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Ketogenic Diets - Your Unconventional Dietitian's Two Cents

You are most probably realizing a lot of people following the “keto diet” these days. I'm noticing that both health professionals and friends of friends are thinking about trying it, if not already in full swing of "going keto". While a ketogenic diet (to be fair, any low-carb diet for that matter,) can cause rapid weight loss, it also comes with similar risks and benefits to regular low-carb diets. Ketogenic diets can vary depending on where you get your info from, but to achieve true ketosis you need less than 5% of energy from carbohydrates, or 20 to 30 grams a day. Otherwise, people assume quite a similar approach to Atkins’, South Beach, and other carb-restrictive diets (ahem, what did Dr. Atkins die from? A heart attack.). Can you point to one person who has sustained any of these diets for their lifetime? I bet you're hard-pressed to find one.

Current research (though fairly new and not very extensive) on ketogenic diets are on specific populations like epilepsy (very effective), Alzheimer’s and dementia (to be determined), Parkinson’s (to be determined), and severe depression (can make it better or worse). While there are promising effects on some of these conditions, the verdict still bounces back and forth between helpful for some and not helpful at all. The rest of the keto clan are probably looking for a "diet cure" for their ongoing struggles to lose weight, or to feel productive in moving towards an ever-changing definition of wellness or health, or just thrilled to find a diet that allows them to drink buttered coffee with a side of bacon and eggs every morning. Spoiler alert: there are a fair number of reasons why I would not recommend a ketogenic diet in the short or long term, in order to do what all healthcare practitioners should aim to do at the least, which is to DO NO HARM.

The anecdotal pros for those of us trying to lose weight is that people indeed drop weight quickly (although a five-year follow-up indicates they have gained the weight back). Keto websites claim that you will have more energy - but then, all my clients report fabulous sustainable energy from all the whole foods they're taking in, with none of the side effects. Let's be honest - "more energy" is totally subjective and could be an exaggerated placebo effect obtained by your thinking that you're doing something different, and thus should anticipate higher energy levels.

Aside from "keto-fog" which can include headaches, brain fogginess, and a drop in energy levels, ketogenic diets may have an eventual result of curbing sugar cravings fairly quickly. Again, this is something my clients experience, without the headaches or carb withdrawals, by including whole foods and removing processed items from their diet.

Other "pros" of keto diets include helping you to lose a ton of water weight, since your body is using up its stores of sugar (glycogen) which naturally want to be surrounded by water. Many studies report ketogenic diets help to preserve a teensy percentage more of muscle mass than otherwise crash dieting would do while you are losing weight - now there's something that's different from your typical diet - unless you count regular exercise and moderate-intensity weightlifting in addition to eating a healthy, well-balanced whole food diet. Ultimately, "keto" is a simple-to-remember set of rules when it comes to eating out, eating in, and preparing meals, backed up by science that is not really intended for the general population when it comes to disease prevention and sustainable weight loss.

From an outsider perspective, I'm happy that many ketogenic fanatics and plans promote vegetable intake, exercise, and at least promote leaner cuts of meat, although most promote outrageous amounts of dairy fat and dairy and meat products as well as coconut oil (not really a health food, see here) as a staple. Some research even shows positive effects on blood sugar control and the body's response to insulin, but of course, simply how your body responds to sugars is not the whole picture of your health!!

Aside from the collateral damages mentioned above, the cons are that it is simply and plainly a diet, which means you might gain the weight back and more if you can’t keep up the habits. Furthermore, it is diet mainly based on animal protein and fat (people most likely will choose animal protein in favour of beans in order to restrict carbs) and that alone will lead to ultimately an increased risk of death from heart attack, complications of diabetes, stroke, and just about every neurodegenerative or inflammatory disease under the sun. Oops. The most widely searched websites claim ketogenic diets reduce the risk of these diseases, with no valid evidence to back up their claims. Even with copious amounts of veggies, you might be starving your gut of soluble, digestion-resistant fiber that your gut naturally anticipates from seeds, nuts, grains, legumes, fruits, and veggies, even root veggies. Saying goodbye to excess weight, including water weight, and hello to an increased risk of bowel cancer is not something I'd like to have on my bucket list. So, 30 to 35 grams is a "good start" for people looking to improve their gut health, and it is almost impossible for keto diets to provide that in vegetables - especially since you'll be too full of animal protein and fat to squeeze in fiber-rich veggies. (Me: "Like omg, when was your last bowel movement?" Seriously.)

Gut health is super important: you can alter your gut microflora to be that of an obese, stressed out person just by what you eat. Or, you can feed the good guys with fiber, and bathe them in fruit and grain and veggie antioxidants to make your gut environment like that of a skinny and healthy person. Let me reiterate, YOUR GUT HEALTH IS MORE IMPORTANT THAN QUICK-FIX WEIGHT LOSS PRODUCTS AND DIETS!

Whatever you decide to use to jumpstart a healthy lifestyle, I encourage you to get some professional guidance from a Dietitian so that you're not missing out on any essential nutrients, and can find out what foods and food lifestyle is right for your social life, physical health, and ethical and environmental beliefs. If you need two hands to count the number of times you have started on a diet, maybe it's time for a complete overhaul in the way you think about food and nourishment. Make 2018 a year of quitting the diet mindset!!!

All the love, all the health, and all the goodness of whole-food nutrition to you!

xoxox - Bri

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