keto adapted
 

Ketosis vs keto adapted vs fat-adapted

From what i have read it can take 2 to 6 weeks to become keto adapted ok.

But is the difference between ketosis and being keto adapted and fat-adapted and how do you tell if your keto adapted or fat adapted are these two or three the same thing or different?

Few questions...

Some of the stuff i have read



Also...



And...

Just wondering if these quotes are right and if someone could explain it?

Where did your quotes come from? I thought I was pretty well read on this subject, but I've never heard of being "fat adapted". I'm intrigued though bc I feel like, according yo those quotes, it may explain something I have noticed which is that I seem to be able to get into ketosis very easily and much more so than in the past. I usually start feeling some of the symptoms of ketosis w/in a few hours of starting low carb and I don't get any headache or fatigue or anything.

I'll also say, though I'm not sure if it addresses your Q at all, that becoming "keto adapted" is like falling off a cliff for me -- very sudden and dramatic.

rubidoux the quotes are just what i have read here and there online which had me a bit confused and thought i ask the more experienced here to explain...


I have read that once you have excess carbs one day even if you are keto adapted for say 5-6 weeks that this one day will kick you out of keto-adaption and have you back starting from scratch day one just wondering if this is correct?

But than others say that once you are full keto adapted you can actually have carb days and this will not kick you out of keto adaption hehe:stars:

Read this online

Hmmm... They're a little all over the place, hard to follow. But I'm hoping that they're right about this part:

As for that last line about not needing to stay at a particular level of carbs... at least for me, the number of carbs (and protein and fat) I'm eating on a given day at least makes a difference for that day. Like, a few days ago I was feeling my ketosis slipping a bit. I was starting to have thoughts of food and feeling my hunger a little more urgently. So today I really upped my fat and didn't have any carb or protein all day until right not (it's after 8 pm). And now I feel much more in control and solid in my control of my appetite.

I do hope it's possible though to recover so quickly from a carb accident. I'm too risk averse to try that without more evidence.

My amateur understanding:

Ketosis is the hour-by-hour process controlled by the brain's glucose needs. If you aren't digesting carbs (or enough extra protein to make carbs), the brain instructs the liver to start modifying fatty acids into a water-soluble form (ketones) that can cross the blood-brain barrier and feed it in place of glucose. Ketone levels rise and fall pretty quickly based on your circulating fuel mixture. Also, short- and medium-chain fats such as butyric acid and lauric acid (like coconut) will become ketones regardless and will offset the brain's glucose consumption accordingly.

I think fat adaptation is a term for mitochondria adjusting to whichever fuel is more prevalent in circulation. When we eat 300+ carbs a day, the mitochondria undergo certain adaptations in order to burn glucose at the rapid rate required to keep up with the flood (they MUST burn it because there's nowhere safe left to store it). The downside: once there's an interruption in the supply, they aren't accustomed to burning the ample fatty acid fuel so the whole body feels lethargic and hungry. Stick it out long enough and they'll eventually optimize for fatty acids once again.

As for ketone adaptation--I'm not sure what it refers to. There are a few types of non-brain cell that can use ketones, but it's not very significant since ketones only appear when the brain needs them and they're rapidly consumed by the brain. If you're low-carbing and you're losing weight, it's because fatty acids are entering cells directly throughout the body.

I have read "fat adapted" in popular magazines like Runners World. I have read "keto adapted" here, paleo/primal sites, and in diet books like Phinney & Volek.

I thought they were the same basic thing.

I wonder too if the difference is what you are getting adapted to.

There is getting over the induction flu and being able to go on about your normal activities. Then there is adapted in relation to endurance sports, like distance running, which I understand may take weeks.

Just wondering if you are keto adapted and slip out after a 1 day break (carb meal) do you have to start from scratch again, Dr Stephen Phinney says in his opinion becoming keto adapted takes 4-6 weeks once you slip out while keto adapted even with a one day break you start from scratch all over again > taking 4-6 weeks in his opinion...while Mark Sisson does not agree with this and he states once your keto adapted and slip out of ketosis it only takes a few days to get back into keto adaption since you body is used to being keto adapted.

Thoughts?

I don't worry about any of those things--I've read the same conflicting information.

I eat low carb by choice, and my goal is to eat healthily and manage my weight. I focus on making good choices on a daily basis. I don't succeed 100% of the time, and that confirms to me that focusing on those choices is better than worrying about my body chemistry.

I should add that because I'm hypothyroid, I have a blood panel every 4 months, and my numbers are always excellent--which is my indicator that my WOE is good for my health.

