Food for Thought Friday: Ketosis, Carbs, and Alcohol

I have tried to make it clear on this blog that I am not what anyone could call a “low carb zealot.” If anything, I’d like to think I offer a level-headed perspective that is sometimes missing when nutritionally-minded folks draw their lines in the sand and refuse to entertain the mere thought that their way might not be the best way or the only way for absolutely everyone else on planet Earth to be healthy and have a body that feels and looks the way they’re happy with. So let this little intro serve as a reminder that I don’t think very low-carb diets are appropriate for everyone. I don’t think half a stick of butter should be used as a condiment, and I don’t think adding 3-5 tablespoons of coconut oil and ghee to a cup of coffee is the best way for everyone to rise & shine first thing in the morning. In fact, if you were to look in my fridge and pantry right now, you might even be convinced that—shocker!—I eat plenty of vegetables along with all the yummy animal fat and protein I think are so good for us. (Also: there might or might not be a pint of ice cream in the freezer. I will neither confirm nor deny.)

That being said, I am a loyal low-carber for my own health and weight management, and I find myself bothered by an argument that pops up here and there about ketosis. It goes something like this: Ketosis is an unnatural and/or dangerous state, because it is so fragile and temporary. The minute the body has enough glucose available to do so, it shuts down ramped-up ketone production and goes back to more glycolytic metabolism.

This is true; I can’t argue with this. (The part about ketosis being fragile, not about it being dangerous.) The people who point this out use it to imply that the body genuinely prefers to run more on glucose than on fatty acids and ketones, because as soon as it can stop running on ketones, it does.

But here’s why this bothers me:

Yes, this is Flat Stanley, having a good time. 

(My nephew sent him to visit 

Aunt Amy a couple years ago, 

and what can I say? After exploring the sights 

in DC all day, Stanley wanted to party!)

If we have the perspective that the fuel source the body switches to running on first when it’s available in sufficient quantities is the body’s preferred fuel source, then the number one most preferred fuel for the body would be booze. Right?

But the generally accepted theory on that is that alcohol is a “toxin,” and the reason the body metabolizes it first when it’s present is to get rid of it as quickly as possible. (But then again, among us friends here, we all know of a few other “generally accepted theories” that haven’t exactly panned out, right? Not that I’m saying alcohol isn’t harmful; I’m just making a point.)

I went through the trouble of saying what I did at the beginning of this post so you’ll understand that I am not about to say that I think glucose is toxic, or that the body uses it first in order to dispose of it immediately. I do not think this. (Refer to this post from back in the fuel partitioning series, wherein I explained that the body really does need glucose because some cells don’t even have mitochondria, and therefore couldn’t burn fats or ketones even if they wanted to.) I only want to point out that the argument that a quick switch to glycolytic metabolism from the state of ketosis upon introduction of even modest amounts of carbohydrate implies that the body “doesn’t like” ketosis, or that ketosis is some kind of dangerous, emergency stopgap backup plan when there are no carbs around, is a spurious one. I’m not saying it’s untrue that it takes very little to “get knocked out of ketosis.” I’m only saying that the next leap of thought—that ketosis is unnatural—is a shaky one.  

The body stops running on ketones as soon as it can, so therefore, ketones must not be a good way to fuel the body. The body runs on ethyl alcohol as soon as it can, so therefore, a few shots of bourbon are metabolic gold. 

Um, no. 

I don’t think it’s natural to be in ketosis 365 days a year, but I don’t think it’s natural to never be in ketosis, either, nor to have influxes of starchy carbohydrate three times a day 365 days a year. It’s feast and famine, not feast, feast, feast. 

And remember: Getting “knocked out of ketosis” does NOT mean you’re not still fat-adapted. Just because you don’t see crayon-bold dark purple on your beloved ketone test strips (“peetones,” as It’s the Wooo calls them) doesn’t mean your body isn’t being fueled mostly by fat, and it doesn’t mean that all your low-carb hard work over the long term has been reversed instantly because you had three Thin Mints. (Or twenty!) It means only that excess acetoacetate isn’t being excreted in your urine. That’s all. If you have spent a significant amount of time on a lower-carb diet, and especially if you have incorporated exercise and more physical activity in general into your life while low-carbing, then all the enzymes, metabolic pathways, and mitochondrial whoosie-whats-its are still in place and going well near full-speed. You can be fat-adapted and not “in ketosis.” (I sense a separate post about this coming at some point if anyone out there would be interested. I kinda just said it all right here, though.)  

To recap: Yes, being “in ketosis” is a fragile state. I absolutely agree there. But can we extrapolate that to mean that ketosis is harmful or unnatural? That part, I’m not so sure about. Very low-carb and ketogenic diets have literally saved lives. And other people feel like roadkill on them. No big deal. Different strokes for different folks. Every Jack has his Jill, and every body has its best diet. (And even then, a body’s “best diet” is subject to change, right? What works when someone’s 25 might not work quite as well when they’re 65, or under a lot of stress, or holed up with a broken leg and not moving around as much. Dammit, if I had known this nutrition stuff was going to be so complicated, I could be using my creative writing degree instead, and I’d be asking if you want fries with that, instead of asking why you want fries with that!)

P.S. If Ash Simmonds happens to be reading this, he might be saying, “But booze is the body's preferred fuel source!” (After a nice, rare steak, that is. And I would have to agree. [Some days!]) Exhibit A: this awesome tweet. 

P.P.S. Ash's Carnivore's Creed is the funniest thing you're not following on Twitter. (Except for Los Feliz Day Care [parody].) And since it's Friday, I'll offer you up yet another way to get your pre-weekend dose of laughter: Ron Swanson Meat Eating Memes. (Suitable for work, except for one word of text. All the images are fine.)

Remember: Amy Berger, M.S., NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition.