A ketogenic diet produces ketosis by suppressing insulin, depleting liver glycogen, and accelerating beta-oxidation of fatty acids, mimicking the metabolic state of fasting.

“A ketogenic diet produces ketosis by suppressing insulin, right? And I think of it as almost like insulin suppression therapy. So, when you fast, you suppress the hormone insulin, you deplete liver glycogen, and then that accelerates beta-oxidation of fatty acids. And it's the oxidation of fatty acids in the liver or the over-oxidation of fatty acids that accelerates production of acetyl-CoA, and then that condenses to acetoacetate and beta-hydroxybutyrate. So that's accelerated at a maximal state with fasting, and you can mimic that state of fasting with a classical ketogenic diet, which is like 90% to 80% fat with a level of carbohydrate that almost has no effect on insulin, really.”