The more one reads about all these the more he gets confused its unreal


“Ketosis” is almost impossible in a normal person! Don’t waste your
money on the highly promoted “ketosis strips.” Adapting to a higher fat,
higher protein diet will almost never produce ketosis. From the Textbook of
Medical Physiology, page 869, we learn the truth:
“ On changing SLOWLY from a carbohydrate diet to an almost
[even] COMPLETELY FAT diet, a person’s body adapts to the
use of far more acetoacetic acid than usual, and in this instance,
ketosis normally does not occur. For instance, the Eskimos, who
sometimes live almost entirely on a fat diet, do not develop ketosis.
Undoubtedly, several factors enhance the rate of acetoacetic acid
metabolism by the cells. Even the brain cells, which normally derive
almost all of their energy from glucose, after a few weeks can derive
50 to 75 percent of their energy from fats.” (emphasis added)

This is the truth based science. Next time you hear about the “horrors of
ketosis,” give them this information, and once again, stop wasting money
testing for ketosis–you won’t find it. The solution is to stop gaining fat by
minimizing carbohydrate consumption. It’s that easy.

In the *general* medical literature, it's called "the adaptation to starvation." In the low-carb world, we have a different relationship to the process so I think different terms have developed to describe and explain this adaptation with regard to the specific restriction of dietary carbohydrates. Most of the information that we have about keto-adaptation comes from medical research into starvation, and there are decades of extremely well-structured clinical studies into the process by which the body's internal mechanics change in response to periods of fuel deprivation.

These studies are directly applicable to ketogenic dieting because depriving the body of dietary carbohydrates exactly mimics the fuel adaptation process that occurs when the body is completely deprived of food. When the body isn't being fed dietary carbohydrates -- during the period BEFORE "the adaptation to starvation" but AFTER the body's stores of glycogen have been exhausted -- the body will convert protein into glucose to serve as fuel and it will supplement the newly-converted glucose with additional fuel from fat. In periods of total starvation, the protein source for glucose will come from muscle tissue and the fat will come from the body's fat stores. On a ketogenic diet, the protein source for glucose will generally come from dietary protein and the fat will come from either the body's fat stores or from dietary fat.

The process is the same in starvation as in ketogenic dieting because of the nature of dietary carbohydrates -- the bulk of dietary carbohydrates can *only* be used as fuel. The other two macronutrients -- protein and fat -- are building blocks: dietary protein is used as a building block for body tissues such as muscle and organs and skin, etcetera; dietary fats are used as building blocks for body tissues such as the nervous system and brain and components within the skin and organs, etcetera. The micronutrients -- such as the vitamins, minerals, and enzymes -- in dietary carbohydrates are used as building blocks but the bulk of dietary carbohydrates can only be used as fuel -- the body can't do anything with it except burn it, store it as glycogen, or convert it into fat.

Since the body can only use dietary carbohydrates as fuel, the tissues within the human body are engineered to preferentially burn dietary carbohydrates whenever they are available. So when dietary carbohydrates are dramatically restricted, the tissues within the body have to be re-engineered to support a different primary fuel system -- and there is A LOT involved in this process. The body has to change the level of fuel-management enzymes, the cell mitochondria have to change their fuel-conversion process, and many many MANY other processes have to change. The end result of this adaptation process is that the skeletal muscles and the bulk of the rest of the body's systems will directly burn fatty acids as fuel. At least 25% of the brain will always burn glucose as fuel and the other 75% of the brain will use ketones as fuel because fatty acids can't cross the blood-brain barrier. But on a ketogenic diet, after keto-adaptation, most of the body will directly burn fatty acids -- either from the body's fat stores or from dietary fats.

There are decades of detailed medical studies of this process and there is absolutely no question that this process takes a minimum of 2-4 weeks for the adaptation to occur. The conversion process to keto-adaptation typically takes this period of time because the re-engineering process within the cells of the body is progressive and happens in stages -- more cell mitochondria are re-engineered each day that dietary carbohydrates are restricted. The body is *actually* fueled by a substance called "adenosine triphosphate" (ATP), which is produced by the process of burning either glucose or fat, so the fueling process is extremely complex and the mechanics of changing the primary fuel system is quite complicated. The conversion process can take an even longer amount of time in bodies that are particularly insulin-resistant. In fact, in many people, some cells in the body have been metabolically damaged but other cells have not become as damaged, so some cells may not become keto-adaptated until long after the rest of the body has converted. There is no shortcut to this adaptation process.

