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Understanding a Ketogenic Diet, or Keto Diet.

Keto Diet

“Is butter a carb?….”.

No Regina George, butter is not a carb. I know, you really want to lose 3 pounds. Well one of the recent health fads that suggests quick weight loss is a diet style called the Ketogenic Diet, or Keto. Ever heard of it?

Unless you’re living in a remote village without internet, mail, or any other inhabitants; odds are you’ve at least heard the word. But what exactly is a keto diet?

Most magazine articles, web blogs, or diet books may have you believe that its your body burning fat instead of carbs; which sounds almost magical. Burning fat? All the butter you can eat? Is there a downside?

Well, who can explain what a ketoacid is?…..anyone?…. 

The misconception about ketogenic diets is they lead people to believe “you can eat fat and burn fat” without providing enough information on how to execute this diet properly or educating the affects it has on your body. 

Care to learn?

The body’s number one fuel source is Carbohydrates. That’s because all carbohydrates yield glucose which is the fuel source our organs need in order to perform their jobs (breathing, thinking, pumping blood, digesting food…the list goes on)

Once a carbohydrate is ingested, it is broken down into a molecule called AcetylCoA. That molecule must combine with another carbohydrate substance called oxaloacetate; and together they form Citric Acid. Citric acid is what starts the TCA or “Kreb’s Cycle” (think 10th grade biology) so that the energy, or ATP, can be extracted and used for fuel. 

Well guess what. When a fat is ingested, it too is broken down into AcetylCoA… and Ketone bodies. Ketone bodies are water soluble acidic molecules made by the liver using fatty acids and are a back-up source of fuel for periods of starvation. The AcetylCoA from fat must also combine with Oxaloacetate to form citric acid and start the kreb cycle. This is how we normally burn fat for fuel. 

Think of that little carb piece, oxaloacetate, as the gasoline to start a fire. 

What would happen if you didn’t have it? How would you “burn” fat?

This is ketosis.

Keto infographic

Ketosis is a manipulation of our normal biological functioning. Rather than eating the average 45-65% carbohydrates, 25-35% fat, and 10-20% protein; a person skews their eating style to be 80% fat, about 15% protein, and 5% carbs. Eating large amounts of fat causes an accumulation of ketones to build up. Limiting carbohydrates to such a minimal extreme (think 20C or less) eliminates the production of oxaloacetate. Without enough oxaloacetate, the body cannot handle the AcetylCoA from fat metabolism and therefore must use ketone bodies instead; putting the body into a state of ketosis. 

Not exactly “burning fat for fuel” like the bloggers and diet books lead us to believe; but that certainly is a simpler explanation than the scientific truth. As with any extreme diet it’s important to understand the choice you’re making and how it affects your body. Ketosis has been shown to help with weight loss, insulin sensitivity, and blood glucose. But so have other diets; without as many risky side effects. 

Ketones are very acidic and put a greater workload on the kidneys to maintain the acid base balance while acting as a filter for your blood. What happens when you put something in acid? Well, it erodes. Blood pH can become acidic and the only aid to rid the body of the excess acid is through your urine and your breath. That’s right, your breath. Carbonic acid builds up in the lungs causing the infamous keto breath. And who wants to kiss that?

Another risk to ketogenic diets, besides the lack of glucose for your organs, is the acidic environment it creates and the foods this diet limits: fruits, vegetables, and their corresponding antioxidants, vitamins, and electrolytes. Plus it’s a difficult diet style to maintain. Butter is delicious. But so is salad. 

The best decisions are informed decisions. The rest is up to the individual to decide. You’re informed and therefore more empowered. And if this is too overwhelming, like Regina George you can always just get cheese fries. 


  1. Mahan LK, Escott-Stump S. Krauses Food & Nutrition Therapy. St. Louis, MO: Saunders/Elsevier; 2008
  2. Gropper SAS, Smith JL, Carr TP. Advanced Nutrition and Human Metabolism. Boston, MA: Cengage Learning; 2018