The 3 Stages of the Ketogenic Diet

Siim Land

Is the ketogenic diet the best one out there? Do you have to be in ketosis all the time? These questions are relevant for dissecting the 3 stages of the ketogenic diet.

The 3 Stages of the Ketogenic Diet

The more I learn about ketosis and the ketogenic diet, the more I’m amazed by how powerful it is for overall health, cognition, and physical performance. It’s truly one of those optimal human diets because it not only keeps you healthy but also puts you into this post-optimal state where your body can create its own fuel without calories.

Even though I could happily eat the ketogenic diet for the rest of my life because you feel amazing all the time – and the foods are also delicious – I still recommend you to occasionally dip in and out of ketosis.

There are many reasons for it – not because it’s unhealthy or to voluntarily go through the drudgery of keto flu again – but to increase metabolic flexibility and improve diversity in the microbiome.

People do the ketogenic diet for many reasons – to lose fat, to battle diabetes, improve their health or to eat bacon – but healthy people who simply want to live the keto lifestyle should follow certain stages on their ketosis journey.

I’m going to share with you the 3 stages of the ketogenic diet you should go through.

Stage 1
Getting into Ketosis

The first purpose of the ketogenic diet is to maintain nutritional ketosis for the vast majority of time – to be in this fat burning state where you’re body burns ketones the ketones in your bloodstream. That energy can come from either dietary fat intake or straight from your adipose tissue when you’re in a caloric deficit.

  • If you’re doing keto because of diabetes, then you should pay particularly close attention to this because irregular ups and downs of insulin can make your disease worse. That’s the reason why therapeutic ketosis is so effective – it allows your body to heal itself more rapidly. High levels of blood sugar will elevate insulin, which makes your cells more prone to insulin resistance and you more prone to storing the food you eat. In some cases, long-term keto or prolonged fasting can reverse insulin resistance and very much cure diabetes. It’s even used to treat cancer patients, tumor growth, and neurodegenerative diseases.
  • If, however, you don’t have any serious medical condition, then you don’t need to be so strict all the time because your metabolism is more robust. Of course, you can’t be eating a lot of carbs and stay in ketosis but you won’t have any severe consequences for your health if you eat like 20 grams more carbohydrates. If you’re not that keto-adapted, then you may feel slightly sluggish or tired the day afterward but this is just temporary.

How Do You Get Into Ketosis

Whatever the case, you still want to first establish nutritional ketosis and maintain it if you were to go on a ketogenic diet both as a long-term and short-term thing.

This is the stage in which you’re depleting your liver from glycogen and teaching your body to use ketones for fuel.

  • When liver glycogen gets low, the liver starts producing ketones as a new source of energy. Because your body realizes there’s no readily available fuel around, it will become self-sufficient and start converting all of those triglycerides stored in your adipose tissue into energy. There are 100-150 grams of glycogen in the liver, so this takes about 16-24 hours of fasting to take effect.
  • Muscle glycogen stores are substantially larger as they can deposit 300-500 grams of glycogen. You don’t need to deplete muscle glycogen to get into ketosis because you only use this type of fuel in very intense and strenuous physical activity that taxes the anaerobic respiratory system. Things like resistance training, HIIT cardio, sprinting, or steady state cardio for very long hours.

Getting into ketosis is going to suck in the beginning because your muscles aren’t used to utilizing fat for energy yet.

Getting Into Ketosis Cheatsheet

In this stage, you want to be very strict with the foods you eat because any hiccups or hidden sugars are going to have a much greater effect on you.

