Note that urine measurements may not reflect blood concentrations. Urine concentrations are lower with greater hydration, and after adaptation to a ketogenic diet the amount lost in the urine may drop while the metabolism remains ketotic. Most urine strips only measure acetoacetate, while when ketosis is more severe the predominant ketone body is β-hydroxybutyrate. Unlike glucose, ketones are excreted into urine at any blood level. Ketoacidosis is a metabolic derangement that cannot occur in a healthy individual who can produce insulin, and should not be confused with physiologic ketosis.
Shifting your metabolism and achieving ketosis may speed up weight loss and result in other health benefits, like more energy and a lower blood pressure. But while ketosis is a preferred nutritional state for some people, it isn’t recommended for everyone — and it’s not a good long-term eating approach due to its restrictive nature, which may lead to potentially dangerous nutritional deficiencies.
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We now know the ketogenic diet has many other therapeutic benefits. One of them being that it trains the body to burn fat (in place of sugar) for fuel making the ketogenic diet an excellent choice for weight loss and improvement in body composition. The ketogenic diet is also excellent at treating and preventing insulin resistance like as found in type 2 diabetes and can even lower diabetic medication dosage or even prevent one’s need for blood sugar lowering medication. Weight loss through a ketogenic diet can also help lower cholesterol and triglycerides and improve overall cardiovascular function as well.
Dr. Perlmutter is the leading integrative medicine neurologist in North America today. His ability to fully integrate conventional medicine diagnosis and treatment with the latest innovations in nutritional and environmental medicine is phenomenal. As a teacher and clinician, he has fundamentally changed how physicians and patients think about neurological degeneration and, happily, regeneration.
So our brains do require some glucose, and this is the main reason that registered dietitians (RDs) will tell you that carbohydrates are essential nutrients (meaning we have to eat them or we will die). But a biochemical fact check shows that this is not true. RDs neglect the research which shows that the brain can use ketones for over half of its fuel requirements once carbohydrate intake is lowered and ketone levels ramp up to full production. When ketones are available as a secondary fuel source, the brain requirement for glucose is lower, and the process of gluconeogenesis can make all the glucose the brain needs (about 50 grams/day). So although glucose is essential for the brain, eating carbohydrates to make glucose for the brain is NOT required. If you are have blood ketone levels above 1-3 mmol, the brain can use the ketones as an alternative fuel source.
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There are three instances where there’s research to back up a ketogenic diet, including to help control type 2 diabetes, as part of epilepsy treatment, or for weight loss, says Mattinson. “In terms of diabetes, there is some promising research showing that the ketogenic diet may improve glycemic control. It may cause a reduction in A1C — a key test for diabetes that measures a person’s average blood sugar control over two to three months — something that may help you reduce medication use,” she says.