February 2, 2016

Being Fat Adapted Versus "In Ketosis" (Pt.3/3)






Now that the issues of fat adaptation and fat loss versus ketosis—or the lack thereof—have been clarified, let’s move on to a related issue that drives me crazy: newbie low-carbers freaking out if they eat something that not only takes away that beloved purple, but—gasp!—causes the scale to go up a few pounds.

When a low-carber who doesn’t understand some basics about human physiology gains weight after indulging in a pile of something sweet or starchy, they go absolutely apoplectic. Not knowing any better, they step on the scale the next day, see that their weight has gone up a few pounds, and they Just. Freak. Out. I can’t count how many times I’ve seen people post to forums and message boards either in tears or in a raging anger, because they ate a donut, or a bagel, or two slices of pizza, and gained, say, four pounds the next day. They then fall into thinking that their body is so fundamentally carbohydrate intolerant that after indulging in one carbohydrate-laden meal, they gained, overnight, four pounds of fat. (Never mind that the total weight of the amount of food they consumed for the entire day probably didn't even weigh four pounds, let alone that one bit of carb splurge, so I don't see any logic to how they think this works, but I digress.)

I’m not really sure how to talk about this without expressing grave concern over these well-intentioned folks’ ignorance as to the inner workings of their own bodies. (And by “expressing grave concern,” I mean, “shaking my head at the utter lunacy out there.”)

Time for a quick lesson in glycogen storage. 



Glycogen is the stored form of carbohydrate in our bodies. It is stored in the liver and in the muscles, but the muscles have a much greater storage capacity than the liver. For every gram of glycogen stored, the body also hangs onto about 2.5 grams of water. That’s right—over twice as much. If someone is following a low-carb diet, generally speaking, their glycogen levels will be lower than if they were eating lots of carbs. (Glycogen is never fully, completely depleted, not even when someone “hits the wall” or “bonks” during an endurance race.) So when they decide to indulge in a carbohydrate-heavy meal, their glycogen stores are champing at the bit to be refilled with all that nice carbohydrate. The obvious result will be a relatively quick increase in scale weight, thanks to all the water being hoarded along with the glycogen.

Remember, too, that insulin affects sodium retention in the body, and the physiology adage is that "water follows sodium." Higher insulin levels ---> more sodium, and therefore, more water, being retained by the body.  

This is NO BIG DEAL to people who understand that this is just water, and in a day or two of getting back to their normal low-carbing, it’ll be gone. Remember when you first went low carb and lost a bunch of weight rather quickly? Well, some of that was all the water being released as your glycogen stores were being reduced. The rapid gain of scale weight is simply this process happening in reverse. It’s not body fat, and it has not, in one fell swoop, completely undone whatever progress has occurred up until then. Most veteran low-carbers know this, and a bump of a few pounds here and there doesn’t worry us. It’s usually the newbies who feel completely dejected. My advice to them is: STAY OFF THE SCALE, SILLYHEADS! Now that you know a carb-fest will cause the scale to go up a little for a day or two after, why do that to yourself? Why subject yourself to the mental torture you know will likely ensue? Stay off the scale for a couple of days, until your body has let go of that very temporary extra water.

But that’s specific to weight. What about ketosis and fat adaptation? Well, the answer is different, depending on how long someone’s been low-carbing, and how well adapted they are to running on fat. The longer someone’s been at it, and the longer they’ve been fat-adapted, the less impact an occasional carb-fest will have. On the other hand, for someone who’s new to this, the more often they stray from low-carb, the more difficult it will be for their body to even become truly fat-adapted, never mind staying there in the face of a big carb onslaught.

As I explained in the previous post, ketosis is fragile and fleeting. Fat adaptation is hardier. It’s quite easy to get rid of ketosis. It’s much harder to undo years (or even several months) of fat adaptation.

To share another example from my own personal experience with all this (any of you getting tired of me talking about myself?), I’ll share with you what happened the first time I attempted a low-carb diet, and then what I’ve learned more recently, after having been a low-carber for several years.