However, the body can immediately convert back to primarily burning glucose even after the body has become keto-adapted. There is no adaptation period for the change from primary fat-burning to primary glucose-burning the way that there is an adaptation period for the reverse process. There is usually a lag time with the body's glucose-management enzymes, but the cell mitochondria are immediately converted whenever the body is given enough dietary carbohydrates to put a significant amount of glucose into circulation. The body *has to* process dietary carbohydrates as fuel -- unlike protein and fat, which can serve other building and storage purposes. So plentiful glucose and raised insulin signal the body to immediately reconvert the cells, and they will again become programmed to primarily burn glucose as fuel.

The amount of systemic glucose it will take an individual body to end keto-adaptation depends on the metabolism of that individual body. And the process of converting back to keto-adaptation always takes at least another 2-4 weeks, every time the conversion process is halted or keto-adaptation is ended. This is just the way that the body works, due to the different roles that the macronutrients play in the human body.

Different people may have differing opinions about the body's ability to *quickly adjust* to re-conversion once the body has spent a period of time keto-adaptated. But there are thousands of medical studies of this process -- the adaptation to starvation has been extensively and obsessively studied throughout the entire history of human medical research -- and the studies show that the conversion to primary fat burning takes several weeks, at minimum. And the only way to tell that the underlying adaptations have occurred is through the medical testing of enzymes and reactions and by examining the cellular action within the skeletal muscle. Testing blood ketones or gauging the way the body feels isn't sufficient to tell whether the skeletal muscle is directly burning fatty acids.

First of all thanks Trillex for the detailed explanation :goodpost: and easy to understand.

One question Trillex why is everyone using keto sticks?...and now the new thing in is blood ketone meters might as well not?

Ketone level testing shows that the body is not using dietary carbohydrates as fuel. This testing can't show that the body is keto-adapted and can't tell whether the fat that is metabolized is bodyfat or from dietary fat BUT can indicate ketosis, which is the first step towards keto-adaptation. And testing can indicate that most of the body's glycogen stores have been depleted. When glycogen or dietary carbohydrates are being used as the body's primary fuel source, the body's ketone level is low. Although, the body does produce some ketones --during endurance exercise or while sleeping, for example -- even while the body is being fed a high amount of carbohydrates. But regularly producing a higher than typical level of ketones -- in a healthy body -- can indicate that neither glycogen nor dietary carbohydrates are being used to fuel the body.

Trillex, I'm just going to follow you around and :notwrthy:, if you don't mind. I love how well you can share the knowledge you've worked so hard to gain, and I really appreciate it.

According to what I have seen in the literature, there has never been a scientific study done on how long you can leave ketoadaptation and return without having to readapt, so for someone to claim that once you have ketoadapted you can eat as many carbohydrates as you want and go back is just not proven and probably not true. There are a lot of things in this science that the jury is still out on and there are advances being made at a very high rate in this field of research.

Quick answer - the body needs fuel to run. We have two pathways for this conversion, and we low carbers preferentially choose lipolysis instead of glycolysis as that pathway, for a number of reasons. We can temporarily do this through carbohydrate restriction, and see the presence of ketones in our blood and urine (sometimes) as the result. Longer term, if the body is consistently in lipolysis, our mitochondria adapt to that pathway as our preferential default and the metabolism becomes more efficient at producing ATP that way.

Ketosis is not really what we're aiming for in Atkins or any other ketogenic diet. Lipolysis is the real goal, whereby our bodies easily and preferentially metabolize either dietary or stored triglycerides instead of glucose. A body well adapted to lipolysis (fat adapted, long term) will be able to handle even moderate amounts of glucose without a flood of compensatory mechanisms in the body to manage it. As Creseis said, we don't know exactly how much glucose or for how long, before the body needs re-adapting and the mitochondria need the full cycle of restriction to prefer lipolysis as the energy pathway. We do know it takes less time than the other direction - ie: it is easier to lose lipolytic adaptation in favor of glycogenic adaptation, than the alternative. But I don't think I've ever seen a number put on that, either in terms of bolus amount of glucose or number of days at a certain level of carbohydrate consumption. There's just too many individual factors involved in metabolizing energy to narrow it down, and there hasn't been much interest from the medical/scientific community in doing so, either.

Not Tril, but I don't use either and have no plans to. It's useless. I can tell, based on my dietary composition and symptoms (or lack thereof!) when my body becomes adapted to ketone bodies and lipolysis. Testing is one of those crutches that sometimes helps fire people up, especially in the beginning of the diet, when they are skeptical or not sure it is working. And for those working to narrow the window of their own performance (or make money off of selling expensive supples :confused: ) there may be some value in a blood ketone meter.

