What is your take on this article from Kevin MD.com?
That itās a POS that someone wrote because they had a deadline but no time to do any actual research so they rolled out the usual old questions that meant they didnāt have to do any thinking (or proof-reading, clearly).
Standard issue nonsense. Also one of the reasons Iāve never been a fan of defending keto with the 100 yr old thing, weāre not doing the Epileptic ketogenic diet (At least the majority of us) so when thatās the go to defense people will always bring up the downsides of THAT diet, which we donāt do. No different than the studies of āketoā or ālow carbā diets that give people 5x the carbs we eat then try to pass it off as the same thing.
He sounds like he reads the plant based crowd. May be his inbox is getting quiet. If Dr Westmanās results were as this guy describes I doubt the clinic would still be operating.
I am interested in knowing the difference of the one that treated the kids back in the 1920s and the one that most people do today. Can you elaborate?
Discussion points:
- maintenance: maintaining a health improving diet for diabetic or obese people
- initial weight loss
- long term weight reduction
- safety (opens the door to fear seeds)
Risks
- heart disease
- strokes
- colon cancer (lack of fibre)
- kidney stones
- bone fractures
- heart arrhythmia (electrolyte imbalance)
- pancreatitis
Authorās point of view:
diabetes and obesity are not a product of ketone deficiency but the symptom of caloric excess, dietary indiscretion, and torpor.
ā¦a larger meta-analysis of diabetic patients on either the ketogenic diet or a high-carbohydrate, low-fat diet for more than one year showed no difference in hemoglobin A1cs or glycemic levels between the two diets.
Firstly they write how researchers used a nutrition approach to treat diabetes. That is a good step. There was a population selection of some very motivated or compliant diabetes sufferers based on the description, āhigh-carbohydrate, low-fat diet for more than one yearā. My bolding. The recent Virta Health studies show compliance and ability to sustain a nutritional change is good on a low carbohydrate diet. Maintaining a strict low fat diet is not impossible.
The dietās initial ability to induce weight loss may non-trivially be related to its ketone production. Since ketones are osmotically active, they can induce a diuretic-like response, causing dieters to lose fluid-related weight, especially during the beginning of the diet. Those early results can serve to positively reinforce dieters and may be crucial in deciding whether to continue dieting, particularly in the face of restrictive dietary options and the malaise associated with the transition, dubbed āthe keto flu,āā¦
Fair enough. The magician has revealed an important part of the trick. It is a clear statement of fact, that initial weight loss, in those people seeking weight loss, is a great motivator to maintain a dietary change.
Long-term weight loss on the keto diet is less mystical than its powers to reduce blood sugar levels: Itās the product of devoted caloric restriction.
More magic explained by science. I think the adjective ādevotedā is telling, however. If a ketogenic eater was writing this article they may have used an term such as āan easy ability to unconsciously restrict dietary calories due to the satiety effects of a ketogenic diet.ā
I think the article could be easily rewritten using the same scaffold of factual information updated and from a a knowledgeable ketogenic practitioner point of view, to be more relevant to people following a ketogenic way of eating.
Just looking at the scary risks again with some ketogenic responses. My thoughts as I work through the list. An interesting exercise to test my own, personal knowledge (and bias):
Risks
- heart disease -
low carb diet increases blood cholesterol. Elevated blood cholesterol through dietary changes is not a heart disease cause. Currently the cause is thought to be inflammation related. Extremely high blood cholesterol may indicate other concurrent disease (genetic), and at very high levels are a concern. Risk management: Eat a well formulated ketogenic diet, particularly healthy fats and oils. Avoid pro-inflammatory oils such as processed seed oils. check the cholesterol biomarker routinely and interpret it in conjunction with a wider scope of a lipid panel, inflammatory biomarkers, HbA1C and blood insulin response curves. Have a coronary artery calcium CT scan done every few years, and consider carotid artery ultrasound at the same time, for completeness. - strokes -
have a similar mechanism of action as a heart attack with the blockage of an important blood supply artery. Apply the same risk management. Strokes may also occur with bleeding in the brain. Fat soluble vitamins are important for normal blood clotting. A well formulated ketogenic diet should include food sources of Vitamin K. - colon cancer (due to lack of fibre).
A ketogenic diet is not a no-carb diet. Risk management: eat a well formulated nutrient dense ketogenic diet that includes the building block nutrition for a healthy gut biome. - kidney stones.
Risk management: maintain hydration with a knowledge of the nutritionally induced apparent diuresis on a ketogenic diet. Eat a well formulated ketogenic diet with the correct amounts of vitamins and minerals. Supplement micronutrients that may be deficient in the food sources (this goes for any diet). - bone fractures
(in children that were on a very nutrient restricted diet to treat epilepsy in the early 20th century) Risk management: Eat a well formulated ketogenic diet with the correct amounts of vitamins and minerals. Supplement micronutrients that may be deficient in the food sources (this goes for any diet). - heart arrhythmia (electrolyte imbalance) Risk management: Eat a well formulated ketogenic diet with the correct amounts of vitamins and minerals. Supplement micronutrients that may be deficient in the food sources (this goes for any diet). Avoid over supplementation. A lot of nutrients fall in to a āGoldilocks Zoneā where too much, or not enough will cause symptoms of disease.
- pancreatitis.
Pancreatitis is caused by a sudden change in diet. Risk management: Eat a well formulated ketogenic diet with the correct amounts of vitamins and minerals.Start this way of eating with foods that are familiar from a previous way of eating but making the necessary adjustments to achieve nutritional ketosis. Try new foods as time progresses and add these to the variety of foods available. Jettison old foods, sweetner crutches and historical cravings as ketoadaptation and better health occurs.
All these risks and concerns are based on increasing fats in a diet without understanding how to formulate a healthy ketogenic diet. Rather than pursuing the interesting health project of creating a well formulated ketogenic diet.
I like the views of ketogenic diet sceptics as it allows us to look at our way of eating from the point of view of an other. That in turn encourages us to learn more about ourselves and our nutrition for better health.