The very first time I tried to lose weight via low-carb was in 2000. I was a college senior, and I guess I just wasn’t quite ready to really do it. I would start the day very well, but invariably, I would eventually be confronted with temptation. Whether it was someone bringing in cake at my work-study job, free cookies at an editorial board meeting for the literary journal, or just me being tempted by pretzels, rather than string cheese, in the campus grab-and-go snack shop, I don’t think I made it even two days in a row of sticking to low-carb. Not surprisingly, my body never got into that awesome zone where it was running primarily on dietary and stored fat. Every time I ate a cookie, or savored cake frosting, I was putting up a roadblock to my body becoming  a “fatburner,” rather than a sugar-burner.

Fast forward sixteen years, and I know far more about all this now than I did back then. I’ve been low-carbing for about twelve years now (having finally started and stayed with it since mid-2003). And while I have always made it clear that I am by no means super-strict all the time, overall, even on my highest-carb days, and through my longest bouts of slightly higher carb intake, I was and am still low-carb compared to anyone eating the standard American diet. So my body is quite well fat-adapted, whether or not I’m in ketosis. And the occasional carb bender really doesn’t affect me much. I don’t get a headache the next day, I don’t feel sluggish, there’s no brain fog, and I don’t crave yet more carbohydrate. Sure, I’ll be a little bloated, but that’s just water, and I know it’ll be gone quickly. (Even more quickly if I work out, with the intent to get rid of that glycogen & water asap.)

I began the first post in this short series with a list of things urine ketone strips are not good for. So let’s end with what they are good for: 
  • Encouragement
  • A confidence boost
  • Visual confirmation that, at least to some degree, your body is burning fat. (They cannot tell you, however, whether it is the fat from your food, or the fat from your arse. [Or your belly, hips, thighs, upper arms, or second chin.])
  • Visual confirmation that your body “works.” (Meaning, it is doing what it’s supposed to do when you cut back dramatically on carbs.)
  • At least some feedback about the metabolic state of your body around the time you tested.

In conclusion, urine ketone test strips are not useless. They can be quite handy, provided we understand how to interpret the information they give us, and provided we use them as tools to help us reach our end goals, rather than using dark purple as the end goal, itself. (After having attended a conference on ketogenic & metabolic therapies this past weekend, I'll be posting an addendum to this series at some point, and I'll talk just a little more about how much we don't know yet about whether higher ketones [say, BOHB at 3-5mM, rather than 1.5-3mM] are important for anything except bragging about them on social media. They may or may not be helpful for managing certain medical conditions...a lot is as yet unknown, but we do know that higher ketones do not cause magic fat loss.)


For more on this topic, check out what other folks have to say (all of whom are far more succinct than I am): 



P.S. Regarding getting rid of water and glycogen after a little carb-up, whether intentional or unplanned: there are ways to speed up the process. First, drink plenty of water. (Yes, even though you’re trying to get rid of some.) Fasting will help, too, even just 12 hours or so. Just try to go several hours without eating. This will reduce liver glycogen. The extra weight & water you’re carrying, however, is mostly wrapped up in muscle glycogen, and the way to reduce that is through physical activity. An intense workout would be best—maybe some sprints, or something else hard & fast. (Umm...) You could start the morning with a fasted walk, which will help, too, but at some point during the day, something intense will be more effective. Your mitochondria will thank you.


P.P.S. I have never used a blood ketone meter, but I am most definitely interested in getting one, if any manufacturers out there want to send a meter and some test strips my way. ;-)  (To my Australian readers [if there are any of you] – I’m told you can get these much cheaper than in the U.S. If this is true, and you’re interested in a little deal, let me know!)








Remember: Amy Berger, M.S., NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

23 comments:

  1. I've just discovered your blog - and can't wait to go back a bit and read what I've missed. I've been LCHF for about 4-5 years now. Like yourself, not always super strict, but have always managed to lose whatever weight I gained from overindulgence, and lost it in short order. But, right now, I have increased my fat intake and completely abstaining from sugar and 90% grain free, and my weight is going up. Steadily, over the past month, about 4 lb. Trying not to freak out, wondering if it's possible to eat too high fat? Currently at about 60-70% fat depending on the day, carbs less than 50 and that from veggies. I've made a real effort to be strict since Christmas was a disaster. I know enough not to step on the scale after a 'slip' as it does take a couple of days to see things go back to normal but this month is trying my patience - rather January. Any suggestions? I thought I knew what I was doing, but I'm a bit perplexed at the moment. I don't want to let the weight climb too high, I'm well past my scream weight as I was up after the Christmas debacle. Thanks.