But for most of us, better to stick to our plans and watch our physiological feedback in terms of sleep quality, energy, satiety, inflammation, and yes, even what the scale is doing. There is never a necessity for ketone meters or strips in your standard, well constructed ketogenic diet :)

This seems like it could be a very relevant study though. I wonder if anyone has ever tried to get something like this funded? The reason why I would think it's relevant is because so many people have a hard time staying very low carb for an indefinite period, myself included. I can stay low carb consistently for several months, but I will have a day or two here and there when I cave and have a beer [IPA or Porter of course] or fruit or whatever carby things for a day, but what are the ramifications, does this have a health effect on the overall system? What are the effects of switching back and forth?

Yes! Actually this is the exact sort of thing I believe the NuSi foundation wants to work on. Peter Attia and the others involved in that project (like Taubes) are looking at the specifics and performance related side of lipolysis. I know he explains a fair bit about his research goals at The Eating Acadamy, I'd poke around there to see what's being said.

Dr. Atkins was also interested in researching these specific points more and set up a foundation to do it, but I'm not sure too much has been done since his death and the sale of Atkins Nutritionals regarding the research side. :shrug:

I've been re-reading Attia's Cholesterol stuff all day, I'm totally obsessed! I'll take a look in there, too. I actually asked him this question in the comments section on one of his posts last year, but he never answered it.

You're very kind! My buddy that's coaching me on my diet and exercise required me to read a bunch of stuff when I started. I initially resented it, because I didn't think I needed to know the inner workings of human metabolism just to lose weight. But now I'm glad I read it all because the human body is amazing and I now realize that I didn't fully appreciate the tiny miracles of my own existence.

There is a CRAZY amount of research on the adaptation to starvation! You can just search PubMed for free, if you're interested. Unfortunately, you can't read the full text of a lot of the studies. But once I have the reference information, I can just go through the library here and get the full text. I'm sure you could probably do the same in your area, if you're interested. There are some amazingly detailed studies on the physical processes that take place and of the corresponding impact. I can't even believe some of the questions that researchers took the initiative to study! I work at the University of Michigan and I just randomly saw an ad last week from the school of kinesiology that was looking for participants for a study on insulin resistance and fasting that offered $700. So people are out there looking for answers.

There isn't a lot of data that comes specifically from the study of ketogenic diets with regard to the adaptations -- for one thing, the adherence rates on all studies of ketogenic diets tend to be extremely low because they haven't been done in a clinical setting -- but researchers have studied at least hundreds of different aspects of metabolic behavior as subjects adapt to total food deprivation.

Here's my favorite study because, seriously, did they need to do a study that was this specific? It just seems so random to me! It's fascinating but I can't believe somebody thought of this.

The effect of carbohydrates on ammonium and ketoacid excretion during starvation
The effect of carbohydrates on ammonium and ke... [J Clin Invest. 1972] - PubMed - NCBI

There are also a bunch of studies of the metabolic reactions within individuals that have specific gene profiles. Most of the ones I've seen are animal studies, but they're still freaking fascinating to me because -- really -- who sits around thinking of these super-specific aspects to study? Scientists are just so creative!

Successful adaptation to ketosis by mice with tissue-specific deficiency of ketone body oxidation
Successful adaptation to ketos... [Am J Physiol Endocrinol Metab. 2012] - PubMed - NCBI

Ah, I should have clarified, as I spend most of my online time on health/research blogs like Peter's or Suppversity looking at the data. What I meant was that the specific threshhold regarding full adaptation and alteration of the cell structure BACK when glycolysis is resumed hasn't been narrowed in the same way that adaptation to lipolysis has.

There is definitely anemic research regarding ketosis specifically, I keep looking et these studies and being really annoyed when they indicate low carb as being 80-100 net per day, include confounders like sucrose or rancid seed oils, or the duration/sample size is completely insufficient. Grr!

And big shout out to University of Michigan. That's my hubsand's grad school alma mater (he's a structural engineer, who nearly ended up with a master's in physics, too, so much time was spent in the library and science facilities around there).

If you have time (and the emotional energy to deal with obsessiveness of bodybuilders), you should read some of the training journals that bodybuilders keep while they're on ketogenic "cutting" diets. It isn't clinical research, but these journals are obsessively detailed and contain some fascinating practical details that test the mechanics of ketosis and glycogen storage.

