: Episode 559 – On this Wednesday edition of the Celebrity Fitness Trainer podcast, Nicole Recine fills in for Andy Schreiber to co-host alongside Vinnie Tortorich. The two talk about the critical distinction in the sometimes mixed up Ketosis and Ketoacidosis, and what ketosis is and its relation to losing fat.
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KETOSIS VS. KETOACIDOSIS
- Ketoacidosis is a serious condition type 1 diabetics (& severe alcoholics) get, where their bodies make far too many ketones (10x higher blood ketone levels)
- Ketosis is when your body is in a great metabolic state from restricting carb intake — very good for you
KETOSIS AND LOSING FAT
- You DO NOT need to be in ketosis to lose fat
- Additionally, if you are in ketosis it does not necessarily mean you are losing fat
- You can even gain weight in ketosis
- People get confused because ketones are made in the process of fat burning
- Doesn’t necessarily correlate to fat loss though
PODCAST TRANSCRIPT (Compliments of Margaret Vitalis)
Vinnie Tortorich (VT): What are we talking about today?
Nicole Recine (NR): Ketosis
VT: Ketosis. I’ve heard about this stuff. I’ve heard that if you go into ketosis, you could die, right? Oh no wait, that’s ketoacidosis.
NR: Ketoacidosis. I think that’s been cleared up enough. I think all the listeners know…
VT: No they don’t…no they don’t, because we get new listeners all the time, Nicole.
NR: Okay, new listeners, ketoacidosis is something you can die from and go into a coma. It’s weird. It can only happen to type 1 diabetics, and it’s very, very high ketone levels, typically 10 times higher blood ketone levels than ketosis. Ketosis is a healthy natural metabolic state that you can get into when you restrict your carbohydrates and protein well enough – very healthy – two different things.
VT: Now Nicole, all the times I’ve had you on the show, and by the way folks, Nicole is a nurse, and she is a nurse practitioner? Are you?
NR: Studying to get my nurse practitioner. I’m an RN. I am also a certified diabetes educator.
VT: So she’s got a lot of credentials, and nurse practitioners are basically doctors. As a matter of fact, I would go as far as to say you guys know more than doctors. Anyway, I finally heard you say something that wasn’t completely correct.
NR: Did I?
VT: Yeah, finally! Because type 1 diabetics are not the only people that can get ketoacidosis. People who are severe alcoholics…
NR: They can too, that’s true.
VT: Yeah, like in their final stage when they’re trying to kill themselves with chemicals, they can end up in ketoacidosis, and there are a few other ways that you can get it, but it’s extreme.
NR: Very, very, very extreme, and you’re not gonna do it by just not eating carbohydrates.
VT: Yeah, so check the amount of wine you’re having, and by the way don’t drink wine. So, what do you want to say about ketosis today?
NR: So, there’s a lot of confusion. People think that they need to be in ketosis to be losing fat, and they think that being in ketosis means you’re losing fat, and it does not guarantee fat loss.
VT: Our very own Anna Vocino used to – like in the early days of this podcast – Anna was under the impression that, just like everybody else who has been through twenty different kinds of weight loss programs, she was under the impression of – because everybody wants to know – just tell me what to do. Do I just eat raspberries all day? Or do I just eat avocados? Just tell me what to do. That’s why some people got mad at my book, Fitness Confidential, saying, “You didn’t tell us what to do!” It’s like, I’m not the Pied Piper. Don’t follow me. I’m just telling you how it works.
NR: There’s not one thing to do. There’s not one answer for everybody.
VT: So Anna heard in show number 50 or 52 or 53, she heard – well, Vinnie says ketosis…your body burns…and she was peeing on a stick every day.
NR: People are peeing on sticks all day long.
VT: Deep purple every time.
NR: Deep purple every day. She probably wasn’t losing weight.
VT: She was gaining weight.
NR: Yeah. You can gain weight on ketones.
VT: Do you know why?
NR: Because it doesn’t guarantee fat loss.
VT: And explain why. Because I’ve explained it 20 different ways. I think people would love to hear it from a beautiful girl like you.
NR: I’ve been just studying these biochemical reactions all day so I can understand it myself, because it’s very nuanced. People hear ketones are the result of fat burning, they’re the products of fat burning, so then they hear that and think, “Oh, well if I have ketones in my blood, that means I’m burning fat.” It does, but that doesn’t mean fat loss, and this is the point I want everyone to take away from this. Keto doesn’t equal fat loss, and fat loss does not have to mean keto. They’re two different things.
VT: Now explain that a bit.
NR: You can be losing fat without being in ketosis, and you can be in ketosis without losing fat.
VT: Now Nicole, I’ve said that on the show a thousand times. Give it to us in a way that…make it simple.
