There are so many pseudoexperts, and so much misinformation out there on nutrition - including in this thread. I am a professional (registered) nutritionist with an advanced degree, have worked in hospitals for many years and have seen thousands of people with all types of ailments, from heart disease to gastrointestinal cancers to eating disorders, and have read thousands of studies over the course of my education and professional work. It's unfortunately difficult to change peoples' perceptions on certain foods as food choices are a deeply personal decision, and I hate debating nutrition on the internet because of this. But here goes.
I never recommend the ketogenic diet. Ever. There's multiple reasons for this. First and foremost it cuts out the healthiest foods that you can put in your body - beans, lentils, fruits, certain vegetables, some nuts (depending on how you plan things out) and nutritious grains such as quinoa. Second, it is has not been shown to be superior if the long-run - which is what matters - than other "diets" for weight loss. Third, it's often inadequate in certain micronutrients (such as potassium, which is actually vastly underappreciated, and others such as folate and magnesium) and inadequate in fiber (not technically a nutrient, but also vastly underappreciated in its role in human health). Fourth, from biochemical and physiological standpoints, combined with observation data, the ketogenic diet stands on shaky ground. It's not just heart disease that is of concern, but increased risk of other ailments such as colorectal cancer. Fifth, few people are knowledgeable enough, or dedicated enough, to actually tailor their daily diet to reach and maintain a true state of ketosis. Sixth, weight loss is great, but it by itself is not a panacea, and you are still at risk for developing medical problems if your overall diet is unhealthy, especially if compounded by other factors (stress, lack of sleep, smoking, etc). If your weight rebounds because you couldn't maintain the diet, then you're actually worse of than when you started since large scale weight fluctuations have a negative impact on your health. Seventh, the potential benefits do not outweigh risks or the effort involved to follow the diet. You can achieve the same weight loss goals while including all foods. There are more reasons but that should suffice. A ketogenic diet is medically indicated is for epilepsy or perhaps other neurological conditions but otherwise it's not a good idea.
A nutrition pattern (I hate the word diet) that is predominantly - or exclusively - plant-based is far superior. There's not only growing scientific evidence of this from observational and clinical data, but it makes sense from physiological and biochemical theory as well. Of course you don't have to be a vegetarian/vegan to be healthy, but if you want to offer your body the best chance of remaining healthy (nothing in health or medicine is certain), or reversing/managing certain chronic diseases, then a plant-based diet is the way to go. I'd bet my entire bank account - hell, I'd bet my life - that if every American adopted a plant-based diet overnight and stuck with it, that you would see the prevalence of the top killers of Americans - heart disease, cancer, obesity-related conditions such as diabetes - plummet dramatically. Flexitarian can work, and the Mediterranean pattern is very good too. Just like any nutrition pattern, your food choices need to be balanced. And ultimately, just do what works best for your body. A co-worker of mine is vegetarian, she tried being vegan for a while but for some reason felt low on energy without some dairy. So she's lactovegetarian and does just fine this way.
It's also a bit sad that some people still think that you have to eat tofu (or some other generally unpopular item) or you're out of luck. True, there was a dearth of convenience vegetarian/vegan items not long ago, but today there are tons of options - plant-based yogurts, ice cream, cheeses, protein bars, meat substitutes - along with the true staples of a healthy eating pattern (vegetables, legumes, etc). There's also an abundance of websites dedicated to plant-based cooking with incredible recipes. I don't even need to list them because google will help with that (but I certainly can if needed).
With regard to Danny, I believe I read somewhere that his hypercholesterolemia is genetic. Some people cannot achieve normal cholesterol numbers even with a good diet, exercise, and other lifestyle changes. But what he is doing cannot hurt. Good luck Danny.
I'm not looking to challenge your expertise, as you are 100x more qualified than I am. That said, I'm curious as to your thoughts about the idea that there isn't enough conclusive research to determine whether or not the Keto diet is healthy. I have a few friends that decided to try the diet on their own and here were some of the biggest mistakes they made:
- Super high protein and not enough healthy fats
- Lots of processed meats
- Didn't up their sodium intake to account for loss of water
I feel like too much protein is the biggest mistake people make on a ketogenic diet. It really keeps your body in a constant state of confusion, never knowing whether to utilize glucose or ketones for energy. Correct me if I'm wrong, but a high amount of protein will lead to heavy insulin spikes even without the presence of carbohydrates.
Are you ruling out the idea that a ketogenic diet could be completely healthy if people are consuming local grass fed protein in moderation? I just wonder what research will say in 10-15 years after we have more concrete studies.
Again, I want to make it clear that I'm not trying to say you're wrong. Just curious how you feel about the idea that we still have a lot to learn.
I do not completely rule out that the ketogenic diet can be a healthy change for some people. Different lifestyle changes - different things - work for different people. Anecdotally, I have seen this in rare instances. I've also seen many people attempt to follow it and fail with poor results.
What you're describing above is one of many reasons why I do not recommend the diet (as I had previously listed). It's rigid, requires lots of planning, and can be difficult to follow. What I've learned over the years working with people is that many struggle to plan adequately, even when given proper tools to do so - whether it's due to decreasing motivation to follow the diet over time, and/or because there's so many other things going on in their lives with work/school, taking care of kids, etc., or other factors such as budget shortfalls. On top of that many people indeed seem to think that as long as their carb intake is low enough to maintain ketosis that they can eat whatever they want. They'll wrap steaks with bacon strips for example. To assume that most people would follow a healthful pattern of eating on the keto diet is a broad leap of faith. With as much misinformation out there as there is, many people will follow an unbalanced meal plan based on information they found on the internet rather than consulting a professional.
As for excess protein in the diet, that's largely unavoidable just based on what you're eating on the keto diet, and because protein needs are extremely easy to meet for the average person. I would not expect as large an insulin response with high protein intake compared to high carb intake. Circulating insulin levels will be lower in general on the keto diet. Theoretically too much protein could disturb the true state of ketosis because you'll be getting larger amounts of glucogenic amino acids (amino acids that will be converted to glucose) as part of eating more protein sources, but I'm not certain about this. In general the human body is very adaptable. What it chooses to use as energy can be largely influenced by the composition of your last meal, i.e. if you had a very high-fat meal then your body will adjust accordingly. You can measure this using the respiratory quotient. The truth is your body prefers glucose - carbohydrate - as it's primary source of energy. That's true for your brain, for skeletal muscle (esp during high intensity exercise), and for your red blood cells.
Evaluating the whole picture overall, I would not recommend such a diet, especially at the public health level. Of course you will find other professionals - physicians, even the occasional nutritionist - who will disagree with me. There's always different schools of thought on things, and reasonable people can disagree reasonably.
https://www.ncbi.nlm.nih.gov/pubmed/31067015 Recent trial showing transition to an isocaloric ketogenic diet leading to increased LDL and C-reactive protein (an inflammatory biomarker).
https://www.ncbi.nlm.nih.gov/pubmed/27712963https://www.ncbi.nlm.nih.gov/pubmed/26791878Two studies showing the keto diet causing dyslipidemia in children treated with the diet for epilepsy.
Those studies can be countered with some studies showing positive effects of the keto diet. As I said before nutrition is an imprecise science and we're always going to get conflicting information.
Celticsclay - the ketogenic diet has not been studied rigorously enough to make claims that it reduces the risk of chronic diseases such as cancer and diabetes. I'm not sure where you're getting that from.
Topic: Reddit: Danny Ainge strolling downtown - Switching over to plant based diet (Read 8722 times)