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7 tips to achieve ketosis

7 Tipps, um eine Ketose zu erreichen

Ketosis is a normal metabolic process that can have several health benefits. When your body is in a state of ketosis, it converts fat into compounds called ketones or keto bodies and begins to use them as its main source of energy.

Studies have shown that diets that promote ketosis have a very positive effect on weight loss, partly due to their appetite-suppressing effects (1, 2).

More recent research suggests that ketosis may also be helpful for type 2 diabetes and neurological disorders, among other conditions (3,4).

However, it can take some work and planning to achieve a state of ketosis. It's not simply a matter of reducing your carbohydrate intake.

Here are 7 effective tips to achieve a state of ketosis:

1. minimize your carbohydrate consumption

Eating a very low-carb diet is the most important factor when it comes to achieving a state of ketosis. Normally, your cells use glucose - or sugar - as their primary source of energy. However, most of your cells can also use other energy sources. These include fatty acids and ketones, which are also known as keto bodies.

Your body stores glucose in your liver and muscles in the form of glycogen. When carbohydrate intake is very low, glycogen stores in these glycogen stores are depleted and levels of the hormone insulin drop. This allows the release of fatty acids from your body's fat stores.

Your liver converts these fatty acids into the keto bodies acetone, acetoacetate and beta-hydroxybutyrate. These ketones can be used by parts of the brain as a source of energy (5, 6).

The degree of carbohydrate restriction required to induce ketosis varies between individuals. Some people will need to reduce their net carbohydrates (total carbohydrates minus fiber) to 20 grams per day, while others may be able to achieve a state of ketosis with twice the amount of carbohydrates or more.

For this reason, the Atkins diet has specified that carbohydrates should be reduced to 20 grams or less per day for two weeks for 20 weeks to ensure that a state of ketosis is achieved. Once this state is reached, additional carbohydrates can be gradually added to the diet as long as the state of ketosis can be maintained.

In one study, subjects with type 2 diabetes who reduced their net carbohydrate intake to 21 grams or less per day had daily urinary excretion of ketones 27 times higher than baseline levels (7).

In another study, adults with type 2 diabetes were allowed a daily intake of 20 to 50 grams of digestible carbohydrate, depending on the amount of carbohydrate that allowed them to maintain blood levels of ketones within a target range of 0.5 to 3 mmol/l (8).

These carbohydrate and keto body ranges are recommended for people who want to achieve a state of ketosis to achieve weight loss, better control of blood glucose levels or a reduction in risk factors for heart disease.

In contrast, therapeutic ketogenic diets used to treat epilepsy or as part of experimental cancer therapy often restrict carbohydrate intake to less than 5% of total calorie intake or less than 15 grams per day to further drive the level of ketosis (9, 10).

Anyone wishing to use a ketogenic diet for therapeutic purposes should only do so under medical supervision.

Summary: Limiting carbohydrate intake to 20 to 50 grams of net carbohydrates per day reduces blood glucose and insulin levels, which leads to the release of stored fatty acids that are converted to ketones by the liver.

2. include coconut oil in your diet

Consuming coconut oil can help you reach a state of ketosis. Coconut oil contains so-called medium-chain triglycerides (MCTs). Unlike most fats, MCTs are quickly absorbed and transported directly to the liver where they can be immediately used for energy or converted into ketones.

In fact, it has been suggested that consuming coconut oil may be one of the best ways to increase levels of ketones in Alzheimer's patients or patients with other nervous system disorders (11).

Although coconut oil contains four types of MCTs, 50% of the fats in coconut oil are lauric acid. Some research suggests that fat sources with a higher percentage of lauric acid may produce more stable levels of ketosis. This is due to the fact that lauric acid is metabolized more slowly than other MCTs (12, 13).

MCTs have been used to induce ketosis in epileptic children without reducing carbohydrates as drastically as a classic ketogenic diet.

