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| The Atkins Nutritional Approach is perfect. It teaches you how many carbs you can eat and still lose weight without being hungry! |
In 2012, the low-carb community began awakening to the reality of ketosis and its importance in achieving your weight-loss goals. Up to that point, ketosis was just taken for granted.
Eat fewer carbs than the brain needs to sustain it's life and the liver has to tap into its glycogen stores, the storage form of carbohydrates. If glycogen gets low enough, as it does on low-carb diets, then you'll automatically force the body to switch to the alternative metabolic pathway.
Or so we thought.
Turns out the process of getting into ketosis and staying there for maximum fat-burning efficient is more complex than we realized. But was this awakening to complexities of nutritional ketosis just another trick to get the scales moving again?
Was the low-carb community buying into another deception as to what ketosis is and what it does for you?
Most of the things taught about ketosis, insulin, and low-carb diets is just theory.
These ideas started out as an hypothesis (a guess as to why low carb works) and evolved into theory as more and more individuals accepted the Insulin Hypothesis as fact.
What many low-carb advocates believe has never been proven to be true.
The difference between hypothesis and theory is how many people believe it. Hypothesis has a small group of believers and theory has a much larger group of advocates, but hypothesis and theory both only function within the world of imagination. Neither hypothesis, nor theory, are fact.
So what's the truth about ketosis?
And how important is ketosis to your low-carb diet?
The Truth About Ketosis
The state of ketosis is not necessary to achieve a healthy weight.Many people lose weight easily even though they have high basal insulin levels, provided they are eating at a calorie deficit. At the fundamental level, all weight-loss diets work the same way. They create an energy imbalance to force the body to use its body fat for fuel until equilibrium can be attained.
And the same holds true for low-carb high-fat diets (LCHF).
How the LCHF Diet Was Born
In 2012, one of the low-carb influencers felt he had it all figured out.After reading The Art and Science of Low Carbohydrate Performance, a book written for endurance athletes, Jimmy Moore ran a n=1 experiment on himself to see if the principles of Nutritional Ketosis, as described in that book, would help him manage his weight, as well as improve his athletic performance.
(Available at Amazon)
He purchased a blood ketone monitor and checked out his level of ketones in the blood. It wasn't very good, so he adjusted his protein and fat intake to give him the blood ketone level he wanted to see.
That blood ketone level required him to lower his protein to about 80 grams a day, which upped his dietary fat to 80 percent of his calories.
(Available at Amazon)
Since the dietary manipulations Jimmy implemented resulted in his weight finally starting to go down again, a huge portion of the low-carb community decided to follow in his tracks.
As people purchased the blood ketone meter that Jimmy recommended to his audience, many people discovered that their own ketone level was not within the optimal range for Nutritional Ketosis, as defined by Dr. Phinney.
They also discovered that they needed to lower their protein intake and up their dietary fats to force their ketones to rise into this optimal range.
However, many low-carb dieters started to think that if 1.5 to 3 mmol/L was an optimal level of ketones in the bloodstream, then going higher than 3 mmol/L was even better.
As a result of this type of distorted thinking, many people lowered their protein level to only 50 grams a day, or less, in order to achieve maximum ketones in the bloodstream.
What these dieters didn't understand was that when your ketones soar above 3.0 mmol/L, starvation kicks in because you aren't eating enough protein to supply the body with the amino acids it needs.
While the body will be perfectly content to live off its old protein structures for a few days, it can't keep doing that forever.
In addition, people were extremely confused over what was optimal for LCHF weight loss. According to one of Dr. Phinney's videos, the best ketone level for weight loss is about 1 to 1.5 mmol/L, or so.
The 1.5 to 3 mmol/L reference point that many people use to justify their ketone starvation has to do with athletic performance. The slightly higher ketone level was a sign that the muscles had plenty of fatty acids, so long-term physical activity would not be compromised.
Athletes use these extra ketones to fuel their activities.
For standard weight loss, and for those with sit-down jobs, any level between 0.5 and 3 mmol/L works BEST because the ketones in the bloodstream, once the muscles have adapted to burning fatty acids for fuel, are only used to fuel the brain.
