Here are a few sensational headlines from the recent CNN reporting on the US News and World Report Diet Article for 2020. As millions around the world achieve better health on a low carb eating patterns with real food its shocking the “experts” still think this is “dangerous”. Read up on the topic, try it if you have a condition that can be improved (obesity and diabetes are the primary ones), and decide for yourself
Best and worst diets for 2020, ranked by experts, with a popular one near last
By Sandee LaMotte, CNN
https://www.cnn.com/2020/01/02/health/best-diet-worst-diet-2020-wellness/
…. And I took this article by Sandee and dissected with some comments between the paragraphs
Experts say the keto diet isn’t sustainable, so why is it so popular?
https://www.cnn.com/2020/01/05/health/keto-diet-day-wellness/index.html
By Sandee LaMotte, CNN
(CNN)America is in the midst of a keto craze. The trendy diet — which bans carbs to make your body burn fat for fuel — has kicked Weight Watchers’ derrière on the stock market, captured the endorsement of celebrities such as Kourtney Kardashian and Halle Berry, and deluged the internet with recipes and copious social media chatter about pounds lost.
Lindsey Pelas
@LindseyPelas
I wanna love something as much as people love talking about their keto diets.
Now the popular diet even has a day named after it. The Vitamin Shoppe, which wants to sell you a ton of keto-based products, has named the first Sunday of this new decade “National Keto Day.”
“What on Earth justifies granting a day to memorialize a fad diet?” said Dr. David Katz, founding director of the Yale University Prevention Research Center. “The grapefruit diet surely warrants its own day too!”
MC note: nice to see Dr. Katz still thinks this is a fad diet and not a pattern of eating for people with insulin resistance, obesity, diabetes, or a number of other chronic inflammatory issues
https://www.healthline.com/nutrition/23-studies-on-low-carb-and-low-fat-diets
https://insulinresistance.org/index.php/jir/article/view/30/88
Katz is no fan of keto, or any other diet that restricts entire food groups, calling them unhealthy and unsustainable.
“Losing weight fast by using a severely restricted, silly, unbalanced diet inevitably leads to even faster weight regain,” said Katz, who is the president of the True Health Initiative, a non-profit organization dedicated to health promotion and disease prevention.
MC note: Dr. Katz thanks for your opinion that eating plants and animals is silly and unbalanced. Please see the True Health Initiative Partner page for an unbalanced view- lots of companies promoting vegetarian products and grains. Not a single animal product on the site . https://www.truehealthinitiative.org/thi_partners/
“Absent ketosis, keto is just a false label for some kind of diet that presumably restricts added sugar and refined carbohydrate — which, frankly, any good diet does,” Katz said.
MC note: No doctor Katz this way of eating is a means to reduce hyperinsulinemia which is driving the majority of modern chronic disease. It takes a degree of total carbohydrate reduction including natural carbohydrates like fruits to achieve this and stabilize blood sugar in both type 1 and type 2 diabetes patients.
Katz’s low opinion of keto is echoed by many nutritional specialists across the country. Katz joined 24 other top names in the field to rank 35 popular weight loss programs for 2020 recently put out by U.S. News and World Report.
MC note: This is known as “consensus expert opinion” or “eminence based medicine” and when the consensus believes they are correct there is never any change in the consensus opinion so I am a dissenting opinion. For a strong opinion and some facts on the ethics of Dr. Katz read these.
https://keepfitnesslegal.crossfit.com/2016/09/26/david-katz-junk-foods-slyest-defender/
http://foodmed.net/2018/09/david-l-katz-coi-forbes-terminates/
https://yaledailynews.com/blog/2015/11/04/katz-faces-criticism-for-book-review/
For an interesting point of view listen to Tom Naughton Keynote at the Weston Price Conference on the wisdom of the crowds vs the power of the anointed
in addition to Dr Katz another in the expert panel is the Dr Michael Gregor who spews much unscientific “nutrition facts” through https://nutritionfacts.org/
https://www.humanewatch.org/hsus_doc_exposed_as_schlock/
The popular keto diet flunked, coming in next to last — which it has done for several years now. Only the highly restrictive protein-only Dukan Diet ranks lower.
“Most health professionals are concerned that the degree of carb restriction requires someone to cut out many of the foods that have been consistently recommended as being healthy: fruits, beans/legumes and whole intact grains,” said Stanford professor Christopher Gardner, who conducts research on low-carb diets at Stanford Prevention Research Center.
