Once ketone levels in the blood rise to a certain point, you officially enter into a state of ketosis. This state results in fairly rapid and consistent weight loss until you reach a healthier (and stable) body weight. Overall, people enter into ketosis at different rates, usually after 3–4 days of fasting or following a very low-carbohydrate diet (20 grams of net carbs or less) that forces the need for an alternative energy source. (3)
Over 8–10 mmol/l: It’s normally impossible to get to this level just by eating a keto diet. It means that something is wrong. The most common cause by far is type 1 diabetes, with severe lack of insulin. Symptoms include feeling very sick with nausea, vomiting, abdominal pain and confusion. The possible end result, ketoacidosis, may be fatal and requires immediate medical care. Learn more
Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
Remember the low-fat diet craze? Back in the 1990s, we were told that swapping regular cookies and chips for those labeled "low fat" would be the ticket to easy weight loss and better health. Today, it's the opposite—a low-carb, high-fat eating plan called the ketogenic diet, or keto diet for short, is getting all the buzz. Celebrities like Halle Berry, Kim Kardashian, and Megan Fox are fans; more than 7 million Instagram posts have been tagged #keto; and upwards of 1 million people search "keto diet" on Google every month.
The biggest draw for me is how many of those who’ve tried it say they don’t get hungry. The possibility of that blows my mind, as someone who’s used to any sort of calorie restriction meaning hours of feeling hungry every day. It’s tantalizing enough that I at least want to try. And what have I got to lose, right? I’m already morbidly obese; it’s hard to imagine screwing this up so bad it makes that worse.
“Eggs have a lot of vitamins like vitamin A, B complex, D, K, E, calcium, and zinc,” says Ryan Weaver, a personal trainer and keto enthusiast. “That’s why eggs are an excellent choice for breakfast when you follow the keto diet. To avoid getting bored, you can try different ways of preparing the eggs—boiled, fried, or baked. Also, you can combine the eggs with different foods like bacon, ham, cheddar cheese, butter, mayonnaise, so you get a different recipe each day although using the same main ingredient.”
• Constipation: No one likes to feel backed up, and sadly if you're not careful about your diet choices when going keto, it could become a regular concern. One 10-year (albeit small) study looking at the effects of a keto diet on young children found that 65 percent experienced digestive woes. Thankfully, going keto is not a life sentence for problem bowels. Since you're cutting out whole grains and fruit (two of the most common sources of fiber), aim to up your fiber-rich veggies, and consider a supplement.
This is an adaptation period, where we’re essentially re-training our muscles and our brain to use fat as the primary fuel source instead of glucose. This adaptation can take a couple of weeks to a couple of months. As a hallmark of being keto-adapted and not just in ketosis, the skeletal muscles are able to burn fat directly for fuel, and the brain relies on the higher volume of ketones in the blood as its main source of energy.
Symptoms of the keto flu include headache, fatigue, dizziness, sleep problems, heart palpitations, cramps, and diarrhea. These side effects usually lessen and eventually resolve in about two weeks. (2) But to lessen the effects of any discomfort, simply consider slowly transitioning onto a ketogenic diet rather than rushing to change your eating habits. By slowly lowering your carbohydrate intake, while gradually increasing your intake of dietary fat over time, you can transition with less of a negative impact and potentially prevent the keto flu.
Your lean body mass is your total body weight minus your fat. For example, if you currently weigh 180 lbs (81.65 kg) and your body fat is at 30%, your lean body mass is 126 lbs (57.16 kg). In order to obtain the amount of protein you need to eat daily, you need to multiply 126 per 0.6 to 1.2, and you’ll get a range of 76 to 151 g protein/day. 75.6 g would be the minimum amount you need in order to maintain your bodily functions and muscle mass.
• Standard ketogenic diet (SKD) — SKD is the type I typically recommend for most people, because it is very effective. It focuses on high consumption of healthy fats: As I explain in my book, "Fat for Fuel," you should aim for having 70 to 85 percent of your total daily calories to come from healthy fats. For your protein intake, the general rule of thumb is to follow the formula of 1 gram of protein for every kilogram of your lean body mass.
• Water Loss: There is some evidence that higher-protein diets like the keto diet do have some weight-loss benefits, partially because both fat and protein are satiating so you don't feel hungry, but also because of the loss in glycogen stores. Glycogen is the body's glucose storage that is bound up with water, so when we deplete the glycogen, you also deplete your water storage. Lose a ton of water, and you're going to drop weight fast.
The ketogenic diet — a high-fat and very low-carb eating plan — can be tough to start. After all, it’s likely a radical departure from the way you’re eating now (a typical standard American diet is high in carbohydrates and processed foods). But many people are trying the keto diet, which puts your body in a state of ketosis. That's what happens when your body’s carb-burning switch flips to a fat-burning one, a change that can cause weight loss and has even been credited with controlling diabetes. (1)
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