Ketones do not fuel the whole body except when:
- you are not fat adapted
- you are an endurance athlete and need to fuel your activities
But those ketones can come from your diet. There is no guarantee that they will come from your fat stores. Neither is there any guarantee that you will lose weight if you are in ketosis. You can definitely be in ketosis and not lose body fat. This happens all the time due to the misconceptions and misunderstandings about nutritional ketosis and weight loss.
Like their presence in the urine, ketones in the blood does not mean that you are burning body fat.
Where Did the Low-Carb Community Get Off Track?
The Art and Science of Low Carbohydrate Performance is not a weight-loss book.
It is a book about fueling your workouts and athletic activities with a high-fat, moderate-protein, low-carb maintenance diet. This diet was designed for endurance athetes who wanted to use carbohydrate restriction for weight maintenance.
In the introduction of that book, the authors recognize the individual differences in metabolism, and admit that low-carb diets are not suitable for everyone:
"If you are completely content with your body, health, and performance on a high carbohydrate diet there is probably no reason to consider a low carbohydrate diet. If it isn't broke, don't fix it.
"But if you have hit a plateau, are in a rut, suffer from overtraining, have trouble recovering from your workouts, want to change your body composition, or simply want to experiment with how your body adapts to restricting carbohydrate, then this book is for 'You.'"
The book further defines who it was written for:
- elite athletes
- coaches
- trainers
- dietitians
- physicians
- scientists
- casual fitness enthusiasts
- week-end warriors
- veterans of the gym
This was a second book in this two-book series.
(Available at Amazon)
The Art and Science of Low Carbohydrate Living is a weight-loss book written for physicians that put forth the idea that a low-carb diet was the best approach for those trying to manage insulin resistance.
Insulin resistance is defined by the authors as carbohydrate intolerance. This first book was a weight-loss book.
The Art and Science of Low Carbohydrate Performance, however, was not written for those with insulin resistance.
"On the continuum of insulin resistance, athletes as a group cluster on the side of insulin sensitivity. Thus athletes do not have anywhere near the same level of carbohydrate intolerance as someone who is overweight and has metabolic syndrome or diabetes."
The Art and Science of Low Carbohydrate Performance was written for endurance athletes, who are insulin sensitive, and can't fuel their activities with glucose long enough to avoid hitting the wall. It was not written for those with insulin resistance, pre-diabetes, or those having trouble losing weight.
Dr. Phinney and Jeff Volek showed these athletes who didn't have metabolic syndrome or diabetes how to fuel their extended workouts and other physical pursuits with dietary fat.
This is a key point.
Jimmy Moore took the principles designed for insulin-sensitive athletes as the basis for his personal dietary experiment and many of his non-athletic, insulin-resistant followers copied what he did, hoping to achieve the same results that Jimmy got.
The book was not written for those who play basketball a couple of times a week or have a great interest in lifting weights or going to the gym. Endurance sports is a whole other thing.
A Closer Look at the Ketogenic Diet's Beginnings
When Dr. Atkins was young, he was one of those kids who
could eat anything he wanted and not gain weight.
In the early 60s, however, he found himself with three chins looking 15 years older than he was. This sudden self-realization was a critical turning point in his life. He had to face what he’d become:
Although Atkins knew he needed to do something about his condition, like most of us, he was afraid of being hungry. He didn’t want to reduce his portion sizes and go on a low-calorie diet. He wanted something magical. He wanted to find the easy way to get thin.
In the early 60s, however, he found himself with three chins looking 15 years older than he was. This sudden self-realization was a critical turning point in his life. He had to face what he’d become:
A FAT MAN!
Although Atkins knew he needed to do something about his condition, like most of us, he was afraid of being hungry. He didn’t want to reduce his portion sizes and go on a low-calorie diet. He wanted something magical. He wanted to find the easy way to get thin.
