5

votes

how long is too long to be in ketosis?

Answered on August 19, 2014
Created January 17, 2011 at 11:55 PM

First, I have been strictly Paleo for a couple of weeks and noticed strong bad breath that didn't go away with brushing. FYI, my boyfriend has it too, so its definitely a turn-off for both of us! I'm sure our foul breath is from ketosis. According to Mark of Mark's Daily Apple, being in a state of ketosis for more than a few days is bad. Other research I've done points to ketosis as a crucial part of losing excess body fat. Should I be concerned about being in ketosis for more than a week but less than a month? When I lose a decent amount I'll slowly introduce carbs to find my body's personal maintenance level. I'm tracking my carb intake on fitday.com.

3b7e6c77a5412587152c9e3f22b41c2a

(434)

on September 01, 2011
at 01:35 AM

This is pretty much the same question as http://paleohacks.com/questions/46724/57966

D31a2a2d43191b15ca4a1c7ec7d03038

(4134)

on January 18, 2011
at 12:22 PM

WayfinderAli, there are many on low-carb diets, such as Dr. Richard Berstein's, or Atkins, who like to stay in ketosis for general well being and to lose weight or avoid gaining weight. If you do a search for "very low carb" with "forum" or "challenge", you'll find other people eating very few carbs and enjoying life. I wish you all the best.

4b97e3bb2ee4a9588783f5d56d687da1

(22923)

on January 18, 2011
at 12:10 PM

While in a fasted state, yes, right after consuming any type of sugar , no. Your body will always remove excess glucose from your blood first, as too high blood sugar is deadly

Medium avatar

(2169)

on January 18, 2011
at 03:41 AM

wow! thank you for all the info! I definitely have some reading to do, but it seems like for my relatively low weight loss needs (I need to loose about 15 to 20 pounds) I needn't worry.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on January 18, 2011
at 02:55 AM

So does that mean when you're keto-adapted, body will still use fat as fuel even when not in full-blown Ketosis?

4b97e3bb2ee4a9588783f5d56d687da1

(22923)

on January 18, 2011
at 01:57 AM

Hmm not exactly. Keto adapted mean your body is good at running off ketones. What your talking about is cyclic ketogenic, zero carb into ketosis, then carbs for glycogen replenish, then back to ZC to go back to ketosis. Once keto adapted(body good at using fat as fuel) I think full blown ketosis is unnecessary.

D31a2a2d43191b15ca4a1c7ec7d03038

(4134)

on January 18, 2011
at 01:06 AM

Sorry, that ought to read: ...requiring attention, other than drinking enough water.

D31a2a2d43191b15ca4a1c7ec7d03038

(4134)

on January 18, 2011
at 01:00 AM

Ambimorph, thanks. I've been reading about ketogenic diets today, and ran across this. I have yet to find anything that reports risks requiring needs attention, other than drinking enough water. I think this subject is important, so if you think of something that would help folks make wise choices, I think it would be great. I always enjoy your posts.

100fd85230060e754fc13394eee6d6f1

(18696)

on January 18, 2011
at 12:55 AM

Nice answer, PG! I was about to make a much lesser post, but won't bother now. Essentially, there is no evidence that I'm aware of that shows any problem with being in ketosis long term, and I've searched a lot.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on January 18, 2011
at 12:43 AM

ok, this is something i've been confused about for awhile. if you're "keto-adapted" and cycling calories, is your body still running off of ketones and the re-feed days are only to put glycogen back into the muscles while the lowish- carb days put the body firmly back into ketosis. is this in the ballpark?

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7 Answers

best answer

8
D31a2a2d43191b15ca4a1c7ec7d03038

on January 18, 2011
at 12:51 AM

How the content of a diet effects someone depends on that person's health. Each person must do some serious reading, and make a well informed decision. Making an important choice about health requires careful, studied consideration.

That said, here is a bit of information:

Many people are on life-time ketogenic diets for epilepsy, Alzheimer's and other dementia, Parkinson's, Multiple Sclerosis, bipolar, cancer, brain tumors, metabolic syndrome, PCOS, diabetes, and ALS, to name a few that come to mind. With such conditions, their ketogenic diets are monitored by doctors.


