One wonderful source of energy has attracted the attention of many nutrition experts and researchers over the past decade. No, it’s not carbohydrates, fats, or even protein. We call them ketones or ketone bodies (more on the difference between them later). However, ketones are not new to your body.
In fact, your heart and kidney bark (the part of the kidney where ultrafiltration takes place) use ketones as fuel right now. These cells prefer to use ketones instead of sugar.
After a few days of fasting or a ketogenic diet, the production of ketones increases, and other cells, such as your muscles and brain cells, begin to use them also for energy. This is the main purpose of the ketogenic diet, but why is this important? Ketones are another fuel source, right?
The advantage of using ketones as an energy source instead of sugar.
Glucose is the main source of energy for almost every cell in the body. This is due to the fact that it can be converted into energy much faster than any other source of fuel, and does so without the help of mitochondria (the main energy-producing component of the cell). However, the use of glucose as a fuel leads to some negative consequences.
What is gained quickly loses its effectiveness. During the sugar burning process, free radicals and reactive types of oxygen (harmful compounds that can cause cell damage) are released, and less energy is generated than using ketones from fat as fuel.
Ketones are a more efficient source of fuel that inhibits the formation of free radicals and reactive oxygen species. This leads to many advantages, especially for brain cells that use ketones instead of sugar for fuel. For example, studies conducted with people with different types of cognitive problems, from Parkinson’s disease to epilepsy, confirm that using ketones as fuel can significantly improve brain function.
However, the benefits of burning ketones for energy do not stop only on the brain. Many other cells, such as muscle cells, also benefit from the use of ketones (more on this later), but you cannot take advantage of these benefits until you have consumed sugar in your body.
On the way to ketosis.
The use of ketones as the dominant source of fuel — a process known as ketosis — occurs when the body does not have enough glucose. This happens when the body uses all of its glycogen (sugar), and it does not get enough carbohydrates from the incoming food.
However, before we start burning more ketones, the body relies on gluconeogenesis – the process of converting non-sugar compounds, such as amino acids, into sugar. It is a process of self-preservation, but it is also very inefficient and causes muscle loss.
Fortunately, amino acids are used as the dominant source of fuel only during the first two or three days of carbohydrate restriction, because your body wants to save energy and muscle mass (just like you). To replace the protein, then the body uses a more efficient source of fuel that retains muscle mass – ketones.
What are ketones?
A google search for “ketones” will give several results that relate to ketone bodies. In many cases, ketones and ketone bodies are used interchangeably, but they are not exactly the same.
Technically, ketones are organic compounds that contain a carbonyl group (a carbon atom that is double bound to an oxygen atom), which is simply connected to two hydrocarbon groups obtained by oxidation of secondary alcohols. Organic chemistry – I’m sure you understood everything)
Let’s look at examples of ketones that will help us get a clearer idea:
Acetone is the simplest ketone. During the first 2 weeks on a ketogenic diet, the body can produce some of them and release them with breathing. That is why you may have bad breath during the first couple of weeks on a ketogenic diet.
If you look at the picture of acetone, you will see a carbonyl group linked to two hydrocarbon groups. The carbonyl group is a large “C” or carbon atom that has a double bond (indicated by double straight lines) to a large “O” or oxygen. This carbon atom is also a single compound (indicated by single lines) to two hydrocarbon groups.
The hydrocarbon group is any compound consisting entirely of hydrogen and carbon. In our acetone molecule you will find two hydrocarbon groups, each of which is called a methyl group. Each methyl group contains one carbon atom, one linked to three hydrogen molecules.
Does organic chemistry still seem too complicated? Well, the good news is that it is not absolutely necessary to understand. All you really need to know is that acetone is a ketone and a ketone body at the same time, and diacetyl is another natural ketone that was a popular artificial flavor oil for popcorn — it’s just ketone. You may also want to know why this is so.
What are real ketone bodies?
All ketone bodies are ketones, but not all ketones are ketone bodies. Incredible, but true.
There are millions of potential ketone compounds that can be formed with various combinations of different hydrocarbon groups, but not all of them are considered ketone bodies. When studies and articles talk about ketone bodies, they refer to three ketones that the body naturally forms. Other ketones, such as diacetyl (ketone, which we mentioned earlier), are not produced by the body, so they do not fall under the category of “ketone bodies”.
Here are ketones, which are also ketone bodies:
- Acetoacetic acid
- Beta-hydroxybutyrate (BHB)
These three species are the only ketones that are produced by the body. All of them are produced by the liver and used as an energy source when glucose is not available, but they are all produced at different times in several different ways.
How are ketone bodies formed?
When glucose is not available, fat is broken down by the liver into glycerol and fatty acid molecules. Then the fatty acid is destroyed in a process called ketogenesis. During this process, the first ketone body produced is acetoacetate.
The acetoacetate is then converted to BHB or acetone. Acetone is a poorly produced ketone body, but it can be produced in large quantities when you first start a ketogenic diet.