MC note: Dr. Gardner respectfully this is not a recommendation for the entire country but for those who have difficulty with blood glucose and hyperinsulinemia reducing the carbohydrates is the most effective means of correcting this condition. We suggest people eat to their glucometers. As a physician I am concerned about high blood sugar and unstable blood sugar not about some theoretically grain deficiency in the human being. The ADA 2020 standard of care document acknowledges this too.
https://care.diabetesjournals.org/content/43/Supplement_1
With such negative reviews, just how did keto capture such a faithful following? Experts say it’s because its legions of fans are focusing on the short-term benefits of fast weight loss, without factoring in possible long-term risks.
MC note: Well-controlled diabetes is the leading cause of absolutely nothing. Poorly controlled diabetes drives about every chronic disease , organ system failure, as well as many forms of cancer. So I am not sure what the risks are of reversing metabolic disease with a safe and well formulated low carbohydrate dietary pattern.
What is keto?
Keto is short for ketosis, a metabolic state that occurs when your liver begins to use stored fat to produce ketones for energy. The liver is programmed to do that when your body loses access to its preferred fuel — carbohydrates — and thinks it’s starving.
MC note: From evolutionary biology as well as metabolic health and inflammatory standpoint I would disagree the carbohydrates of the preferred fuel of the body
The diet has actually been around since the 1920s, when a doctor stumbled on it as a way of controlling seizures in children with epilepsy who didn’t respond to other treatment methods.
“It was recognized long ago that denying the brain access to glucose, and converting to ketone-based metabolism, dampens brain electrical activity,” Katz said. “But why on Earth would you want to dampen brain electrical activity unless you had refractory (unmanageable) epilepsy?”
MC note: The Dr. Katz the Special Forces in the military are now looking closely at ketones for improving mental clarity and cognitive function not dampening it as well as sustained physical performance and diving tolerance for elite combat troops
https://www.army.mil/article/229120/ketogenic_diet_useful_or_not
https://www.sciencedaily.com/releases/2019/04/190430173202.htm
Creating ketosis is not as simple as it seems. Your liver is only forced into producing ketones when carb intake is drastically slashed. In the keto diet, you limit your intake of carbs to only 20 to 50 a day, the lower the better. To put that into perspective, a medium banana or apple is around 27 carbs, the full day’s allowance.
MC note: Not sure which physicians are recommending “the lower the better” but I am glad the article is confident that this is our standard advice. Athletes can be in ketosis with 100 g of carbohydrates a day and maybe even more and have amazing endurance performance.
Zach Bitter just broke the 100 mile world record (running under 7 min/mile for 100 miles!) eating in this pattern
Here is my story from metabolic testing.
http://naturalrunningcenter.com/2017/03/07/burn-fat-health-performance-better-butter-burner/
It can take several days to weeks before your body fully transitions into burning fat. In the meantime, it will scream for carbs, and (speaking from personal experience) will punish you by sending a zombie to suck out your brains, a vampire to drain your blood and a giant troll to jump up and down on your body.
The feeling of fatigue and malaise is so bad that keto-lovers have christened the experience “keto-flu.”
MC note: Sandee I have advised 100s of people in this way of eating for the last 7 years and no one has ever told me that they felt the brains being sucked out. And if your energy is down and you feel like you have “the flu” I recommend people chill out, drink some bullion, and not try to do a CrossFit workout.
You’ll also have “keto-breath,” a wonderfully metallic smell similar to nail polish remover emanating from your mouth. Other than urination, that’s the only way ketones can escape your body.
MC note: Correction: the body can use ketones as fuel in the mitochondrial of all muscle as well as the brain. Also is this “keto breath” a similar condition to “keto crotch” which was circulating in the media a year ago. https://www.bostonmagazine.com/health/2019/03/25/keto-crotch-conspiracy/
Drinking water might help with dragon-breath. You’ll also need to drink a lot of water to try to counter constipation and other gastric-grumblings due to the lack of fiber from fruits and starchy veggies.
MC note: A well formulated keto diet is plant rich of non-starchy vegetables so not sure where the fiber deficiency comes from. So eat kale to your bowels content.
Once all that passes, keto-lovers maintain, you’ll have more energy, a more focused brain, and best of all, very little hunger.
But those effects only last if you stay in ketosis. Cheat a bit, and your body scrambles to go back to what nature intended.
MC note: Please clarify “what nature intended”. Fats and proteins (plant and animal varieties) are very satiating whether you are in ketosis or not and these are foods found in nature.
Therefore low-carb diets like keto rely heavily on fats to fill you up. At least 70% of the keto diet will be made up of fat — some say it’s more like 90%. Of course you can get all that fat from healthy unsaturated fats such as avocados, tofu, almonds, walnuts, seeds and olive oil.
But just in case you can’t eat that many avocados, the diet also allows those not-so-good-for-your-arteries saturated fats like lard, butter, palm and coconut oils as well as whole-fat milk, cheese and mayonnaise.
