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3 huge new studies of more than half a million people are casting major doubts on the keto diet

3 huge new studies of more than half a million people are casting major doubts on the keto diet

Nutritionists are zeroing in on healthy, whole foods that come mainly from plants, not animals, as the secret to a longer life.

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Nutritionists are zeroing in on healthy, whole foods that come mainly from plants, not animals, as the secret to a longer life.
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with wind/Flickr
  • Low-carb diets like the ketogenic diet are popular strategies for rapid weight loss and appetite control.
  • Keto diets require eaters to essentially forgo all carbohydrates and fuel up on fats and limited amounts of proteins instead.
  • Because sugar is a carb, many keto dieters drastically reduce their sugar intake – but they eliminate healthier carbs too.
  • Nutritionists are starting to notice that people who live the longest tend to incorporate more plant-based foods, including some fiber-rich carbs, into their diets.
  • It’s another reminder that focusing on healthy, plant-based, whole foods is a better long-term strategy than dieting.

Scientists and dietitians are starting to agree on a recipe for a long, healthy life. It’s not sexy, and it doesn’t involve fancy pills or pricey diet potions.

Fill your plate with plants. Include vegetables, whole grains, healthy fats, and legumes. Don’t include a lot of meat, milk, or highly processed foods that a gardener or farmer wouldn’t recognize.

“There’s absolutely nothing more important for our health than what we eat each and every day,” Sara Seidelmann, a cardiologist and nutrition researcher at Brigham and Women’s Hospital in Boston, told Business Insider.

Seidelmann recently published a massive, blockbuster global study of the eating patterns of more than 447,000 people around the world. What she discovered – and what is probably not a huge surprise – is that no matter where you live or what your daily diet is like, banning entire food groups and thinking you can cheat your way into good health might work for a while, but it could also send you into an early grave.

The popular ketogenic diet, which involves strictly limiting carbs to less than 50 grams a day (that’s no more than two apples’ worth) and subsisting primarily on high-fat foods, is one of those restrictive diets that could have harmful long-term consequences.

Other low-carb weight-loss diets that fall into this category include paleo, Atkins, Dukan, and Whole 30. Nutrition experts say that besides their potential for harm, these popular diets are really hard to follow.

[Read More: The keto diet could make certain cancer treatments more effective in mice, a study found – and a human trial is moving forward]

Some benefits of going keto are difficult to dispute. Following a high-fat, low-carb diet can be a solid strategy for rapid weight loss and blood-sugar control. The keto diet can also be great for children with tough-to-control epileptic seizures. For decades, people have seen stellar results managing those conditions on a keto diet with the help and guidance of professionals.

But there’s some limited evidence that going low-carb might also lead people to become less tolerant of glucose and develop diabetes, though more research is needed.

What we do know, based on carefully conducted laboratory testing of overweight men, is that going keto probably doesn’t help burn more body fat than a regular regimen. Instead, it forces people to dramatically curb their sugar intake (remember, sugar is 100% carbohydrate) and kick processed foods to the curb. Those are both good habits for overall health and blood-sugar levels, and they can help reduce your likelihood of developing cancer.

But like taking aspirin, eating a special high-fat, low-carb diet probably shouldn’t be an everyday habit for otherwise healthy people. Our bodies simply aren’t designed to fuel up on fats, unless we’re literally starving. Even Josh Axe, a keto evangelist, has said it’s not a diet that should be followed for more than a few months at a time.

Finally, low-carb diets make it easy to neglect key nutrients like magnesium, calcium, and potassium that can be plentiful on less restrictive diets with fresh, high-carb foods like beans, bananas, and oats.

More studies suggest that people who eat whole, nutrient-rich foods live the longest and have a lower risk of cancer

Quinoa

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Flickr/Rusvaplauke

More research that backs up Seidelmann’s was presented in August at the European Society of Cardiology Congress.

Researchers who presented at that conference studied the self-reported eating patterns of nearly 25,000 people in the US and compared their results with studies involving more than 447,500 people. Again, they found that those who ate a moderate amount of carbohydrates were more likely to live longer than either low-carb or high-carb dieters.

“Our study suggests that in the long-term, [low-carb diets] are linked with an increased risk of death from any cause, and deaths due to cardiovascular disease, cerebrovascular disease, and cancer,” Maciej Banach, a professor at the Medical University of Lodz in Poland who helped write the study, said in a release.

A third study published this week in the journal PLOS Medicine that surveyed the eating habits of 471,495 Europeans over 22 years found that people whose diets had lower “nutritional quality” (i.e., fewer fresh vegetables, legumes, and nuts) were more likely to develop some of the most common and deadliest forms of cancer, including colon, stomach, lung, liver, and breast cancers.

[Read More: Silicon Valley’s favorite diet can lead to kidney trouble – here’s how to go keto without getting sick]

Basically, we’re learning there’s no shortcut to healthy eating

It can be tricky calculating the precise kind of diet that leads to a long life. Part of the problem is that (thankfully) we don’t live our lives in highly controlled laboratory conditions. Until that terrifying day arrives and we all become well-studied lab rats, we have to rely on long-term observational data, usually in the form of surveys, to know more about which diets are the best long-term plans.

