There can be no doubt that the keto diet is popular. What’s more, it is a fascinating technique, offering many health benefits along the way.
Keto can be powerful for many reasons, giving people a good alternative to the conventional low-fat and high-carb diet.
But, to truly understand why keto diets work, you have to know about the benefits of ketones.
What are ketones? And what do terms like ketone bodies, ketogenesis and ketogenic actually mean?
This post explores the topic in depth, considering what ketones actually are, the way they’re produced and their implications for health.
The Process of Ketogenesis
The term ketogenesis simply refers to the creation of ketone bodies (ketones, in other words). It is a biochemical process that involves the breakdown of fats and some amino acids.
The process mostly occurs during fasting and or when carbohydrate intake is restricted.
- Normally, carbs are the main fuel source for the body. When available, they’re used preferentially.
- But, carbs aren’t our only source of energy. They’re not even essential for energy, despite what some people claim.
- When you have limited carbs for long enough, your body will go into ketosis.
- Reaching sustainable ketosis typically takes 2 - 7 days. The exact amount of time depends on various factors, including your body type, food, and how active you are.
The keto diet is a technique to remain in ketosis from day-to-day. To do so, you dramatically restrict carb intake – normally no more than 50 grams of carbs per day.
You might hit ketosis at higher carb intakes sometimes, as we all have different carb tolerances. But, keeping carb intake low is the best way to ensure consistent ketosis (also called nutritional ketosis).
Ketone Bodies and Ketosis
Being in ketosis produces ketone bodies or ketones. These ketones offer energy, much like glucose does. They’re the reason that you can still be a high performing athlete on a ketosis diet.
But, ketones are also different. They don’t have the same structure as glucose, which means their effects on the body vary as well.
- For one thing, they don’t impact blood sugar or insulin in the same way that glucose does. This makes them very relevant for weight loss and people with diabetes
- They are also associated with health benefits, which we’ll talk about shortly
There are three main types of ketone body: Acetoacetate, beta-hydroxybutyrate and acetone (1). Scientifically, acetoacetic acid and acetone are ketones, while beta-hydroxybutyric acid isn’t. But, all three behave in a similar way, so they’re all considered ketones in this context (2).
The ketones bodies can potentially have different impacts, although most research considers them collectively. After all, the compounds aren’t produced in isolation and you’ll never just have one of them.
The site Ketosource offers more details about the biochemistry behind ketones and how they behave in the body.
Nutritional Ketosis vs. Ketoacidosis
You’ll sometimes hear of a related process, called ketoacidosis. This can occur when the levels of ketone bodies are too high and it is dangerous. Ketoacidosis can even be life-threatening.
But, in most cases, ketoacidosis is a side effect of uncontrolled diabetes. It is the result of a lack of insulin, which leads to ketones rapidly increasing in the blood, much faster than they can be removed. Mayo Clinic examines the causes and symptoms in more detail.
There are other possible causes as well and the site Perfect Keto has a list of these.
While ketoacidosis is undesirable, it’s a different process entirely.
A keto diet is unlikely to cause ketoacidosis because healthy individuals have a ketone feedback loop. This prevents ketone levels from getting too high and leading to ketoacidosis.
You should still keep an eye out for the symptoms of ketoacidosis, including feeling confused or experiencing extreme thirst (much more so than a keto diet causes). While a keto diet could theoretically lead to ketoacidosis in sensitive individuals (3), there is little evidence that this actually occurs.
Instead, most people following a keto diet see health benefits.
Health Benefits of Ketones and Ketogenesis
The ketosis diet boasts many positive outcomes – like increased energy, improved weight loss and decreased disease risk.
Some of these impacts are associated with the focus on healthy foods, along with the avoidance of carbs and processed foods. But, other outcomes are associated with ketosis itself and the ketone bodies that are produced.
The areas below are all benefits that are currently supported by research. There are many other potential health impacts as well that researchers haven’t examined in depth.
1. Lowers Insulin and Blood Sugar Levels
When we consume carbs regularly, blood sugar levels typically cycle, spiking when we eat meals. That pattern is never great for health and impacts insulin levels as well.
The issue is even more significant for diabetics and they need to minimize the cycling as much as they can.
Unlike glucose, ketones don’t have significant impacts on blood sugar. As a result, relying on fat as a fuel source lowers glucose levels and insulin as well.
- This is significant, as high blood sugar and insulin levels are linked to many diseases. For example, insulin helps promote inflammation and may contribute to heart disease risk (4).
- Researchers suggest that high insulin may also play a key role in most chronic diseases (5) and similar claims have been made for inflammation (6).
2. Can Improve Diabetes Management
The previous impacts make a ketogenic diet appealing for anyone with diabetes or prediabetes. The ketones mean that diabetics need to stress less about their food and can keep their blood sugar levels more stable.
In turn, this means a lower risk of diabetes complications and improved quality of life overall. However, it’s important to talk to your doctor first and pay close attention to your body, due to the risk of ketoacidosis.
3. Lower Hunger and Food Cravings
A key benefit of a ketosis diet is decreased hunger. Many people find that they naturally eat less, which makes weight loss much easier.