MC note: The saturated fat clogging artery hypothesis has been debunked. Here is one of many meta analyses as well as randomized trials on the topic. https://www.ncbi.nlm.nih.gov/pubmed/20071648
Vic
@ketocoachvic
How many calories in this piece of Keto cheesecake ? I don’t know and I don’t care all I know is what’s important 3gr of carbs ! 2 years ago I would put on 10lbs during the holidays ! #keto #omad No weight gain ! CICO matters is fake news !
And here’s a twist: You can’t rely too much on lean protein to accomplish ketosis. Eat more protein than an average 20% of your daily calories and your body will use that, and not fat, for fuel. Bye bye, ketosis.
Therefore protein sources for ketosis reply on “skin-on poultry, fattier parts like chicken thighs, rib-eye steaks, grass-fed ground beef, fattier fish like salmon, beef brisket or pork shoulder,” according to U.S. News, as well as — get ready America — bacon!
MC note: Please show me the reference where the body will start using protein as fuel if you eat more than 20% of calories from protein. Also show me where a couple strips of good quality bacon in the morning will contribute to anything but improved health and joy of cooking and eating.
https://fee.org/articles/15-economic-historical-and-health-facts-about-bacon/
MC disclosure- I like bacon 🙂
Yessss. That’s why this is a popular diet right? Like the dog in the 1980s commercial, we as a nation collectively jump up and down for bacon.
‘Dirty’ vs ‘clean’ eating
Of course the lure of all-the-bacon-or-fat-you-can-eat was arguably behind the initial success of the Atkins diet that exploded into popularity in the ’90s. It was followed by more low-carb options such as South Beach, Paelo, Whole30 and Zone, among others.
MC note: I have read the original Atkins book and have yet to find the page that tells you its “all-the-bacon-or-fat-you-can-eat “
Yet critics say those initially popular plans have struggled to keep the public’s interest as dieters have succeeded in losing some weight, only to fail to keep it off over the long term.
Atkins has rebranded, offering different levels of carb restriction they call “Atkins 20” and “Atkins 40.” Colette Heimowitz, Atkins vice president for Nutrition Communication & Education, told CNN the company’s approach allows for more flexibility than keto “as we encourage people to incorporate foods back into their meals and find their carb tolerance level.”
Keto appears to be undergoing the same process, with some promoting “clean” keto, which focuses on using all those avocados, nuts and seeds for fat sources, instead of “dirty” keto, in which folks take the buns off their fast food burger and chow down.
MC note: I have yet to see any knowledgeable physician recommending what you described as “dirty keto”. Not saying they aren’t highly scientifically accurate blogs, tweets, and Facebook pages talking about this
Toni Hammer
@thetonihammer
Keto shopping list:
– Meat
– Cheese
– Eggs
– Butter
– Cream cheese
– More butter
– Coconut flour
– More cheese
– Avocados
– Even more butter
– All the cheese
in the store
Clean keto advocates admit that it takes a good deal of effort to research food items and plan and prep meals, so “unsurprisingly, many a keto eater takes the easy way out, eating a diet centered around foods like bacon, cheese, butter, and packaged foods,” according to an article on the Vitamin Shoppe’s Keto HQ.
MC note: I am glad the vitamin shop is so sure that eating natural plants and animals like our grandparents did takes a ton of research, planning, and prepping. I see they have quite a bit to sell to you that are the opposite of natural real food.
https://www.vitaminshoppe.com/
And that’s the crux of the problem for nutritionists.
“Most people who claim to eat ‘Paleo’ use that banner to justify eating any kind of meat they like, notably, bacon, burgers and pepperoni,” Katz said. “There was no paleolithic pepperoni!
“No doubt, the same is going on with keto — people invoke the label to eat the foods they want to eat, notably processed meat,” he said. “I suspect a very tiny minority of those attempting to eat keto are either eating clean or are in ketosis.”
MC note: Dr. Katz I guess the Kind Bars which you have graciously accepted many dollars from were found in the Paleolithic era.
What do the studies say
Then there’s the issue of varying health claims for keto and other low carb diets.
“The ketogenic diet is designed to be a short-term diet, and there are a number of studies and trials demonstrating its effectiveness,” said chiropractor Josh Axe, a spokesperson for the Vitamin Shoppe, in statement.
MC note: Wow CNN found a spokesperson for a commercial vitamin company as an expert
“When done correctly, it can be a great tool used to treat and prevent several chronic conditions while also supporting overall health,” said Axe, who is the author of “The Keto Diet: Your 30-day Plan to Lose Weight, Balance Hormones and Reverse Disease.”
An Atkins spokesperson pointed to a two-year study by a health group selling ketosis diet interventions and told CNN in a statement that “today’s science” shows “people can improve health markers pertaining to weight loss, cardiovascular disease and metabolic syndrome” when they control carbs.
