FOOD, FACTS and FADS

Exploring the sense and nonsense of food and health


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Is the Ketogenic Diet for Weight Loss Safe?

 

What is the Ketogenic Diet?

Sally Feltner, PhD, RDN

Glucose is the preferred fuel for the body to use for energy. However, when carbohydrates are limited there may not be adequate glucose for energy use. The body can make some glucose from protein but it can also supply an energy source from fatty acids called ketones.

Ketones ( ketosis) are molecules formed in the liver from fatty acids and released in the blood when there is not sufficient carbohydrate. Ketosis can be generated in a ketogenic diet by fasting or by strictly restricting carbohydrate intake to less than 20-40 grams a day. Fat intake is increased to about 70-80 percent of total calories. Protein intake makes up the rest of the calories.

Ketone production is a normal response to starvation or to a diet very low in carbohydrate. Ketones can be used for energy by the heart, muscle, and kidney. After about three days of fasting, even the brain adapts and can obtain about half its energy from ketones. Ketones not used are excreted in urine. However, if produced in excess, they can build up in the blood. If severe in untreated diabetes, it can increase the blood’s acidity so much that normal body processes cannot proceed, eventually causing possible coma or even death.

The ketogenic diet was originally developed to treat children with epilepsy with some success. Lately, it has become a new diet trend in weight loss. When ketones are used for energy, the body can burn fat stores more efficiently often resulting in rapid body fat loss. Ketosis also lessens hunger helping to avoid excessive calorie intake.

In general, registered dietitians, but not all, do not recommend the ketogenic diet for weight loss due to some serious concerns about its safety. This is due to the lack of research especially on long-term effects. It may in some people cause adverse kidney function and bone metabolism leading to a reduction in bone mineral content. Since it is a carbohydrate restrictive diet, there may be other nutritional deficiencies that occur from a lack of fruits, vegetables, or fiber-rich foods. It is also generally a high fat diet causing some to question the safety of consuming high saturated fats and increasing heart disease risks.

There are other cautions. It is estimated that about 7 million people don’t know they have diabetes type 2. With a high number of people in the population that may have undiagnosed diabetes, the serious dangers of high levels of ketones in the blood can have serious consequences as previously discussed above.

Food choices should be monitored by a registered dietitian/nutritionist (RDN) in order to keep the carbohydrate content low and help the dieter choose healthy fats. Electrolytes such as sodium and magnesium should be assessed periodically. Lab values for total cholesterol, LDL, HDL, triglycerides, blood glucose and blood pressure should be monitored.

My opinion? Long-term use of the ketogenic diet is not recommended until more research tells us more about its safety. Perhaps it may help people  to lose weight on a short-term basis; however, please consult your physician before trying any version of a ketogenic diet.

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The Obesity Epidemic: Nature or Nurture?

Fat shaming is found in many aspects of our culture. The obese are described as fat and lazy and looked upon with disdain by even some of the health professionals they seek out to solve many of their health care needs. Perhaps we need to examine the complexities of the interactions that may have contributed to this so-called obesity epidemic to gain a better understanding of what the obese population has to contend with.

In 1960, only 13.4 % of Americans were overweight or obese. By 1990, about 23% were obese, and today, only two decades later, almost 36% are obese. Obesity affects both men and women and all racial and ethnic groups. As far as we know, we still had the same genes and physiology during these decades; however, the food environment or culture had obviously changed.

“The interplay between genetics and lifestyle is often illustrated by the higher incidence of obesity in Pima Indians living in Arizona than in a genetically similar group of Pima Indians living in Mexico. When this genetic susceptibility is combined with an environment that fosters a sedentary lifestyle and consumption of a calorie dense diet, the outcome is the strikingly high incidence of obesity seen in this population. The Pima Indians of Mexico are farmers who work in the fields and consume the food they grow. On the other hand, the Arizona Pima eat the high-calorie, high-fat processed foods,  found in the Standard American Diet (SAD) and lead a more sedentary lifestyle. Both groups have  higher rates of obesity due to their genetic susceptibility; however, the average BMI or the Mexican Pima is significantly lower than that of their American counterparts.” Smolin and Grosvenor, Nutrition: Science and Applications, Third Edition.

Check out my previous post HERE.

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Are Fish Oil Supplements Helpful?

 

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Since the 1980’s, the benefits of fish oil has been a hot nutrition topic. I was a graduate student at the time and my research involved the hypothesis that omega-3 fatty acids (as menhaden oil) would suppress breast cancer tumors when compared to omega-6 fatty acids (as corn oil) in rats. Previous research had suggested that there was enough evidence to warrant the study. Bottom Line: There were no significant differences in tumor formation even when rats were fed high or low menhaden or corn oil diets. This was a surprising finding at the time; therefore, the study was replicated the next year and results were the same. At the present time, further research has shown some promising results in breast cancer research, but some studies with omega-3 fats in humans have been inconclusive.

Since then fish oil (omega-3) fats have been extensively studied in a wide range of afflictions to see if any beneficial effects occurred. This interest was a boon for the supplement industry due to the sale of fish oil capsules that still continues to this day. How effective have fish oil supplements been in supporting some of the health claims that have been made?

First of all, it is important to know the article does not pertain to eating fatty fish high in omega-3 fats. The picture becomes very complicated when it come to fish oil capsules. The news is both good and bad; the research is both positive and negative. The best takeaway is to be careful of the quality of fish oil capsules you choose. The article suggests that fish oil be of pharmaceutical grade so read labels carefully. However, this term is not regulated or clearly defined so it may be meaningless according to ConsumerLab.com.  If you take fish oil capsules, this article is a must read. Then talk it over with your doctor as to whether fish oil supplementation is for you.

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The FODMAP Diet: Some Common Sense

 

As with any restrictive diet, caution must be used to avoid nutritional deficiencies.  That is why it is important to pay attention to a registered dietitian when embarking on any diet that restricts certain food groups. If a dietitian is not available, seek out the advice found in the following article from an expert on the FODMAP  diet. The best advice is if this diet approach does not produce any positive results, it may not be for you.

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Is Soy Safe? Or Not?

Soy foods have been the subject of such controversey in the past decades, it is almost impossible to sort out the sense from the nonsense. The latest article I could find explains the confusion. The article is a long read, but well worth it if you are a tofu, soy, edamame lover  or eat any type of vegan diet and rely on soy foods for your protein source.

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