Keto Diet Fad or Fact?

Would it be okay for anyone to jump onto the bandwagon and start a keto diet for the perceived health benefits and weight loss? While many medical practitioners recommend this diet program to their patients, there are many who are against it. The skepticism comes from the fact that there has not been enough research to show the long-term effects of following such a diet pattern.

In the last few years, the keto diet has been all the rave. We have not been immune to the trend, either. Whenever we meet up with friends, relatives, and colleagues around a dining table, someone or the other always seems to be following some kind of a diet program, and keto seems to be it these days. It is doctor-recommended and nutritionist-prescribed for some. Hence, in the last couple of years, it has become quite popular here in Nepal, too.
What exactly does it mean to be on a keto diet? The term stands for ketogenic diet, which means a diet that is high in fat, moderate in protein, and low in carbs. The carbohydrates intake is restricted to only 20 g to 50 g per day, or less. Therefore, our daily staples like rice and other grains like wheat, corn, millet, and buckwheat, legumes like kidney beans, black eyed peas, pulses, etc., and other sources of carbs like bread, pasta, noodles, most fruits, and starchy vegetables like potatoes and beetroots are either nonexistent or significantly reduced from our meals. For example, if I were to eat one medium-sized banana (about 30 g of carbs), my daily intake of carbohydrates would be just that much for that day. In a keto diet, anything sweet like sugar, sugar substitute, and honey would be completely out of the equation. Even milk would be considered high in calories. What would a person eat when on a keto diet, if all these daily staples are removed from our diet?

Keto Diet Fad or Facts final (1)

What happens to the body when in a ketogenic state? Normally, the body breaks down foods containing carbohydrates into glucose, and glucose is the body’s preferred source of fuel because it can be quickly used for energy. The body needs fuel to function even during rest. The idea behind this type of eating habit is that, when the body is restricted of carbohydrates, it is forced to turn to other sources for energy and keep blood glucose levels within a healthy threshold. Therefore, the liver breaks down fat instead to produce ketones, which then becomes our primary source of energy. Because ketosis causes a shift in our metabolism, and our body relies on stored fat for energy, our bodies are constantly burning fat. Hence, weight loss is considered to be one of the major health benefits of the keto diet. Other potential health benefits are considered to be improved lipid profile, decrease in blood glucose level, and improved insulin resistance (benefitting especially patients with type II diabetes), improved hypertension, better cardiovascular health, minimization of low-level inflammation throughout the body, neuro protective effects, and overall improvement in general health. Besides the health benefits, what makes the diet popular is the fact that a person could eat a variety of keto-based food, stay full and satiated, have surplus of energy, and still lose weight!

Another concept that makes this diet convincing for some is the “modern caveman” narrative. According to this, various illnesses today are due to modern lifestyle and eating habits, and if we were to return to our old eating habits, so many of the lifestyle diseases could be prevented and hopefully reversed. Meaning, in the past, cavemen hunted, and their diet consisted of mainly meat and fish, animal fat, nuts and berries, and whatever wild edibles greens they found while foraging in the forest. Hence, a high fat and protein diet with very little carbs. Since there was no concept of cultivation and farming, grains, milk, pulses, etc. were not a part of their diet. Neither was refined sugar, or any other processed food. Hunting was a tough job, and some believe that this kind of lifestyle and eating habits kept them healthy, so that they never suffered from any of the lifestyle diseases we do today.

Despite advances in the medical field, obesity continues to be one of the major health hazards worldwide, and the global spread has been labeled a pandemic. A diet program that promises a quick fix without much independent scientific data to back the claims would be considered a fad diet. Since keto promises quick weight loss and better health, but its long term effects are yet to be determined, it falls into that category. However, the concept of ketogenic diet is not new. It is believed that ancient Greek athletes ate low carbs and high protein diet for better performance. The keto diet has been used as a medical tool since the 1920s, and was started by Dr. Wilder of Mayo clinic. The diet was originally intended to treat children diagnosed with refractory epilepsy.

So, would it be okay for anyone to jump onto the bandwagon and start a keto diet for the perceived health benefits and weight loss? While many medical practitioners recommend this diet program to their patients, there are many who are against it. They believe this is an unhealthy way to lose weight, and in some instances, it can do more harm than good. The skepticism comes from the fact that there has not been enough research to show the long-term effects of following such a diet pattern. To fully assess the safety of this eating pattern for a prolonged period of time, more evidence-based studies are needed. Moreover, if a person has a pre-existing health condition like pancreatic disease, liver conditions, thyroid problems, and disease of the gallbladder, or if the gall bladder has been removed, or eating disorders, etc. this kind of diet may not safe. It is a diet that is trending now, but will it soon fade away into oblivion, because of it either being unsustainable or if future studies show potential health hazards, or will it tip to mainstream is yet to be seen.

The keto diet is a hard diet to follow, and many believe it may not be sustainable in the long term. To stick to just about 20 g to 50 g of carbs a day is not an easy path to follow in the long term. It is not simply a matter of willpower, but resources, affordability, and time, as well. When one begins a keto diet, one may experience flu-like symptoms, such as headaches, upset stomach, fatigue and dizzy spells, trouble sleeping, etc. This is called keto flu and may last a few days. Though the keto diet is supposed to improve the lipid profile, some studies have shown an initial rise in LDL cholesterol (bad cholesterol) in patients who start on the diet. In the long term, cutting down high fiber fruits and vegetables may increase the risk of chronic constipation. A lack of balanced diet may cause vitamins and mineral deficiencies.

A delicate balance needs to be achieved for the body to stay in ketosis. One should keep in mind to take the right kind of fats. Poly- or mono-unsaturated fat are good fats, whereas, saturated and trans fat are bad for us. The right amount of carbs and the right amount of protein are a must, too. Excess carbs breaks one from the state of ketosis, whereas excess protein does the same. If we eat more protein than the body requires, amino acids (the building blocks of protein) turn into glucose. In this process, called gluconeogenesis, the body produces glucose using non-carbohydrate sources like amino acids in this case, because glucose is easier for the body to access for energy than resort to fat.

What should one do if you think you might want to try a new diet regime? The first thing to do is to consult your physician and find out if it is the right choice for you. A holistic approach is important, and a healthcare team should manage this. Your doctor, taking into consideration all your health issues, may suggest if something is appropriate for you to try. A nutritionist/dietitian will be able to properly tailor a diet plan for you to meet your individual health needs. A physical therapist will be able to create a personalized exercise plan for you and guide you to do the correct exercises, so you may gain optimal benefit from the regime.

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