As your cells become accustomed to restricting carbohydrates, BHB becomes the most common ketone body, and your brain and muscle cells begin to use it as a primary fuel. In fact, when you are keto-adapted, ketones can provide up to 50% of your basic energy needs and 70% of your brain’s energy needs.
But this is just a metabolic by-product of the fat we are talking about. How can this be a source of primary fuel for your brain?
Acetyl CoA and Citric Acid Cycle.
Acetoacetate and BHB would not be sources of fuel if it were not for the cycle of citric acid passing in the mitochondria of aerobic cells. This cycle is a metabolic process that most cells in the body use to use high-energy electrons from a carbon compound called acetyl CoA.
Acetyl CoA? Where does it come from? From carbohydrates, proteins, fats and ketones.
In fact, the main reason why the liver forms acetoacetate and BHB is that it can be divided into two acetyl-CoA molecules in the cell that need energy. As soon as they get inside the cell, two molecules of acetyl CoA enter the citric acid cycle, their electrons with high energy are transferred to the molecules NAD and FAD, and they turn into carbon dioxide.
Then NAD and FAD molecules combine with electrons to form NADH and FADH2. In other words, these NADH and FADH2 molecules act as a temporary storage molecule for high-energy electrons that we received from the destruction of acetyl-CoA molecules.
And what is the purpose of this process? In the creation of ATP (the most common compound that the body uses to store and release energy). (If you want to know more, you can read here: https://en.wikipedia.org/wiki/Bioenergetic_systems) .
However, to create ATP, electrons taken from acetyl CoA during the citric acid cycle must pass through another process called oxidative phosphorylation. During oxidative phosphorylation, electrons from NADH and FADH2 are transferred to the oxygen molecule, so that ATP can be finally formed. This is one of the processes our body goes through to produce energy.
It is important to keep in mind that the amount of energy produced during these two processes (citric acid cycle and oxidative phosphorylation) depends on the energy source used. For example, BHB generates 3 ATP molecules more than acetoacetate, because it undergoes a unique reaction that provides the cell with an additional NADH molecule.
In general, the citric acid cycle in combination with oxidative phosphorylation provides more than 95% of the energy used by aerobic cells, such as the heart, muscles, brain, and kidney cells. However, they do not include red blood cells and liver cells, which cannot burn ketones to produce fuel.
The body cannot survive only on ketones.
In order for a cell to use the citric acid cycle and oxidative phosphorylation to produce energy, it must have mitochondria and various specific enzymes. However, every cell in the body does not have both.
For example, red blood cells do not have mitochondria, and the liver cells lack an enzyme called CoA transferase. Therefore, these cells need glucose for their energy supply. However, this does not mean that we must eat carbohydrates for our liver and red blood cells in order to survive. The liver has another way to make sugar.
Ketogenesis and gluconeogenesis work together.
Remember the glycerin we mentioned earlier, which was created by breaking down fat? He is not lost.
While fatty acid is converted from fat to ketones, glycerol is converted to glucose during gluconeogenesis. This is a normal metabolic process that creates glucose from amino acids in a protein, lactate from muscles, and glycerol from fatty acids.
During fasting or carbohydrate restriction, gluconeogenesis maintains a healthy blood sugar level and provides energy for the liver and red blood cells, while ketogenesis (burning ketones for fuel) is used to provide energy to the brain, heart, kidneys, muscles, and other aerobic cells.
The link between ketogenesis and gluconeogenesis is necessary for understanding ketogenic diets, but why?
Because if you do not eat enough protein, your muscle tissue will burn to make glucose necessary for your body. On the other hand, if you eat too much protein, your body will never fall into deep ketosis.
However, even if you get all of your macro-element rate, your body will not immediately increase the production of ketones. In fact, it takes up to three days for your body to get into ketosis (without the help of exogenous ketones).
Exogenous ketones – what is it? Are they worth it?
The whole article is about endogenous ketones or ketones that are made by the body. However, you can also use exogenous ketones to send your body to ketosis, without waiting for your liver to produce ketones itself.
The only real exogenous ketones on the market today are natural ketone salts that combine acetoacetate or BHB with sodium, potassium and / or calcium. KetoForce, KetoCaNa and Keto OS are the most popular ketones on the market, but do they work?
Studies of ketone salts are rare, but they seem to actually increase the level of ketone. In studies conducted during fasting, the ketone salt of sodium acetoacetate was injected through a dropper. This led to an increase in total ketone levels by 47% -92%. However, the endogenous production of ketones decreased to 67% -90% of the normal level of starvation.
What does this mean for you?
The use of ketone salts is likely to increase the level of ketones, but this may not be very useful for long-term ketogenic diets. This is due to the fact that the absorption of ketones leads to an increase in the level of ketones, which in turn leads to the fact that the liver stops the production of ketones. In other words, taking ketone supplements will restrain your own production of ketones by your body.
If your goal is to be in long-term ketosis, then exogenous ketones are not the best choice. However, there is another supplement that can help increase the production of endogenous ketones – MCT. With this supplement, your liver will naturally start burning more ketones to produce fuel immediately (and much cheaper than exogenous ketones).
