Rules for Ketosis: Lessons from Dr. Bosworth

Rule #1: Ketosis Can’t Begin if you Have Extra Sugar in Your Blood
No fat-burning until the extra sugar is gone. Your body will not allow you to use ketones as fuel until your sugars are burned through. Your mitochondria are the “furnaces” inside each cell that fuels your system. Burning sugars as your fuel spike your energy up and then it crashes down. Pop a sugar into the furnace and you produce a spark of energy that only lasts for a flash of a moment.

Linked up a string of sugars to burn through your furnace and your energy rushes up, only to be followed by a crash when the fuel is gone. Each sugar molecule gives 2 units of energy. Compare that to the 32 units of energy each ketone provides.

If you want a steady, constant source of energy, use fat as your fuel. You CANNOT use this fat-burning option if you have a bunch of sugars in your system. Let me say that again: Glucose or carbohydrate fuel is always used before fat fuel. There is no getting around this. This rule always applies.

At first glance, you might want to call the human body lazy. Using those carbohydrates as energy first seems like the easy way out, but there is more to the story. Our body must use those carbohydrates first. You see, too much sugar in your blood damages your body. As your sugars rise, along with the extra sugars you will collect more and more inflammation within your blood vessels, joints, and even your brain. Your body will protect you from toxic, inflammatory sugar levels at all costs. How is sugar toxic?

Each sugar molecules attracts nearly 100 water molecules as it floats around your system. This creates a toxic inflammatory state. As your blood sugars rise and rise, so does the level of inflammation. If your system does not reduce sugars, soon every part of your body will swell with inflammation. The end results are a coma and death due to the swollen inflamed brain led by the toxic amounts of sugar.

You defend against this toxic death as you churn those sugars through your furnaces, your mitochondria. Your blood glucose lowers along with the extra inflammation. That toxic level of sugar disappears as does the inflammation.

Rule #2: Ketosis Can’t Begin with High Insulin in your Blood
When your blood sugar spikes, an alarm signal rings throughout your body warning against uncontrolled sugar levels. This chemical alarm signal is called insulin.

Insulin is the hormone your body uses to protect from toxic sugar levels and the associated swelling.

Insulin is your body’s most important hormone. Nothing speaks louder and rules over more parts of the human body than insulin. When insulin circulates in the blood, sugars disappear into your cells. Insulin signals the alarm until sugar levels return to ‘normal.’

How long does it take before your mitochondria switch from using carbs to burning fat for energy? Put another way, how long does it take for insulin to sink back down allowing fat to become available for your furnaces? ANSWER: Days

Yes. It takes most American days before their extra stored sugar gets low enough for their insulin levels to sink to normal. High-carb diets have intoxicated your body with sugar followed by insulin. The insulin chases those sugars out of the bloodstream keeping your body safe from toxic sugar levels. Before you can be rescued by ketone power, your sugars and insulin must drop back to normal.

Your Standard American Diet ensures that your blood pools with extra insulin. Before your mitochondria flip the switch from carb-burning to fat-burning, you have to first lower the amount of insulin in your blood. This means reduce sugar intake. Again: cut the carbohydrates.

What? Do I have to go days without my carbohydrates in order to lose fat? Doc, this sounds like a starvation nightmare!!

Rule #3: Eat fat to burn fat
When you stop eating the carbs, your system must empty out the stored sugar you’ve stuffed into your liver. As the storage empties your blood sugar level creeps back up. By emptying that storage, your blood sugar stays up and that keeps triggering insulin.

It can take a couple of days before your liver storage bin is empty. No matter if those sugars come from the carbs you’re eating or from storage, insulin enters the equation and always stops ketosis. The enemy of ketones is insulin. When insulin is whipping those carbohydrates around, not one stinkin’ ketone circulates in your system. Insulin blocks that process until the sugars are low enough. No ketones allowed until both your carbs and insulin have settled down.

To exit this whole messy cycle of insulin and sugars, eat fat without consuming carbs. We call this a “fat fast.” The one food you can eat that signals NO insulin is fat. Stop the carbs, and eat fat.

You stop releasing insulin once your sugar level drops low enough. If you have struggled with your weight for fifteen years, your system is very used to producing a large amount of insulin to manage the abundant carbohydrate you eat. The reversal of that insulin is not instant. If you lower your carbohydrate intake to 20 carbs per day, your insulin can take several days to adapt to the reduced carb intake. In some of my patients with years of weight troubles, we have struggled for several weeks before we lowered their insulin levels.

After both your insulin and sugars are lowered your mitochondria flip their furnaces from burning carbs to burning fat. That’s when you will find a trickle of ketones circulating in your system. Stay away from carbs day after day and you will turn that trickle of ketones into a bath of steady fuel from fat. Ketones deliver steady and stable energy.

Rule #4: Measure Ketones
How will you know when your furnaces switched fuels? MEASURE IT!!

This is my favorite part. Don’t guess which fuel you’re using-MEASURE IT. When your body is making ketones by fueling from fat, the urine and blood will show it. Prick your finger to check for ketones in your blood, or more simply pee on a urine ketone stick. You can pick these up at your local pharmacy. These sticks will quickly let you know if you’ve achieved ketosis.

Recapping the Rules for Ketosis:
Mitochondria produce energy throughout the human body. These little furnaces within your cells pump out the energy your body needs to survive. You can choose which energy your body runs on by your choice of food.

You can choose your energy source by what fuel you put in your furnaces.

If you eat carbs, you will flood your bloodstream with glucose. Insulin chases those sugars out of circulation and into your cells. Your mitochondria rapidly process those carbs to produce hot, fast energy. Much like the fire from dried pine needles, this sugar energy shoots up and crashes down within a short timeframe. That super hot fire feels like a rush at first, but over time that repeating frame does more damage than good.

Stop eating carbohydrates and fuel your body with fat. Within days, you will shift away from carb-chemistry and start burning fat.

Switching the body to ketone production will not begin until you significantly lower your sugar and insulin. While your system empties the stored sugar from years of carb-fueling, eat fat so as not to produce any extra insulin.

Learn more about what foods to eat through our FOOD GUIDE teaching you the good – better – and best options for ketosis eating.

Westman, Eric C. ADAPT Program: a Low Carbohydrate, Ketogenic Diet Manual. Adapt Your Life, Inc., 2015.
Klement, Rainer J., and Reinhart A. Sweeney. “Impact of a Ketogenic Diet Intervention during Radiotherapy on Body Composition: I. Initial Clinical Experience with Six Prospectively Studied Patients.” BMC Research Notes, vol. 9, no. 1, May 2016, doi:10.1186/s13104-016-1959-9.

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