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Autism Research Institute: Ketosis is a bad thing

One of the ways that parents of kids with Autism frequently look to help their children is by finding a DAN doctor.  DAN is an acronym that means "Defeat Autism Now," and the idea is that physician in question knows and utilizes therapies that can help alleviate some of the symptoms of Autism.

I personally know of some people who have reported great gains for their kids after having been on a treatment program with a DAN doctor.  Some of these therapies are diet-related, some are medicinal, and there are probably others that I don't know about as I haven't learned as much about the programs yet as I'd like.

But in my perusal of this subject this morning, and wondering if there are DAN doctors in the Columbus area, I came across this statement on the webpage for one of the referring groups for DAN doctors, the Autism Research Institute.
Nutrition and supplementation are a very big part of addressing the needs of those on the spectrum. Dietary adjustment is one of the most effective treatments, though it’s often not as simple as gluten-free, casein-free, and soy-free. Some diets, such as the Specific Carbohydrate Diet, can provide impressive results when implemented correctly, but can actually be harmful when done wrong (kidney damage, ketosis).

So given the title and the knowledge that this is a Paleo blog, I know that you picked out what I have a problem with here.

Ketosis, as many of you know, is a state where our bodies stop using carbs as much for energy and begins synthesizing fats into ketones, which are an energy source that our cardiac systems and brains can use in many cases to replace glucose.  In fact, many of the processes that glucose power in our bodies become more effective when we switch over to ketones.

Ketosis allowed our ancestors to nourish themselves during periods where more carbohydrate-rich vegetable matter was not as available (such as during ice ages and droughts and the like), and explain why we were able to thrive during those periods.  Ketosis, combined with gluconeogenesis to get the small amounts of glucose that are needed, is a healthy way to lose fat.

So why does this ARI website say it's dangerous?  I suspect that there are two reasons that this may be happening:

  1. They're confusing ketosis with ketoacidosis (and please ignore the cholesterol comment in the web link - the rest of the description seems pretty good to me).    This is a condition in Type 1 diabetics where the body basically goes overboard in ketone production due to the lower insulin levels and low carbohydrate levels in the blood (if I have this wrong, PLEASE feel free to comment and tell me... not being diabetic I've not had to deal with this myself).  It can lead to kidney issues and coma.

  2. They're assuming that if you're in this state, your body is starving due to a lack of carbs (based on the conventional wisdom of a high-carb low-fat diet, which we all know to be hooey).
Now ketosis may not be a state that one should stay in for too long - the jury is still out on this one.  Even respected low-carb diets like Atkins don't keep a person in ketosis for too long, just enough to spur the body to start burning away fat healthily.

But I question the reasoning behind this by the ARI, particularly in the case of #2, above.  A diet consisting of more than 50 grams of carbohydrate a day should be sufficient to keep you out of ketosis - and as most people who've tracked their carbs for any period of time know, that is incredibly easy to do even on a Paleo diet.

So comment!  What do you think about this statement by ARI?

Edit: I came across this Psychology Today article by Dr. Emily Deans, the author of the blog Evolutionary Psychiatry today, in which she discusses the use of ketosis in the treatment of seizures.  Although it doesn't dwell much on the longer-term effects of being in ketosis, it's a very enlightening article that tends to lend creedence to my concerns about the ARI's standpoint on ketosis.

Edit 2: Dana left a comment below about a more accurate description of ketoacidosis, thanks to her for that! 


  1. You hit the nail on the head! There are a lot of nutritionists and even doctors that confuse ketosis with ketoacidosis. Even today there are large populations, the Inuits for example, that thrive on virtually a zero carb diet. Nice post!

  2. What's amazing to me is that even with all the research going on to see if a high-cholesterol (read: high-fat) diet is good for autistic children, they're still holding on to the carbohydrate myth (assuming, again, that #2 is the primary reason for the inclusion of ketosis in their "dangerous" category). It just doesn't make any sense.

  3. Actually, ketoacidosis involves not only the formation of ketones but also a very high blood sugar level. It occurs in type 1s (and sometimes type 2s, or so I hear) whose blood sugar has gotten ridiculously out of control. The ketones are being thrown because the body is getting next to no energy despite the presence of the glucose. At the same time, the level of ketosis is way, way, WAY higher than normal, creating a condition of metabolic acidosis (which I'm guessing the excess glucose aggravates--sugar creates acidic conditions in the body). You're not going to go into ketoacidosis just being in ketosis. Not possible. The really high blood sugar has to happen too.

    As for regular ketosis, nearly everybody goes into it at some point in their 24-hour cycle, usually when they're sleeping. If it were that dangerous, people should be dropping like flies round about midnight--but they don't.

  4. Thank you Dana, for adding this. So I was wrong about the glucose level - actually, it's the other way around. But the practical upshot of this post remains, I think.

  5. Being in Ketosis increases risk of kidney stones. This risk can be reduced vastly by taking potassium supplements or by having a diet high in potassium.

    Nothing said was overtly wrong. Any diet can have good effects when done right and bad effects when done wrong.

    Trying to pretend something is all good is just as bad as people whom claim it is all bad.


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