My Nutritional Ketosis Disaster (What Happens When You Follow the Crowd)

Does lowering protein and upping fat to 80 percent
of your calories really work?

*This article on Nutritional Ketosis was originally written before I learned what Nutritional Ketosis actually was. 

It was full of inaccuracies and misconceptions because I listened to what others said Nutritional Ketosis was, instead of finding out for myself. Even so, thousands of low carbers are actually doing it this way. 

I have cleaned up the misconceptions as best I can.

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 one of my low-carb blog readers. 

I get a lot of email from those struggling to make a low-carb diet work for them, so I'm always looking for additional tips and tricks.

Upon taking a closer look:

I got more than a little bit bowled over and distracted by the success that many people claimed they were having following this high-fat way of eating.

I know that earlier I said how I was ready to let go of the low-carb dream and was switching to the Old Weight Watchers Exchange Program, but life was hectic, and I got sucked into the LCHF hysteria (low-carb high-fat) without really knowing what I was getting myself into.

That was a big mistake!

The Gluconeogenesis Theory

I thought I'd done my homework properly.

I typed “Nutritional Ketosis” into a search engine, and the number one result at that time led me to a blog written by someone who didn’t believe that eating too much protein can cause the liver to go crazy with gluconeogenesis.

The reason why that blog’s author didn’t believe in the theory was because there are no scientific studies to back up the hypothesis, and because when they ate too much protein, their blood sugar didn’t rise excessively.

For those with metabolic syndrome, there are different degrees of insulin resistance or sensitivity to carbohydrates.

Not everyone has metabolic syndrome, so blood glucose reactions to various foods will be extremely individual – even among pre-diabetics and diabetics. These over-responses are generally genetic, but they can also be caused from metabolic damage.

The degree of insulin resistance you have and the amount of beta cells that function correctly play a large role in the way your liver handles the protein you eat.

The liver doesn't detect glucose in your blood directly. It looks at how high your glucagon level is. Glucagon is a stress hormone that becomes elevated when insulin levels are low.

The lower the insulin level, the higher your stress hormones go, because low insulin occurs when your blood sugar falls too low. When glucagon and other stress hormones are high, glycogen (the storage form of carbohydrates) gets broken down into glucose by the liver and released into the bloodstream to bring it back up to normal.

The higher the insulin level, the less glucagon you'll have, so the liver won't break down glycogen into glucose because it doesn't need to. Your blood sugar is stable.

Insulin works to keep glucagon in check.

Restricting carbohydrates lowers your body’s carbohydrate stores. When those stores get too low, the body increases protein oxidation to take up the slack.

This is the first adaption the body makes, but it's only good for a few days because burning muscle tissue for calories endangers your life.

If there are no carbs coming in, after about a week, the liver stops using muscle for glucose and pulls fat out of your fat cells to provide energy for the cells that have mitochondria.

Some people believe this fat mobilization is used to fuel the conversion of protein into glucose, but that doesn't make sense because the body is already oxidizing proteins before it turns to your body fat. In addition, the liver can't use body fat. It can only use glucose.

The body needs glucose to feed the:

• brain
• some kidneys cells
• heart, when glucose or fatty acids aren't available

Glucose also feeds other organs like the liver and body tissues that don't have mitochondria.

Liver decides what to do with the protein you eat.
Most of what's not needed for repairs and building is
oxidized for calories. Only a little becomes glucose.

Some of the fat pulled out of your fat stores is used to fuel your muscles, but recent studies funded by Gary Taubes and other low-carb advocates showed the amount of fat used on a weekly basis is actually less than what your body would burn on a normal weight-loss diet.

It's thought by the low-carb community that insulin helps the glucose broken down by the liver to get into your cells.

But this is not accurate.

The body can oxidize amino acids directly, so there's no need to turn amino acids into glucose except when your glycogen is low and the amino acids are needed to keep your blood glucose level steady.

Blood glucose level is the only thing your liver glycogen stores are used for, so when certain amino acids are converted into glucose by the liver, the glucose is used to replenish your glycogen stores. It is not used for energy. Only indirectly.

The brain does use the glucose that's in the bloodstream, just not in the way that the low-carb community believes.

Insulin is secreted when you eat protein.
This insulin encourages body cells to pull glucose in faster.

Insulin is essential. It's not the bad guy here. If you didn't release insulin, you'd die.

If you are insulin resistant or you don’t make enough insulin to get the excess glucose out of the bloodstream, that blood glucose will back up. This excessive blood glucose also occurs when glucagon remains elevated or if you have chronic cortisol levels, but I didn't know that back then.

All I knew was that my blood glucose level would rise sharply whenever I ate at very low carb levels -- 20 carbs per day, or less. My blood sugar after meals would literally go through the roof.