Competitive bodybuilders don't typically do long ketogenic periods because most of them believe they need high-carb re-feeds to produce an anabolic environment during weight training. But the focus of bodybuilding "cutting" cycles is on fat loss, so the guys who use "targeted ketogenic diets" (TKD) work to limit their periods of glycolysis specifically to workout periods. So these bodybuilders have been doing ketone level testing since the 1980s and they were the first people I ever heard of who used blood ketone meters. The re-feed formulas that the advanced coaches use are carefully calibrated so that the client can be in ketosis right before the pre-training re-feed and then be back in ketosis within an hour after the workout. They really test the boundaries of carbohydrate management and ketosis.

And there's a "staged" glucose re-feed formula that high-end coaches use that is designed to do a pre-contest re-feed for their clients, which specifically restores and super-compensates muscle glycogen. The muscle glycogen pump is important for contests because it aesthetically enhances the muscle size and texture, but the glycogen recomposition must not lead to aesthetic problems like skin re-hydration (after they've used diuretics to "thin" the skin texture) or bloating or excessive liver glycogen storage (that would make the abdomen less aesthetically tight). So they've found ways to manipulate the body's glucose management system to replenish glycogen stores in a very targeted way. It's really quite amazing, to me, to think about the mechanics involved in this!

These coaches have developed these methods based on experimental practical applications of trial theories and, in the process, have made some fascinating discoveries about human metabolic processes. I'm not sure how helpful any of this is to the average person that is trying to lose pounds, but it's fascinating stuff because they have such tight control over incredibly complex instruments. They've exposed so much about which actions lead to specific metabolic reactions. If you're just generally interested in what people are doing on the boundaries of ketosis and glucose metabolism, in my opinion, it's really great information.

By the way -- please tell your husband "GO BLUE!" The engineers here are super awesome. My housemate is a researcher in financial engineering and she and all of her colleagues are the coolest people in the world!

I am so grateful for you guys doing all this research so I don't have to :) I am stretched a little thin right now so I don't have as much time to do reading for fun. Also, I know I've said this a zillion times, but I am forever grateful to Peter Attia for his blog. I don't know how he has the time...

Trillex, do you know what causes this? Is it too much fructose consumption or just too much consumption of carbs in general. Because I've had this before and was never sure of what was causing it.

Hi, Punkin!

When bodybuilders deplete the body's glycogen stores and then re-feed, the body increases the amount of glycogen that it is able to store in the muscles AND in the liver. When the body expands its glycogen storage ability, it's called "glycogen super-compensation." Each glycogen molecule is attached to 3-4 water molecules, so super-compensation *swells* the liver and it can get pretty large. The advantage for bodybuilders is that super-compensation of muscle glycogen can make the muscles physically larger. But no one wants a swollen abdomen, so they've developed ways to work around that effect. Some endurance athletes super-compensate, too, because they'll have more glucose-fuel available when they expand their muscle glycogen stores and, as a result, they can perform at high-intensity for longer periods of time.

Not every bodybuilder does this before competition because it can be very tricky. But when they do this type of pre-contest depletion/dehydration/super-compensation-re-feed they use a water + liquid glucose solution fed in specific amounts, at specific intervals, over a specific period of time. The amount of glucose, the intervals, and the time period are all based on the amount of muscle tissue they're aiming to re-feed. They can't re-feed the muscle glycogen without also re-feeding the liver BUT -- and this is the *trick* to it -- liver glycogen is put into circulation whenever dietary carbohydrates are not available but the bulk of muscle glycogen is reserved for use by muscle tissues so, they can re-feed the glycogen and then cut all dietary carbohydrate intake (as low as possible) to deplete enough liver glycogen to reduce its effect on the abdomen.

It's actually a lot more complicated than this because, in reality, they use drugs (or supplements) to deplete and then some guys also use insulin with the re-feed -- not just the naturally elevated insulin level that comes with the high-carb re-feed -- because insulin is the vehicle that directs the nutrients into muscle tissue. It's super complex and it seems like a big risk to take right before competition, in my opinion, but I think it's fascinating that they've figured this system out. I guess it's not really a risk for people who know what they're doing but if you get a coach who *thinks* he knows what he's doing and actually *doesn't* know what the heck he's doing, that could go horribly wrong.

There's another super-specialized re-feed that combines sugar and fat, and is targeted at over-filling the muscles so that they'll be larger and harder. This approach is designed to re-feed glycogen stores AND increase the amount of fatty acids that are stored within the muscle tissue. There's a specific technique and formula and drug regime that makes this happen, but I don't know enough about the specifics to know *how* they actually do it.