Being Fat Adapted Versus "In Ketosis" (Pt.1/3)

UPDATE!! (9/20/2017)
I have a new post that explains how and why the body produces ketones, It will help you understand much better the difference between burning fat and having a fat-based metabolism, versus being "in ketosis." It's very long, but I think it's worth reading if you'd really like to understand this -- and if you want to stop freaking out about your ketone levels. (If you click over to that post and want to read only the section that explains the difference between ketosis and running on fat, scroll way down to where it says Ketogenesis: How and Why Do We Make Ketones? Also: Fat Adaptation versus Ketosis.) Happy reading!

“I got kicked out of ketosis.”

If I never hear or read those six words, in that order, ever again, I’ll be one happy individual.

Based on what I come across on low-carb forums, blogs, and videos, there is a lot of confusion about the correct use of urine ketone test strips (which I’ll sometimes refer to as ketostix, since “ketone test strips” is a mouthful, even when you’re only reading). So allow me to ‘splain a little bit about how to interpret these things, and what role they should play—if any—in your low-carb life.

First and foremost is the most important thing you will read in today’s post. (And it is so important that I will likely repeat it in all the posts to follow in this little series. Plus, you can tell it’s important because it’s red, bold, in italics, and all caps, hehheh.)

You can be in ketosis and not lose body fat, 

and you can lose body fat without being in ketosis.

  

Food for Thought Friday: Ketosis, Carbs, and Alcohol

I have tried to make it clear on this blog that I am not what anyone could call a “low carb zealot.” If anything, I’d like to think I offer a level-headed perspective that is sometimes missing when nutritionally-minded folks draw their lines in the sand and refuse to entertain the mere thought that their way might not be the best way or the only way for absolutely everyone else on planet Earth to be healthy and have a body that feels and looks the way they’re happy with. So let this little intro serve as a reminder that I don’t think very low-carb diets are appropriate for everyone. I don’t think half a stick of butter should be used as a condiment, and I don’t think adding 3-5 tablespoons of coconut oil and ghee to a cup of coffee is the best way for everyone to rise & shine first thing in the morning. In fact, if you were to look in my fridge and pantry right now, you might even be convinced that—shocker!—I eat plenty of vegetables along with all the yummy animal fat and protein I think are so good for us. (Also: there might or might not be a pint of ice cream in the freezer. I will neither confirm nor deny.)

That being said, I am a loyal low-carber for my own health and weight management, and I find myself bothered by an argument that pops up here and there about ketosis. It goes something like this: Ketosis is an unnatural and/or dangerous state, because it is so fragile and temporary. The minute the body has enough glucose available to do so, it shuts down ramped-up ketone production and goes back to more glycolytic metabolism.

This is true; I can’t argue with this. (The part about ketosis being fragile, not about it being dangerous.) The people who point this out use it to imply that the body genuinely prefers to run more on glucose than on fatty acids and ketones, because as soon as it can stop running on ketones, it does.

But here’s why this bothers me:

To Carb or Not to Carb: That is NOT the Question

The question is: Why are we still even having this debate? (Or is it a discussion?) Is it really that difficult for folks to accept and/or agree that some people thrive on lower amounts of carbohydrate, while others feel their best with more? I’m not sure why the controversy continues. It is well established that there is no absolute human need for dietary carbohydrate. Let me say that again: there is no human dietary need for carbohydrate. Just so we’re clear, this doesn’t mean glucose isn’t needed for plenty of biochemical pathways and physiological mechanisms in our bodies. It means only that our bodies can get the glucose they need by means other than us ingesting it.

That being said, very few people are saying that because there is no human dietary requirement for carbohydrate, we should all be on a ketogenic diet from birth until death, every single one of us, no exceptions. (Not even Jimmy Moore, the keto man, himself, is saying this. [See point #3 in this post.]) If anything, it seems to me that the main messages being put out make it clear that people need to find what works best for them, and that even if/when they do find it, it might change over time. (See: Kelsey Marksteiner's 3 step process to determining your ideal carbohydrate intake; and Chris Kresser's 7 things everyone should know about low carb diets.)

See also Robb Wolf's Thoughts on Carbs & Paleo: Part 1, Part 2, and Part 3. (And maybe even this one, written by yours truly.)

The macronutrient (and micronutrient!!) numbers that work best for your wife/brother/boss/next-door neighbor/favorite internet health guru might not be best for YOU. As Robb Wolf might say, “Shocker!”

I guess it all started with Laura Schoenfeld's post, Is a Low-Carb Diet Ruining Your Health? Like I explained here, I really have no problem with the article itself. It's only the title I didn't like so much.