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    1. Hey Isabel, welcome to my little corner of the low-carb world. :) It's hard for me to comment on your weight gain without knowing how much you weigh, your height, age, etc. It all plays into things, but the short answer is, yes, it is absolutely possible to consume too much fat on a low-carb or ketogenic diet. If your goal is specifically fat loss, and you are less concerned about maintaining a constant state of high-ish ketones, then generally speaking, going a little lower on fat will help. Make sure you're not skimping on protein. For fat loss, it helps to make sure you're getting enough protein (many women aren't), don't be afraid of fat, but don't go out of your way to add lots and lots of *extra* fat to things, and don't be afraid of non-starchy vegetables. I think the die-hard keto crowd is starting to do some of us a disservice by making people scared of protein and broccoli. Not all of us do so well with "MOAR FAT." Those extra Tbsps of butter and olive oil still have to *go somewhere,* and if you're not burning them, they might go to ... your hips, your belly, your thighs...

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    2. Thanks Amy. Delighted to get a reply! I did wonder about the fat. Such. I think I need to get myself together and make a list of all my questions and perhaps book a chat with you.

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  2. Hey Amy, if you're interested in a ketone/glucometer many manufacturers will send you one for free since they assume you're diabetic and buying strips for life, strips is the hard part since they're expensive in the US (about half the price online in Canada too, give it a google).

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    1. Yeah, it's not the meter, it's the strips where they get you. I'll give in at some point and get one. I don't plan to test often, but it would be nice to check once in a while, especially if I'm aiming for higher ketones at some point. (Not usually, but now and then.)

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  3. The Australian company is http://www.ketosistools.com/collections/ketone-strips
    However, after two months ago Dr. Ede ordered 150 strips for $165.90 including the shipping, saving almost 65 dollars, they have been sold out.
    Noora

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  4. Female newbies also panic as they approach that time of the month where there is some water weight gain. When I was cycling it was about 3 pounds each time, often followed by a "whoosh" after my period started that sometimes took off more than just the three pounds.

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  5. Thanks for this series, Amy. As usual, a broad assessment of the dynamics regarding being in ketosis and being fat adapted. Ketosis is a candidate for one of the more misunderstood aspects of LCHF. Your thorough treatment did this topic justice.

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  6. Check ebay in Australia. You can get them cheap there. Search for freestyle. If you get stuck, let me know I can organise one for you I'm sure.

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  7. the group I'm in is always pushing fat.. I'm thinking I should cut it down... I usually eat 18-20 carbs a day and 70% of my diet is fat and 25% is protein...But I always feel hungry even tho I'm eating 1400 calories a day... frustrating

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    1. Unless there is a specific reason why you *need* to follow a medically therapeutic ketogenic diet, eating that was can be counterproductive for certain other goals. Why are you eating so few carbs? The goal is to feel well and be healthy; not to be perpetually in ketosis for the sake of being in ketosis. Re-evaluate your goals and ask yourself is this is the best strategy for you to achieve them. 18-20g carbs/day is probably far too restrictive for you and most likely completely unnecessary. Higher carbs, a little less fat, and maybe more protein. Protein should be a *gram* goal, not a percentage goal. Personally, I've always found that *protein* satiates me far better than fat. Please do not avoid perfectly good non-starchy vegetables out of some misguided terror of going over some completely arbitrary and ridiculously low daily intake of carbohydrate. I have an epic rant about this issue coming up in a few weeks.

      If you'd like to discuss issues further, please consider booking a phone session: http://www.tuitnutrition.com/p/services.html

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  8. Hey Amy! How long do you think one should eat strictly low carb to become fat adapted? I don't intend to cheat, but sometimes I'd like to have something more carby and don't want to obsess about interrupting the process or something. Right now I'm on week 2, I plan to be strict for 4 weeks minimum, but not sure whether to be strict longer.

