Ketogenic diet

The battle of the bulge, the intense desire to have a healthy body and maximal longevity, is a universal dream more sought for than ever before. Besides daily physical exercise (walking, moderate or brisk, as tolerated, at least 5 times a week, is recommended over the joint-busting jogging), various diets have been developed, like Adkins, South Beach, Mediterranean, Vegetarian, Ducan, Pescatarian, Flexitarian, etc.).

The trillion-dollar food supplement industry, mostly fraudulent, without evidence-based medical data to support its advertised hyped-up claims on the health benefits and safety of the thousands or so advertised products, was not be outdone. More than 90 percent of those marketed supplements are basically “modern snake-oil remedies,” purely useless, a waste of money, and potentially dangerous down the road among chronic users. Liver and kidney complications have been reported as side-effects of countless food supplements on the market. With good nutrition, we do not need any food supplement. Caveat emptor (let the buyer beware), indeed!

The latest diet, which has skyrocketed in popularity because of several celebrities on it, is the Ketogenic diet. Some of the stars include: Halle Berry, Alicia Vikander, Gwyneth Paltrow, Tim Tebow, Kim and Kourtney Kardasian, Vanessa Hudgens, Lebron James, Megan Fox, Adriana Lima, Vinny Guadagnino, Katie Curic, and a host of others.

Not being a luminary, I am not on that list, but, as a cardiac surgeon, who is a health nut, I am fond of the ketogenic diet, modifying it a bit for my personal preference, to help reduce or lose my belly-pot (fat) and for general health. It was really a version of the Adkins diet which I started in the mid-80s, nearly a decade after cardiologist Robert C. Adkins introduced in 1972 his revolutionary diet. The ketogenic diet leads to a more rapid weight loss than Adkins. My abstinence from rice and other carbs since March 2018 dramatically helps, even in maintaining a normal blood pressure and blood sugar level. Carbohydrates, most especially rice, increase the risk for obesity, diabetes, high blood pressure, and other metabolic and cardiovascular illnesses. Soft drinks, which are loaded with carbs or artificial sugar and additives, are actually toxic to the body in the long run.

What is Ketogenic diet?

            Ketogenic or Keto diet is a nutrition plan that severely minimizes carbohydrate intake (rice, bread, soft drinks, sweets, sugars, starches, etc), Keto diet includes 75 percent of the total daily calories from fat, twenty percent from protein, and reduces carbohydrate intake to 5 percent. After a few days on this diet, the body system enters ketosis, a metabolic state where the body starts burning fats efficiently instead of carbohydrates for fuel. Normally, the body burns and uses carbohydrates to a great degree for fuel to produce energy. The faster and more efficient weight-reducing fat-burning feature of the keto diet is the one attractive “side-effect” that captivates avid keto-dieters. While there are 4 versions of the ketogenic diet, the Standard Ketogenic Diet is the only one most extensively studied. The targeted or cyclical form is primarily for body builders and athletes, not recommended for the general public.

Effects on glucose metabolism

            The keto diet induces ketone (beta-hyrdroxylbutyrate) formation. If one eats very little carbohydrates, which leads to lower glucose (sugar) storage level in the system, the body taps into fat stores instead for production of energy, using the ketones as an alternative metabolic fuel, a process called ketosis. This assists in weight loss, blood sugar, triglyceride, and cholesterol control, and in preventing or reducing the risk for a host of illnesses including acne, diabetes, polycystic ovary, heart disease, stroke, epilepsy, Parkinson, dementia, and even cancer. Ketones in the liver also supply energy to the brain.     

One side effect is termed “keto flu,” which includes irritability, headache, sense of hunger, mild sleep impairment, slight digestive discomfort, sometimes nausea, and tiredness, which is reported as temporary, while the system is adjusting and getting used to this diet. The severity varies among individuals.   As I have stated earlier, I have abstained from rice and other carbs since 8 months ago, but the craving for rice is still there, especially at restaurants or parties, having sinigang, adobo, kare kare, sisig, laing, etc. However, looking at my reward (shrinking belly, belt-size down to 32) helps me resist the temptation. My mild “keto flu” lasted only about two weeks.

Which foods are included?

            Keto diet allows the following: chicken, lean red meats (from grass-fed animal sources), seafoods (not farm raised, where antibiotics or other chemicals are used) like salmon, sardines, mackerel, shrimps, oysters, crabs, mussels, clam, squid, lobster, virgin olive oil, avocado, oat meal, high fiber grains, nuts (almonds, walnuts, pumpkin seeds, flaxseeds, chia), organic green leafy vegetables, tomatoes, onions, pepper, garlic, spinach, Brussel sprouts, cauliflower, zucchini, cottage cheese, cheese, butter, and other antioxidants (anti-inflammatory) foods that protect the body from the cell-damaging free radicals.

Which are the foods to avoid?

In Keto diet, any high carbohydrate (high glycemic index) foods are to be avoided. Among them are rice, soft drinks of any variety, ice cream, smoothies, candy, sweets in general, wheat-based starches, bread, pasta, cereal, fruits (except moderate portions of berries), processed foods in general, roots and tubers (potatoes, parsnips, sweet potatoes, carrots), legumes (beans, chick peas, lentils), diet products, mayonnaise, sugar-free foods, basically eliminating carbohydrates and food additives.

Is ketosis the same as ketoacidosis?

            No, ketosis results from fasting from carbohydrates, a controlled insulin regulated process that releases fatty acids, while ketoacidosis (seen among diabetics) is a dangerous state due to lack of insulin, causing the blood sugar to catapult to a life-threatening level. One good feature of keto diet is in reducing cellular resistance to insulin (increasing sensitivity to insulin by 75 percent), thus allowing insulin to enter the cells more easily to aid (more efficiently) in glucose metabolism.  Reducing cellular resistance to insulin is the principal beneficial action, for instance, of Metformin and other medications for the treatment of T2 diabetes. When cells are resistant, the person’s own endogenous insulin is not able to penetrate the cells to do its job, hence the blood sugar shoots up. Keto diet is reported to be beneficial in the management of pre-diabetics and actual T2 diabetics.

Caution: Before making any changes in your diet or medications and other therapy you might be on, I strongly recommend for you to consult with your attending physician first. Each person reacts differently. Safety is utmost.

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