Several studies have found that a diet rich in MCTs and containing 20% of calories in the form of carbohydrates produces similar effects to a classic ketogenic diet, which provides less than 5% of calories in the form of carbohydrates (14, 15, 16).

When adding coconut oil to your diet, it's a good idea to do so slowly and gradually to minimize potential digestive issues such as stomach cramps and diarrhea. Start with one teaspoon a day and work your way up to two or three tablespoons over the course of a week.

Summary: Consuming coconut oil provides your body with MCTs, which are quickly absorbed and converted into keto bodies in the liver.

3. increase your physical activity

A growing number of studies have found that a state of ketosis can have a beneficial effect on some types of exercise, including endurance training (17, 18, 19, 20). In addition to this, being more active can help you get into a state of ketosis.

When you exercise, you deplete your body's glycogen stores. Normally, these are replenished when you eat carbohydrates, which are broken down into glucose molecules that are then converted into glycogen.

However, when carbohydrate intake is minimized, glycogen stores remain low. In response, your liver increases the production of ketones, which can be used as an alternative energy source for the muscles.

One study found that exercising when blood levels of ketones are low increases the rate at which ketones are produced. However, when blood levels of ketones are already elevated, exercise does not increase them further and may even decrease them for a short period of time (21). In addition, it has been shown that training in a fasting state increases the levels of ketone bodies (22, 23)

In a small study, nine older women exercised either before or after a meal. Their blood levels of ketone bodies were 137 to 314% higher when the subjects exercised before a meal rather than after a meal (23).

Keep in mind that even though exercise increases ketone body production, it can take one to four weeks for your body to adapt to using ketones and fatty acids as primary energy sources. During this adaptation period, physical performance may be temporarily reduced (20).

Summary: Physical activity can increase ketone body levels during carbohydrate restriction. This effect can be further enhanced by performing exercise while fasting.

4. increase your intake of healthy fats

Consuming plenty of healthy fats can increase keto body levels and help you reach a state of ketosis. In fact, a low-carb diet not only minimizes carbohydrate intake - it's also high in fat.

Ketogenic diets to support weight loss, better metabolic health and better exercise performance usually provide 60 to 80% of calories in the form of fat. The classic ketogenic diet used for epilepsy is even higher in fat, providing 85 to 90% of calories in the form of fat (24).

However, an extremely high fat intake does not necessarily result in higher ketone body levels. A three-week study of 11 healthy volunteers compared the effects of fasting with different amounts of fat on ketone body concentrations in exhaled air. It was found that ketone body concentrations were similar when 79 and 90% of calories were consumed in the form of fat (25).

Additionally, because fat makes up such a large percentage of food intake during a ketogenic diet, it is important to choose high quality fat sources. Good fats include olive oil, avocado oil, coconut oil and butter. In addition to these, there are many healthy, high-fat foods that are low in carbohydrates.

However, if your goal is weight loss, it is important that you do not consume too many calories overall, as this will stall weight loss regardless of potential ketosis.

Summary: Consuming at least 60% of your daily calories in the form of fat will help to stimulate the production of keto bodies. Choose a wide range of healthy fats from plant and animal sources.

5. try a short fast or a fat fast

Another way to achieve a state of ketosis is to not eat for several hours. In fact, many people achieve a mild state of ketosis between dinner and breakfast.

Children with epilepsy sometimes need to fast for 24 to 48 hours before starting a ketogenic diet phase. This is to get them into a state of ketosis faster to reduce seizures more quickly (26, 27).

Intermittent fasting, a nutritional approach that involves regular short periods of fasting, could also induce ketosis (28, 29).

In addition, "fat fasting" is another approach that stimulates keto body production and mimics the effects of fasting. This approach involves the consumption of approximately 1000 kcal per day, 85 to 90% of which is fat. This combination of very low calorie intake and very high fat intake could help you reach a state of ketosis more quickly.

A 1965 study reported significant fat loss in overweight patients who undertook a fat fast. However, other scientists have pointed out that these results appear to have been greatly exaggerated (30).

