Some people may hear that the ketogenic diet is dangerous, can land you in the hospital, or worse. Studies show that ketogenic diets high in healthy fats promote weight loss and heart health. Principles of the Key Eats Program are based on these studies and the collective knowledge of key opinion leaders in this field.
Nutritional Ketosis
One point of confusion surrounds two very different conditions, nutritional ketosis and diabetic ketoacidosis. Nutritional ketosis is a beneficial state that results from carbohydrate restriction. It is a primitive pathway that allowed our ancestors to survive in times when food was not readily available. In fact, without it, we may not be here today as a species. In addition, ketosis has been used to treat epilepsy for over 100 years.
When you limit carbs and deplete glycogen, your body breaks down fat into fatty acids, and coverts them into ketones for energy. If you are NOT a Type I diabetic, you always have some circulating insulin which, even on a ketogenic diet, increases in response to the foods you eat. The insulin limits or turns off ketogenesis in the liver so dangerously high ketone levels are not possible.
Diabetic Ketoacidosis
For Type I diabetics with no appreciable insulin production, the feedback loop is absent. With no insulin to shuttle glucose into cells, the body ramps up ketone production to provide itself with a source of energy. And without insulin-mediated signaling to halt ketogenesis, it continues unhindered leading to extremely high levels of ketones. This causes a dangerous reduction in the blood’s pH (more acidic), which is disruptive to critical metabolic pathways.
The levels of ketones achieved during diabetic ketoacidosis are ten times higher than those seen during nutritional ketosis. But remember, this serious condition can occur only if there is NO insulin which does not happen in healthy, non-Type I diabetic patients or in response to some diabetes medications called SGLT2 inhibitors.
As you can see, the ketogenic diet is not dangerous for those who can make their own insulin. In fact, the ketogenic diet can actually improve insulin sensitivity thereby decreasing the amount required for it to do its job. Hopefully this short summary of the differences between these two opposing physiologic states will better equip you to deal with the misinformation circulated all too frequently.