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Feb 8

The Big Debate: Is the keto diet good for long-term weight loss? | The – Toronto Star

Long Term Weight Loss Comments Off on The Big Debate: Is the keto diet good for long-term weight loss? | The – Toronto Star

The keto diet has generated a lot of headlines in support and critical of the diet. Nutritionist and author Maria Emmerich writes in favour of the diet and Dr. David Jenkins, a professor of nutritional sciences, writes against its limitations.

The ketogenic diet is portrayed as an extreme or fad diet, but it really isnt. It is just meat and vegetables. When did that become extreme?

Our diet over the last 50 to 100 years has changed drastically. Most of it due to the modern food industry making highly processed versions of foods we eat and hiding sugar in almost every product on the shelves.

A ketogenic diet is what our ancestors ate most of the time. They had long winters where fruits and vegetables werent available. Also, our fruits and vegetables look nothing like what our ancestors ate. They are the result of hybridizations and cross breeding over the last 100 to 200 years, which turned them into sweeter and sweeter versions.

Just one of many examples is the peach. The wild peach was about 1 inch across and almost 36 per cent of the fruit was the stone. Todays peach is 4 inches across (67 times more volume) and the stone is only 10 per cent. Each peach eaten gives you 725 times as much sugar; an increase of 7,250 per cent.

Even following the modern guidelines of eating more fruits and vegetables will result in eating many times more sugar than our ancestors ever consumed. With modern refrigeration and canning technologies people can eat them year-round. Frozen veggies in America didnt start until about 100 years ago. As a result, our modern diet is one of the most unnatural diets and contains more sugar than we have ever consumed in our history.

The other side of the debate will probably bring up many of the same old talking points used against a ketogenic diet. Like saying it isnt sustainable or it's too hard and restrictive, it will give you high cholesterol, make you lethargic or not able to perform in sports and it will lead to nutrient deficiencies.

We are living proof that is it sustainable and with my recipes, like my Keto Comfort Foods cookbook, you can make any of your favourite recipes keto by changing a couple ingredients.

Studies have shown that on average cholesterol goes down with a ketogenic diet and other health markers all improve.

For performance, Zach Bitter is a keto runner that just broke the world record for 100 miles running it in 11 hours and 19 minutes.

The last point about nutrients is also incorrect. Animal protein is some of the most nutrient dense food you can eat. Beef has more nutrients than superfoods like kale and broccoli and beef liver is the true superfood.

The arguments in favour of a ketogenic diet for long-term weight loss are numerous. The primary issue with long-term weight loss for any diet is compliance. There are recipes that make compliance easy by substituting any of the modern recipes with healthier versions. But the main thing that helps with compliance is how good people feel. The weight loss is a bonus.

Eating a ketogenic diet switches the bodies fuel source from glucose (carbs) to primarily fat. This has several effects on the body.

First, our fat storage is much greater than our glucose storage. We can only store 1,500 to 2,000 calories in glucose (in muscle and liver) but can have almost unlimited storage in fat (even lean athletes have 20,000 plus calories stored as fat). This helps increases satiety and decreases hunger and cravings.

Some of the fats used for fuel are converted into ketones in the liver to fuel the brain and other tissues like the heart. The brain loves running on ketones and people see improved moods, mental clarity and focus. This is one reason why keto is beneficial for Alzheimers, dementia and mood disorders.

All of these factors drive compliance. People dont want to go back to feeling terrible again, having afternoon crashes, hunger and cravings cycles throughout the day, brain fog and reduced focus they have as a sugar burner. And compliance to a ketogenic diet means they have less hunger and cravings making it easier to keep the weight off.

I think the ketogenic diet is the easiest diet to stick to long term. You dont feel deprived, get to eat tasty food, have no cravings, feel amazing and your energy soars. Who doesnt want that?

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Maria Emmerich is a nutrition expert and international bestselling author.

Low-carb ketogenic diets have recently come into vogue again. This kind of diet has been around a long time, although research shows there may be better ways to lose weight and certainly better ways to promote overall health.

A plant-based diet with unprocessed high-fibre carbohydrate foods will do much to sustain a healthy weight and to address the risk of developing chronic diseases. Moreover, eating this way will also help to reduce the damage to the planet and address global warming, environmental destruction and species loss.

In the prediabetic era, doctors did prescribe patients diets for type-one diabetes that provided mainly fat and protein with minimal carbohydrates. The aim at that time was to eliminate the need for insulin by restricting carbohydrates. With the advent of insulin therapy, however, in the 1920s, carbohydrate intakes were liberalized.

Over the last century, increasingly, the recommended diets for both type- 1 (insulin dependent) and type-2 (noninsulin dependent) diabetes have focused on reducing the burden of cardiovascular disease, which in type 2 diabetes is two to four times more common than in the general population.

Dietary advice is now more focused on: eating high-fibre carbohydrate foods with low glycemic indices; reducing saturated fats and cholesterol; and eliminating trans fats. These changes all help to reduce LDL cholesterol, which is a major risk factor for cardiovascular disease.

The keto diet runs counter to advice from most public health agencies concerned with controlling diabetes, including Diabetes Canada. It also runs counter to advice from Health Canada for the general public to eat more fruit, vegetables, whole grain cereals and legumes, all of which are foods with carbohydrates.

THE BIG DEBATE: For more opposing view columns from Toronto Star contributors, click here.

Low-carb diets, on the other hand, encourage people to eat animal-based foods, including butter, cream, cheese and fatty meats. This dietary pattern deprives people of foods that lower cholesterol and blood pressure and increases blood levels of the new risk factor for cardiovascular disease and chronic disease Trimethylamine-N-oxide.

Keto diets are considered of some use in treating seizures and intractable epilepsy in children; they may increase the effectiveness of medication. Such diets are restrictive and require careful planning and monitoring by a dietitian and a medical team.

While this diet may reduce seizures in children, it can also be associated with slowed growth, reduced bone density leading to the risk of bone fractures, kidney stones, raised serum LDL-cholesterol and constipation. Some of the side effects may result in mobilizing bone calcium to neutralize the acid products (ketones) of fat metabolism, and with the higher fat intakes also raising serum cholesterol levels.

People who favour low-carb diets, such as the Atkins, Paleo and Keto diets, believe they help in the short-term with weight control. They reason that such diets are more satiating and the presence of ketones, produced from free fatty acid metabolism by the liver, may also depress the appetite.

They cite that people on higher protein diets with increased protein metabolism, will waste calories (the thermogenic effect of food) and that ketone body loss in the urine also increases the loss of calories from the body and contributes to further weight loss.

Some quote the Warburg effect that cancer cells may have a dependency on glucose metabolism and that unlike healthy cells, cancer cells may not adapt to ketone body utilization. In this way, tumour growth may be limited.

The problem with these conclusions is the lack of clinical trial evidence of effectiveness.

In fact, studies on low-carb diets collectively have shown little advantage for weight loss a year out. And in diabetes, they have not resulted in improved glycemic control. The possible benefits of short-term studies have not been born out in the long term.

Plant-based diets can be effective for weight loss over time and have the added benefit of being better for the planet. A move to more plant food consumption is recommended internationally for health and planetary sustainability.

David Jenkins is a professor of nutritional sciences at the University of Toronto.

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