Since a fat fast provides so little protein and calories, it should be followed for a maximum of three to five days to prevent excessive loss of muscle mass. It may also be difficult to follow such a dietary approach for more than a few days.

Summary: Fasting, intermittent fasting and a fat fast can all help to achieve a state of ketosis relatively quickly.

6. maintain an adequate protein intake

Achieving a state of ketosis requires a protein intake that is adequate but not excessive. The classic ketogenic diet used for epilepsy patients restricts both carbohydrate and protein intake to maximize keto body levels.

The same diet may also be beneficial for cancer patients as it may limit tumor growth (31, 32). However, for most people, reducing protein intake to increase the production of ketones is not a healthy approach.

First of all, it is important to consume enough protein to supply the liver with amino acids needed for the process of gluconeogenesis - the production of glucose from proteins. As part of this process, the liver provides glucose for the few cells in the body that cannot use ketones as an energy source. These include the red blood cells and parts of the kidneys and brain.

Secondly, protein intake should be high enough to maintain muscle mass when carbohydrate intake is low, which is particularly important during weight loss. Although weight loss will typically result in a loss of both fat and muscle mass, consuming enough protein as part of a very low-carbohydrate ketogenic diet can help maintain existing muscle mass (5, 30).

Several studies have shown that maintenance of muscle mass and physical performance is maximized when protein intake is in the range of 1.2 to 1.7 grams per kilogram of lean body mass (20).

Weight loss studies have shown that very low carbohydrate diets with a protein intake in this range induce and maintain a state of ketosis (7, 8, 33, 34).

In a study of 17 men who followed a ketogenic diet for four weeks, which provided 30% of their daily calorie intake in the form of protein, blood ketone concentrations averaged 1.52 mmol/L. This is within the 0.5 to 3.0 mmol/l range of nutritional ketosis (34).

To calculate your protein requirements during a ketogenic diet, simply multiply your body weight by 1.2 to 1.7. For a woman with a body weight of 59 kilos, for example, this would be a range of 71 to 100 grams.

Summary: Consuming too little protein can lead to a loss of muscle mass, while excessive protein intake can suppress the production of ketones.

7. test your keto body levels and adjust your diet if necessary

As with many things in nutrition, achieving and maintaining a state of ketosis is a very individual matter. For this reason, it can be helpful to test your levels of ketones to ensure you are achieving your goals.

The three types of ketones - acetone, beta-hydroxybutyrate and acetoacetate - can be measured in breath, blood and urine. Acetone is found in the breath and studies have shown that testing breath acetone concentrations is a reliable way to monitor ketosis in people on a ketogenic diet (35, 36).

There are meters that you can use to measure the amount of acetone in your breath. After you breathe into the meter, a colored indicator shows you whether you are in ketosis and how high your levels are.

Ketones can also be measured in the blood using a meter. Similar to a blood glucose meter, a drop of blood is applied to a measuring strip, which is then inserted into a meter. This meter measures the concentration of beta-hydroxybutyrate in the blood and has proven to be a valid indicator of the degree of ketosis (37). The disadvantage of measuring ketones in the blood is that the strips are very expensive.

Finally, the ketone that is measured in urine is acetoacetate. For this purpose, so-called ketostix are dipped into the urine and change color from pink to purple depending on the amount of keto bodies. A darker color is synonymous with higher concentrations of ketobodies.

Ketostix are easy to use and quite inexpensive. Although their accuracy for long-term use has been questioned, they should be able to provide reconfirmation that you are in a state of ketosis when starting a ketogenic diet.

A recent study found that ketone body concentrations are highest in the early morning and after dinner during a ketogenic diet (38).

Using one or more of these methods to measure ketone body levels can help you determine if you need to make any adjustments to your diet to achieve a state of ketosis.

References:

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Source: https://www.healthline.com/nutrition/7-tips-to-get-into-ketosis#section7

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