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

Steak Topped with Herbed Butter: Protein is Limited on NK
Does Lowering Protein and Upping Fat to 80 Percent
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:

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 were having following this way of eating.

I know that I said earlier I was letting go of the low-carb dream and switching to the Old Weight Watchers Old Exchange Program, but life was hectic back then, and I got sucked into the hysteria 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.

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. This was how I justified ignoring that number one Google search result.

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.

WHY?

Because of gluconeogenesis.

This was the gluconeogenesis theory that was circulating around the web at the time I played around with the Nutritional Ketosis diet.

Restricting carbohydrates lowered your body’s carbohydrate stores. When those stores get too low, the body increases protein oxidation. This is the first adaption the body makes, but it's only good for a few days because burning muscle tissue endangers your life.

If there are no carbs coming in after about a week, the liver stops using muscle and pulls fat out of your fat cells. Some people believe this fat mobilization is used to fuel the conversion of protein into glucose. The body needs glucose to feed the:
  • brain
  • some kidneys cells
  • heart, when glucose or fatty acids aren't available
and other organs and body tissues when carbs are lacking in the diet.

Some of the fat pulled out of your fat stores is also used for fuel, but recent studies showed the amount of fat used is less than what your body would burn on a normal weight-loss diet.

Insulin is secreted when you eat protein.

Plate Filled with Baked Chicken Legs
Eating protein results in insulin being secreted.
Low-carb experts believe this is due to protein
being turned into glucose.


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

This is not accurate.

The body can oxidize amino acids directly, so there's no need to turn amino acids into glucose first 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 used for glucose by the liver, it's used to replenish your glycogen stores. It is not used for energy.

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

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

If you are insulin resistant or you don’t make enough insulin to handle excess glucose in the blood, that blood glucose will back up in your bloodstream. 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 net 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, but the low-carb community back then insisted it was more than simply creating ketones to fuel the brain. Everyone said that fat loss had to do with the number of ketones built up in the bloodstream.


Nutritional Ketosis quickly became the name of a high-fat, low-carb program popular within the low-carb community when I first wrote this post. Whenever people use the term Nutritional Ketosis, they were always talking about this low-carb, high-fat, low-protein diet.

This diet is NOT the ketogenic diet used by those with epilepsy. 

This is a diet that fine-tunes the macronutrients you eat to reach a deeper state of ketosis than the Atkins Diet offers.

Most people who have gone to the expense and effort of checking their blood for ketones, rather than checking out their urine, discovered that they were not in this deep state of ketosis. At least, not to the extent that the Nutritional Ketosis diet, as followed by the majority of low-carb community, required it to be.

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 also discovered that there was a close relationship between the amount of protein they ate and being in a deeper state of ketosis. There was a biological reason for that, but not really for the reason these people gave me.

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 only secretes the amount of insulin you need to get those important macronutrients into your body's cells.

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.

What to Eat to Get Into Nutritional Ketosis


The theory behind Nutritional Ketosis is different from what Dr. Atkins taught.

Nutritional Ketosis theory being taught as truth back then said that most low-carb dieters were not in ketosis due to gluconeogenesis interfering with their diet. If you ate too much protein, people told me, your body will convert that protein into glucose and you’ll predominantly burn glucose for fuel rather than fats.

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

If your insulin response to protein is normal, your body will release insulin to handle the protein, so you won’t see 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.

Any glucose released by the liver can be taken up by body cells and used for fuel provided those cells are not insulin resistant. 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.

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.


Man eating a large pork roast
Nutritional Ketosis 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 said constituted a Nutritional Ketosis program.

Most of this was based on rumor due to one blogger's interpretation of what they 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.

Those following this 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 do that.

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

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

In addition, excess body fat is only tapped into when the supply of dietary fatty acids or glycogen in the liver gets too low.

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 or ketogentic 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 Nutritional Ketosis does, I thought I’d give protein restriction a try.

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

Avocado Cut Open
Nutritional Ketosis Consists
of 70% 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 and encouraging me to drop my protein intake down to that extreme level.

I ate 1200 calories per day to make the test fair.

I limited my carbohydrates to 20 grams, and I ate the rest of my calories in fat even though they 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 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!

The body wanted meat and vegetables. It didn't want more fat!

And yet, 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.

Others (which included low-carb gurus) ridiculed me because I wasn't using an expensive blood ketone monitor like they were.

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.

Although the Weight Watchers Original Exchange Program allows the same amount of meat, eggs, and cheese per day, with Weight Watchers, you also drink 2 cups of milk per day.

That milk adds another 16 grams of protein to the diet for a total protein count that is closer to 80.

People on 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.

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
where the protein powder is drastically reduced or totally eliminated.

Cream Cheese Roll

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, that wouldn't have stopped me from gaining the weight I did. Nor would it have made the diet any more tolerable. 

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 state of ketosis, which I never did

If you're interested in reading that update, check out:

My Latest Nutritional Ketosis Update


Comments

  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.

    ReplyDelete
  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.

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  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

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

    http://jackkruse.com/brain-gut-6-epi-paleo-rx/

    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

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  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.

    ReplyDelete
  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.


    ReplyDelete
    Replies
    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.

      Delete
  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.

    ReplyDelete
    Replies
    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.

      Delete
    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!

      Delete
  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.

    ReplyDelete
  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.

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

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

      Delete
  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

    http://www.enzymeessentials.com/HTML/lipase.html

    2) oxbile extract

    http://www.nationalnutrition.ca/Articles_Ox_Bile.aspx

    ReplyDelete
  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.

    THANK YOU!

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  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.

    Lamberts

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

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  15. This comment has been removed by the author.

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  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.

    ReplyDelete
  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 binger...it 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 consuming...so 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.

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  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.

    ReplyDelete

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