  1. Keep carbs around 20-30g NET – the fewer carbs you eat the faster you can get into ketosis. This gives your liver more opportunities to be converting ketones.
  2. Don’t be in a caloric deficit – it’s going to make you feel more tired and may cause more muscle loss. You should just eat around maintenance for a few days to let your body get used to it.
  3. Eat enough protein and fat – you need the essential amino and fatty acids to preserve lean tissue and promote fat burning. Ketones are muscle sparing, but only if you’re able to utilize them. During adaptation, you want to keep a stable intake of nutrients but afterward, you’re not that much negatively affected by fasting or caloric restriction.
  4. To avoid the keto flu consume more sodium, drink bone broth, bouillon cubes and reduce your stress levels. Getting enough potassium and magnesium are also crucial because you may suffer from electrolyte imbalances. Once you stop eating carbs, you may excrete more water and thus lose these micronutrients. To prevent that, add more salt to your foods, drink mineral water, and eat nutrient dense foods like spinach, broccoli, eggs, salmon, pumpkin seeds and avocados.
  5. Do less intermittent fasting – at first, it’s going to make your body more stressed out than need be. Don’t fast any longer than 16 hours when first adapting because your body isn’t that used to prolonged periods of abstinence from food.

Why You May Lose Muscle While Fasting

That’s the biggest problem with being on a sugar burning metabolism. Once your glycogen stores get depleted, and you’re still in demand of energy, then your body will begin to search for more glucose. You may burn some fat but not to its fullest extent as you can simply excrete ketones through urine as well.

What’s the second thing after carbs that can produce glucose? Yes – protein through gluconeogenesis.

So, what happens is that when you’re in caloric restriction or exercising on a sugar burning metabolism, then you’ll start converting your muscles, organs and lean tissue into glucose while preserving most of your fat stores. If done over a long time, this will lead to the skinny-fat syndrome.

And when you look at the average person who exercises at the gym or does cardio, then they don’t look fit at all – they still have some fat or puffiness while not having that crisp dense look. The reason being – they’re burning sugar and muscle not fat for fuel. That’s why you want to get into ketosis as fast as possible.

Should You Fast to Get Into Ketosis

To get into ketosis you can fast for about 3 days or eat low carb for about 2 weeks.

  • If you choose to take the fasting route then bewary of increased muscle loss.

When you’re coming off a diet that doesn’t restrict carbohydrate intake then you’re going to experience slightly higher rates of gluconeogenesis. And once you stop eating food, the energy it does need will be derived from your lean tissue and organs. A lot of it will come from fat, because fat can also be converted into glucose via the same process of gluconeogenesis, but a significant amount will be still your protein being converted to glucose.

  • If you want to get into ketosis faster with fasting, then you should deplete your liver glycogen first by eating very low carb for a few days. You don’t need to be consuming any more than 100-150 grams of carbs a day even if you’re on a regular diet because that’s the amount your liver can deposit. If you’re not physically active, then your muscle glycogen will remain stable. This will prime your body’s ability to cope with the lack of glucose and makes you better at utilizing ketones for fuel.

Whichever route you take, it generally takes about 2 weeks to see the first signs of successfully being in ketosis.

The state of ketosis begins at 0.5 mMols, which is about less than 80 mg/dls of blood glucose. If you’re not feeling hypoglycemic after not having eaten anything for 20+ hours, then you’re more than likely burning those ketones for fuel.

This leads us to the second stage of the ketogenic diet.

Stage 2

When the first few weeks were your attempts of establishing nutritional ketosis, then the second stage of the ketogenic diet is about becoming keto-adapted.

You might have heard these words being thrown around but what do they actually mean? They’re not mutually inclusive and they have some distinctions. Some people may disagree with me on this, which is fine because what matters is that they are different conditions. Here’s how I define the two.

  • Being in ketosis is the actual metabolic state with the appropriate levels of blood sugar and ketone bodies of 0.5 mMols and above. You can be in mild ketosis already after fasting for 24 hours but it doesn’t mean you’re successfully using fat and ketones for fuel.
  • Keto Adaptation is the process by which your body adapts to utilizing fat and ketones as a primary source of energy. It means you don’t need glucose to produce ATP and can thrive on consuming dietary fat or by burning your own stored body fat.

Keto adaptation results from nutritional ketosis but it’s not needed to maintain it.

You have to go through a period where your liver’s enzymes and metabolic processes change so you could have the ability to burn fat for fuel.

The purpose in this stage is to build up your fat burning engine by continuing to eat the ketogenic diet and incorporating more exercise.