There are some interesting abstracts, and a few full text reports, at Pubmed, on ketogenic diets. Here is the search results list, using the phrase, "ketogenic diet":

http://www.ncbi.nlm.nih.gov/pubmed


This article might be of use.

http://www.medicalnewstoday.com/articles/179311.php

*High-Fat Ketogenic Diet To Control Seizures Is Safe Over Long Term Current and former patients treated with the high-fat ketogenic diet to control multiple, daily and severe seizures can be reassured by the news that not only is the diet effective, but it also appears to have no long-lasting side effects, say scientists at Johns Hopkins Children's Center.

A study report supporting their conclusion, and believed to be one of the first analyses of the long-term safety and efficacy of the diet, appears online in the February edition of the journal Epilepsia.*

The ketogenic diet, consisting of high-fat foods and very few carbohydrates, is believed to trigger biochemical changes that eliminate seizure-causing short circuits in the brain's signaling system. Used as first-line therapy for infantile spasms and in children whose seizures cannot be controlled with drugs, the diet is highly effective but complicated and sometimes difficult to maintain. It can temporarily raise cholesterol, impair growth and, in rare cases, lead to kidney stones, among other side effects.

"Despite its temporary side effects, we have always suspected that the ketogenic diet is relatively safe long term, and we now have proof," says senior investigator Eric Kossoff, M.D., a pediatric neurologist and director of the ketogenic diet program at Hopkins Children's. "Our study should help put to rest some of the nagging doubts about the long-term safety of the ketogenic diet," he adds.

The evidence is based on a study of 101 patients ages 2 to 26 years treated with the ketogenic diet for a minimum of 16 months and for up to eight years at Hopkins Children's between 1993 and 2008. At the time of the follow-up, patients were off the diet anywhere between eight months and 14 years. Nearly 80 percent of the patients remained either seizure-free or had their seizures reduced by half. Most patients' seizures did not worsen even years after stopping the diet.

Researchers caution it is possible that some effects may not show up for decades. However, the evidence, especially among patients who were off the diet for more than 10 years, suggests no long-term harm.

During interviews, none of the patients reported adverse cardiovascular side effects such as heart attacks, enlargement of the heart or abnormal plaque buildup in their arteries. One patient reported having high blood pressure.

Only two of the 101 patients reported kidney stones after stopping the diet, the same rate found in the general population not treated with the ketogenic diet, the researchers say. None of the 25 patients who had liver and kidney function tests had abnormal results. Among the 26 patients who had their cholesterol tested, the average level was 157 milligrams per deciliter of blood (less than 200 is considered normal), with three of the 26 having abnormal levels. Most patients' cholesterol levels go up while on the diet, but are believed to return to normal thereafter. The Hopkins study now confirms that this is the case. Most patients older than 18 at the time of the study had normal body mass index of 22 on average (25 and below is considered normal). And most of them were within a few inches of their expected heights, based on their parents' heights. Patients 18 years and younger at the time of the study were, on average, in the 25th percentile for height and in the 36th percentile for weight for their age. While this is below average, the investigators say, it is also much higher than the usual 5th-to-10th percentile while on the diet.

"We have every reason to believe that most children will start catching up once they are off the diet as they grow up because this is what we see in older former patients," Kossoff says.

100fd85230060e754fc13394eee6d6f1

(18696)

on January 18, 2011
at 12:55 AM

Nice answer, PG! I was about to make a much lesser post, but won't bother now. Essentially, there is no evidence that I'm aware of that shows any problem with being in ketosis long term, and I've searched a lot.

Medium avatar

(2169)

on January 18, 2011
at 03:41 AM

wow! thank you for all the info! I definitely have some reading to do, but it seems like for my relatively low weight loss needs (I need to loose about 15 to 20 pounds) I needn't worry.

D31a2a2d43191b15ca4a1c7ec7d03038

(4134)

on January 18, 2011
at 01:00 AM

Ambimorph, thanks. I've been reading about ketogenic diets today, and ran across this. I have yet to find anything that reports risks requiring needs attention, other than drinking enough water. I think this subject is important, so if you think of something that would help folks make wise choices, I think it would be great. I always enjoy your posts.

