“Will I have weight loss if I’m over 20 g carbs per day?”

How much insulin does it take to totally stop ketosis? Do I keep to the 20 g carbs per day? High or low levels of ketones in the blood when keto-adapted? And, how can a pizza that has over 1,000 calories be conducive to weight loss?
Get the answers in this week’s Q&A with me:
Insulin and ketosis
Hello,
As a person with type 2 diabetes I have had success in losing some weight, reducing my Hba1c and ditching some of my insulin by following keto. Given that, as I understand it, insulin can “turn off” ketosis I assume that I have probably never been in ketosis as I still take 124 units slow per day.
What I would like to know is just how MUCH insulin does it take to totally stop ketosis? Presumably, healthy people following keto have a certain amount of insulin circulating in their bodies… but how much?
Daren
Hi Daren,
Interesting question. There are likely individual differences, e.g. it’s not just about the amount of insulin, it’s more about the effect of the insulin. So if you’re insulin resistant (T2D) you’d need more insulin to get the same effect as someone without insulin resistance.
With normal insulin resistance, about 0.25 units per pound of body weight might be considered normal for many people on a standard diet. To get into ketosis would then require significantly less than that, on average. But with insulin resistance, e.g. T2D, this number could be higher.
These numbers are highly individual. It’s impossible to give personalized advice about it. So everyone should consult with a healthcare professional.
Best,
Andreas Eenfeldt
I recently started the keto diet and would like to continue. Do I keep to the 20 g carbs per day?
As I select the various meals for the weekly planner, I realize that the carbs are not high. I remember watching a video from DD where you mentioned not surpassing 50 g. Is this correct? I want to continue experiencing weight loss, so what is recommended?
Leah
Hi Leah!
The effect on weight loss tends to be higher the lower you go with carbs. Below 20 net grams per day seems to be the most effective level, but below 50 can work fine too for many people, and it’s easier to do.
Best,
Andreas Eenfeldt
Ketone level for keto-adapted individuals
If a person is keto-adapted, wouldn’t you want to see fewer ketones in the blood? There seems to be to be so much emphasis on high ketone levels.
Sandy
You’re right, the emphasis on high ketone levels may be exaggerated. It’s not a contest, and higher levels are not always better.
Best,
Andreas Eenfeldt
A serving of pizza has over 1,000 calories, how can that be conducive to weight loss?
Hi,
I’m a 23-year-old female, (5’9 and 65ish kilos, not overweight but looking to lose fat/define muscle). I signed up for the 2-week challenge and was looking at the recipe for the pizza, which has 1,000+ calories for one serving – for 1 meal it seems like a lot. I watched the video about why counting calories aren’t the best method, and that it matters where your calories come from, and I understand, but this seems like a lot of calories for one meal, and are calories really that arbitrary?
Lana
Hi Lana!
It’s not required that you finish it. If you feel that you’d be satisfied with a smaller portion, feel free to make a smaller pizza or leave some leftovers. In the future we hope to have a feature where you can enter your size/weight etc. and get serving sizes more tailored for you.
The idea, however, is to get your weight-regulating hormones (like insulin) working so that you can lose excess weight without voluntarily having to restrict food amounts. It’s better if you’re able to eat what you feel you want, to feel satisfied, and still be able to lose excess weight.
Best,
Andreas Eenfeldt
More
Intermittent fasting for beginners
More questions and answers
Many more questions and answers:
Read all earlier questions and answers – and ask your own! – here:
However, it's after 'induction' where there are differences.
Atkins gradually adds carbs and tends to be higher in protein, whereas with Keto your fat remains high, proteins are moderate, and carbs remain (for many of us) under 20g.
Atkins Phase 4/Maintenance averages 30-50g of carbs daily (minimum of 20g must come from leafy greens).
I've been Keto since April 2nd per my dr's orders and have lost 50 lbs (so far), am off high blood pressure meds and insulin... The rest of my life I'll need to stay under 25g of carbs a day, but I'm ok with that.
I personally notice a spike in my blood sugar and experience headaches if I go above 30g/day.
So while Dr Atkins does need to be recognized as knowing what he's talking about, it's in the later phases where there are differences.
https://www.dietdoctor.com/low-carb-work-long-term
https://www.dietdoctor.com/new-study-is-low-carb-sustainable-long-term
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/
https://www.virtahealth.com/research
I was diagnosed as having postmenopausal breast cancer Dec 18. Grade 2 HER negative, ER8 positive for oestrogen. Mastectomy followed Jan 19.
I am seeing a dietitian via NHS who is advocating a Mediterranean diet particularly low in fat, high in fruit/vegetables, based around starchy carbs. Indeed they say particularly consuming less dietary fat may significantly improve my survival rate.
I find this conflicting advice confusing and would be grateful for your thoughts, as well as any pointers to studies/evidence to the contrary please especially around breast cancer.