So, what is Keto? The short and most direct answer is that Keto is being in a state of ketosis. The Keto way of eating gets you into ketosis and keeps you there. This is very different then being in ketoacidosis. Let’s address what ketoacidosis is first.
From Dietdoctor.com:
Ketoacidosis occurs mostly in people with type 1 diabetes and results from a severe deficiency of insulin. In this setting, blood glucose is typically quite high, while ketone levels rise above 7 mmol/L (and usually above 10), causing the blood to become more acidic and placing the individual at tremendous risk.2
https://www.dietdoctor.com/low-carb/skeptical-doctors and
American Family Physician 2013: Diabetic ketoacidosis: Evaluation and treatment
To look at this from a normal person’s perspective, most cases of ketoacidosis occur in Type 1 Diabetics. What it means is that their ketone levels rise above 7mmol/L (if you are using a Ketone meter, like Keto Mojo, that would be 7.0 or higher. It could happen to anyone, whether you are on a Keto way of eating or not. I was talking to a former nurse one day, and she was driving herself to the hospital because she wasn’t feeling well, and they found her passed out in the hospital parking lot. They ran tests and she was in ketoacidosis. She is not a Type 1 Diabetic and she was not eating Keto. So, it could happen to anyone, at any time. But rest assured, it is rare.
Having addressed ketoacidosis, let’s talk about Keto and being in nutritional ketosis. To be in ketosis, your ketone level should be 0.5mmol/L or above, preferably lower than 5mmol/L. If you are at 0.5mmol/L or higher for a day, you are in ketosis. If you are at that level for more than a day, you are technically in nutritional ketosis. This is where it is important to be aware of your macros and what you intend to do with this way of eating.
A couple of things to be aware of specifically. Just because your ketone number is higher, does not mean that you will lose weight faster. It just means that your ketones are higher. Each persons body handles this differently, but generally speaking, between 0.5 and 1 are perfectly fine. Secondly, you do not have to check your ketones all the time, or even at all. If you wish, there are several ways you can check:
- Urine strips – This is the least expensive way to test. The urine strips check for acetoacetate which is removed from the body through your urine. The strips can be good for the first few weeks of eating Keto, but after that, they are not as much help.
- Breath meters – This is the next least expensive way to test. The breath meters check for acetone in your breath. They can be unreliable. Diet Doctor tested multiple breath meters, and this particular statement stood out to me:
“LEVL cautions against testing within 60 minutes of the following: Alcohol, breath mints, chewing gum, cough drops, throat lozenges, tobacco and e-cigarettes, lip balm, smoking, mint or green tea, mouthwash, non-sugar sweeteners (e.g., Sorbitol), toothpaste, water enhancers.” (https://www.dietdoctor.com/low-carb/keto/ketone-testing-three-ways) - Blood tests – This is the most expensive way to test, but likely the most accurate. Probably one of the most popular testers is Keto Mojo. You test your ketones as you would test your blood sugar level. You prick your finger, and measure a drop of blood on a strip. It’s pretty simple, but more expensive. The nice thing about Keto Mojo is that it also has the ability to test your blood sugar, so if you are a diabetic, you can use the one machine, however you will have to test twice as it does not combine the information in 1 test.
But remember, you do not have to test for ketosis. Simply put, if you keep your carbohydrates to 20g or less per day, you will be in ketosis. That’s it, and you will start to feel the difference pretty quickly.
But what about high fat? You don’t necessarily have to be high fat to be Keto. Maria and Craig Emmerich from Keto-adapted.com and Mariamindbody advise to focus on getting your macros correct, keep your carbs at less than 20g, and make sure to get your proper amount of protein. Depending on if you want to lose weight, maintain your weight, or gain weight, will determine how much fat you eat with your meal. They have a great calculator on their website, for free, to help you determine what those numbers are.
Next blog, I’ll talk about how to track your macros, more specifically, how to track your eating to see where your macros are.