Ketosis: definition, symptoms and risks

Ketosis: definition, symptoms and risks

To function well, the body needs carbohydrates, proteins and lipids. With ketosis, this hierarchy is shaken up. The premium is given to fats, at the risk of exposing oneself to undesirable effects that are anything but trivial.

Ketosis or state of ketosis is achieved by depriving the body of its carbohydrate reserves (in particular by removing them from the diet). Metabolism deprived of its primary source of energy is thus disrupted and will use fats from adipose tissue… but not only that. This type of diet exposes you to significant side effects in the short and long term.

What is ketosis?

In a normal situation, our body produces the energy it needs to function from carbohydrates, or sugars, usually considered the body’s fuel. These carbohydrates are found in starchy foods (bread, cereals, legumes, etc.), but also in fruits and vegetables and even dairy products. “According to the recommendationsunderlines Nathalie Négro, dietitian-nutritionist, carbohydrates should represent between 45% and 55% of daily energy intake. Translation: between 200 and 250 g per day for women and 250 to 300 g for men. The brain alone needs 148 g of carbohydrates per day to function well.

To understand ketosis, or the state of ketosis, we must imagine the body deprived of its primary energy source, following the exhaustion of carbohydrate reserves or a sharp reduction in their consumption. “Ketosis corresponds to a state where the body uses fats from adipose tissue as sources of energy, specifies the specialist. The problem is that the body also draws on protein reserves, that is to say in the muscles. If the goal of so-called “ketogenic” diets, which aim to get closer to the state of ketosis, is to lose fat, incidentally they also lead to a weakening of muscle mass.

The fats used will be transformed in the liver to give ketone bodies or ketones, divided into 3 types, depending on the fatty acids used, and which, passing into the blood produce this replacement energy, although of less good quality. “This process signs the state of ketosis., summarizes Nathalie Négro. This phenomenon (the body produces ketone bodies) only appears if the sugar level (blood sugar) is sufficiently low.

How to achieve ketosis?

To achieve the state of ketosis, you should drastically reduce your consumption of carbohydrates, which should only account for 2 to 15% of daily energy intake, which is equivalent to a maximum of 60 g of carbohydrates per day. Sugar intake being reduced, the body is thus forced to seek energy resources elsewhere: exhaustion of carbohydrate reserves, in the liver and in the muscles, initially, then demand on muscle proteins and finally on the tissue. adipose.

Each organism is different, but, believes Nathalie Négro, “the production of ketone bodies occurs after 3 to 4 days on average.

It is possible to identify the presence of ketone bodies in the body and, therefore, to measure their level, thanks to urine sampling with a strip, or ketonuria, which is carried out in an analysis laboratory. Note that this urine examination may reveal hyperketonemia: “This is called ketoacidotic coma which affects diabetic patients with insulin deficiency. Diabetic ketoacidosis is a common complication of diabetes due to the accumulation of ketone bodies. Ketoacidosis gives patients green apple breath. This risk of ketosis can manifest when diabetes is not well balanced or controlled, both in type 1 and type 2 diabetes, and lead to a coma.

What symptoms can be induced by a ketogenic diet?

Initially, the person will feel a kind of euphoria, but also difficulty concentrating, nausea, dehydration and irritability, describes Nathalie Négro. This phenomenon is also called ketogenic flu. “When the body does not receive its normal dose of carbohydrates, it obviously performs less well, and this is particularly the case for the brain. Fat is less efficient than anything that contains sugars., explains the nutritionist. And moreover, for the same reasons, these signs are also found in people who follow a high-protein diet. “The keto diet contravenes our normal functioning”insists the expert.

Other symptoms may develop if the keto diet continues, starting with a vitamin deficiency and therefore a reduction in immune defenses and progressive muscle wasting.

What are the benefits of being in ketosis?

The ketogenic diet would be accompanied by weight loss. At least in the early days. Which is quite logical, notes Nathalie Négro: “As soon as we eliminate a source of energy, we reduce our energy intake”.

For the record, sources of fatty acids are fatty fish, meats, cold meats, eggs, dairy products, oils, nuts and even avocado.

But the state of ketosis is very difficult to maintain. In addition to the immediate health inconveniences (fatigue, dizziness, nausea, etc.), the diet that this involves adopting is not compatible with social life. However, stopping any diet, including the ketogenic diet, is often accompanied by weight regain. This is the famous yoyo effect. “When we lose weight, the fat cells are emptied but are still there, and therefore at risk of filling up again, or even multiplying when weight regains. In addition, when we empty fat cells too much, it can change the feeling of hunger. Some people find themselves with uncontrollable cravings.”warns the head of the Nutritionist Center at the Brides-les-Bains thermal baths.

The ketogenic diet is a therapeutic tool in the management of treatment-refractory epilepsy in children. This diet was first tested at the Mayo Clinic in Rochester, Minnesota (United States). Between 1921 and 1930, doctors gave it to around 100 children with the disease, with results ranging from remission (fewer or even more epileptic seizures) in some of these little patients to better- be for others. After the Second World War, it was replaced by medicines. But in children who remain refractory to drug treatments, it is still practiced, “in a medical setting, in a very controlled manner, with specialized dietitians, and never in the long term”insists the nutritionist.

What are the risks of a ketogenic diet?

They are numerous and potentially serious.

  • A court terme : it can have undesirable effects, including difficulty concentrating, nausea or irritability, already mentioned. But the list doesn’t end there. “There is also a risk of dehydration, hypoglycemia, an increase in uric acid (which can be responsible for kidney stones and gout attacks), abdominal and digestive pain, transit disorders, whether diarrhea or constipation, vomiting, lists Nathalie Négro. The ketogenic diet can also lead to hepatitis or acute pancreatic disease”;
  • Longer term : we must add the more or less long-term risk of lipolysis, i.e. the excessive destruction of the fat mass, involved in the production of numerous hormones – with the risk, for example, of ending up in hypertriglyceridemia –, and muscle wasting . Because if proteins are not banned (meat, fish, eggs, etc.), this is not enough to replenish your supplies, following the exhaustion of reserves and, moreover, the amino acids which make up proteins are of various kinds, and all useful. “All food families are important, and this is what will prevent, combined with appropriate physical activity, the process of weight gain.recalls Nathalie Négro.