More threads by David Baxter PhD

David Baxter PhD

Late Founder
Ketogenic Diet: Is the ultimate low-carb diet good for you?
by Marcelo Campos, MD, Harvard Health Blog
July 27, 2017

Recently, many of my patients have been asking about a ketogenic diet. Is it safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.

What is a ketogenic diet?
In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body?s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.

Because it lacks carbohydrates, a ketogenic diet is rich in proteins and fats. It typically includes plenty of meats, eggs, processed meats, sausages, cheeses, fish, nuts, butter, oils, seeds, and fibrous vegetables. Because it is so restrictive, it is really hard to follow over the long run. Carbohydrates normally account for at least 50% of the typical American diet. One of the main criticisms of this diet is that many people tend to eat too much protein and poor-quality fats from processed foods, with very few fruits and vegetables. Patients with kidney disease need to be cautious because this diet could worsen their condition. Additionally, some patients may feel a little tired in the beginning, while some may have bad breath, nausea, vomiting, constipation, and sleep problems.

Are there benefits of a ketogenic diet?
We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson?s, Alzheimer?s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.

Weight loss is the primary reason my patients use the ketogenic diet. Previous research shows good evidence of a faster weight loss when patients go on a ketogenic or very low carbohydrate diet compared to participants on a more traditional low-fat diet, or even a Mediterranean diet. However, that difference in weight loss seems to disappear over time.

A ketogenic diet also has been shown to improve blood sugar control for patients with type 2 diabetes, at least in the short term. There is even more controversy when we consider the effect on cholesterol levels. A few studies show some patients have increase in cholesterol levels in the beginning, only to see cholesterol fall a few months later. However, there is no long-term research analyzing its effects over time on diabetes and high cholesterol.

What?s the bottom line?
A ketogenic diet could be an interesting alternative to treat certain conditions, and may accelerate weight loss.

But it is hard to follow and it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects, probably because it?s so hard to stick with that people can?t eat this way for a long time.

It is also important to remember that ?yo-yo diets? that lead to rapid weight loss fluctuation are associated with increased mortality. Instead of engaging in the next popular diet that would last only a few weeks to months (for most people that includes a ketogenic diet), try to embrace change that is sustainable over the long term. A balanced, unprocessed diet, rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water seems to have the best evidence for a long, healthier, vibrant life.
 

Daniel E.

daniel@psychlinks.ca
Administrator
One good thing: You can have all the diet soda you want :D

200+ Low Carb Foods for Atkins 20, Phase 1 | Atkins

Pay close attention to your beverages, as they are often a major source of hidden sugars and carbs. It is important to drink at least 64 ounces of water a day during Atkins 20, Phase 1. Drinking enough fluid assists with weight loss and is essential to maintaining good health.

  • Clear broth/ bouillon (make sure it has no sugars added)
  • Club soda
  • Cream, heavy or light
  • Decaffeinated or regular coffee and tea*
  • Diet soda (be sure to note the carb count)
  • Flavored seltzer (must say no calories)
  • Herb tea (without added barley or fruit sugar added)
  • Unflavored soy/almond milk
  • Water – at least eight 8-ounce glasses per day including:

    • Filtered water
    • Mineral water
    • Spring water
    • Tap water
* One to two cups of caffeinated tea or coffee is allowed as desired and tolerated by each individual.

OTOH, the options are so limited they have to iterate different types of water to beef up the list :coffee:
 

Daniel E.

daniel@psychlinks.ca
Administrator
Doctors Finally Constructed a Hierarchy of Healthy Low-Carbohydrate Diets
Aug. 2018

This analysis points out that plant-based low-carb diets that rely on other sources of protein, like lentils or beans, might win out in the realm of low carb dieting. Co-author Sara Siedelmann, M.D., Ph.D., of Brigham and Women’s Hospital tells Inverse that diets that cut out carbohydrates and rely on meat (which are typical of many fad diets in the US and Europe) were associated with even greater risks of “all-cause mortality” in the team’s meta-analysis of 423,000 people from 20 countries.
 
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