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    1. It really depends. Probably at least 6 weeks, if not more. If you're athletic and very active, you probably have more leeway with eating carbs, whether you're fully fat-adapted or not. ;-) Just don't fall into the trap of being obsessed with chasing high ketones. As this series is intended to explain, you need not be in ketosis to have a fat-based metabolism and reap the benefits of low-carb. Most people really don't need to be as restrictive as 20-30g of carbs per day. I've been getting way too many clients lately who are following super-strict medically therapeutic-type ketogenic diets and *not* doing well. I have to convince people to eat *more* carbs! (Not like 200g/day or anything, and not necessarily from grains and sugar, but more like 40-70g, from larger portions of vegetables and a greater variety. No one ever became obese or diabetic from too much eggplant...)

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    2. Thank you Amy :) Honestly, I've been doing low carb for almost 8 months, but I've cheated every week or two and figured out I've never got truly fat adapted. I decided to "man up" and will try to do these 6 weeks at least, maybe 8.

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  9. Wow! What a great article! I'm still a newby at this 10 weeks, and to have all of this information summarized so succinctly is very reassuring that what I have observed during this period of time is *all* normal!

    I've never really panicked about anything that I observed (except for that one period where I had a bad keto flu, started a new workout plan at the gym and couldn't remember anything that I had done the next time I went back) but I am curious about one thing:

    I bought the keto stix when I started my keto diet but only because I wanted to see them turn purple :) Everything I've read said that when I fat adapted and my body is burning ketones efficiently that the stix probably won't work any more. I still always show up as dark purple.

    Like I said, I'm not worried about it and after reading your article I'm really not worried about it, and I wouldn't be worried about it if they stopped showing purple altogether, but since I'm not cheating, should I expect them one day to not show up as purple or is dark purple just normal for me?

    Cheers!
    Ken

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    1. Thanks for reading, Ken. :) (And thanks for sticking through until part 3. Based on page views, it looks like most people read part 1 and then quit, which is a shame, because I think part 2 is probably even more important.) As for the keto strips, honestly, it varies. I know a lot of long-time low carbers who still show pink/purple after years of eating this way. Maybe not all the time, every day, but they'll see a color change regularly enough that they know they're still in a good place, fuel-burning-wise. Just remember that *any* color change is fine. No need to see dark purple all the time. Even just light pink shows you're running on fat -- and even if you *don't* see it, you could very well still be running on fat and just not excreting *extra* acetoacetate into your urine. Don't get too hung up on things either way. If you do see a color change on the test strips after months (or years), that's fine, and it's also fine if you don't. ;-) (There's nothing "wrong" with you if you continue to see the color change, even if strangers online claim that when you are truly fat- or keto-adapted, they won't change.)

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  10. very interesting, ive been keeping my macros to 80%fat, 15%protein and 5%carbs and after an initial drop my body fat has stalled the last month. I also realize now ive maybe gone a bit crazy panicking if i eat too much brocoli as my carbs will go up! will try relaxing my 20g total carb plan ive been sticking to :)

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    1. You might do even better cutting back a little on fat and increasing protein. Percentages are pretty meaningless for me without knowing what your actual *grams* of prtein, fat, and carbs are. I'm starting to see far too many low carbers skimping on protein because they've become afraid of consuming "too much protein" and causing gluconeogenesis. This is madness, and I have a post coming up about it. Please make sure you're not UNDER-eating protein. Depending on what your total calories are, 80% fat is quite high, unless you need to follow a medically therapeutic ketogenic diet. If your main goal is fat loss, consider increasing protein slightly and cutting back on fat. You want more of the fat that is fueling you to come from your stored body fat, rather than massive amounts of fat added to your plate. ;-)

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  11. Thank you!! As a race we are obsessed with bloody numbers!!! Money, time, measurements of all sorts! How on earth did the human race exist without numbers when they didn't have them LOL! I'm starting a new business that aims to help our ever growing nation get back their health and one of the things I have decided is that they will only weigh and measure once a month to try and get them out of this obsession! Being a Relational Psychotherapist I am constantly working with this obsession with numbers!

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