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Tuesday, March 3, 2015

The Ketogenic Diet

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As you know, if you've been following this blog for a while, I don't really believe in super restrictive diets.  Not because they can't help you lose weight, but because most people can't stay on them for very long.  Oh, if only I had a dollar for every client that has come to me for assistance losing weight, who has lost a significant amount of weight on one or another restrictive diet, only to gain it back, and then some, because it was unsustainable.

But they continue to grow in popularity: Low-Carb, Paleo, Gluten-Free...

I've noticed that many of the health bloggers I follow who spent a period of time swearing by these diets and what a cure-all they are, eventually go off them and admit they weren't all they hoped they would be and were too difficult to maintain long-term.

So I really wasn't expecting much when I was sent The Ketogenic Diet to read.  What is it, you ask?

A ketogenic diet is essentially a super low carbohydrate diet, like below 50g per day...I probably get more than that at breakfast alone! It was originally created as a way to treat epilepsy, and is still sometimes used for that purpose today, as well as for other therapeutic uses. It basically puts your body into a state of ketosis, where it is burning fat instead of carbohydrates for fuel.

The author, Kristen Mancinelli is a registered dietician who put herself on the diet for a few months to get first hand knowledge of the experience, and she outlines her experience.  She apparently lost weight, even though she was already thin, and felt great, yet she doesn't explain why she didn't stay on it.  Perhaps its because there is relatively little data on its long-term safety.

The book is not a diet plan, in fact, while it includes a few recipes, it has no menu plan at all.  It mostly focuses on the science behind the diet and on strategies to begin the diet and stick with it.

Thankfully, it departs from diets like Atkins by encouraging the majority of your fat intake to be healthy fats, rather than saturated animal fats.

The diet is primarily proteins and non-starchy vegetables, along with some nuts and seeds. 

Forbidden on the ketogenic diet are all grains, fruit (except limited amounts of berries), low-fat dairy, starchy vegetables, and sugars of any kind.

The only legume allowed is soy in the form of tofu and tempeh.

So its safe to say if you are vegan, and don't want to get almost all your protein from soy products, this diet probably isn't for you.

Because of the large quantity of animal products and non-starchy veggies, which are expensive, this diet is not going to be feasible for anyone on a tight budget.

I'll be honest, when the whole low-carb thing re-gained popularity after the 1990s low-fat craze, I was outraged.  It went against much of what we were told about nutrition, but more importantly, I couldn't imagine giving up all the carbohydrate foods I ate.  Just thinking about it got me depressed.

Over the years of carefully tracking the research though, I've realized that a diet too high in carbs is no good either.  Although I didn't really set out to change how I ate, I have, mostly because what I desire has changed. I chalk it up to less cardio and more strength training, but who knows.  For whatever reason, I am not as stuck on carbs and very happy to eat a diet more focused on protein and veggies.

But here's the thing, I still like some grains in my diet (you'll have to pry the spoon out of my cold, dead hand before I give up my morning oatmeal), and I don't want to be too restricted.  I don't count calories or carbs or anything else for that matter.  I eat what I want and, fortunately, what I want is usually pretty good for me.

With the ketogenic diet, it is very important to know the carbohydrate content of everything you eat and keep track of what you consume.  It is very, very strict.  For example, broccoli has a lot more carbs than cauliflower, so you'd actually have to watch how much broccoli you eat, and try to eat more cauliflower instead.  Now seriously, I like both, but limit broccoli? 

The other thing is the lack of fruit.  I don't eat that much, but don't even try to get between me and my apples!  But apples are forbidden.  While I avoid sitting down and pigging out on dried fruit, I do enjoy throwing them into savoury dishes to add some sweetness. 

You can eat a lot of fat on this diet, but even Mancinelli warns that you can't eat unlimited amounts, as excess calories from anything will prevent weight loss.

So why bother with this diet anyways?

Well, it seems the key benefit is that you can lose a lot of weight quickly.  I don't think, however, that losing weight quickly should be one's goal, unless its a matter of life or death.  Losing weight and being able to maintain that weight loss should be the goal.  And believe you me, if you do the ketogenic diet, lose weight, but then return to your usual eating habits, you will gain the weight back!

There is no specific recommendation of how long to be on this diet, but essentially I think the idea is that you do it for some weeks or months until you reach your goal weight. Then you switch to a regular low-carb diet.  So remember, if the weight loss is going to last, you have to maintain some degree of lifestyle change for the rest of your life.  You can't just go back to your regular way of eating.

Is this diet 'healthy'?

I checked the peer-reviewed literature and it is used, on occasion, by the medical community, as I stated before, to treat various conditions.  If weight loss occurs, it can have a positive effect on heart health, although, long-term data isn't available.

The book mentions that it has been hypothesized that it could help prevent cancer.  Now I have read a bit about the potential role of sugar in the development of cancer - one of the reasons I now believe in limiting carbs in ones diet - but there is little evidence of this in the literature at this point.

Mancinelli warns that this diet is not appropriate for everyone, and should only be attempted by healthy individuals.  Researchers go further than that and suggest it likely shouldn't be done by anyone without the supervision of a physician.

So my conclusion is, if you think this diet may be useful to you for some reason, pick up the book, but speak to your doctor first before attempting it, and remember, long-term health relies on consistency and healthy habits, not short-term, drastic measures that you can't sustain.  I say, develop the healthiest lifestyle you can love and keep it up for your whole life.

Disclosure: The publisher sent me this book, but all opinions on this blog are my own.

I have shared this post with Urban Naturale's Healthy, Happy, Green and Natural Party Blog Hop.