D31a2a2d43191b15ca4a1c7ec7d03038

(4134)

on January 18, 2011
at 01:06 AM

Sorry, that ought to read: ...requiring attention, other than drinking enough water.

D31a2a2d43191b15ca4a1c7ec7d03038

(4134)

on January 18, 2011
at 12:22 PM

WayfinderAli, there are many on low-carb diets, such as Dr. Richard Berstein's, or Atkins, who like to stay in ketosis for general well being and to lose weight or avoid gaining weight. If you do a search for "very low carb" with "forum" or "challenge", you'll find other people eating very few carbs and enjoying life. I wish you all the best.

1
9e10d8fac08a922a9c5e733965e8cce8

on April 18, 2011
at 02:31 PM

There are two scientifically rigorous books by Gary Taubes that exhaustively review the research related to carbohydrates and diets that restrict carbohydrates. Please read "Good Calories, Bad Calories" and "Why We Get Fat."

First, there is 150 years of research that supports carbohydrate restriction as the best way to maintain an appropriate weight. In our grandmother's generation it was a given that you kept weight off by avoiding sugar and starch. Only in the 60s and 70s did American scientists, misled by some bad data and a few influential scientists, start to preach that fat was the danger and that low-fat, high-carb diets were good for you.

Second, in the last decade, as the low-fat diet has increasingly been challenged and low-carb approaches like Atkins and Paleo have been scientifically validated, the tide is turning. A large variety of recent studies have shown carb restriction to be effective and safe.

The notion that dietary fat is bad for you dies hard, but it is finally dying because the scientific evidence -- from animal and human studies, and from well established findings about how metabolism works -- is glaringly clear.

Taubes, who has spent 10 years reviewing the available research and interviewing more than 600 scientists in the field, has concluded that a low-carb approach is not only safe over the long term but may in fact be a better diet for human beings. There are indications that many diseases characteristic of advanced western societies, such as autoimmune disorders and many types of cancers, only appeared when large quantities of refined carbohydrates (mainly sugar and flour) were added to the diet, and Taubes believes many of these diseases would recede if people would stop eating refined carbs.

1
667f6c030b0245d71d8ef50c72b097dc

(15976)

on January 18, 2011
at 12:27 AM

i definitely would not worry at all. Whether you function better running off burning glucose or running off ketones is another issue. I ate nothing but animal products for three months as a self experiment. Caveat: i was well ketone-adapted from months of being very low carb for a while before starting no-plant-matter. I had no ill health, no issues at all. I was not however involved in heavy weight training just so you know.

Right now im more active with the weights and i am fueling myself with starch as well: sweet potatoes and white potatoes. i feel more or less the same as when I was in ketosis.

My point is just that you do not have to worry about being in a state of ketosis for one, two, or three months in my experience.

1
7e746be2f0e550a8cd7df881322ae705

on January 18, 2011
at 12:24 AM

You have to weigh the research and methods behind each study you've read and make an informed decision as to which you believe is the most accurate.

There are people who do zero carb or VLC (very low carb) for life and seem to be fine. I believe there has been new research that indicates some recent issues though, but my understanding the issue is with people who have been doing zero or VLC for years, not days or months.

If you plan on doing a zero carb or VLC for the rest of your life, then more research is in order. If you plan on doing this for a few weeks or even a few months, you should be fine.

0
Cec206b30f9ab636111ab3af49e2390a

on August 08, 2012
at 09:26 AM

For me a key reason that LCHF is good is the last HF-part: More Fat stimulates the liver to produce more bile. This means the liver is made able to clean itself better as the bile is the only (?) route for the liver to expel toxins it extracts from the blood. The opposite is obviously true for a low fat diet: At what point is the liver itself becoming toxic from a prolonged low fat diet? Any studies before low-fat was promoted as "heart safe"? My skin problems has ceared up and my skin in general is much better now one long term (6 months!) result of the LCHF diet, although it only took weeks to notice a difference. All of my "liver spots" have actually faded strongly when I compare with old pictures, despite a good sun tan! Maybe the old name is right after all ? These liver-effects alone give a very strong support for high fat being able to improve health long term. The high fat must in my opinion be combined with plenty of greens to provide some variety and also some material that toxins from the liver in the bile can bind/attach to in the intestines if not properly bound already.