Warning: This is a rant. It is not an especially politically correct one. I am telling it like it is, or, at least, like I think it is. You have been warned.

Second warning: Most (but not all) of what appears below is speculation and informed reasoning on my part. There is some science, but I'm not using a ton of PubMed links because, well, frankly, peer-reviewed scientific literature leaves a lot to be desired these days. I know; I do freelance writing for a supplement company some of you might be familiar with, and in the course of my work, I do a lot of digging on good ol' PubMed. It ain't the gold mine it's cracked up to be. More on that some other time. Bottom line: if you think this post is useless because of its lack of copious citations, you know how to delete the email or close the window. 

To the rest of you, happy reading.

Fuel Partitioning 101: Willpower (Addendum)

We have a little unfinished business to tackle from last time. Before Captain Obvious kicks me out of the force, I’d like to clarify a few things about discipline and willpower. I didn’t mean to imply that D&W are figments of our collective imaginations, or that they’re not required to at least some degree in order to get healthy and lose excess body fat. For sure, they are part of the puzzle, but the whole thing only comes together nicely when all the other puzzle pieces are in the right place, too.

Where I work at my festering open wound of a soul-suck non-nutrition day job, there’s a never-ending stream of treats coming in. Someone’s always coming or going, retiring, having a baby or a birthday, or maybe just decided to bake a bunch of cookies or whip up a batch of fudge over the weekend. The result is, hardly a day goes by that there isn’t some kind of yummy, sugary, vegetable oily, floury thing on the front desk, mere inches from my dungeon cubicle. And as I have made clear on this blog, I’m not 100% refined sugar free. I’m not 100% gluten free. I may even, on occasion, ingest a molecule of canola oil via restaurant salad dressing or somesuch. (And now I’ve probably lost the four loyal readers I had.) My point is, once in a while, I’ll help myself to a little bit of whatever these treats are. However, more often than not, I take a look, and then walk right past.

I’ve been known to refuse ice cream cake, cupcakes, cookies, and the like. My coworkers often say I must have a lot of willpower. I usually reply with something along the lines of needing to set a good example, or needing to “look the part” of someone capable of helping others with nutrition.

But the truth is, I don’t have a lot of willpower. 

Fuel Partitioning 101: Discipline and "Willpower"

Fat people are so lazy, aren’t they?

So weak-willed and undisciplined.

Such greedy sloths.

I mean, really. Eat less, move more. It’s not that hard. They’ve been saying it for decades. All the experts: doctors, personal trainers, dietitians and nutritionists, and all the bigwig MDs, PhDs, and politicos behind the USDA, FDA, American Heart Association, and American Diabetes Association. In order to lose weight, all you have to do is eat less and move more. That’s it. Two steps. Take fewer calories into your body, make sure more get expended via exercise, and you’ll lose weight. Done. Period. End of story. If it wasn’t true—or at least, wasn’t the whole truth—surely someone would have said something by now, right?

Seriously. Obviously everyone struggling to lose excess body fat eats too much and moves too little. That’s really all there is to it. Put down the Fritos and get up off the couch, fatties. Problem solved.

Um, not exactly.

Fuel Partitioning 101: Hormones

Recall from the previous post in this series on fuel partitioning that we were talking about three things that determine which types of fuel our bodies use: 1) The type of activity being fueled; 2) The type of cells/tissue performing the activity; and 3) The hormonal milieu under which the activity is occurring.

We covered the first two last time, and because the post was getting long (shocker…), I decided to have mercy on people’s attention spans and save the third for a separate post. Well, here we are.

The hormonal milieu under which the activity is occurring

As I emphasized previously, this fuel stuff isn’t an all-or-nothing scenario. Thanks to the wonderful, elegant, infuriating, and fascinating complexity of the human body, we use a few different types of fuel concurrently. That being said, depending on what’s going on with our hormones, different biochemical pathways will predominate and others will take a backseat. (Kind of like how hormones made math homework take a backseat to the magazines you found in your father’s nightstand when you were 16…)

Fuel Partitioning 101: Not a Binary System

Yikes. Heck of a post title, huh? Partitioning and binary. That’s two scary-ish words and we haven’t even gotten started yet. If I’m not careful, someone’s going to think I actually know something about science and/or the human body. (Some days I’m not so sure, to be honest with ya.)

Aaaaanyhow, welcome back to the series on fuel partitioning. Recall from the last couple of posts that we’re thinking about the human body as a hybrid car. It’s not a perfect comparison, but it’s suiting us fairly well so far. Two posts ago, we did a little bit of math and determined that, gram for gram, molecule for molecule, fats seem like a more efficient fuel than carbohydrates. Last time, we talked about how the body “runs on” different types of fuel, and we went right to the gas tank, to see what kind of fuel the body stores the most of—that is, which fuel the gas tank seems to prefer to hold in reserve. Here again, it seems like fat trumps carbs. (Remember that nifty chart? The one that showed the human body doesn’t keep a lot of carbohydrate on hand, but it’ll tuck away fat like a champ?)