NR: Sure. The two end products of fat burning are carbohydrate and water. Your body makes energy. It’s going to use something to make energy. It can use two things, and it’s going to use two things primarily. We’ve all learned it can only use sugar to make energy, but in reality, it can use two different things: fatty acids or sugar. The main driver behind that is insulin. If your insulin is low enough, you’re going to be able to use fatty acids to produce energy. The end product of that is carbon dioxide and water. If you’re breathing and your insulin is low enough, then you’re burning fat – ketones or not. You can pee on a stick with no purple, and if you’re breathing out carbon dioxide and you’re producing pee and your insulin is low enough, you will be burning free fatty acids that were once stored in your fat tissue.
VT: Give it to me in more of a cartoon version. Go a little more cartoon than that.
NR: Okay. The main driver…
VT: Nicole, pretend I’m in kindergarten. Give it to me again.
NR: I see you have a lot of body fat on you there.
VT: Me?
NR: I’m pretending you’re in kindergarten.
VT: Oh, I’m in kindergarten. Yeah I do Nicole, because my mommy gives me Popsicles, and she tells me to eat pizza all the time.
NR: I see that you want to use that and burn that body fat.
VT: Well, I didn’t know I did, but the other kids are kinda goofin’ on me now…
NR: Let’s say you did, so the one thing I want you to do, when you eat all that sugar, your insulin gets really high, and your body is unable to…
VT: Wait, no. Nicole. Sugar doesn’t have fat in it. As a matter of fact, I learned how to read in kindergarten, and what I read was fat-free, so there’s no fat, so how….?
NR: Well, when you eat that sugar, there is no fat in it, but it makes this hormone in your blood go really high called insulin, and when insulin is around in your blood, all that fat that’s sitting on your belly can’t get out, and your body can’t use it for energy. Now if you stop eating that sugar and stop eating those grains and let your blood insulin level get low enough, that unlocks those fat cells and lets all that fat that’s stored in your belly flow out as free fatty acids.
VT: Where does it go to?
NR: It goes in your bloodstream. So just like glucose…
VT: Well, won’t that cause some kind of cholesterol? I heard my mom talking about cholesterol.
NR: No. That’s something different. It’s free fatty acids. It’s not cholesterol. The body can use it for energy just like it can use blood sugar. It can put it into the same little powerhouse things in your cell that produce energy. It can use sugar, or it can use free fatty acids equally, whatever is more abundant, and when that insulin is low, because you’re not eating that sugar and not eating those grains, the free fatty acids can come out of your belly fat into your blood, and your cells can use them for energy. It’s called…we like to call it fat adaptation sometimes. This all happens, and there are no ketones involved. Do you understand that?
VT: So far, but wait. You were talking about deep purple a little while ago?
NR: Yeah, so people think that this is what causes the deep purple, is just the process of burning fat for fuel. And you can be doing this, burning free fatty acids for fuel all day and never produce a ketone, never pee purple on a stick, because free fatty acids can be used all the time by everybody. The one place in your body that cannot use free fatty acids for fuel is the brain, because free fatty acids cannot cross the blood-brain barrier. So in emergency situations, the liver – and this is what happens in a ketogenic diet – you deplete your glycogen, and your blood sugar gets low enough, your body starts to divert basically the products of free fatty acids to refill the glycogen, and it’s like, “Oh shit. Now what am I gonna use to feed my brain?. All this glucose, I’m using it to fill my glycogen again, so it starts accumulating products of basically fatty acid synthesis in the liver and starts to produce ketones, basically as an emergency, because it’s afraid that it won’t have glucose to feed the brain. It needs a very, very small amount of glucose to feed the brain.
VT: But let’s be clear. Our brain can also run on ketone bodies.
NR: Yes. So that’s why when the glucose gets low enough, when you deplete your glycogen stores in your liver, and your insulin is low, your body starts to get afraid that the glucose is going to get so low, it’s not going to have enough for the brain, because the brain can only use glucose. When it starts producing those ketones, the ketones go out into the bloodstream, and now the brain can use those ketones. The ketones can cross the blood-brain barrier. So it’s just kind of an ocean emergency thing.
VT: What do you have to say about Blackmore?
NR: Blackmore?
VT: You don’t know who Blackmore is? Well maybe you should listen for a second. Deep Purple, yeah! Smoke on the Water, 1973, live in the USA. Ritchie Blackmore, guitarist. Yeah. (“Smoke On the Water” playing). There was a group called Deep Purple. Probably one of the hottest rock groups ever. And when you kept saying “deep purple…”
NR: You had to go play it.
VT: Ever heard the song “Smoke on the Water?”
NR: No.
VT: You’ve never heard “Smoke on the Water?” You’ve gotta look it up later.
NR: While I’m peeing on a stick.
VT: Yeah, you pee on the stick, and I want you to listen to Deep Purple, and you can listen to the song “Smoke on the Water” talks about when a guy shot a flare guy off in the studio in Montreux and burned the place to the ground. Frank Zappa and the Mothers of Invention were in there, and all these groups, and they used to all go to Montreux to record. It was like the hot thing to do in the 70s. Yeah. That was one of their songs. And they had this song, “Highway Star.” You’ve heard “Highway Star,” come on.
