Hide caption By Chris Willis / Boomers & Beyond
Happy new year, everyone! Wishing you a healthy 2019!
The big buzz word this past year has been the low-carb diet craze, specifically the keto diet. I took it upon myself to interview many individuals who were on the plan or left the plan (no surprise) to find out what challenges they encountered. What I found out is that weight loss WILL occur and that long-term commitment to the plan is likely NOT to occur, similar to most “fad” diet plans out there. The outcome never changes and yo-yo weight continues, along with the incidence of obesity in the United States escalating.
A recent webinar I attended talked about how the U.S.A. ranks No. 1 in obesity (when you don’t count the very under-developed countries). We are currently sitting at 68 percent obese and overweight, and 20 percent of our youth are the same way. The leanest nations are France, Italy, Switzerland and Japan. It is interesting to note that many factors are involved for these countries, which include socially engaged meal times, increased activity and less access to processed foods (more local markets with locally grown foods), along with emphasis on eating more fish, poultry, fruits, vegetables, nuts and oils. Additionally, their “food pyramids” include water as a large part of their healthy incentive.
So, why are Americans so fat? That is the million-dollar question. That is why there are so many conflicting thoughts and published studies out there. I am reading a book called “The Obesity Code” in which a Canadian physician touts the use of intermittent fasting to rev up the metabolism (which can be very challenging for most people and takes a dedicated personality to accomplish) and something that has to do with decreasing our insulin output. Basically he encourages healthy eating by reducing your intake of refined sugars, especially sucrose and high-fructose corn syrup; reduced intake of refined grains such as white breads and white flour products; moderating your protein intake (20 to 30 percent of your diet); increasing your intake of natural fats such as olives, avocados, nuts and full-fat dairy products; and increased fiber intake. All of these ideas are what the dietetic world promotes and is similar to my favorite diet plan, the Mediterranean diet. (You can Google it.)
The keto diet is similar to the eating plan prescribed for people with diabetes before the availability of insulin in 1921. It encourages a carb intake of less than 50 grams per day (equivalent to two slices of bread and a large apple). By taking in few carbs, the body starts to burn stored fat for energy, which produces ketone bodies as a byproduct, leading to “easy” weight loss.
“The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don’t know if it works in the long term, nor whether it’s safe,” warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women’s Hospital.
Consequences of the diet may include kidney stones; increased uric acid production (gout) from increased protein intake; osteoporosis secondary to limited milk and calcium-rich food intake; decreased fiber intake, which affects colon health; and a decrease in phytochemical intake (plant foods with healthy antioxidant benefits), to name a few. With so much fat to metabolize, the diet could make any existing liver conditions worse.
What I do know as a dietitian who has been practicing for many years is that like the old saying “no one shoe fits everyone,” no one diet plan fits everyone. Similarly, as I tell all my diabetics, no two diabetics will have the same blood sugar response to the same meal they eat. There are too many variables involved, including your own body’s metabolism, your stress levels, your activity levels, your medication or no medication, your support system and your work situation — not to mention your personal food likes and dislikes and your personality. Therefore, ideally, your macronutrient (carbs, proteins and fats) distribution should be based on all of the above and what your ultimate goal is.
You also need to ask yourself what is realistic for you for long-term health and lifestyle management. Perhaps you need to try small changes instead of drastic changes. Perhaps you are a person who can “clean out the cupboards and start from scratch.” Knowing what will work for you and who is around you to support your lifestyle changes is the real question. Additionally, I highly recommend discussing drastic diet changes with your health care provider first. It is important to know baseline lab values, not to mention if you have underlying health issues already, such as kidney or liver decline or cardiovascular disease, as both of these may be contraindicated for very low-carb eating plans.
Bottom line, there are still few long-term human studies to cite benefits or harm of long-term keto-type diet plans and, to date, there is no magic formula, pill or potion to lose weight and keep it off. And just so you know, I am here to support you and your decisions in any way possible. I am not closed-minded to the options out there so long as it’s safe for you. We all come in varied sizes and shapes, but what’s inside counts way more than the outside.
To be continued…
Chris Willis is a clinical dietitian/certified diabetes educator at OSF HealthCare St. Mary Medical Center in Galesburg.
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