There are various mechanisms for that effect, including the satiating effect of the food. Plus, keto meals are often more appealing than regular diet food and the style can feel much less restrictive. This means you’ll often feel more satisfied.
The ketones produced could also decrease hunger, perhaps by suppressing hunger hormones (7,8). The evidence here is very limited. While ketosis diets seem to lower appetite for some people – it’s not clear whether ketones themselves are responsible. Other aspects may also be significant, such as the protein content of food.
Despite this, it’s likely that ketones play some role in the mechanism for decreased appetite. They’re probably not the only compounds responsible but there may be some direct effect.
Outcomes are also mixed. For example, some studies have seen appetite decreases with ketosis, while others haven’t (9,10). The same is true for individual experiences. But, this may simply mean that effects vary depending on the person and their metabolism.
4. May be Neuroprotective
Neuroprotective simply means protecting the brain – and ketone bodies may do just that. In fact, the compounds have even been associated with cognitive benefits.
The research in this field is still early but there can be no doubt that ketone bodies affect the brain.
- Therapeutic keto diets successfully treat drug-resistant epilepsy in children. The diet has been used like this since the 1920s and perhaps even earlier (11).
- Emerging research suggests similar benefits may apply to other conditions, including sleep disorders, autism and brain cancer (12,13).
- Studies suggest that ketosis can promote memory for people with cognitive impairment (14). Improvements have been seen for Alzheimer’s disease and Parkinson’s disease as well (15,16).
There are various mechanisms for these effects.
- First, our brains can’t directly use fat for fuel. Instead, there are various pathways to provide the energy that is needed (17). As a result, a ketosis diet mimics starvation. That sounds bad, but the concept is similar to autophagy diets, which do have positive implications for health.
- Ketones also have an antioxidant role.
- A ketogenic diet may increase mitochondria levels and function in the brain. This effect could help combat age-related neurological conditions, providing the brain with more resources to fight back (18).
Even so, research is limited, often relying on small sample sizes and animal studies. There is much we don’t know about how ketones impact the brain or their long-term effects. Still, the potential to protect the brain is powerful and well-worth exploring.
5. Could Impact Mental Health
These outcomes could also promote improved mental health. There hasn’t been a large amount of research in this field – but many people claim that keto has helped with depression, while improving focus and mental clarity.
The difference in food choices may also help improve mental health. After all, a keto diet does involve a greater focus on whole foods and means you’re avoiding many processed options.
6. May Improve Mitochondrial Function
The mitochondria are considered the powerhouses of the cell, playing a critical role in energy production (21). Increasing mitochondria levels and function may improve health in many ways – such as reducing some symptoms of aging. Indeed, problems with mitochondria may play a role in disease development (22,23).
This is an area that sites like Bulletproof focus on in depth and there are various ways to improve mitochondria function.
Research suggests ketones can increase the expression of genes that code for mitochondria in your brain (24). Ketone bodies can also protect the mitochondria, helping to reduce dysfunction and improve their performance (25,26,27).
Some such effects occur from increasing fat intake as well, which is another powerful implication for a ketosis diet (28).
7. Improved Cholesterol Profiles
Ketones can also improve cholesterol levels but not in the way you might expect.
They affect one specific area – the ratio of triglycerides to HDL. This is a topic that is often overlooked. We tend to focus on HDL and LDL much more strongly.
But, the ratio of triglycerides to HDL is a powerful predictor of heart disease risk – and may be much more effective. In particular, having high HDL and low triglyceride levels should decrease the risk of heart disease (29,30,31).
Low HDL and high triglycerides generally occur when significant insulin is present (32). Decreasing insulin should lead to a more favorable ratio of triglycerides to HDL.
There are clear benefits to ketosis and ketones. Yet, many people don’t see these initially. As Ketovangelist explains, this is because of the adaption process.
To see all the advantages of ketones, you need to be ketone-adapted (or fat-adapted). This basically means you’re burning fat as your primary fuel source. Getting to this point takes time.
As a result, you don’t see all the benefits the moment you start a keto diet. You’ll probably go through an adaptation period instead, where you’re transitioning from carbs as fuel to fat. You might experience the keto flu during this time, which includes symptoms like:
- Muscle cramps
- Low energy
- Digestive problems
Thankfully, the keto flu doesn’t last. Once you move past it, you’ll start to see more benefits from ketosis, such as the ones discussed previously.
Ketosis isn’t the only way to lose weight and get healthy. Some people thrive on a keto diet, seeing many health benefits. Others struggle and might even find that the diet makes them feel worse, not better.
But, it’s clear that there are many health benefits from ketones and ketogenesis. The keto diet is worth trying for this reason alone.
There are other ways to get benefits too. For example, Mark Sisson from Mark’s Daily Apple talks about the concept of a keto zone. This is a modified style that allows you to get some of the benefits that ketones offer, without fully being in ketosis all the time.
There are other variations too. In many cases, the best solution is to try different options out for yourself and figure out how your body responds. You can check out our guide to ketosis for more information about how to get started. You could also choose a low-carb diet instead.
These may help you get into ketosis faster and make it easier to stay there. Even so, most of the benefits come from producing ketones yourself through a keto diet or a variation of it.
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