How to Exercise to Become Keto-Adapted

During the initial weeks of trying to get into ketosis, your physical performance might suffer because of this small energy crisis.

  • Intense exercise like lifting weights, sprinting, or doing endurance for many hours will deplete your muscle glycogen. You don’t need carbs to replenish your muscle glycogen stores but you may not be able to do this during the first few weeks. Afterwards you’ll be able to perform equally as good at high intensities as you would when eating carbs
  • Low intensity aerobic activities burn exclusively fat for fuel. This is where the ketogenic diet is superior to everything else. If you’re keto-adapted then you’ll always have access for your own body fat and you don’t need to refeed on carbs or sports drinks.

To first become keto-adapted you should focus more on low intensity activities but still incorporate some resistance training for the other health benefits.

Once you’re feeling great on keto, you should incorporate both of these training modalities – aerobic and anaerobic energy systems for increased mitochondrial density.

keto bodybuilding
keto bodybuilding

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What I recommend is resistance training 3-4 times per week and 2 steady state cardio sessions with 1 day for rest and active recovery where you go for a walk, do some foam rolling or go to a sauna or an ice bath even.

Exercise Mistakes on Keto

Where people make a mistake is the intensity at which they do cardio. They think that the harder they push themselves, the better they’re doing. It might work in some cases, but doing cardio anaerobically for too long isn’t ideal.

This is called Black Hole Training. 

It’s a nightmare exercise zone somewhere between a piece of cake and a Navy SEAL workout. The pace is vigorous but not painful, which is enjoyable for your mindYou get an endorphin rush, which makes you think I’m getting a good workout but it’s still stressful for the body.

Basically, the Black Hole is a heart rate zone that exceeds your aerobic capacity just a tiny bit.

Once you can’t hold a conversation anymore and have to breathe through your mouth, then you’re using more glycogen and less fat for fuel. For a few minutes that’s fine, but most people never go running for 10. They hit runner’s flow because of the adrenaline rush and can easily empty their glycogen tank. Once this happens, the body still needs glucose to perform at such an intensity. As a result, it begins to break down the protein.

Consequences of Too Much Cardio the Wrong Way

  • Increases stress hormone cortisol, which, if elevate for too long, can lead to adrenal fatigue.
  • Causes systemic inflammation through gluconeogenesis (protein to sugar).
  • Induces oxidative stress and damage because burning carbohydrates causes the accumulation of advanced-glycolytic end-products (AGEs).
  • Tears down your joints and causes aches and pains because of following repetitive motions for long periods of time, especially if you hit the pavement. Most people have horrible running form and they simply heel strike the ground because of perceived fatigue.

Doing cardio for 30+ minutes means that you should stay aerobic for the majority of the time. That’s when your heart rate is below your 60-70% of your VO2 max. At that intensity, you’re using fat not glucose as fuel.

Enhance the Ketogenic Diet

Becoming fully keto-adapted takes more than several months. You need to really engrave these fat burning pathways into your metabolism to gain the maximum benefits.

The general guideline is that the longer you do the ketogenic diet the easier it gets and the better you’ll start performing.

However, using carbohydrates strategically will not only improve your performance but health overall.

There are a few reasons why you should occasionally get out of ketosis.

  • Some people get hormonal imbalances, like a low thyroid or testosterone
  • Your energy levels may also suffer from time to time because of overtraining or too much stress
  • Low mucous production of the ketogenic diet will prevent your body from creating enough mucus that surrounds and moisturizes your gut and eyes
  • Some carbohydrate foods can promote a healthy gut by increasing diversity in your microbiome
  • Carbs can be used to boost your performance while working out but they can also be used for better sleep
  • Eating carbs seasonally will fit better with the circadian rhythms and your own individual genetic blueprint
  • And of course, it’s nice to sometimes eat foods that aren’t bacon and eggs or vegetables

But don’t worry, getting kicked out of ketosis doesn’t mean you’ll lose keto-adaptation. You’ll still be able to effectively burn fat for fuel. It’s just that you’ll gain some of the other benefits of metabolic flexibility.

