Although for me medical school was decades ago, I remember well what was taught about nutrition — nothing. In my early years as a physician I was often embarrassed by my lack of knowledge in this area. I have educated myself through reading articles and scientific studies about nutrition and various approaches about weight-loss diets. I will still admit I am nowhere near being an expert in this area, but that is not going to stop me from sharing some of my insight.
Over the years that I have had the honor of writing this column, I have steered away from dietary advice because I know there are so many different opinions out there. I have been told by my readers that one of the reasons they enjoy my articles is that they are straightforward and rather simple, like me. So, allow me to break down one of the more popular and complex diets of 2018 in the simplest terms I can.
Let me first put this in perspective. Although taking care of your body is important, there are many good people who get so caught up in the latest food fad and end up worshiping their bodies. Much of their daily life is about what diet they are currently on and how they are going to keep themselves at their ideal body weight. Please don’t forget that your spiritual health is so much more important than your body’s health. Having said that, taking care of your body may enhance your ability to better be a disciple of Jesus.
The most common dietary question in my office in recent months surrounds the ketogenic diet. It’s about minimizing carbohydrates. The keto diet is generally defined as eating about 75 percent fat, 20 percent protein and only 5 percent carbohydrates. It has been around for a long time because many years ago it was discovered to be effective in treating seizure disorders in the pediatric population. This diet has proven effective at reducing seizures even after multiple medications for epilepsy have failed.
The basic concept of the keto diet is that by eating very few carbohydrates you force your body to begin to burn fat rather than glucose. Your body preferentially will use glucose, from carbs, as its fuel, but it will also use ketones, from fat, if forced to. One of the great advantages of this diet is that it actually suppresses your appetite. By eating low-carb, satiating foods, you feel full longer. When you eat a diet high in carbohydrates like potato chips, candy and soda you feel hunger again just an hour or two later.
There are three ketones the body uses as fuel. The majority, or 78 percent, come from burning beta-hydroxybutyrate; 20 percent comes from acetoacetate; and 2 percent from acetone. Foods that you can eat on this diet include cheese, cage-free eggs, meat (grass-fed over grain-fed), poultry, fatty fish like salmon and mackerel, and nuts and seeds like almonds, walnuts and flaxseed. You can eat vegetables, but they must be low in carbs. These includes spinach, broccoli, cauliflower and asparagus. You may have noticed at your grocery store the option of buying pizza crust made of cauliflower: This is in part catering to people trying to eat healthier, and the popularity of the ketogenic diet.
The restriction of carbohydrates needed to get your body into ketosis is rather difficult. Most experts say you need to restrict yourself to between 20 and 50 grams of carbs per day. The sweet spot for most people is 30 grams of carbs daily. This will be a challenge! Fruits are, of course, healthy, but if your goal is to drive your metabolism into ketosis you don’t get to eat much fruit which is high in carbs. One medium-size banana or apple is 30 carbs. Fruits with increased fiber are an advantage, because on this diet you get to subtract out the grams of fiber. For example, an apple has 7g of fiber so you only count 23 carbs.
A banana only has 3 grams of fiber, so it is worth 27 carbs. One sweet potato will take care of all the carbs you get to eat in a day, being about 30 grams of carbohydrates. Other ways to quickly consume your allotted amount of carbs in one day include eating two slices of whole-wheat bread, a bowl of Cheerios or drinking one 8.4-ounce can of Red Bull. This diet is not for wimps!
The sweetheart of the ketogenic diet is the avocado. This fruit is a good source of fat which is the mainstay of the ketogenic diet. One cup of avocado supplies 21 grams of fat, 3 grams of protein and 12 grams of carbohydrates. Here is the kicker. It has 10 grams of fiber so the net carbs turns out to be only 2.
So why don’t we all eat lots of avocados? If the reason you have embarked upon the keto diet is for weight loss, it may not be the best choice. They are very high in calories, and that’s just eating it straight up. If you make it into guacamole, and then add all the calories from the chips, you have successfully blown your diet for the day.
When people start out on this diet and their body enters into a state of ketosis, some people begin to feel awful. This is called the keto flu, which is manifested by headaches, nausea, reduced concentration (keto fog), fatigue, dehydration and even hypoglycemia. Since ketosis increases urination, staying hydrated on this diet is one key element to preventing this side effect. Many advocates of this diet also recommend you verify that you have restricted carbohydrates enough to enter into ketosis. You can easily do this by using ketone test strips. You dip one of these strips into your urine stream and if it turns dark purple you are in ketosis. As you stay on this diet and your body more efficiently uses ketones for its fuel, the strips will usually begin to become a light pink.
Benefits to the ketogenic diet include reduced insulin levels and reduced insulin resistance that can help prevent diabetes. Ketones also seem to be very important in brain health. They are full of neuroprotective antioxidants and are a more efficient fuel for the brain than sugar. Some believe this diet may help in treating and preventing Alzheimer’s disease, but this has not been proven in any controlled trials that I am aware of.
Most people start the ketogenic diet to lose weight. I have believed for some time now that reducing carbohydrates in your diet is one of the best ways to more successfully take the pounds off. I see many advantages to this diet, but I sincerely doubt that most people can maintain this diet long term. I personally recommend a more balanced dietary plan that can be maintained lifelong.
The formula for losing weight remains a constant. Burn more calories than you eat and you will lose weight. It doesn’t matter whether it’s high or low in carbs, or whether you eat once per day or graze all day long. It’s calories in versus calories out. God has blessed us with plentiful food choices that we can all enjoy as we strive to keep our bodies healthy and continue to do His work.
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