Often when we hear about a diet that puts the body in a state of ketosis we are fearful having heard that ketosis is a potentially dangerous imbalance of blood glucose, the result of a low carbohydrate, high fat high protein diet. Ketosis results when the body switches from burning glucose for energy to burning ketones for energy. Glucose comes from carbohydrates which are the bodys first choice to metabolize for energy. Ketones are used for energy when there is not enough glucose (from carbohydrates) present in the bloodstream to use for energy.
Clinically stated, “Ketosis is a condition in which levels of ketones (ketone bodies) in the blood are elevated. Ketones are formed when glycogen stores in the liver have run out. The ketones are used for energy. Ketones are small carbon fragments that are fuel created by the breakdown of fat stores. Ketosis is potentially a serious condition if keytone levels go too high.”
Most patients of bariatric surgery are instructed to follow a high protein, low carbohydrate diet with a modest amount of fat. The body only needs proteins and fats for building and repairing tissue and cells, carbohydrates do not play a part in this metabolic function. Additionally, the body can get all its energy from fats and proteins. A ketogenic diet, which was first developed in the early 1900s, is a high-fat and low-carbohydrate diet. When following a ketogenic diet the body will switch from being a carb-burning machine to a fat-burning machine. As a result weight is lost.
Perhaps the best known ketonic diet is the Atkins plan in which ketosis is deliberately achieved by way of high fat high protein and low carbohydrate diet. According to the Atkins program proper monitoring via urine tests will keep ketosis within safe limits and the dieter can reach an ideal body weight without suffering unbearable hunger. Most weight loss surgery patients are discouraged from following an Atkins-type diet because of the high fat content. Surgery reduces the amount of gastric juice available for digestion and many patients do not tolerate high fat foods.
Speaking to the general population (not necessarily weight loss surgery patients) experts are divided regarding the health risk versus benefit of a ketogenic diet. Some experts say it is dangerous because if keytone levels are not properly monitored there may be a strain on the kidneys, and a significant loss of calcium excreted through urine may cause kidney stones or osteoporosis. Proponents of a ketogenic diet cite human evolution in their argument saying during most of the time that humans have existed we have been a hunter-gatherer species living in a ketogenic state for extended periods. Documented studies suggest that after a 2 to 4 week period of adaptation human physical endurance is not affected by ketosis. Some studies go so far to suggest that humans do not necessarily need a high carbohydrate intake in order to replace depleted glycogen stores for energy.
Patients of weight loss surgery should work closely with their bariatric center to develop a diet and lifestyle program specific to their condition of obesity and recovery. While many consider the primary goal of weight loss surgery to be weight loss to improve physical appearance, the higher goal is improved health, energy and longevity.