If I had a dollar for every time I heard some variation of the title of this column, I’d be a very rich man. Ever since I started on my n=1 nutritional ketosis experiment in May 2012 (read my four 30-day update posts: Day 1-30, Day 31-60, Day 61-90 and Day 91-120), I have seen interest that is near-unprecedented in my eight years of blogging about low carbohydrate diet and health. It just goes to show you that despite the best efforts by the media and all the so-called health “experts” trying to discredit healthy low carb living, countless numbers of people who want to lose weight and attain optimal health still believe in its amazing benefits. There’s certainly something there that warrants a closer look for those who have been struggling in their nutritional health goals.
If you’ve been following a low carb lifestyle for any length of time, you probably already understand the importance of being in a ketogenic state, where your body switches from using carbohydrates to fat — both dietary and stored body fat — and ketone bodies as its primary fuel sources. The late, great Dr. Robert C. Atkins made this key concept the centerpiece of his bestselling books. Unfortunately, dietary ketosis has been severely maligned by Dr. Atkins detractors as somehow being a “dangerous” state. “Ketosis” has a mistaken negative association with the truly dangerous and potentially fatal “diabetic ketoacidosis” that most frequently occurs in people with Type 1 diabetes. I encourage you to go listen to my podcast with Mark Sisson from the “Mark’s Daily Apple” blog in Episode 5 of “Ask The Low-Carb Experts” where we take on this misconception about ketosis.
Another problem with using the term “ketosis” alone, as Dr. Atkins did throughout his work, is that it neglects to communicate any concrete, practical meaning regarding what it takes to get there. There are true benefits from ketosis, so this understanding is crucial. This is why I believe the phrase “nutritional ketosis” is a better way of framing the idea of becoming keto-adapted or fat-adapted through the use of a well-formulated high-fat, adequate (moderate) protein, low carb diet. Until you get the macronutrient mix that is right for YOU, the health benefits of nutritional ketosis will continue to elude you.
The term “nutritional ketosis” has become popular in the low carb community in recent years thanks to a series of books written by Dr. Stephen Phinney and Dr. Jeff Volek. They first used the phrase “nutritional ketosis” in their 2010 New York Times bestselling book The New Atkins For A New You (written with Dr. Eric Westman). Phinney and Volek continued to use and define the term in their subsequent books The Art And Science of Low Carbohydrate Living and The Art and Science of Low Carbohydrate Performance. This branding of the “nutritional ketosis” concept has been the best addition to the low carb vernacular since many stopped calling low carb a “diet’ and started calling it a “lifestyle.”
So what’s the difference between “nutritional ketosis” and the ketosis that has been a part of the Atkins diet for the past four decades? It’s a subtle but very important distinction. First, though, let me express my incredible gratitude to Dr. Atkins for helping to change my life through his diet. Starting at 410 pounds in 2004, I lost 180 pounds that year and my life has never been the same. I’m honored and blessed to have a very popular health blog and three podcasts dedicated to spreading the message of low carb living to the masses.
Though I never had the privilege of meeting him, none of that would have been possible without the inspiration and education that came from that amazing man. His legacy is still making ripples in the world nearly a decade after his tragic death following a slip-and-fall accident on an icy New York City sidewalk. His memory lives on through those of us who have picked up the baton and continued the race. God bless you Dr. Atkins for saving my life, and the lives of millions of others who benefit from your passionate zeal about low carbohydrate nutrition, and what it can do for those who want to become healthy.
If Dr. Atkins were still around today, I’m sure he’d be all in favor of this notion of “nutritional ketosis.” So what exactly is the difference and distinction between nutritional ketosis and Atkins? Nutritional ketosis (measured by blood ketones) is ketosis, but ketosis (measured by urine ketones traditionally by Atkins and low-carb dieters) may not necessarily be nutritional ketosis. Traditionally, ketosis has been measured with urine testing strips. These turn some shade of pink or purple when you are excreting ketones (acetoacetate) in your urine. But in their Performance book, Drs. Phinney and Volek recommend measuring blood ketones (beta-hydroxybutyrate) as a better and more reliable way of gauging ketone levels, allowing you to aim for the optimal range of 0.5-3.0mm. The two most popular brands of blood ketone meters are Precision Xtra and Nova Max Plus. Both provide invaluable information about your level of nutritional ketosis. While test strips for these meters can be pricey, ranging from $1-6/strip, it’s so worth knowing exactly where you stand when it comes to your low carb lifestyle. A Google search will help you turn up the cheapest sources for a monitor and strips.
If you haven’t yet tested your blood ketone levels and wanna take a peek at how well you are doing on your chosen low carb plan, I highly encourage you to pick up a meter and test for yourself. Back in May, when I did this for the first time, I was shocked to see my blood ketones measuring in at a paltry 0.3. I’d been eating what I thought was a pretty good high-fat, moderate protein, low carb diet for close to nine years! In my next CarbSmart column, I’ll be sharing more about the mistakes I believe I was making in my low carb plan that prevented me from attaining nutritional ketosis and what you can do to get there to experience the incredible health benefits that come from it.