How to increase the production of ketones without negative consequences?
Although they are not ketones, medium chain triglycerides (MCT) can be broken down into ketone bodies in the liver, whether you are ketosed or not.
MCT is saturated fat, which is different from any other saturated fat. Most of the saturated fats that we consume pass through the lymph to the heart and muscles, leaving residues in your liver that can be turned into ketones.
These ketone enhancing fats are found in coconut, coconut milk, and coconut oil, but the most effective way to consume MCT is to use MCT as an oil.
How to choose MCT oil? The best MCT oil to choose is one that contains only medium chain triglyceride, which is called caprylic acid (medium chain triglyceride C-8). Caprylic acid is known to be converted into ketones faster and easier than other types of medium chain triglycerides.
However, if you cannot afford more expensive caprylic acid, any other MCT oil will do.
Proper dosage of MCT oil is required. If you drink too much too quickly, you are likely to experience digestive problems. That is why it is important to choose a dosage that increases your energy level without any side effects. Then you can either stick to this dose or slowly increase it.
An important caveat is that MCT supplements cannot help diabetics. Studies in rats have shown that the addition of MCT oil can damage the health of rats that have problems with the regulation of blood sugar levels. These data may indicate that adding MCT oil may increase the likelihood of ketoacidosis in people with diabetes.
Ketoacidosis is the bad side of ketosis.
Increasing blood ketones is not a good sign for everyone. When insulin is not produced or does not work properly, the level of ketones can increase dramatically and continue to rise to an unhealthy level. This is commonly called diabetic ketoacidosis. “Diabetic” because it occurs in people with type 1 and type 2 diabetes and “ketoacidosis” because an excessive amount of ketones causes the blood to become very acidic.
This shift in blood acidity can be fatal, but it can be easily mitigated. The most common symptoms are thirst, frequent urination, nausea, abdominal pain, weakness, aromatic breathing and confusion. If you have these symptoms, drink plenty of water, and they may recede. Check with your doctor if symptoms do not improve.
However, diabetic ketoacidosis can be prevented. Following a ketogenic diet, type 1 and type 2 diabetics will be less prone to problems with blood sugar and ketones, and are more likely to experience the benefits of ketosis (provided they control the insulin levels).
But what about people who do not have diabetes?
For healthy people, ketoacido is extremely unlikely. A healthy body creates a lot of insulin, and its cells respond to this insulin accordingly. This allows the liver to produce ketones at the right time and stop them when too many ketone bodies enter the blood.
The good side of ketones is complex health benefits.
I am sure that in the coming decade we can expect a much larger number of studies of ketones, but here is a short list of benefits that have already been scientifically confirmed:
1. Ketones stimulate mitochondrial production.
New mitochondria are formed in cells after they start burning only ketones for fuel. This has been found to occur in the brain cells of people on a ketogenic diet.
Why is it important? Because a large number of mitochondria leads to more energy and more healthy cells.
2. Ketosis protects and restores the nervous system.
Many studies have shown that ketones help preserve the function of aging nerve cells and help in the regeneration of damaged and malfunctioning nervous systems. For example, one study found that ketones helped patients with acute brain injury get significant improvements.
3. Ketones act as antioxidants.
Burning ketones as a fuel reduces the number of reactive oxygen species and the resulting free radicals. It helps protect the body from damage and diseases that can cause reactive oxygen species and free radicals.
4. Ketones retain muscle mass.
When you lose muscle mass, you lose years of your life. This is an unpleasant side effect of aging, but a ketogenic diet can be a protective tool.
Many studies have shown that ketones have the effect of muscle preservation. This effect was especially noticeable in people who limited calories to lose weight. This makes the ketogenic diet and ketones not only an excellent means for losing fat, but also for longevity.
5. Help ketones in preventing the growth of cancer cells.
Studies show that ketones can help fight cancer. This is due to the fact that cancer cells cannot use ketones as fuel. Without fuel, cancer cells do not have the energy to grow, and the immune system can help eliminate them from the body.
6. Ketones can improve the quality of life of people with autism.
Studies on mice that have shown similar behaviors, like people with autism, give us promising results. In these studies, it was found that the ketogenic diet can improve and even cancel autistic-like behavior in mice.
These positive results were probably caused by two factors. The first factor is that brain cells function more efficiently when they use ketones for fuel, not sugar. Secondly, ketones can have an inhibitory effect on nerve cells. What happens when you make the hyper-excitable nervous system more efficient and less active? Less autistic behavior.
Here are the six benefits of ketones, which are backed by science. However, keep in mind that we are still only beginning to understand the effects that ketones have on the body, so this list is far from complete.
If you maintain a healthy insulin level and eat a ketogenic diet with the correct ratio of macronutrients, you get ketosis and enjoy the many benefits of ketones without any side effects.
If you need a quick rise in ketones, try adding MCT oil. This saturated fat will make it easier for your body to produce ketones and adapt to the ketogenic diet.
And do not forget about gluconeogenesis. Without proper protein and fat intake, your body will continue to use gluconeogenesis as a fuel instead of going into ketosis.