NR: No.
VT: You’ve never heard Highway Star?
NR: I come on this show just to learn all of these bands and songs from the 70s.
[music break]
VT: Anyway, where were we?
NR: Ketosis. So yeah, it’s basically…it doesn’t mean you’re burning fat. It doesn’t mean you’re losing fat. It just means it’s a different form of energy for your body to use, particularly your brain. It’s really good for your brain. Your brain runs very effectively on it.
VT: We’ve had people in here that say it’s basically the cure for seizures.
NR: It’s been used, and I just saw this at the Metabolic Therapeutics conference, it’s a proven therapy for epilepsy for over 100 years. There’s a lot of research on it. I mean, little epileptic kids are on keto, and they don’t lose weight. They’re growing. You know what I’m saying? It does not mean net fat loss.
VT: Now, just your opinion, I’m going to ask your opinion. Do you think there’s anything wrong with being ketogenic if you want to?
NR: I don’t, but it’s a choice. It doesn’t mean you’re burning fat better than somebody who is not in ketosis. A lot of people go on it, and it has effects that reduce hunger, actually knocks out your hunger, and you’re able to go longer without eating. It does help create fat loss because of the fact that you’re able to go longer without eating and tolerate…not a calorie deficit but a net fat loss is a lot easier. It’s easier to create a fat loss while being in ketosis, but it is not necessary. I would say that instead of investing in a blood glucose measurement device or a ketone device – everyone’s going out and buying these ketone devices and measuring their blood – the most important thing is to get your blood insulin lower. No one checks their blood insulin. Go to the doctor, get a fasting blood insulin level. If you have elevated fasting insulin…
VT: And where would you say elevated starts?
NR: The reference range is anything above 25 fasting. I like it below 10 fasting, and you can get that online, Direct Labs or whatever, a self laboratory you can go to, I don’t know if I can say that or not, but you know, if you don’t want to go to a doctor you can order it yourself, because doctors don’t even know how to interpret it.
VT: Right
NR: If your fasting insulin is super high, that means your insulin is high all the time, and your fat is locked into your fat cells.
VT: And it won’t come out. Your body will just keep spinning. It’s almost like being in the mud with your car. You’ll just keep spinning out. You’ll keep taking in carbohydrates and just spin out, spin out, spin out.
NR: And you’re going feel hungry all the time, because as soon as your blood sugar drops, you’re not going to be able to access those fat stores.
VT: Absolutely
NR: That’s a more important measure to look at than worrying about peeing on a stick and looking at ketones and all of this other stuff. If you’re in ketosis, great, but so many people think they’re failing or can’t understand why they’re not losing weight when they’re in ketosis.
VT: I’ve seen people gain weight in ketosis, because they’re just simply eating too much fat. This is not about what you can do with impunity, and that’s what I’m always trying to explain to people. This is not the diet you can just do with impunity, and that’s one of the things that I get people straight on whenever I do my phone calls. Speaking of phone calls. Are you set up? Are you doing that now for people with diabetes and that sort of thing?
NR: I am. Yes. I do phone sessions and packages for people who want more intensive coaching or monitoring, help with this kind of stuff, interpret lab values, look at food plans, tweak, make changes on an ongoing basis. I do that.
VT: By the way folks, that is not connected to me or anything I do, but Nicole has her own thing over there. She is qualified to do this. You take in their information, and you look into it, and you figure out…now is it just type 1, or do you do type 1 and type 2?
NR: No, it’s type 1, type 2, anybody who wants help with NSNG. I obviously follow what you practice and everything.
VT: Cool. So she’s someone – people always want to know, “Where can I go? Where can I get help?” It’s as easy as a phone call away. Where can they get that information, Nicole?
NR: http://www.nicolerecine.com
VT: Nicole, I want to thank you again for coming on. Hang with me, I’m gonna play a little music going out, so it’s going to be silent for about a minute, but then I want to say goodbye to you properly, because then I want to do what I have to do. Folks, this was brought to you by Pure Vitamin Club.com. Go to http://purevitaminclub.com and check out what we have going on there.
People always want to know how to help out this podcast. It won’t cost you anything. We all go to Amazon and buy things. Go to https://vinnietortorich.com first, click through the Amazon banner, and whatever you buy, we get a little taste of it. It doesn’t cost you anything extra. People ask me how they can help out. Tell a friend and then go to iTunes and give us a nice 5-star review. If you don’t want to talk to me, but you want to learn if you have type 2 diabetes or type 1 diabetes, there’s an expert out there, Nicole Recine – http://www.nicolerecine.com. Go there, and you can book a phone call. She has all kinds of things there to help you. I’m enamored with this woman. She really knows her thing, and she’s good at what she does. On behalf of Nicole Recine, my name is Vinnie Tortorich. Put life into living, and do it with Ritchie Blackmore.
[Outro music – “Smoke On The Water”]