

  11. Vickie, do you take digestive enzymes or anything to help you break down fat? I understand this is a major issue if you've had your gall bladder out. I was just hearing something today on Dave Asprey's podcast to do with that. Let me check it out.

    1) Lipase

    2) oxbile extract

  12. Thanks for the links. I'll check them out.

    I tried taking digestive enzymes several years ago and it didn't work. My last round of research said that it was because fat is broken down in the small intestine, not the stomach, making enzymes by mouth worthless, but I'll read your links and see if they've discovered anything new about that yet.

    I'm always interested in everything that has to do with fat or dietary metabolism. I get a LOT of mail from people who have exactly the same problem I do. Most of them have told me that they gained weight when they attempted to follow the rules of Nutritional Ketosis. So even if this won't work for me it might work for someone else.


  13. Ah! looks so yummy and delicious.. Though natural food sources all necessary elements to our body, still it needs vitamins and minerals in a right quantity.


  14. Technically a two week trial isn't enough time for your body to enter ketosis, maybe a very low level, but not full.

  15. This comment has been removed by the author.

  16. Yeah, to enter ketosis, you need to start out by eating a lot of fat (like... a lot) and it probably needs to be longer than two weeks. You nutritional ketosis experiment likely failed because you weren't actually in nutritional ketosis. What you did was basically tantamount to eating a calorie resticted diet on nothing but M&M's. Also, you can't really say you were in nutritional ketosis without properly testing your blood ketones.

  17. Ketogenic is calorie restrictive but because of all the fats, it does not really matter. I think if you have an eating disorder and perhaps a might not help to know you can eat so many fats...My own problem is with metabolic syndrome. Because of my insulin resistance, I simply cannot tolerate all the carbs recommended by the ADA. Ketogenic was the first diet ever that reduced my blood glucose levels to normal and reduced my triglycerides without medication. Statins are so bad for your brain. this diet is imperative for metabolic issues. If you don't have it, it really does not matter. However, no matter how you look at it, over time, aging with cause you to become insulin resistance sooner or later due to all the carbs you are you end up needing ketogenic. Thank goodness someone discovered the benefits of this diet for the metabolic disorders. I can finally live a normal life.

  18. Too bad this didn't work for you for weight loss. Sometimes it doesn't work for women in the beginning especially if her hormones are out of balance and have been that way for a while. The high fat balances hormones and some women need extra help such as "The Hormone Cure" (a book) to get higher fat options to work for them. I am disappointed however that your article is too shallow and doesn't mention the medical uses to which this diet is put. For example, epilepsy and other neurological diseases, and nowadays even cancer are treated sometimes with this diet. It's really a medical diet that is sometimes used as a weight loss tool, not the other way around.