Personally I am now moving in to a ketogenic phase after 2 months of weight loss (97-92) followed by 4 months plateau or stagnation, (92-90). Target is 80 kgs. After reading Jimmy Moores account of his start with ketosis I realize that the reason my weight loss stopped is too much proteins converting to blood glucose, after a while. Once the liver "re-learns" how to make blood glucose out of proteins, after a month or a few, the initial ketosis disappear and with that the continued weight loss. Simple as that? I now try to change my food habits towards the old saying: Breakfast as King, Linch as a lord and dinner as a pauper. By lowering protein intake at night the idea is to have minimum proteins available for blood sugar conversion duing the night when the slow protein-BS conversion otherwise could exceed usage and result in high morning blood glucose - and/or end insulin.

Thanks for the reassuring reports that ketogenic diet has not shown any long term bad side effects. The long term side effects so far seem to the opposite. Can we hear more experiences of the long term positive side effects? Like curing IBS and improve blood markers? Here is a study from Kuwait - naturally not suffering from economic dependence from its sponsors - paid for by Kuwait department of health. They were concerned if a low carb high fat diet which worked very well to treat a growing local obesity could cause increased risk for heart disease - the main argument in the west to stay away from it (especially given to diabetics!). It was an intervention study of 81 subjects for 6 month and showed 10% plus weightloss and improved standard blood lipids allover instead of the feared worsening. Study done already 2004. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/ There are preliminary Swedish measurement trials checking LCHF followers for "arterial stiffness" with ultrasound annually. The preliminary results after a few years is a lowering of average arterial stiffness. This is something that gradually increases with age in the average population. Age matched reduced "cardiac age" in this sense was seen progressing with duration of LCHF. The test are continually being made by Professor P.A. Öckerman in Sweden.

0
Medium avatar

on January 18, 2011
at 12:20 AM

I was under the impression that everyone enters ketosis (or at least ketogenesis) some number of hours after a meal, so it's definitely something that your body is used to in small doses, but I remain unconvinced that total ketosis is necessary for good health. I think a survey of every paleolithic diet that has ever existed would be skewed away from ketosis (especially if you controlled for season), but that's just my gut feeling.

-1
4b97e3bb2ee4a9588783f5d56d687da1

on January 18, 2011
at 12:00 AM

Omg your gonna die!

Or lose alot of weight.

Personally I didn't enjoy the feeling. I cpul lose just as fast cycling calories put of ketosis. I believe it to be an adaptive measure and not what were meant to run on. That said a couple weeks I think is fine, all the tine could lead to deficiencies if not eating nose to tail...

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on January 18, 2011
at 12:43 AM

ok, this is something i've been confused about for awhile. if you're "keto-adapted" and cycling calories, is your body still running off of ketones and the re-feed days are only to put glycogen back into the muscles while the lowish- carb days put the body firmly back into ketosis. is this in the ballpark?

4b97e3bb2ee4a9588783f5d56d687da1

(22923)

on January 18, 2011
at 12:10 PM

While in a fasted state, yes, right after consuming any type of sugar , no. Your body will always remove excess glucose from your blood first, as too high blood sugar is deadly

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on January 18, 2011
at 02:55 AM

So does that mean when you're keto-adapted, body will still use fat as fuel even when not in full-blown Ketosis?

4b97e3bb2ee4a9588783f5d56d687da1

(22923)

on January 18, 2011
at 01:57 AM

Hmm not exactly. Keto adapted mean your body is good at running off ketones. What your talking about is cyclic ketogenic, zero carb into ketosis, then carbs for glycogen replenish, then back to ZC to go back to ketosis. Once keto adapted(body good at using fat as fuel) I think full blown ketosis is unnecessary.

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