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Eat Fat To Lose Fat? A Functional Medicine Expert Explains 4 Ways To Do The Ketogenic Diet

Alicia Armitstead
February 1, 2017
February 1, 2017

We are trained to think that in order to lose weight, we need to eat less…especially less fat. But what if I told you that the key to making the body a fat-burning machine was to eat fat? That's right! To lose fat you need to eat fat, and lots of it.

How does the ketogenic diet work?

This is the basis behind the ketogenic diet. The ketogenic diet is a diet high in fat, low in protein, and even lower in carbohydrates. Eating this way makes the body produce ketones in the liver from the digested fat, which is where the "ketogenic" diet gets its name. The ketones then take the place of glucose as fuel for the body, which is what our bodies typically use when we eat the average American diet of higher carbs and protein. With a high level of ketones and a low level of glucose in the blood, the body produces less insulin. In turn, it becomes a fat-burning machine, as less insulin being pumped out means that the body has a far easier time burning stored fat for energy.

What are the benefits of the ketogenic diet?

How can you get into a ketogenic state?

So, what does the ketogenic diet look like? There are several variations on the ketogenic diet, broken down below:

  • Standard ketogenic diet (SKD): This is a very low-carb, moderate-protein, and high-fat diet. It typically contains 75 precent fat, 20 percent protein, and only 5 percent carbs.
  • Cyclical ketogenic diet (CKD): This diet involves periods of higher-carb refeeds, such as 5 ketogenic days followed by 2 high-carb days.
  • Targeted ketogenic diet (TKD): This diet allows you to add carbs around workouts, consuming most carbs before a workout.
  • High-protein ketogenic diet: This is similar to a standard ketogenic diet but includes more protein. The ratio is more like 60 percent fat, 35 percent protein, and 5 percent carbs.

Keep in mind that only the standard and high-protein ketogenic diets have been studied extensively. Cyclical or targeted ketogenic diets are more advanced methods and are primarily used by bodybuilders or athletes.

What should you eat on a ketogenic diet?

The exact amount of fat and protein is a matter of individual body responses and activity levels, but almost everyone on a ketogenic diet will consume only 10 percent or less of calories from carbohydrates. This means that any food high in carbohydrates should be limited or avoided, including sugary foods like cakes, cookies; and candy, grains and starches including beans and root vegetables like potatoes, carrots, and beets; fruits (except for small portions of berries), tomatoes, low-fat/sugar-free products, and alcohol.

The good-foods list includes meat, fish (especially fatty fish like mackerel, salmon, tuna), eggs, butter, full-fat cream, cheese, nuts, seeds, healthy oils (I would stick to olive oil, coconut oil, and avocado oil), low-carb vegetables, avocados, herbs, and spices.

The good news is that you can also have coffee and tea on a ketogenic diet, as long as there is no added sweetener. However, I do recommend sticking to only one cup a day, as too much caffeine may down-regulate ketosis. Many people who adhere to the ketogenic diet also swear by bulletproof coffee, or butter coffee: coffee infused with butter, MCT oil, or both.

How do you know if you're in ketosis?

So, you've changed your diet to include a much higher fat content in order to try to put the body into ketosis. Now, how do you know if it's working? Typically, the results will speak for themselves, but to find the perfect balance of fats, proteins, and carbs for your body you can buy a ketone meter, and with the prick of a finger you can find out your blood ketone levels. As another and cheaper option for checking your ketone levels you could purchase ketone urine strips, but I am not quick to recommend this method as there are many variables that may affect the outcome, including your level of hydration as well as the amount you are excreting versus what is actually the level inside your body. You might also be interested to know that you can actually tell if you are in ketosis if you sense that your breath, sweat, or urine smells sweet. This is the smell of acetone, which is a by-product of breaking down ketones, and some people refer to it as the ketogenic "fruity" smell.

How many ketones are optimal for ketosis?

If you choose to test your blood ketones, you should be looking for levels between 0.5 and 5.0 mM, which means that you are in therapeutic ketosis. In my opinion, the ideal range is 1.5 to 3.0 mM, and levels above 3.0 mM are not necessary in order to get results. In fact, when there are too many ketones, meaning over 20 mM, this can be detrimental to the body. It is called ketoacidosis and cannot occur on a ketogenic diet but when there is a disease in the body. Ketoacidosis can often be seen in the end stages of diabetes.

If you are having trouble reaching the ideal range of blood ketones even when you feel your carb intake is minimal, I would look to see if you are eating too much protein. Excess eggs and meat will turn into glucose in the body, compromising optimal ketosis. To counter this, eat more fat! For example, if you add more butter to your steak you might not feel like having a second portion of steak because you are more satisfied and satiated from the first one. Simply, more fat in your food will fill you up more. This will ensure you eat less protein and even fewer carbs, and as a result your insulin levels will drop and you'll be able to reach optimal ketosis.

Most people can safely do a ketogenic diet, but I recommend running any major dietary changes by your doctor, especially if you are diabetic and on insulin, on medication for high blood pressure. If you are pregnant or breastfeeding, I wouldn't recommend the ketogenic diet unless ordered by your doctor.

Alicia Armitstead author page.
Alicia Armitstead

For over 10 years Dr. Armitstead has helped hundreds of patients in New York City restore health and reverse disease through applied kinesiology, nutrition, rehabilitation, and chiropractic. She has earned her Bachelor’s of Science (B.S.) and Doctor of Chiropractic (D.C.) degrees from the University of Bridgeport and University of Bridgeport Chiropractic College (UBCC) and is Advanced Clinical certified in Nutrition Response Testing. She has offices in Manhattan, Brooklyn and Connecticut. To learn more go to