Ketosis occurs when there are raised levels of chemicals, called ketones, in the blood. It is a potentially very serious condition. A diet that is very low in carbohydrate can cause ketosis. Carbohydrate is the main food group. Foods high in carbohydrates include breads, pastas, beans, potatoes, bran, rice, and cereals. Most of these foods are high in starch. Carbohydrates are the most common source of energy. Proteins and fat are necessary building components for body tissue and cells, and are also a source of energy for most organisms. However, carbohydrates are not essential nutrients in humans: the body can obtain all its energy from protein and fats. The brain and neurons generally cannot burn fat for energy, but can use glucose or ketones. Fat metabolism Normally, carbohydrates are broken down into glucose. It is then converted into energy. Subsequently, it is transported to the body's muscles and organs. In some cases, there is a lack of glucose or it is impossible for glucose to be broken down. This can happen for instance if the body does not produce enough insulin. As part of the fat metabolism, the body will have to break down stored fat in order to convert it into energy. Fat metabolism causes a buildup of ketones in the blood, resulting in ketosis. Ketosis can occur in specific conditions, such as: alcoholism diabetes mellitus (type 1 diabetes) starvation Ketones When the body starts to break down fat, rather than glucose, the levels of ketone in the blood will begin to increase. Ketones are toxic, acidic chemicals such as: acetone acetoacetate beta-hydroxybutyrate If ketones increase, the blood's acidity levels will rise. This can have an effect on urine. Eventually, it may cause serious damage to the liver and kidneys. The body may attempt to liberate the excess amount of acetone through the lungs. This causes the breath to have a sweet, fruity smell. It is sometimes mistaken for alcohol. The ketogenic diet The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet primarily used to treat difficult-to-control epilepsy in children. The diet mimics aspects of starvation by forcing the body to burn fats rather than carbohydrates. It has an adequate amount of protein, and is low in carbohydrate. This diet was first designed in the early 1900s for treating children with epileptic seizures. Initial research indicated that extended periods of fasting could help control severe epilepsy in children. It was more efficient than the limited medication that was on hand at the time. Since the initial introduction of the ketogenic diet, there have been considerable developments in the anticonvulsant medications used to control epileptic seizures in children. In recent years, the ketogenic diet has proven successful in controlling seizures in cases where medication has failed. When the diet is changed from one that is highly glycemic to one that does not provide sufficient carbohydrate to replenish glycogen stores, the body goes through a set of stages to enter ketosis. After about 48 hours of this process, the brain starts burning ketones in order to directly utilize the energy from the fat stores. It reserves the glucose only for its absolute needs and avoids the depletion of the body's protein store in the muscles. Whether ketosis is taking place can be checked by using special urine test strips such as Ketostix. Ketosis is deliberately induced in the ketogenic diet used to treat epilepsy. Other uses of low-carbohydrate diets remain controversial. Some regard ketosis as a physiological state associated with chronic starvation. Some clinicians consider ketosis as a crisis reaction of the body due to a lack of carbohydrates in the diet. They view it as a dangerous and potentially life-threatening state that stresses the liver and causes destruction of muscle tissues. However, there is discussion whether ketogenesis does destroy muscle tissue. Ketogenesis can occur solely from the byproduct of fat degradation. Ketosis accompanied by gluconeogenesis (the creation of de novo glucose from amino acids), is the specific state with which clinicians are concerned. The conclusions against ketosis have been challenged by a number of doctors and adherents of low-carbohydrate diets. They dispute claims that the body has a preference for glucose and that there are dangers associated with ketosis. It has been debated that hunter societies lived for thousands of years in a primarily ketogenic state. Also, there are many known cases of modern humans living in these societies for extended periods of time. Some assume that exercise requires carbohydrate intake in order to replace used-up glycogen stores. But studies have shown that after a period of adaptation of two to four weeks, physical endurance is unaffected by ketosis. How does the ketogenic diet work? The ketogenic diet is cautiously controlled. The mechanism stimulates the biochemical effects of starvation. The low amount of carbohydrate in the diet leads to the buildup of ketones in the blood. It has been established that the high levels of ketones suppress epileptic seizures. The diet provides just enough protein for body growth and repair, and sufficient calories to maintain the correct weight for age and height. The calories that are consumed are restricted in accordance with the age and activity levels of the child. The diet excludes carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains and sugar, while increasing the consumption of foods high in fat such as cream and butter. With accurate calculations, the child will not lose or gain weight. The ideal weight for the height and build should be reached. In the case of overweight children, calories are limited until their ideal weight is obtained. Calcium and vitamins supplements may be necessary. An alternative treatment method: The ketogenic diet is an alternative treatment method for epilepsy in children. It is useful in cases where it is difficult to control seizures by using medication. It is recommended in cases where the child has two or more epileptic seizures a week, despite the use of two or more appropriate anticonvulsant medications. Medical supervision is required: The ketogenic diet should not be used without medical supervision. Furthermore, its effects have not been thoroughly studied in adults, or children who are under one year of age. Parents considering the use of the ketogenic diet to control their child's epileptic seizures should consult their doctor. Currently, the ketogenic diet is widely available in many centers. Less restrictive variants, such as the modified Atkins diet, have come into use, particularly among older children and adults. The ketogenic diet is also under investigation for the treatment of a wide variety of disorders other than epilepsy. People trying to lose weight, should seek medical guidance or consult a qualified nutritionist. They can get information about healthy eating and advice about how to lose weight safely. Similar condition Ketosis should not be confused with ketoacidosis, diabetic ketoacidosis or the less common alcoholic ketoacidosis. It is severe ketosis causing the pH of the blood to drop sharply. Ketoacidosis is a medical condition caused by uncontrolled diabetes mellitus (diabetes type 1). It is a combination of ketosis (the buildup of ketones in the blood) and acidosis (increased blood acidity). People who are diabetic and fail to have their insulin injections for a prolonged period of time may experience ketoacidosis. The lack of insulin means that the body will start to break down fats instead of glucose. This will lead to an increased production of ketones and raise the acidity level of the blood. The symptoms of ketoacidosis include: a fruity smell on the breath a high temperature a loss of appetite nausea stomach pain the need to urinate frequently vomiting Seek immediate medical attention if experiencing the above symptoms. If left untreated, ketacidosis will lead to coma and, eventually, death. For that reason, the condition must be treated as a medical emergency. Admission to hospital may be necessary in order to receive intravenous fluids, as well as insulin and glucose. Dietary changes may also be recommended. Written by Stephanie Brunner (B.A.) Copyright: Medical News Today