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| Atkins approach teaches you how many carbs you can eat and not be hungry. |
As a doctor, he knew that hunger caused diet failure. As a cardiologist, his medical training wasn’t in nutrition
and metabolism. This lack of training allowed him to be more open to the new possibilities he
was seeing in the medical literature of that time.
In his search for a diet that wouldn’t make him hungry, Atkins ran across a study that suggested a metabolic defect in the way the body handled carbohydrates was the cause (or blame) for most overweight conditions.
In his search for a diet that wouldn’t make him hungry, Atkins ran across a study that suggested a metabolic defect in the way the body handled carbohydrates was the cause (or blame) for most overweight conditions.
In the 60s, a few people discovered, by accident, that carbohydrate
restriction worked. Even though cutting back on bread, potatoes, and dessert was
a popular low-calorie notion at that time, counting carbohydrate grams was relatively
new.
I can still remember the before-and-after pictures in diet magazines.
These advertisements recommended that you buy their homemade booklet to discover the secret to lasting weight loss. The booklet, which promised you this would be the very last book you would ever need to buy, was printed in someone's garage.
Spiral bound, they were sold through back-of-the-magazine advertisements instead of in your local book store.
I know this for a fact because I bought one.
I can still remember the before-and-after pictures in diet magazines.
These advertisements recommended that you buy their homemade booklet to discover the secret to lasting weight loss. The booklet, which promised you this would be the very last book you would ever need to buy, was printed in someone's garage.
Spiral bound, they were sold through back-of-the-magazine advertisements instead of in your local book store.
I know this for a fact because I bought one.
What intrigued Atkins in the 60s wasn’t these 60-gram carbohydrate-restricted diets that closely resembled what William Banting did a
hundred years before.
What caught Dr. Atkins’ attention was:
It might surprise you to learn that Dr. Atkins did not actually create the ketogenic diet.
In fact, one of the scientific papers he looked at during the 60s was a study that Dr. Alfred W. Pennington had done for the DuPont company on several of their employees.
It was Pennington who came up with the idea that a carbohydrate metabolic defect sat at the heart of overweight and obesity – not Dr. Atkins.
What caught Dr. Atkins’ attention was:
KETOSIS
It might surprise you to learn that Dr. Atkins did not actually create the ketogenic diet.
In fact, one of the scientific papers he looked at during the 60s was a study that Dr. Alfred W. Pennington had done for the DuPont company on several of their employees.
It was Pennington who came up with the idea that a carbohydrate metabolic defect sat at the heart of overweight and obesity – not Dr. Atkins.
Dr. Walter Lyons Bloom was also doing work during that time. His work centered on the metabolic changes a carbohydrate-free diet produced.
When Dr. Atkins read that the disappearance of hunger occurred within only a few days on a zero-carb diet, he was hooked.
It was exactly what he was looking for:
When Dr. Atkins read that the disappearance of hunger occurred within only a few days on a zero-carb diet, he was hooked.
It was exactly what he was looking for:
- bacon and eggs for breakfast
- with plenty of meat and salad for lunch and dinner
After the zero-carb start, Dr. Atkins experimented with returning a
small amount of carbohydrates to his diet. This widened his food choices and made the diet more tolerable and sustainable. He believed that as
long as the urine test strips were turning purple, he was burning his body’s
fat stores.
This wasn't biologically accurate because the strips will turn purple if you're eating at 80 percent fat or not drinking enough water, but in the 60s, the Atkins Diet wasn't a high-fat diet.
Through trial-and-error, Dr. Atkins learned that he could eat about 35 to 40 grams of carbohydrates per day and still turn the test strips purple if he added them back gradually enough. This held true even with an occasional Scotch and water before dinner.
This wasn't biologically accurate because the strips will turn purple if you're eating at 80 percent fat or not drinking enough water, but in the 60s, the Atkins Diet wasn't a high-fat diet.
Through trial-and-error, Dr. Atkins learned that he could eat about 35 to 40 grams of carbohydrates per day and still turn the test strips purple if he added them back gradually enough. This held true even with an occasional Scotch and water before dinner.
Because of his fear of hunger, Dr. Atkins ate several small meals
throughout the day instead of two or three.
