Is It Safe To Stay In Ketosis Indefinitely?

Are you willing to pay the consequences
for an extended Atkins Induction?

There seems to be a lot of focus on the state of Nutritional Ketosis these days, with many people asking the same questions:

• Am I in ketosis?
• How many carbs does it take to get thrown out of ketosis?
• What should I do if the Ketostix aren't showing that I'm in ketosis anymore?
• I'm only eating 20 carbs, why am I not in ketosis?
• Is it safe to stay in ketosis indefinitely?

And while some of these questions are certainly important -- like just how safe of a diet is the Atkins Diet long-term -- overall, it seems that the low-carb community is putting too much emphasis on the state of ketosis and not enough focus on the consequences for staying in Induction too long.

With so many different versions of the Atkins program out there, and people still doing all of them, I don't see the questions going away anytime soon.

With that in mind, I thought I'd take a moment and do a post on my own personal views about ketosis, Atkins Induction, and its long-term safety.

Thoughts on Ketone Testing Strips

In the 70s, the whole Atkins' diet was built up around the idea of ketosis being the revolutionary miracle to save you from obesity.

Like everyone else, I rushed out to the drug store and bought myself a bottle of ketone testing strips -- Ketostix they were called back then.

These ketone testing strips were actually created for diabetics who needed to test for the presence of Ketoacidosis.

Acetoacetate ketones are the type of ketone you are actually looking for when you test your urine: the ketones that suggest that a diabetic is in trouble.

The sticks don't test for the state of ketosis because that is actually measured by ketones in the blood.

But at the time, Dr. Atkins felt that ketone testing strips were an accurate enough test. Plus they gave dieters the motivation they needed to put his revolutionary insight to the test.

Since then, we've discovered they aren't very accurate, even for urinary ketones.

When I went on Atkins for the very first time, I registered dark purple no matter how much water I drank. When I went on Atkins again, a second time, the color was somewhat lighter, but still moderate.

Each time I returned to Atkins, the strips grew lighter and lighter, until today -- I don't register on the sticks at all, even when doing Induction.

You can be in ketosis without turning the ketone testing sticks any color at all. You can register dark purple on the sticks, yet still not be burning body fat.

In fact, these variances occur despite the number of carbs you eat.

There's NO standard.

Everything about low carb is individualized. Everything depends on your own:

• circumstances
• goals
• and metabolic damage

And here's the clincher:

You don't even have to be in the state of ketosis to mobilize your fat stores!

Latest scientific research showed participants had absolutely no problem mobilizing their fat stores in the presence of high insulin.

Caloric deficit is what led to fat loss.

In fact, as they moved from a high-carb diet to a low-carb diet, where dietary fat went up, fat loss slowed down tremendously.

Insulin Hypothesis is Not a Fact!

The original idea for ketosis mobilizing your fat stores was tied to ideas about insulin.

Lowering basal insulin levels back to normal was supposed to open the doors to your fat stores and help them to stay open. This is what all of the low-carb experts over the years have taught.

Dr. Eades went a bit further and suggested that ketosis helps you avoid all of the pitfalls and health consequences associated with Insulinemia (high insulin levels) and insulin resistance. Those benefits may, or may not, be true.

I honestly don't know.

What I do know is that somewhere along the way, things got tilted.

People started teaching that low carb meant some kind of high-fat free-for-all.

Stay in ketosis and you can eat all of the low-carb high-fat food you want, whenever you want, including lots of high-calorie, fatty foods and you'll still drop the weight and make it all the way to goal.

For me?

Didn't happen! I stopped losing weight around 165 pounds.

Stay in ketosis, they told me, and your body fat stores, regardless of the amount of calories you eat, will just fall off because carbs are the demon, not calories.

Once again, that's not true for me!

I went back onto a ketogenic diet last year for 6 months and didn't lose a single pound. It did correct my blood glucose problems, temporarily, but it didn't carve off the pounds.

Once the blood glucose normalized, it flipped on its head, and the numbers started to go back up again. It was like glyconeogenesis wouldn't shut off.

Today, I'm back on maintenance in an effort to control my blood sugar because even though what happened was a sign of liver insulin resistance, I have neuropathy and cannot allow my blood glucose to be higher than 120 mg/dl two hours after I eat -- or the neuropathy will come back.

Stay in ketosis, they said, and you'll experience Atkins Magic:

• no hunger
• easy fat loss
• permanent weight loss

Nope. Not for me.

I no longer lose my hunger when I go low carb. That perk is over for me, too. In fact, my hunger grows more intense on low carb, making it particularly difficult to stay within a calorie deficit. Hence, for me, no weight loss on low carb.

These were false promises for me, suggestions that didn't live up to their claim because the Insulin Hypothesis is just an hypothesis. 