Like I said, you don’t need to maintain nutritional ketosis 24/7 to be keto-adapted. You’re not going to get into ketosis by eating keto for one day, and you’re not going to lose your fat-burning metabolism by getting our of ketosis from time to time either. The body is trying to maintain homeostasis and not go through random changes all the time.

Stage 3
Metabolic Flexibility

This is the stage you want to reach with your ketogenic diet.

Metabolic flexibility refers to successfully being able to use different fuel sources and having a well-functioning microbiome.

Most of the time you’d still want to be in ketosis because it’s going to maintain your keto-adaptation, but it may leave you vulnerable to some foods that aren’t keto-proof.

For instance, if you’ve been in ketosis for months and then you accidentally eat some gluten or even just potatoes, you’re going to feel like crap the day afterwards. Of course, the best solution would be to not eat those foods in the first place and stay keto, but it’s still going to leave you fragile to these random changes.

A much better option would be to have the ability to utilize those carbohydrates for increased performance while still maintaining your keto-adaptation.

Eating for Antifragility

This is what Nassim Nicholas Taleb calls ’ANTIFRAGILITY’ – it’s about getting better under stressors and chaotic events.

  • A fragile metabolism would leave you suspectible to fatigue, muscle loss, and brain fog – which is basically the description of an average sugar burner on a high carb diet but so would be strict keto.
  • A robust metabolism would not be that affected by any drastic fluctuations in macronutrient intakes but they wouldn’t benefit from it either. Think of a semi-high-carb diet with maybe 200 grams of carbs per day. You’re not in ketosis and you’re not keto-adapted but you won’t feel a significant difference between eating a ton of carbs or fat either.
  • An antifragile metabolism would greatly benefit from whatever fuel source it has access to – both fatty acids and ketones, carbohydrates and glucose, and also it would thrive in a state of zero caloric intake. This is where you want to get.

How to Increase Metabolic Flexibility

Increasing metabolic flexibility should start with first becoming keto-adapted.

  • The foundation to an antifragile nutrition strategy is the ketogenic diet because you need to be able to burn fat for fuel.
  • On a high carb diet without keto-adaptation you’re only capable of burning glucose while not putting ketones into use. But you want to have both for optimal performance
  • Incorporating both aerobic and anaerobic training is also needed. The purpose of your exercise should be to increase mitochondrial density – your cells’ ability to generate energy whether that be from ketones or carbs

To improve your body’s ability to burn both carbs and ketones for fuel you can do the following

  1. Consume a small dose of carbohydrates during your intense workouts. This is the Targeted Ketogenic Diet (TKD) where you have maybe 5-10 grams of high glycemic carbs with MCT oil and some protein. It’s best for exercises like powerlifting, gymnastics, bodybuilding or some sports.
  2. Eat slightly more carbohydrates on days you train harder. This is called carb backloading where you eat low carb all throughout the day, then go to the gym to have a muscle glycogen depleting workout, and then have a dinner with some additional carbs like a sweet potato or a little bit of rice. How many carbs you consume on your backload depends on your muscle mass, how hard you trained and whether or not you’re trying to gain weight or burn fat.
  3. The Cyclical Ketogenic Diet involves eating keto for the week and on weekends having a day where you eat a lot of carbohydrates. This works best for athletes who are preparing for an event. For most people it can cause some sluggishness the next day because you’ll can end up consuming over 500 grams of carbs.
Keto Carb Cycle Meal Plan 3D Siim Land
Keto Carb Cycle Meal Plan 3D Siim Land

Check out my KETO CARB CYCLE for a cyclical ketogenic diet meal plan

Metabolic Flexibility for Health

But there are other ways you can improve metabolic flexibility. Not for performance enhancing purposes but for gut diversity.

Your gut is inhabited by billions of bacteria all of which influence your mood, how your body metabolizes certain nutrients and how you feel.

That’s why some people do better on keto than others – there are certain genes that make you metabolize fat better like APOE4. If your heritage is equatorial then you’ll do better on more carbohydrates because you’re carrying the DNA of your ancestors inside your microbiome. People in the northern hemisphere tend to do slightly better on more fat and protein.