In study after study, survey data from around the world has shown that people who stick to limited amounts of meats, dairy, and processed foods while fueling up on fiber-rich plant-based foods including vegetables, whole grains, nuts, and, yes, even carb-heavy beans have some of the best health outcomes. Seidelmann describes their diets as being rich in “whole foods.”

“They were not processed,” she said of the diets of people in her study who lived the longest. These people would consume whole-grain rice, not white varieties. They’d eat plants like fruits and vegetables, not more-processed versions like fruit juice or smoothies.

“You have the intact fiber; you have a lot more nutrients,” Seidelmann said.

Fiber isn’t just good for keeping your gut moving – scientists feeding diets rich in fiber to mice are discovering that the carbs, which can’t be absorbed by the body, can help protect aging brains from some of the damaging chemicals associated with Alzheimer’s and reduce inflammation in the gut. They’re confident that the health benefits of eating more fiber extend to humans too.

But a plant-based regimen with lots of fiber can be tricky to maintain on a low-carb diet, because some of the highest-fiber foods are also high in carbs, such as savory beans, crunchy peas, and sweet fruits.

“It is not a common pattern to eat very low-carb, strictly plant-based,” Seidelmann said. “At least in the Western world, it tends to be more animal-based. That just is what it is.”

People on low-carb diets often turn to more butter and meat for sustenance, which can increase blood pressure and, in the case of processed meats, contribute to cancer. Meat and dairy can also contribute to inflammation in the body, which can help cancerous tumors form and grow.

The new scientific findings all support what parents, trainers, and coaches have been saying for years: eat less junk, and continue to be skeptical of the latest miracle diet, be it keto or any other passing fad.

Another look at the keto diet

Another look at the keto diet

In a recent column, I stated, “Even if we entirely avoided all carbohydrates, our bodies would use protein in an alternate recipe to make glucose (sugar) to fuel our cells.”

However, someone responded: “According to Dr Jason Fung, author of The Obesity Code, if one eats a diet of 65% healthy fat, 35% protein, and 5% carbohydrate, the body will be in ketosis and will burn fat, not protein, to make glucose to fuel our cells.

“Only when the body reaches the level of 4% fat will protein be used to make glucose.”

He then goes on to describe his success with this diet under his doctor’s supervision.

“I have lost a pound a week for 15 weeks and feel very good after the initial few days of sugar withdrawal. My regime of full fat yoghurt and milk, unsweetened whipped cream in my coffee, olive and avocado oils, limited fruit, no root vegetables, no flour, beans or pulses, satisfies my hunger as no other diet has. Have you looked into the ketogenic diet? I believe it is revolutionary.”

I applaud this person’s progress. And yes, I have looked into the research on ketogenic diets. Here are my thoughts:

Glucose – the primary fuel for our brain, muscle and other body functions – is easily provided by carbohydrates (sugars and starches in most plant-based foods).

In the absence of carbohydrates, our amazing bodies can make glucose from fat and protein.

Ketogenic diets severely restrict carbohydrates to force the body to manufacture glucose from these alternate sources.

This causes acids (ketones) to build up in the blood – a condition called ketosis. In times of starvation or low carb dieting, take your pick, our brains and muscles can survive on ketone bodies.

The ketogenic diet is extremely popular and controversial. Like you, many of its followers report less hunger and more weight loss compared to other diets.

Yet, experts argue its long term effectiveness and safety.

These diets eliminate or severely restrict any type of sugar or starch including grains, fruit (natural fruit sugar, fructose), potatoes and other starchy vegetables, beans, legumes and milk (natural milk sugar, lactose).

On the plus side, ketogenic diets have been used successfully to treat epileptic seizures in children.

And many people who adopt this eating plan eat more vegetables and less added sugar. Studies over the past 15 years show that animals and humans tend to lose weight faster on ketogenic diets. Their effectiveness over the long term does not seem to be any better than other weight loss plans, however.

On the down side, ketosis means that our bodies must deal with the production of acids, including acetone, that build up in our blood. This, say biochemists, disturbs the body’s natural acid-base balance.

People with diabetes are at risk of ketoacidosis – an extreme form of ketosis that is life-threatening.

While promoters of the keto diet say this is not a risk for healthy people, I personally do not prefer to chronically feed my brain and muscles this way.

My opinion also is that carbohydrates are not evil monsters. They are quite literally the energy from the sun transformed by plants into fuel (sugars and starches). This energy is transferred to me when I eat plant-based foods.

If I severely restrict these foods, I also eliminate some pretty important nutrients and substances that reduce inflammation – a major trigger for obesity, heart disease and diabetes.

A recent study by the US Agricultural Research Service, for example, found that participants who ate whole grains (instead of refined grains) lost weight while boosting beneficial bacteria in their guts that fight off inflammation and harmful gut microbes.

