There are a few misconceptions surrounding ketogenic diets that I hear on a regular basis. The first being that a high-fat diet is a sure-fire way to develop heart disease. I’ve briefly touched upon this myth in a previous blog post, explaining how dietary fat, in the absence of high insulin levels has not been shown to lead to heart disease.
One of the other main misconceptions out there about ketogenic diets is that they lead to ketoacidosis, a life-threatening state in which the body is forced to deal with both high levels of blood sugar and ketones.
While similar in pronunciation, ketosis and ketoacidosis are very different. Today I’ll share some information on both and hopefully clear up some of the confusion.
In a state of ketosis, the body utilizes fat as the primary fuel source. Fatty acids are broken down into ketones, which then fuel most of the human body. This is where the term, ‘fat-adapted’ comes from. In a state of ketosis, blood ketones will rise, typically within the range of range of 0.5-3.0 mmol/L, but possibly up to around 6-7 mmol/L. At the same time, blood glucose drops to a healthy range.
As mentioned, ketoacidosis is a life-threatening state which in both ketone and blood sugar levels rise (remember, blood glucose drops in ketosis). It almost exclusively occurs in people with type-I diabetes. In such cases, the body is unable to produce insulin, a hormone needed to pull sugar from the blood into the body’s cells. In a state of ketoacidosis, blood glucose continues to float around in the blood, and the body’s cells don’t receive any fuel. This triggers production of large amounts of ketones, upwards of 20 mmol/L and greater. If left untreated, both blood sugar and ketones will continue to rise, putting a person at risk of slipping into a coma, or worse, death.
For people without type-I diabetes, there is little to no risk of developing ketoacidosis while following a ketogenic diet. Those with type-II diabetes are also at low risk and can minimize their chances of harm by regularly monitoring their blood sugar and ketone levels. Similarly, someone with type-I diabetes can safely follow a ketogenic diet with careful attention to insulin dosing and blood and ketone monitoring.