How to Make Your Keto Diet Metabolically Flexible

However, the ketogenic diet can work for anyone because when you’re in ketosis you’re changing your gene expression. Epigenetics means that certain genes get expressed only when you trigger them. But for optimal gut health you’d still want to promote gut diversity. What does that mean?

  • When you’re on keto make sure you get enough fiber – about 30 grams per day. It’s not worth it to neglect healthy vegetables and leafy greens just so you could stay in ketosis. Your salads should be massive with a variety of colours and greens. I eat like a huge bowl every day and if you add some sea salt, some pepper, some vinegar and olive oil then it’s going to taste amazing – just so goood and super healthy.
  • Eat fermented foods like sauerkraut, pickles, kimchi and small amounts of raw kefir. There are different types of fermentations you can make, like your own tomato-onion sauce with some carrots, or even fermented garlic with bell peppers or whatever you may come up with.
  • I also like to include apple cider vinegar every day. It doesn’t have any direct probiotic properties, but it can fight the other bad bacteria and viruses that may inhabit your gut, like candida and such. Just drink a few tablespoons of ACV mixed in hot lemon water and you’ll do your intestines a huge favor.
  • Take a probiotic supplement and eat prebiotic foods, like garlic, onions and asparagus. Everyone should take a probiotic, I think because it will guarantee you getting the whole spectrum of microbes. However, to be sure, you can also get a gut panel and see which ones you need the most.
  • Include some resistant starch – Resistant starch is a type of starch that isn’t fully broken down or absorbed but is converted into short-chain fatty acids (SCFA) by the bacteria. SCFAs improve blood flow in the colon, help you lose weight, increase nutrient circulation in the body, inhibit the growth of pathogenes and make you sleep better. Foods high in resistant starch include green bananas, beans, legumes and potato starch. Cooking and cooling white potatoes or rice will also increase the amount of resistant starch in them. You cook them the night before and then you leave them in the fridge to be eaten the next evening. Of course, you don’t want to be eating them on the days you’re trying to be in deep ketosis, but on harder exercise days there’s nothing detrimental about eating slightly more of these foods. You have to test and experiment a lot to see how your body reacts.
  • Consuming some butyric acid will also improve your digestion and gut health. Butyric acid is a saturated short-chain fatty acid found in butter, ghee, raw milk and animal fats. Fermenting carbohydrates and fiber in the gut also creates butyric acid. It’s great for healing cells in the intestines and it’s the favoured source of fuel for the cells lining the interior of the large intestine or colon.
  • Occasionally eat some gluten, peanutes, soy, legumes or dairy. If you’re a healthy individual who doesn’t have a particular intolerance to these allergenes, but is just choosing to avoid them, then you should still eat them from time to time. You don’t want to develop allergies just because your gut isn’t capable of handling them. Strict vegans, strict paleo or keto people may get severe allergic reactions to even just a small exposure to gluten. Again – you can avoid it in your food for as long as you’d like, but you can’t completely protect yourself from the gluten that gets floated around in the air particles, in skin conditioners, hand creams and birthday parties. However, if you have a serious auto-immune condition of some sorts, then you definitely don’t want to be doing this because even just a one time splurge of bread or cake can make your condition worse for the coming months. So, again – get some tests beforehand, experiment with it yourself and try new things.

Don’t Be Dogmatic

There’s the danger of embracing extreme ideologies, whether that be the low carb ketogenic diet or the high carb vegan diet.

I’m not a doctor and I can’t tell you what you should eat because science is constantly learning new things about nutrition. I myself am finding out new stuff every day and then I try it out.

The ketogenic diet has many purposes but you should always remember why you’re doing it. You’re probably not doing it for just weight loss or to eat bacon – you’re doing it to be healthy and feel amazing. Keto is great for just that, but you should still follow these stages as to create optimal health and metabolic flexibility.

If you disagree with me, then go ahead, but I’m not going to be dogmatic about any diet or program – I’m constantly trying to learn new things and try them out. And all I’m doing here is sharing my results and giving you advice.

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