What is Nutritional Ketosis?

Nutritional Ketosis is what Dr. Atkins called dietary ketosis. It's a metabolic state you enter, due to carbohydrate restriction. The word was actually coined by Dr. Phinney, to help people differentiate between dietary ketosis and ketoacidosis, a dangerous acidic state that affects Type 1 Diabetics.

After Dr. Phinney's books about Nutritional Ketosis hit the shelves, Jimmy Moore, a popular blogger, took the maintenance diet from The Art and Science of Low-Carbohydrate Performance, a book written for endurance athletes, instead of the diet in The Art and Science of Low-Carbohydrate Living, the book actually written for weight loss, and began using it like a weight-loss diet.

Since the blogger lost weight eating 15 percent of his calories in protein, 5 percent in carbs, and 80 percent in fats, the low-carb community began insisting that ketones were used for more than just fueling the brain. Everyone thought that the blogger's fat loss had to do with the number of ketones he managed to build up in his bloodstream, rather than a calorie deficit.

At this point in low carb's evolution, ketone blood meters had just hit the shelves, and since Jimmy had used one of these meters to dial himself into the Nutritional Ketosis Zone, or sweet spot for optimal sports performance, his readers began to spread the news like wildfire.

Due to Jimmy's success, Nutritional Ketosis quickly became the name of this low-protein, low-carb, high-fat program instead of the actual Nutritional Program laid out in Dr. Phinney's weight-loss book.

Whenever people use the term Nutritional Ketosis, or LCHF, they are almost always talking about this low-carb, high-fat, low-protein diet created by Jimmy Moore.

They are not talking about the original Nutritional Ketosis Diet created by Dr. Phinney. Nor, the ketogenic diet used by those with epilepsy. 

This diet allows you to fine-tune the macronutrients you eat to reach a deeper state of ketosis than the Atkins Diet offers. At least, that's always been Jimmy's claim.

Most people who have gone to the expense and effort of checking their blood for ketones, same as Jimmy did, have discovered that they were not in this deep state of ketosis that Jimmy talked about.

I honestly don't remember what target these folks were originally trying to hit because the whole optimal thing quickly degraded into a contest about who's ketones were highest. To reach those extensively elevated states, people took their protein consumption down to dangerous levels.

Using a blood ketone meter for data, these individuals played around with the amount of protein, fats, and carbohydrates in their diet to arrive at a particular blood concentration of ketones.

During these experiments, many discovered the close relationship between the amount of protein they ate and being in this deeper state of ketosis. There is a real biological reason for this, but it's not what these people told me.

So what I was told?

The body secretes insulin when you eat protein, so the less protein you eat, the less insulin the body needs to process it.

Fundamentally, that's true. 

The body secretes the amount of insulin you need to help usher the amino acids into your body's cells, so they can be used for repairs and new cell construction. This insulin secretion is not the basal insulin levels that plunge when you first go low carb. This is another type of insulin the body makes.

What they didn't tell me back then was that an excessive amount of ketone build up in the blood meant you had entered a state of ketone starvation. 

Excessively high ketone levels are not to be coveted.

What to Eat to Get Into Nutritional Ketosis

The theory behind Jimmy Moore's version of Nutritional Ketosis is different from what Dr. Atkins taught.

Nutritional Ketosis theory, as believed by the majority of the low-carb community, is that most low-carb dieters are not in ketosis due to gluconeogenesis interfering with their diet. This is believed due to the ketone blood tests that those who could afford to purchase the blood ketone strips ran on themselves.

They didn't like how low their ketone level was in the blood, and decided to actively do what was necessary to drive that level higher.

The explanation they came up with for not being in ketosis on Atkins was that if you ate too much protein, your body converted that protein into glucose, so you went back to predominantly burning glucose for fuel rather than fats. You also won't have enough ketones to fuel the body.

Even at that time, I found no scientific evidence to back up this theory. In fact, today (December 2016), this sounds absolutely crazy to me.

Ketosis begins at 0.5 mmol/L and these guys were freaking out because they had levels that were less than 2.0 mmol/L. Many tried to drive their levels higher than 3.0 mmol/L, telling people you needed to keep your ketones that high in order to drop the weight.

If your insulin response to protein is normal, your body will release insulin to handle the protein break-down, so you won’t see much of a rise in blood sugar.

If you are insulin resistant and tend to over-secrete insulin after meals, you might actually see your blood glucose level go down, which will then spark off a cascade of stress hormonal responses that will work against what you're trying to accomplish.

Any glucose released by the liver can be taken up by body cells and used for fuel provided those cells are not insulin resistant. Insulin is not needed for the body to do this. As ketosis continues past a few weeks, body tissues become insulin resistant to save blood glucose for the brain.

