Where did nutritional ketosis come from? And why did we have to define that as a term? Over a century ago, doctors figured out that when people with what's called type 1 diabetes, the diabetes typically of younger folks where the pancreas stops making any insulin at all, they can't use glucose at all for fuel and the body overproduces ketones.
The ketones build up to very high levels and that's called ketoacidosis. When ketones build up to very high levels, you can actually smell them on a person. It's like a smell this these ketones and say ah you know this is a uncontrolled diabetes and they realize that that changes the acid levels in the blood and that's ketoacidosis. But these are vastly elevated levels of ketones. So figure, let's say a number of 20 would be an extremely high level of ketones.
But if you're eating a well-formulated ketogenic diet, your blood levels are not 20. Your blood levels will be in the range of 0.5 to 3. So it's one-tenth that very high level. And yet, if you eat... Say orange juice and bagel for breakfast, after breakfast your ketone levels will not be 0.5 to 3, they'll be 0.1 or 0.2. So 1 tenth, 10 times higher is nutritional ketosis, 10 times higher that is ketoacidosis. And so we define this state of nutritional ketosis as being a safe blood level where ketones function to feed vital organs in the body when you're not eating a whole lot of carbohydrate.
You can see it in the green zone between 0.5 and 0.5. and three or four that's what we call the optimum ketone zone that's where ketones have beneficial effects in terms of feeding the brain and other organs in the body and as you can see if you are in total starvation which we don't recommend because of negative effects on lean tissue and organ function total starvation ketones will go up as high as seven and you don't get anywhere near the risk of ketoacidosis till the numbers are above ten these are very distinct states differentiating nutritional ketosis from diabetic keto athletes acidosis. The reason we know that this is it's not a rumor or word of mouth there are some very solid scientific papers in the medical literature now indicating not just that gee looks like inflammation goes down we actually know precisely how the beta-hydroxybutyrate this primary ketone we have in our blood makes inflammation and oxidative stress go down and provides optimized control for some inflammatory diseases.
Let's kind of get to a little bit more practical information how does one get into nutritional ketosis. People who have reason to want to have benefit, if they have type 2 diabetes or they're severely overweight or have hypertension, very often those people have what we call insulin resistance. That is their body has begun to lose its responsiveness to this hormone insulin, which is the hormone that causes blood sugar to go into cells and also manages body fat metabolism. So if you're insulin resistant, you probably have to get your daily total carb.
carbohydrate intake down somewhere between 20 and 50 grams of carbohydrate per day. If you want to think about that in terms of macronutrients, that's less than 10% and oftentimes less than 5% of your total daily energy intake comes from carbs. And so that's very carb restricted.
And the more insulin resistant the person is, the lower they have to go to initially get into a state of nutritional ketosis. And then the other key point of a well-formulated ketogenic diet is this is not a calorie restricted diet. stop eating when you eat X number of calories per day.
This is a diet when it's done right is eaten to satiety. That is when you finish a meal you should be satiated and you shouldn't be hungry till it's time for your next meal. And the way you do that if you're eating very little carbohydrate and moderate protein is the majority of your dietary calories have to come from fat. And we'll come back to the safety issues around is it okay to eat that much fat if it's more than half my calories and the answer is yes.