At the end of six weeks, he had lost 28 pounds!
The weight loss caused some mixed emotions. He felt excited and satisfied with the weight loss, but he also felt resentment toward what he believed was deception by the medical community.
What he had discovered was that focusing on calories was not the only way to lose weight. You could also lose weight by going into the state of ketosis.
When in ketosis, Dr. Atkins felt like he was eating all day long. He ate as much as he wanted to eat, and he ate often, going home from work during the day to fill up again, so he wouldn't risk getting hungry.
Since he was able to lose 28 pounds eating well, in his mind, the low-calorie theory had to be wrong.
This was his hypothesis. Ketosis was how Dr. Atkins was able to explain why he lost weight without following a typical low-calorie diet.
At the end of six weeks, he had lost 28 pounds!
The weight loss caused some mixed emotions. He felt excited and satisfied with the weight loss, but he also felt resentment toward what he believed was deception by the medical community.
What he had discovered was that focusing on calories was not the only way to lose weight. You could also lose weight by going into the state of ketosis.
When in ketosis, Dr. Atkins felt like he was eating all day long. He ate as much as he wanted to eat, and he ate often, going home from work during the day to fill up again, so he wouldn't risk getting hungry.
Since he was able to lose 28 pounds eating well, in his mind, the low-calorie theory had to be wrong.
This was his hypothesis. Ketosis was how Dr. Atkins was able to explain why he lost weight without following a typical low-calorie diet.
But is that it?
Is ketosis magic?
Dr. Atkins was not fat adapted when those pounds flew off. His body had never used the famine pathway before, so it was dumping huge amounts of acetoacetate ketones into the urine.
These ketones are not the type of ketones that fuel the brain very well, so the body gets rid of them.
Eventually, after adaption, the muscles become insulin resistant and stop using glucose from the blood. Acetoacetate ketones are then converted into a more usable form for the brain, and fewer acetoacetate ketones are cast off.
But, initially, this doesn't happen quickly, so weight loss for a newbie can be rather dramatic during the first few weeks. When I restricted carbs for the very first time, I lost 5 pounds per week, every single week, and was at goal weight within six weeks before I had a chance to become fat adapted!
These ketones are not the type of ketones that fuel the brain very well, so the body gets rid of them.
Eventually, after adaption, the muscles become insulin resistant and stop using glucose from the blood. Acetoacetate ketones are then converted into a more usable form for the brain, and fewer acetoacetate ketones are cast off.
But, initially, this doesn't happen quickly, so weight loss for a newbie can be rather dramatic during the first few weeks. When I restricted carbs for the very first time, I lost 5 pounds per week, every single week, and was at goal weight within six weeks before I had a chance to become fat adapted!
What Made the Atkins Diet Different from Others?
This first Atkins Diet that Dr. Atkins presented to the world in 1972 was a
ketogenic diet.
It placed the body into a state of ketosis and kept it spilling ketones over into the urine, which Dr. Atkins considered a sign that the body was continuing to mobilize its fat stores. While this wasn't exactly correct, the ketone test strips were the best way Atkins knew to measure ketones outside of a blood test.
Unlike the 60-gram carbohydrate diets popular during that time, Dr. Atkins’ original diet focused on those who were more insulin resistant than those who could lose weight easily at a 60-carb intake.
This is what made the Atkins Diet different from the others.
He cut carbohydrate sources low enough and added them back gradually enough that almost everyone who tried the Atkins Diet at that time succeeded.
It placed the body into a state of ketosis and kept it spilling ketones over into the urine, which Dr. Atkins considered a sign that the body was continuing to mobilize its fat stores. While this wasn't exactly correct, the ketone test strips were the best way Atkins knew to measure ketones outside of a blood test.
Unlike the 60-gram carbohydrate diets popular during that time, Dr. Atkins’ original diet focused on those who were more insulin resistant than those who could lose weight easily at a 60-carb intake.
This is what made the Atkins Diet different from the others.