Not exactly accurate, according to Gardner and Katz.
“There’s very little research, and to the best of my knowledge, all of it is linked to a company marketing the keto diet,” Katz said.
MC note: Here is an extensive database on low-carbohydrate studies
https://docs.google.com/spreadsheets/d/1Z71Nqi94uO3iGx5E2Bu71ESKrpuTMeGCo8aJabaJqFg/edit
“The bottom line is that despite its current popularity, we have very few studies that can support or refute its impact on health,” Gardner said.
The National Lipid Association Nutrition and Lifestyle Task Force reviewed all the available evidence in 2019 and found low and very-low carb diets “are not superior to other dietary approaches for weight loss,” and in some cases even raised cholesterol levels.
MC note: There is very little scientific evidence that cholesterol is the cause of chronic illness. Patterns that travel with the metabolic syndrome, hyperinsulinemia, and insulin resistance create a pattern of lipids specifically high triglyceride and low HDL and small LDL particle size that travels with cardiovascular disease.
https://bmjopen.bmj.com/content/6/6/e010401
In addition, they found “three separate observational studies, including a large prospective cohort study with long-term follow-up,” showed an association between very low-carb diets and “all-cause mortality.”
MC note: I would like to see these three observational studies and the food frequency questionnaires that were done and what they were actually eating over the duration of the study as well as did the participants smoke, exercise, and other lifestyle factors involved as well as what the absolute mortality difference was. Observational studies might at best create a hypothesis that needs to be tested.
So far, at least, it appears science has found the benefits of low-carb diets are fleeting.
“What the early studies have shown is that there are early benefits in terms of weight loss and glucose control,” Gardner said. “But in the few studies that have gone on for 12 months, the benefit in comparison to other diet approaches diminishes and is no longer statistically significant.”
MC note: Dr. Gardner’s DIETFITS study was a wonderful study and both groups reduced processed foods, added sugar, and junk food and at the end of the study they were eating more similar then dissimilar. So it did show that getting rid of crap in your diet is a good thing
https://jamanetwork.com/journals/jama/fullarticle/2673150
Which is why nutritionists fail to see the benefit of subjecting your body to the stresses of a low-carb diet just to lose a bit of weight, gain it back, and then start all over again.
MC note: Thank you for the global nutritionist opinion when I know several who advocate for well formulated low-carbohydrate diets for the correct clinical conditions
“To achieve and maintain a healthy body weight, or optimize diabetes or heart disease risk factors, we should not be focusing on a ‘diet’, ” said Alice Lichtenstein, director and senior scientist at Tuft’s University’s Cardiovascular Nutrition Laboratory.
“We should be focusing on dietary patterns, making changes in current practices that can be sustained lifelong.”
MC note: Thank you Alice for your opinion in calling this a “diet” and not a lifestyle for people who have insulin resistance or diabetes
…..
Dr. Mark Cucuzzella is a Professor of Family Medicine and sees patients at the West Virginia University Center for Diabetes and Metabolic Health
cucuzzellam@wvumedicine.org
https://wvumedicine.org/diabetes-obesity
I am a science advisor of these advocacy groups supporting sharing the science, supporting and education individual patients, and shaping policy to support low carb eating patterns for appropriate health conditions
https://www.nutritioncoalition.us
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Nutrition Coalition take on USNWR Diet Rankings
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my story of diabetes discovery
https://hypoglycemia.org/libre-liberation/
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For a practical guideline for clinicians and patients
It was a privilege to work with Drs Eric Westman, Will Yancy, and Lydia Bazzano on this concise pocket guideline book titled “Low-Carbohydrate Nutrition Approaches in Patients with Obesity, Prediabetes and Type 2 Diabetes”
This sits on Guideline Central. Like all guidelines many are incorrect, incomplete, and some outright wrong. We know this guideline will be revised, improved, and challenged . It’s good debate and I’m proud our little book is included 🙂
https://www.guidelinecentral.com/
Below are a couple links for web and phone versions and even to order the little pocket guide (it comes as a nice bound book).
- Flipbook – http://eguideline.guidelinecentral.com/i/1180534-low-carb-nutritional-approaches-guidelines-advisory/0?
- UK version – http://eguideline.guidelinecentral.com/i/1183584-low-carb-nutrition-queens-units/0?
- Direct Web Link – https://www.guidelinecentral.com/share/pocketcard/5dadda48dd342/
- Link to Claim for Web/Mobile– https://www.guidelinecentral.com/shop/low-carbohydrate-nutrition-approaches-patients-obesity-prediabetes-type-2-diabetes/
Thanks Will, Eric, Lydia , and the team at Guideline Central for giving us this opportunity