Achieving ketosis is not required for most people to succeed on the Undoctored or Wheat Belly lifestyle. However, this can be an important issue to know about. Achieving ketosis is not just a means of accelerating weight loss, but also of enhancing mental and physical performance. You’ll experience this yourself, with heightened mental clarity, energy, and endurance in a ketotic state.
The grain-free lifestyle eliminates junk carbohydrates from the diet. Some individuals find their weight loss efforts seem to plateau after some time on this diet. The occasional person will need to go the full low-carb mile and require a ketogenic state to achieve weight loss.
To achieve a ketogenic state, virtually all carbohydrates will have to be eliminated in order to metabolize fats. An effective ketogenic diet is composed of near-zero (less than 20g net carbohydrates per day) intake of carbohydrates. This is combined with a higher than usual fat intake to quell hunger and divert the metabolism toward mobilization of body fat.
You can detect ketosis by the fruity odor on the breath. This being said, there are more accurate ways to confirm a ketogenic state.
Urine can be tested using a dipstick for ketones, such as Ketostix. However, these can only detect ketones in the higher range, as are experienced by type 1 diabetics during diabetic ketoacidosis, a life-threatening state. Urine monitoring is therefore less sensitive for identifying the subtler levels of ketosis experienced physiologically, which makes urine testing inadequate for weight-loss purposes.
The most assured and precise method to assess blood levels of ketones is with a finger stick, just like checking blood sugar. The only difference is in the timing. Unlike the after-meal checks for blood sugar, ketone checks can be performed at any time.
To maintain a ketogenic state to accelerate weight loss or break a weight-loss plateau, aim for a ketone level of 1.0 to 3.0 mmol/ L, and maintain that for as long as you desire accelerated weight loss. If you fall below this cutoff, it means that continuing carbohydrate consumption is preventing conversion to a ketogenic state.
Physicians and dietitians often warn people that ketosis is dangerous and can lead to kidney damage. This is not true. The clinical data does not demonstrate any deterioration in kidney function with high intakes of protein in people with normal kidneys.
They are confusing ketosis, a natural adaptation to periods when carbohydrates are unavailable, with diabetic ketoacidosis. Diabetic ketoacidosis is a dangerous condition that develops in type 1 diabetics who, when deprived of insulin, develop extremely high levels of blood glucose and a high level of ketones sufficient to generate a life-threatening drop in blood pH. None of this occurs in physiological ketosis generated by carbohydrate restriction in people without type 1 diabetes.
Additionally, ketosis does not necessarily require an increase in protein intake over the usual levels, but rather an increase in fat intake, which has no effect on kidney health.
Attention should still be paid to the intake of prebiotic fibers, which do not impact blood sugar or ketosis. In my view, making sure that you obtain sufficient prebiotic fibers is crucial to maximizing the benefits of a ketogenic state.