He cut carbohydrate sources low enough and added them back gradually enough that almost everyone who tried the Atkins Diet at that time succeeded.
He believed that the urine test strips coincided with the state of ketosis. If the diet wasn’t working, you were doing something wrong. He based
his opinions on his personal experience, the experience of his co-workers, and
the experience of his patients.
It was all just his best guess at the time for why the diet worked.
Fatty acid adaption changes the playing field a little bit, but it doesn’t rule out Dr. Atkins’ belief that you need to stay in ketosis for the full length of the weight-loss period to get the benefits that ketosis offers.
Since his original diet was ketogenic, it was designed to remain ketogenic throughout the weight-loss stage. This makes the state of ketosis extremely important to the diet’s outcome.
But why?
It was all just his best guess at the time for why the diet worked.
Fatty acid adaption changes the playing field a little bit, but it doesn’t rule out Dr. Atkins’ belief that you need to stay in ketosis for the full length of the weight-loss period to get the benefits that ketosis offers.
Since his original diet was ketogenic, it was designed to remain ketogenic throughout the weight-loss stage. This makes the state of ketosis extremely important to the diet’s outcome.
But why?
How Important is Ketosis to Weight Loss?
Dr. Bloom’s diet was only a three-day diet. It wasn’t created to treat insulin resistance. It was a study that was designed to observe the metabolic effects that occur when you cut carbohydrates completely out of your diet.
It included:
- bacon and eggs
- meat, poultry, fish
- lettuce salad
- with an oil-and-vinegar dressing
Dr. Atkins took that study diet and added additional no-carb and very low-carb foods in a specific way.
The design was perfect.
It teaches you exactly how many carbohydrates you can eat and still lose weight without being hungry.
What wasn't perfect is the way we choose to implement the diet, or any low-carb diet for that matter, outside of Dr. Atkins office.
What isn't perfect is the way we read a book, such as The Art and Science of Low Carbohydrate Performance, and walk away with a distorted vision of what the authors were trying to convey.
What isn't perfect is the way we feel compelled to chase after every single new dieting scheme that someone we look up to decides to try as they struggle with their own weight management issues.
Hence, we have a multitude of low-carb dieters who:
The body doesn't LIKE it when your personalized energy equation goes out of balance. It doesn't care if you are:
From the very first day that you restrict your carbohydrates or calories, it begins to adapt to that restriction with the goal of bringing the energy equation back into balance.
You may, or may not, reach goal before equilibrium.
Restricting carbohydrates instead of calories doesn't matter. It's all the same. The body's purpose doesn't change because you decide to count a different macronutrient.
The PURPOSE of ketosis is to make dieting more comfortable.
That's it.
Dr. Atkins learned that ketosis takes away hunger and cravings after a few days, so he felt ketosis was preferable to not being in ketosis during weight loss, especially for those who have insulin resistance because the state of ketosis lowers insulin and corrects blood glucose irregularities that can make you hungrier on a low-calorie diet.
Like all weight-loss diets, the importance of the state of ketosis is simply a matter of context.
- struggle with weight loss
- stall part way to goal weight
- give up when the body reaches equilibrium
What People are Missing
The body doesn't LIKE it when your personalized energy equation goes out of balance. It doesn't care if you are:
- in ketosis
- out of ketosis
- counting calories
- counting carbohydrates
- counting fat grams
From the very first day that you restrict your carbohydrates or calories, it begins to adapt to that restriction with the goal of bringing the energy equation back into balance.
You may, or may not, reach goal before equilibrium.
Restricting carbohydrates instead of calories doesn't matter. It's all the same. The body's purpose doesn't change because you decide to count a different macronutrient.
The PURPOSE of ketosis is to make dieting more comfortable.
That's it.
Dr. Atkins learned that ketosis takes away hunger and cravings after a few days, so he felt ketosis was preferable to not being in ketosis during weight loss, especially for those who have insulin resistance because the state of ketosis lowers insulin and corrects blood glucose irregularities that can make you hungrier on a low-calorie diet.
Like all weight-loss diets, the importance of the state of ketosis is simply a matter of context.
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