This occurs because most body tissues can use fatty acids for fuel. They don't have to have glucose. And they don't use ketones unless your ketone level goes too high or you're an endurance athlete.

Most of the people turning to a Nutritional Ketosis diet plan back then were either severely insulin resistant, didn't make enough insulin to process the amount of protein they were eating, or they needed a visual token to keep them on plan.

Nutritional Ketosis is greatly misunderstood by the
low-carb community who now eat a low-protein diet.

The idea behind a Nutritional Ketosis diet plan was to lower the amount of protein you eat and raise your dietary fats. This was what everyone told me constituted a Nutritional Ketosis program.

Most of this was based on rumor due to Jimmy's interpretation of what he believed Nutritional Ketosis was, but it quickly exploded into a full-fledged diet plan. Basically, this new low-carb diet was a:

• very high-fat
• low-carb
• low-protein diet

Far lower in protein than most low-carb dieters realized.

In our super-sized society, we have taken our overly large portions with us into a low-carb diet. The consequences for doing that will eventually result in the amount of calories you eat catching up with you.

Many low-carb dieters believe they can eat all the low-carb foods they want and still lose weight.

This is not true.

Dr. Atkins' nurse has said many times over the years that when calories catch up to your current metabolic needs, you will begin to maintain.

You can throw yourselves out of Nutritional Ketosis by continuing to eat the large amount of meat, cheese, and eggs you ate when you first started your low-carb program, but not because of its protein content.

Initially, your calorie needs will be quite high. If you live a very active lifestyle, calorie needs will be higher than your average low carber. When it comes to the amount of calories you can eat and still lose weight, how well your thyroid is converting T4 into T3 also matters.

Most low carbers who tried Nutritional Ketosis in 2012 found that they could only eat between 50 and 72 grams of protein a day, or the amount of ketones built up in the blood would be less than they wanted it to be.

A large man like Jimmy Moore could eat closer to 84.

Today, I'm seeing protein gram levels as low as 40 grams a day, with people swearing this is how Nutritional Ketosis is done.

Those following this tweaked plan believed it was the number of ketones built up in the blood that gave them the added kick of burning fatty acids for fuel, even though fatty acids and ketones are not the same substance and biochemistry doesn't work that way.

Benefits of a Nutritional Ketosis Diet Plan

Being in ketosis drops your cravings for carbohydrates and significantly lowers your appetite. This is the number one benefit and side effect of going into the state of ketosis.

The deeper you go into the state of ketosis, the more ketones you have built up in the bloodstream, the fewer the cravings and hunger you'll experience. 

I learned this when I experimented with a no-carb diet.

No hunger can be a huge benefit on any weight-loss program, provided your body is capable of using all of that dietary fat for fuel. Unfortunately, not everyone has the genes necessary to easy use fatty acids for fuel.

Keep in mind that after the first 3 to 4 weeks, the body generally saves the ketones to fuel the brain (hence their build up in the bloodstream) and uses dietary fatty acids for its energy needs instead.

This is the optimal condition, and Dr. Phinney clearly agrees with this. Fat adaption is the goal. Not a super-high ketone level in the bloodstream!

The body doesn't use the built-up ketones for fuel.

In fact, the body will secret insulin if your blood ketone level goes too high. This insulin response shuts down new ketone production until the brain has time to use the ketones the body has already made.

Also keep in mind that excess body fat is only tapped into when the supply of dietary fatty acids or glycogen in the liver gets too low. This dip into body fat stores has nothing to do with the number of ketones you have built up in the blood.

My Own Nutritional Ketosis Experiment

None of this is new to me.

I’ve tried several ketogenic (high fat) and zero-carb diets before. Always, with bad results. But, none of my zero-carb or ketogenic experiments ever monitored the amount of protein grams I was eating.

I always ate to hunger or followed the ketogenic ratios that epileptics use.

Since Kimkins, an HCG diet, and even Lyle McDonald’s Rapid Fat Loss Plan (a protein-sparing modified fast - PSMF) all limit the amount of protein you eat to one degree or another, just not as much as Jimmy's version of Nutritional Ketosis does, I thought I’d give his protein restriction a try.

The main difference between the diets that worked well for me in the past and this new Nutritional Ketosis diet was the amount of fat you eat. 

Jimmy's version of Nutritional Ketosis for weight loss
required you to eat 80% of your calories in dietary fats.

I gave the program a two-week trial.

However, since I'm very short (only 5-feet tall) and my goal weight was 125 pounds, I was only supposed to eat 52 grams of protein, or less per day.

I have more lean body mass than the average woman my age, so I raised that maximum limit to 60.

I was very nervous about the protein content of the diet because Lyle McDonald recommends a minimum of 0.8 grams of protein per pound of lean body mass for women.