The Insulin Hypothesis is not a fact.

When your insulin resistance is severe, your fat cells can't see the insulin you're producing, so the doors to your fat cells are already open before you go low carb, which makes it easier to ditch the weight, regardless of the type of diet you're following.

For those with insulin resistance at the level of the muscles, fatty muscles -- high triglycerides in the blood -- is what causes that resistance, and not insulin.

Likewise, at the level of the liver, a fatty liver will interfere with gluconeogenesis to the point where it will never shut off.

As your insulin resistance at the fat cell level heals, insulin resistance becomes more of a problem because you still have the consequences of a fatty liver and fatty muscles to deal with.

The fat cells start to see the insulin.

You become insulin sensitive, to some degree, and it gets more and more difficult to shed the weight without paying strict attention to your calorie intake.

Talk to any patient of the popular low-carb doctors today, such as Dr. Westman, and they will tell you that eating low calorie is a huge part of the diet's success. Calories matter.

Even Dr. Atkins nurse has said that the diet works best when you eat just enough to avoid hunger, and no more.

Consequences of an Extended Induction

The problem, as I see it, isn't with the Atkins Diet. The Atkins Diet still works as originally designed.

The problem is us.

We read the book cover to cover, but we only saw and retained what we wanted to see and remember.

We didn't think about how the whole book was structured, the different phases of the Atkins Nutritional Approach and the essential steps that we were supposed to move into and out of because Dr. Atkins said that if you have a lot of weight to lose, it was okay to do an extended Induction.

Okay. An extended Induction.

With extended being the key word here.

The low-carb community totally loved the idea of faster weight loss, faster fat loss, no hunger, and super fatty meals, so we embraced the idea of doing a very low-carb diet for an extended period of time because we are totally into FAST.

What we failed to understand:

An extended Induction does something to the metabolism.

I don't know what that is exactly but the body adapts to what you're doing.

It could be a thyroid issue.

It could be a total body metabolic issue, a metabolic adaption so-to-speak, but I watched people do it to themselves in 1999, and I watched people do it to themselves in 2010.

Likewise, I'm still seeing people do it to themselves today.

So here's the rock-bottom truth:

Low carb diets are safe.

They are safe to be on long-term. For most people, they are also safe to do indefinitely.

But there's a catch:

Whatever carb level you choose for the majority of your weight-loss phase is pretty much the carb level you've sealed yourself into living with for the rest of your life.

Did you get that?

The original Atkins diet, and even all of Dr. Atkins' later versions were never designed to keep you in ketosis forever.

They were designed to get you into ketosis quickly to initiate weight loss and make it easier to eat at a caloric deficit because you aren't hungry.

Ketosis is a metabolic state where hunger and cravings can be controlled long enough to teach you how to add more carbs to your diet slowly, as insulin resistance heals itself, so you can learn your own personal tolerance for carbohydrate -- and learn how to stay within that tolerance . . . forever.

What most people did instead?

Instead of doing what was necessary to discover their personal carbohydrate level for losing, they stuck to Induction level of carbs, whether they needed to or not, for faster weight loss.

And they stayed at 20-net carbs for so long that their bodies literally adapted to that carbohydrate level. In a way, you can say that their body created a set point for carbs.

So now, when these people try to up their carbohydrate level, even after the week or so required to up-regulate the enzymes needed to process carbs, they can't do it without gaining weight.

They can't raise their carbs above where they were eating throughout the weight-loss phase.

In a very real sense, people who didn't NEED to stay at those drastically reduced carbohydrate levels literally shut themselves out of a more moderate maintenance diet -- all in the name of faster fat loss.

Extended Induction comes with real consequences.

Willing to Pay the Consequences?

You really need to think about what you're doing to your self.

Right now.

Before it's too late.

Because the original idea behind the Atkins Diet wasn't to stay in the state of ketosis forever.

Unfortunately, staying in ketosis long-term is what a lot of folks are going to have to do, not because that's what was required to correct their insulin resistance, but because they desired faster weight loss.

I've seen some pretty wacky things happen to those who have been in ketosis for too long, myself included.

Despite the public teachings of the low-carb influencers, very low carb is not the right choice for everyone.

So the questions to ask yourself are these:

Are you using the state of ketosis as it was originally intended to be used?

As a tool to help you discover and learn your own unique personal tolerance for carbohydrates?

Are you sticking to that unique carbohydrate level?

Or, are you using the state of ketosis as a crutch because you want to get the weight off right now and very low carb is the fastest way to do that?

Are you willing to pay the price for an extended Induction?

If so, then great!

I'll support you every step of the way because there really are some who do need to stick with 20 carbs a day, or even less. Many have been doing this for decades and are fit, healthy, and thriving.

This is why Atkins is designed the way it is.