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5: Ketosis: Devil or Angel? | Mark Sisson

5: Ketosis: Devil or Angel? | Mark Sisson

AIR DATE: February 9, 2012 at 7PM ET
FEATURED TOPIC: “Ketosis: Devil or Angel?”


Episode 5 of “Jimmy Moore Presents: Ask The Low-Carb Experts” features Mark Sisson who is the man behind the wildly popular “Mark’s Daily Apple” blog and the author of several health books focused on primal/Paleo/low-carb living, including his bestselling 2009 release The Primal Blueprint: Reprogram Your Genes for Effortless Weight Loss, Vibrant Health, and Boundless Energy as well as several cookbooks. He has been critically acclaimed for challenging many flawed elements of conventional wisdom about diet and exercise. Sisson’s “Primal” theme encourages us to reconnect with our hunter-gatherer ancestral roots by eating natural plant and animal foods, getting plenty of low-level daily activity interspersed with occasional brief, intense exercise, and engaging in lifestyle behaviors that balance the stress of hectic modern life. Sisson was one of the world’s most versatile and accomplished endurance athletes, with a 2:18 marathon to his credit and a fourth place finish in the Hawaii Ironman World Triathlon Championships. He also served as the first anti-doping leader of the International Triathlon Union and consulted internationally for the International Olympic Committee on endurance training, nutritional supplementation, and the effects of performance enhancing drugs on athletes. He is the founder and president of Primal Nutrition, Inc. a Malibu, CA-based supplement company. Sisson lives in Malibu with his gorgeous wife and two teenage children.

Mark has studied nutrition very closely over the years and is pretty astute at articulating information from the scientific research on diet and health. One specific area of expertise he possesses is on the controversial subject of ketone bodies. He does a fabulous job addressing the nonsense that ketosis is merely “smelly breath” and goes much deeper into what the purpose of ketone bodies in the body. This is a BIG TOPIC in the low-carb community and Mark Sisson does an excellent job addressing YOUR questions.

Here are the questions about ketosis Mark addresses:

Is it better, when testing for ketones, if the stick is very dark vs. lighter. In other words, is better to have more ketones? Or is any level of ketosis adequate?

How do you explain to someone in the medical field that ketosis is not a bad thing? I was talking to my sister who is in the medical field and it seems that she along with a lot of other medical professionals who should know the difference between ketosis and ketoacidosis don’t. They automatically assume that ketosis and ketoacidosis are both bad. How do you explain the difference to them when they should already know the difference?

When I am in Ketosis – how do I know if the ketosis is from stored body fat or from excess fat that I may be eating?  Is there a certain level of fat per day (in grams or a %) that I should aim for at to ensure my ketosis is from stored body fat (and not eating too much fat).

I’ve always been taught that ketones could only be produced if you eat around 50g of carb or less.  But I’ve seen on your site that you think eating less than 50g could lead to unnecessary deprivation of plant foods.  Could you elaborate on this?

How long does it normally take a body to get adapted to using ketones for energy? I keep starting over (VLC – around 30-40/day) because I feel like a slug for a month and just can’t take it. Now I read it can take longer than that to actually get your body adapted to using ketones for energy well? I need to lose about 75 pounds and have ZERO energy for exercise.

Is ketosis really necessary for most people to lose weight?

Are there any negative health consequences (kidneys, brain function, hypoglycemia, bone and eye health or constipation) to being in ketosis for an extended period of weeks, months or years?

Can excess protein at any one meal bring you out of ketosis? If so how much is too much?

Is a ketogenic diet inflammatory or anti-inflammatory?

Just wanted to ask you guys what to do about the dreaded keto breath. My girlfriend really hates it and refuses to even kiss my when I have it. I’ve heard all kinds of remedies, carrots, parsley and other herbs. Any suggestions?

Where does ketosis fit into my weight loss and muscle gain routine? I’m currently 5’6″ and weigh about 185 pounds.

After about 5 or 6 months of low carbing, my scalp started burning and my hair started falling out. Could this be linked with ketosis?

The brain requires a steady inflow of glucose for proper functioning. Gary Taubes mentions in Why We Get Fat that it isn’t known for sure if the brain can run as effectively on ketones as it can glucose. What are your thoughts?

I am 52 years have returned Atkins low carb eating about 4 week ago after being on the diet roller coast all my life. I am also on several medication (blood pressure, thyroid, quit the statin, supplements etc) that I know do hinder weight loss, can they be preventing me from burning more ketones? Any suggestion how I can bump up my ketosis if need to?

Does approaching diet and health from the Primal point of view consider manipulating ketones/ketosis to lose a lot of weight as the OPTIMUM way to do it? The question is assuming that hunter gatherers would not usually make it to the level of hormone damage and obesity we find common in today’s population, so evolution may not have provided a robust way to get us out of such a huge hormonal mess.

I’m wondering how the absence of a gallbladder can affect someone attempting ketosis or a Primal lifestyle in general. I have heard that others require slightly higher carbs to keep away from IBS type symptoms. Have you found this to be true?