Now that we’ve had that little refresher, we’ve got important ground to cover today, so let’s get going. (Kind of scary that I could compress two long blog posts into one paragraph. I’ve said it before: brevity was never my strong suit. In fact, my strong suit is at the cleaner’s right now. *Ba-dump-tsch!*)

Fuel Partitioning 101: The Hybrid Car's Gas Tank

Hey kids!

Recall from the previous post in this series that we’re attempting to unravel the mysteries of fuel partitioning, appetite regulation, fat loss, and metabolism, and we kicked things off by thinking of the human body as a hybrid car. Using this as a guiding idea, we established that, just as a hybrid car can run on gasoline or electricity, our bodies can run on different types of fuel.

Last time, we looked at the major sources of calories we eat or drink, in order to determine which one(s) make the most sense to use as fuel: fat, carbohydrate, protein, and alcohol. (I haven’t forgotten about my beloved ketones, but we’ve got to put those on hold for now.) We said that protein is too valuable for other purposes to let it be used as our primary fuel source. And unless you can stay gainfully employed and safely operate your motor vehicle under the influence of copious amounts of alcohol, alcohol isn’t the fuel we want as our go-to either. So that leaves fat and carbohydrate.

We compared carbohydrate and fat to quick-burning kindling and long, steady-burning logs, respectively, and determined that fat is a more efficient fuel. (Remember the 4mpg and 9mpg gasoline analogy?)

But let’s not stop there. In order to answer this question and really convince ourselves which type of fuel it’s most sensible to have our bodies run on, let’s take a look at the gas tank. In terms of fuel efficiency, so far, it looks like fat is a better choice than carbohydrate. But which of these is the gas tank, itself, designed to hold?

Fuel Partitioning 101: Human Body as Hybrid Car

In the first post in this series, we talked about the idea of “calories in and calories out,” and why it’s not all that helpful when we’re trying to understand human metabolism, appetite regulation, fat loss, and fuel partitioning. I rolled a pair of dice earlier, and it came up on fuel partitioning, so let’s kick things off with that. (Just kidding. It was a magic-8 ball. Never trust something as important as this to dice.)   

If you’re already pretty familiar with basic human physiology, there might not be all that much here that’s new to you. But I hope you stick around anyway. Maybe I’ll explain something in a way you’ve never thought about it before—or, more importantly, maybe you know something I don’t (very likely!), and if so, I welcome you to set me straight in the comments. (Although, like I pointed out here, this stuff necessitates a little oversimplifying. There will be a few things I’ll gloss over in the beginning, but will dive deeper into in future posts.)

And, of course, if you’re not so well-versed in this stuff, then I really encourage you to stick around. If you’ve ever scratched your head in bewilderment because you had a big breakfast (read: high-calorie) that consisted of things like orange juice, toast, a bowl of cereal, and a bran muffin, yet inexplicably found yourself hungry again not that long afterward, this series is for you. (Because your body’s reaction to that breakfast is not inexplicable. There is, in fact, a quite elegant explanation, which we’ll get to in time.)

Calories In, Calories Out; Calories, Schmalories, All About!

You put your calories in, you put your calories out, you put your calories in and you shake ‘em all about!

Oh, wait, that’s not human physiology, that’s the Hokey-Pokey, and it probably hasn’t been part of your daily routine since you were about four years old. Most of us have grown out of this kindergarten dance (at least, in public), so why does so much of the nutrition and dietetics community still cling to outdated (not to mention flat-out inaccurate) ideas when it comes to the care and feeding of the human body? Maybe brainwashing, maybe herd mentality, maybe fear of stepping outside the mainstream. Maybe fear of upsetting their corporate sponsors. (The Academy of Nutrition and Dietetics [formerly the American Dietetic Association—the body responsible for credentialing registered dietitians] is proudly bankrolled by the likes of Pepsico, Coca-Cola, General Mills, and other producers of such fine, nutritionally sound products as Chocolate Lucky Charms, Doritos, Cheetos, and Fritos.)

Since I don’t have any corporate sponsors (but am open to the idea, hint, hint <--No, just kidding), gather round, kids, and I’ll tell it like it is. If I were Foghorn Leghorn, I’d say something like, “Gather round hea’, and lemme, I say lemme learn ya somethin’ about appetite and metabolism.”