Any strategy that helps us avoid empty calories from excess sugars is a good step. Let’s not throw out the baby with the bathwater, however. – The Monterey County Herald/Tribune News Service

Silicon Valley’s favorite diet can lead to kidney trouble — here’s how to go keto without getting sick

Silicon Valley’s favorite diet can lead to kidney trouble — here’s how to go keto without getting sick

The keto diet lets people eat lots of fat but very few carbohydrates.

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The keto diet lets people eat lots of fat but very few carbohydrates.
source
Shutterstock
  • The keto diet is a popular strategy for rapid weight loss and can help with certain medical conditions like seizures and Type 2 diabetes.
  • But kidney doctors say that if you’re not careful, it can be a recipe for kidney stones and other health concerns.
  • It’s not necessarily the diet itself that’s bad, but the way some people approach it.
  • Make sure you’re staying hydrated, and keep your intake of meats in check.

The keto diet, at its essence, is rather straightforward: stop eating carbs, munch on more fat.

It is a high-fat, low-sugar weight-loss strategy that forces the body into its natural starvation mode, causing it to rely on fat for fuel instead of on sugars and carbohydrates – typically what our bodies like to burn through first.

Some people say it lifts mental fog while slimming their waistlines. Different versions of the plan have picked up a string of celebrity followers, from Kim Kardashian West to LeBron James. The diet is especially popular among Silicon Valley tech workers, who see it as a path to better performance and reduced appetite, albeit with a side of bad breath.

But while decades of research suggest that a keto regimen can treat epileptic seizures and control blood glucose levels in people with Type 2 diabetes, there hasn’t been much study yet of what the diet can do for a wider population.

If keto dieters aren’t careful, they can quickly become dehydrated, ramping up the amount of protein and uric acid in their body to dangerous levels. The diet itself has not been linked to an increase (or decrease) in kidney stone diagnosis rates, but some doctors say they’re already seeing a shift as more of their patients go keto.

[Our reporter spent two months on the keto diet. Here’s what it was like]

Dr. Koushik Shaw, a urologist at the Austin Urology Institute, told a local Fox affiliate he had started noticing a worrisome trend.

“I’ve seen a huge spike in the number of kidney stones that we see,” Shaw said, adding that he hadn’t seen an uptick quite like this before in his 14 years of practice.

“A lot of it I attribute to a lot of these high-protein, low-carb, keto-type diets,” he said.

He hypothesized that many of his patients were probably eating more meat and fish than they used to, something that can increase calcium and uric acid levels and acidify their urine.

Keto dieters can eat meat, fish, butter, and cheese.

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Keto dieters can eat meat, fish, butter, and cheese.
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Flickr / @agentcikay

“All of these things can contribute to a higher rate of kidney stones,” he said.

Higher levels of uric acid in the body can also lead to other health problems, like gout, which can happen when uric acid builds up in the body, “forming sharp, needlelike urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling,” according to the Mayo Clinic.

Other doctors aren’t sure that the keto diet is the true culprit behind the kidney stones.

“Some of the problem might lie in the way that people interpret the keto diet,” Dr. Thomas Chi, a urologist at The University of California, San Francisco, told Business Insider.

He said a combination of “tons and tons of meat” and not enough water could lead to kidney stones.

And Chi said that while he hadn’t noticed any kind of dramatic uptick in kidney stone patients on keto plans, he had seen a few extreme cases of stones in keto dieters.

“While that’s a pretty rare instance,” he said, “it may be driven not necessarily by the fact that you’re having low carbs and higher fat but that you’re subbing in other things,” like more meat.

Fatty keto options like butter and meat can increase your blood pressure, while a higher protein intake can put added stress on kidneys, because it adds more acid to them and messes with the body’s balance of calcium.

Dietitians recommend anyone going on the keto diet consult with their doctor to discuss whether it’s the right choice for their body type and medical history, as well as brainstorm the best things to eat on the plan to stay healthy.

The doctor-recommended way to go keto

Chi said that with so many patients telling him they’re having success losing weight and feeling good on the diet, he didn’t want to discourage a helpful-eating shift.

“I generally tell people, ‘Everything in moderation,’” he said. “We try to take a pragmatic approach.”

He recommends his patients stay well hydrated and don’t overdo it on the meat.

Lemon water

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Gayvoronskaya Yana/Shutterstock

Shaw said: “The weight loss is great and lower carbohydrates are great. But you have to balance that with a high fluid intake so you can wash some of the metabolic products out.”

Something that can help is adding lemon to water, Shaw said, because the citrate in the lemon keeps calcium molecules from sticking together.

Children on the keto diet to help control seizures are sometimes given oral potassium citrate tablets, which can both help decrease the number of stones they develop and prolong the time it takes stones to form.

So while there’s no clear evidence that a keto diet directly causes more kidney stones, it’s a good idea to check whether you’re at an increased risk for developing stones before you go keto.

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