Dr. Steve Phinney, in a video interview with Andreas Eenfeldt, says that someone who takes a one or two day “holiday” from a ketogenic diet generally takes “at least two weeks and more like 4-6 weeks” before they re-enter full nutritional ketosis. Do you have any thoughts on this? It was my assumption that it wouldn’t take that long before someone would recondition their bodies to preferentially burn fat. Do we reset the clock every time we eat enough carbohydrates to come out of ketosis?

Is lowering carbohydrates the only thing that determines whether or not someone will get into ketosis? Specifically, is there any effect food sensitivities have on being in a ketogenic state? When I eat nightshades (which I am sensitive to) my ketone bodies (as measured with ketone urine strips) go down. I generally eat a very low carbohydrate diet (less than 20 grams/day) and am wondering if this effect on my measured ketone bodies is due to food sensitivities, the increase in carbs from the nightshade foods, or some other reason?

I’d like to get Mark’s perspective on ketosis and gout risk. Also what about people who have gout going on ketosis?


NOTICE OF DISCLOSURE: http://cmp.ly/3

  • Thanks Jimmy I love the answer to my question!

    • Anonymous

      Superb question, so thank you for asking it!

  • Leo

    Great information as always !
    Jimmy , Thanks for having Mark Sisson on your show.

    • Anonymous

      Mark is an awesome expert.

  • Dusty


    • Anonymous

      Thanks for supporting the podcast.

  • That was a terrific show, keep it up Jimmy! Thank you!

    • Anonymous

      Thanks Angela!

  • Kathy

    Thanks, Jimmy for this new podcast format, and for all the work you do to keep us all informed and healthy! Mark, as always, is a wealth of information and encouragment.

    • Anonymous

      Appreciate you listening.

  • Amazingly informative show! After having achieved ‘keto-adaptation’ and maintaining it for over a year now, and losing ~63lbs in the process, I didn’t expect to learn much of anything new from this show but I definitely did. Keep up the great work!

    • Anonymous

      THANKS for listening!

    • E.G.

      Hey Mark,
      Just curious. Are you still keto-adapted.
      Hopefully you don’t mind sharing a progress update.

  • Barb

    Hi! I have a question about ketosis as it pertains to a diabetic. I am currently trying to help my sister lose weight, reduce her insulin dosages and get healthier. Her doctors have at times suggested that she is a Type 1 diabetic, while others have suggested that she is Type 2. I suspect that she may be both, as I understand that this is possible. To further complicate things, she only has one kidney, so we have to consider that as well AND she has undergone a quadruple bypass in the last 4 years. No, I’m not making this up… diabetes has ravaged her health… she is 61years old and morbidly obese at 5’2″ and 292 pounds.

    Here is the question… I have helped her get onto a wheat free, low carb diet, and in the past 3 weeks, she has lost 15 pounds (down to 277) and finds that she is feeling better, with more energy. Even her diabetic nerve pain has improved. BUT… now she is beginning to produce ketones in her urine, as expected on a low carb diet. Naturally, her health care providers are having fits about this. Personally, I have yet to find a health care professional who can accurately describe the differences between ketosis and ketoacidosis.

    I understand that a low carb, Paleo type diet (which is pretty much what she is on) can be a God send for both T2DM and T1DM alike. But, along with the low carb comes the ketones, and along with that – ignorance.

    Is it safe for a diabetic to be in ketosis? How about ketosis and compromised kidney function? Is there a minimal amount of carbs that she should be on? She does take intermediate acting insulin (Humulin 30/70) twice daily, at a dose of 40 units per injection.

    She has ignored herself for so long… I just want to be sure that I am helping her and not harming her. Her current Diabetic Nurse tells her to have cereal, skim milk and toast for breakfast… as you can imagine, all that does is drive up her blood sugars… any input would be so very appreciated!!

    • Anonymous

      The podcast has already aired, but thank you for your question! Maybe you can ask this question to one of my other upcoming guests on a week where the question would be relevant to the topic we are discussing.

    • Anonymous

      But to answer your question (which Mark did in this podcast), there is no harm to diabetics simply being in ketosis. Listen to the part of this podcast where Mark Sisson explains the difference between ketosis and ketoacidosis for an illuminating answer to your question.

  • Rob

    All the books I’ve read always instruct everyone to eat mostly fat. Mark clearly stated that to reduce fat stores(lose weight), we would have to reduce dietary fat intake. Am I the only person who found this shocking and maybe the reason a lot of people fail to lose on low carb or am I missing something?

    • LLVLCBlog

      Dr. Ron Rosedale has been saying this for many years. It’s not a great reduction in fat, but slightly to release stored body fat.

  • Stephanie

    OMG Mark, you just totally described me before paleo and my mother and father in law period. They are seriously talking about and worrying about dinner right when we are at lunch. It’s crazy!

  • jo

    Hi! I hear a lot of benefits from ketogenic diet. I went on it and lost a lot of weight and felt good until I had fever suddenly, fainted, confused and weak till put on drip. Anion gap was high and fasting glucose was 9.1 when I am not diabetic. I couldn’t understand but I wish someone will tell me how to do it safely…I realise my protein was very high and not much fat. Could it be the reason? When I started adding carbo, my health problems came back and weight increased too.

    • LLVLCBlog

      Not nutritional ketosis what you did. I can connect you with a ketogenic-friendly doctor if you’re interested. Email me at livinlowcarbman@charter.net.