I’ve been asked what I think about the ketogenic diet more times in the last 6 months than any other question. Okay, well maybe second to what’s the best kind of peanut butter. Regardless…. Keto is taking over the minds of desperate dieters with its promise of rapid weight loss and curing diabetes. It’s also being recommended to patients by misinformed doctors who are lacking in sufficient nutrition education.1 Below you will find my thoughts.
The ketogenic diet was first researched as a treatment for children with epileptic seizures to lessen or control the seizures. Since then, it’s also been studied in relation to starving out brain cancer. There’s decent science to support that. But, for those who don’t have epileptic seizures or neuroblastoma, it’s a great way to get in the fast lane for a heart attack. It’s also a good idea for diabetics looking to make themselves appear not to have diabetes while allowing the disease to get worse on a cellular level. It’s perfect for anyone who wants to lose weight fast in an unhealthy way.
A ketogenic diet is a high fat, ultra-low carbohydrate diet that forces your body to start burning fat for fuel instead of carbohydrates. The natural evolution of the human body is such that the preferred fuel is glucose from carbohydrates. Our brains, muscles and organs all run smoothly on carbohydrates. When you severely restrict your carbohydrate intake, your body thinks you’re starving and turns to an alternate fuel source: fat. Fat gets broken down into acidic ketones which then become fuel for your brain, muscles, etc. The result is rapid weight loss, less hunger and lower blood sugar (since you’re not eating any carbohydrates, obviously).
Neat trick, right?
The problem I see with this diet is that there are very few healthy sources of fat out there. Avocados, nuts and olives are a few that come to mind. Most other concentrated fat sources come from animals. For example, heavy cream, butter, bacon, cheese. To mention the obvious, eating this high amount of saturated fat (and cholesterol) is strongly linked to clogged arteries and the number one killer of Americans: heart disease.2, 3 Secondly, what most people don’t know is that eating too much fat results in diabetes.5 Saturated fat is a primary cause of insulin resistance. We can’t keep blaming the carbohydrates without looking at the whole story. Saturated fat can build up inside our muscle cells and prevent insulin from functioning correctly, leading to high blood sugar and eventually diabetes.4
Thirdly, it’s a well-known fact that toxins accumulate in fat cells. As we ingest the concentrated fat of other animals we can be sure that we’re taking in a multitude more pollutants than if we were to eat lower on the food chain. For example, there’s a certain amount of pollution in the world that gathers in the air, falls in the rain, gets absorbed into the soil and has a baseline presence in grass and plants. As a cow eats that grass all day, toxins concentrate in its fat cells. As we either eat the fatty part of the cow or the dairy fat the cow produces, we then consume all the toxins from all the grass that the cow has ever eaten. Way more than if we’d just eaten the grass (or lettuce/kale) directly. The relationship between toxins and fat cells is even stronger for birds and fish. In following a ketogenic diet and aiming for such a high fat intake, we inevitably increase the amount of pollutants and chemicals we’re consuming.
Lastly, it’s hard to eat that much fat without also eating more animal protein. Most keto-ers are looking for super fatty cuts of steak, pork, etc. This comes with the risks inherent in eating a high animal protein diet: heart disease, kidney disease, cancer, diabetes, kidney stones, gallstones, early death and higher rates of all-cause mortality to name a few. 6, 7. 8. 9. 10. 11. 12. 13 For this reason, it’s my opinion that recommending this diet to anyone who is not a brain cancer patient, a young child with epilepsy or anyone who is not fully informed of these risks is completely irresponsible, at best .
And though media coverage may have led us to believe that the dangers of saturated fat are unwarranted, it’s worth looking a little more closely at the science. The study that’s best known for making the cover of Time Magazine in 2014 with the subtitle Eat Butter has been widely criticized for mistakenly combining studies that cancelled each other out and led to faulty conclusions. Other poorly-designed studies have attempted to paint cholesterol in a less-damaging light as well. These studies are deeply flawed and are simply serving the interests of the food industry. 14
Interestingly enough, there’s a small group of people out there who have success on a plant-based keto diet. They eat a lot of avocados, olives, nuts, seeds and oil. They do not eat beans, whole grains, fruits or starchy vegetables. If one can do this while keeping saturated fat (coconut and other tropical oils) low, this would be the way to do it.
However, the health benefits of eating whole grains, beans, fruits and starchy vegetables are undeniable. A meta-analysis combining seven major studies revealed that those who ate at least 2.5 servings of whole grains per day had a 21% decreased risk of heart disease compared with those who ate less than 2 servings a week.15 Eating just 20 grams (7 ounces or a half can) of beans each day decreases one’s risk of death by 8%. 16 And eating just one serving of fruit per day can cut a person’s risk of heart disease by 27% and decrease their overall risk of death by 32%.17 For diabetics, decreasing fruit intake is not associated with better blood sugar control.18 No one ever got diabetes from eating too much fruit. With such staggering benefits from even the smallest amount of these healthy carbohydrates, imagine the health you could achieve if your diet was composed of mostly fruits, vegetables, whole grains and legumes.
To those who say that carbohydrates are the problem, I say carbohydrates are the solution. Yes, cocoa puffs and white bread are not good for us. But if we take a step back and look at whole unprocessed foods, we find lentils, split peas, garbanzo beans, black beans, pinto beans, soy beans, quinoa, brown rice, steel cut oats, barley, corn, sweet potatoes, blueberries, raspberries, and apples. The list goes on.
Instead of looking for a fast way to lose weight or hopping on the next diet hack that all your co-workers are raving about, have a little patience. It’s not worth tricking your body into thinking you’re starving and need to burn fat for fuel. This is a survival mechanism, a last resort. It’s not the way our metabolism is supposed to function for months and years on end. We’re surrounded by beautiful, natural, colorful and healthy foods that grow on trees and in the ground and that our bodies are already adapted to using for fuel. We should eat those. Why not aim to lose weight slowly and in a healthy way that will allow us to maintain a healthy weight for years to come?
And instead of classifying our diet by macronutrients and looking at ratios and percentages, why don’t we just talk about food? What do the longest-living, healthiest populations eat? Minimally processed plant foods.18 That is what we should all be eating right now. So rather than vilifying one macronutrient, lets teach people about real foods, the benefits of getting enough fiber and how to eat the way our bodies have adapted to over thousands of years. The bottom line: love your body, don’t play tricks on it, and your body will love you back.
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