At 0.8 grams, I would have needed around 84 grams of protein per day to maintain muscle mass. Cutting down to 60 grams was really pushing it, but everyone I knew who was doing the program was only eating 50 grams a day, or less, and encouraging me to drop my protein intake down to that extreme level.

I limited my carbohydrates to 20 grams, and I ate the rest of my calories in fat even though those fats played severe havoc with my digestive system. Fats I used included:

• avocados
• extra-virgin coconut oil
• grapeseed oil
• real butter
• cream cheese
• hard cheddar

I even ate peanut butter to test out the Fat Bomb craze as well.

Results of My Nutritional Ketosis Diet Plan 

I gained five pounds during that two-week trial, which my body decided to store on my belly.

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!

The body wanted meat and vegetables. It didn't want cream cheese and other fats!

Even with this bad experience, Nutritional Ketosis advocates continued to pressure me into sticking with the diet for a few more weeks since two weeks wasn't long enough to adapt to the state of ketosis.

This attitude floored me because I'd been in ketosis for several years and was already completely fat adapted by this time.

Others (which included low-carb gurus) ridiculed me because I wasn't using an expensive blood ketone monitor like they were. In fact, Jimmy Moore told me I couldn't call what I was doing Nutritional Ketosis if I had not tested my ketones with a blood ketone meter first. 

He insisted a blood ketone monitor was mandatory for Nutritional Ketosis; it was not optional.

Still others insisted that I was either:

1) in a severe state of malnutrition and needed to gain weight to heal my metabolism.

OR

2) I was doing the diet wrong.

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 than that.

In comparison, the Weight Watchers Original Exchange Program allows the same amount of meat, eggs, and cheese per day, but with Weight Watchers, you also drink 2 cups of milk.
That milk adds another 16 grams of protein to the diet for a total protein count that is closer to 80.

And that's for a diet with a moderate-carb intake.

I wasn't doing moderate carbs. I was only eating 20 carbs a day.

People on very low-carb diets need MORE protein than those on moderate-carb diets like Weight Watchers or South Beach. 

In addition, Weight Watchers gives you 2 servings of starches, and 3 fruits, along with those 2 servings of milk, which easily takes care of the brain's need for glucose.

If you subtract the starches, fruit, and milk, as well as the extra 550 calories for extras per week, you're left with very little real food. It's just 9 ounces of protein and 20 carbs worth of veggies. Most of your diet is fat.

To meet that very low level of protein, most people only eat once or twice a day. Those who eat more are living on:

• fat Bombs
• avocados
• salads with no protein added
• and homemade protein shakes

The homemade shakes allows you to drastically reduce or eliminate the protein powder entirely.

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 the mixture as well.

Others are eating straight butter or coconut oil right off the spoon or dishing themselves up slices of cream cheese on a snack plate in order to reach 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, at $5 a pop, that wouldn't have stopped me from gaining the weight I did. Nor would it have made the diet any more tolerable. 

Do people honestly believe that I gained weight because I ate 60 grams of protein instead of 50? Because that's what people are telling me!

Limiting myself to 60 grams of protein per day with no carbs to take up the slack was low enough.

Now the only problems is this:

How do I get rid of the extra five pounds I gained in my belly from eating all of that dietary fat???

Have You Ever Tried Nutritional Ketosis?

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.

UPDATE: I received a lot of flack for doing this Nutritional Ketosis Diet Plan review. Some people ridiculed the name of this blog and said its name proved to them I wasn't serious about low carb, so it wasn't a fair test. Others said I wasn't doing Nutritional Ketosis if I wasn't using a ketone meter that measured the ketones in my bloodstream. Still others told me that 2 weeks wasn't a long enough test.

Although this diet review is written from the vantage point of me quitting after the first 2 weeks, I didn't. Despite the discomfort, I continued with the diet for several weeks -- long enough to adapt to the deeper state of ketosis, which I never did. 

If you're interested in reading that update, and how I went on to gain over 30 pounds eating Jimmy's version of Nutritional Ketosis, please check out:

My Latest Nutritional Ketosis Update

That's where you'll find more of the details.

LATEST UPDATE: A few months ago, I took the time to watch a couple of Dr. Phinney's videos and read about 3/4 of his book, The Art and Science of Low-Carbohydrate Living. 

And let me tell you, I'm completely blown away. 

What people are calling Nutritional Ketosis, LCHF, and Keto is NOT what Dr. Phinney teaches. 

In fact, my own Atkins tweak, which only contained 60 grams of fat, and worked extremely well, was the correct way to do this diet. 

It is only called high fat because a large portion of your fat intake is coming from your body fat! The ratios that most people are doing are for maintenance only.