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07-10-2019 06:34 AM - edited 07-10-2019 06:44 AM
Is a Keto Diet for You?
This fat-burning approach may not be safe for everyone
by Clint Carter, AARP, July 8, 2019
Maybe you know someone who snarfs down piles of bacon, but thinks toast is evil. Perhaps you have friends who won’t go to dinner after 7, because the time falls outside their “food window.” You might have even seen someone drinking “bulletproof coffee” — regular joe with a pat of butter and some oil mixed in.
These behaviors are all linked to popular weight-loss programs that share a common approach: to make your body achieve ketosis, a metabolic state that switches your body’s engine from sugar burner to fat burner.
Ketogenic, or “keto,” diets have been around a long time. Conceived in the 1920s as a treatment for epilepsy, they provided the science behind the Atkins diet that first became popular in the 1970s. Now they’re back.
Here are answers to questions about how they work and whether ketogenic diets are a sensible approach to weight loss for older people.
What is the underlying theory of ketosis?
After you eat carbohydrates, your blood surges with glucose, the primary sugar that powers all your body’s cells. But when you don’t consume carbohydrates for an extended period — as your ancestors might have done in times of famine — the glucose runs dry, and your liver begins converting stored body fat into W-shaped molecules called ketones. This is the backup fuel system for your body: It is, essentially, running on body fat.
How do you trigger ketosis?
Most proponents point to two approaches: intermittent fasting or following a keto diet. Many ketosis advocates combine the two methods to one extent or another.
Intermittent fasting attempts to mimic the effects of a temporary famine by limiting one’s food intake to a daily window (usually about eight hours), or by integrating a couple of very-low-calorie days into each week to force the body into ketosis.
Following a keto diet, on the other hand, involves eating primarily fat plus a limited amount of protein (because protein can be converted to glucose) and almost nothing else.
“The keto diet is designed to mimic the effect of fasting without actually starving,” says Stephen Cunnane, a professor with the Research Centre on Aging at the University of Sherbrooke in Quebec. “Broadly speaking, they do the same thing.”
But it’s not easy. “We can only get into ketosis by eating less than about 50 grams of carbs a day — about a cup of cooked pasta,” says Carla Prado, an associate professor of nutrition at the University of Alberta in Edmonton.
Do keto diets work?
Yes and no.
In a study published this year, volunteers who went on a ketogenic diet for three months lost 17 pounds and 5.1 percent of their body fat, on average. And a yearlong study published in Diabetes Therapy found that a daily carbohydrate cap of 30 grams — about what you’d get from a banana — could help people lose 12 percent of their body weight on average.
But while these results sound promising, they may have nothing to do with whether or not people achieve ketosis.
“The diet is very monotonous,” Prado says. “There just isn’t much that you can eat, so of course you end up eating less.” When government researchers designed a study to hold calorie intakes constant, they found no advantage to keto versus a balanced diet with carbohydrates. And a review of 23 randomized controlled trials found no difference in body weight between those on low-carb and high-carb diets.
Plus, much of what people lose in ketosis, at least initially, is water weight. Sugar stored in your body is bound with H2O. So when you start cutting carbs, your body grabs that sugar and releases the water. “People think they’re losing fat, but they’re actually rapidly losing water,” Prado says.
Can Keto Halt Cognitive Decline?
Your brain on sugar
• Like the rest of your body, your brain runs largely on sugar, says Cunnane. As the brain ages, neural tissue can sometimes struggle to metabolize that sugar properly, leading to cognitive decline.
Your fasting brain
• “Ketones are actually its preferred source of energy,” Cunnane says. With as little as 12 hours of fasting, your brain begins shifting toward ketone metabolism, and as ketosis ramps up, ketones can supply more than 60 percent of your brain’s energy, which helps it overcome the problem of sugar metabolism.
Your brain on fat
• In a study, Cunnane and his colleagues gave 19 cognitively impaired subjects — average age 75 — two daily drinks containing medium-chain triglycerides (MCT), a fatty acid that converts into ketones more efficiently than the mixed fats in food sources.
• In six months the subjects’ language skills, processing speed and executive function improved significantly, and they scored 54 percent higher on a test of visual memory.
And the caveat...
• There’s no evidence that ketones will have the same cognitive-boosting effect on normal, healthy brains that process glucose properly, says Cunnane.
Are keto diets appropriate for people with diabetes?
Talk to your doctor about it, but studies have shown that keto diets can help people improve their insulin sensitivity. “Type 2 diabetes can be controlled with a ketogenic diet,” says Cunnane.
A review of studies in the International Journal of Diabetes and Clinical Research concluded that keto diets “should be taken into serious consideration as a possible standard therapy in the future treatment ... of diabetes.”
But again, following a keto diet is difficult. For diabetics, it’s best done under a doctor’s supervision. “This is a prescription-strength diet,” says Eric Westman, an associate professor of medicine at Duke University in Durham, N.C., and the cofounder of Heal Clinics, a company that used dietary ketosis to treat type 2 diabetes. (Virta Health is another company that does this.)
Can a keto diet help fight cancer?
There is some positive evidence. Cancer cells predominantly eat glucose; some cancer cells can’t metabolize ketones. “With a ketogenic diet, we may be able to essentially starve cancer cells,” Prado says. In studies on animals, researchers have shown that fasting or severe restrictions on carbohydrates can slow or halt the growth of some tumors. Small studies on humans suggest this might prove to be a useful supplement to radiation and chemotherapy.
But the research is still too young to say for sure. “The results are promising,” Prado says. “But they’re not consistent. And it’s really difficult to have people follow the diet.” Until there is better data, it’s too early for experts to make sweeping recommendations for cancer patients who are already undergoing difficult treatment plans.
So, should you try it?
If the keto diet sounds difficult and complicated — well, it can be. Even in Westman’s clinic, where patients were trying to beat diabetes with the help of professionals. about 50 percent of patients dropped out within a year. And some researchers are concerned about the potential for things like kidney stones, renal damage and elevated LDL cholesterol.
Others warn about “keto flu” — an electrolyte imbalance that often affects people on the diet.
But for older adults, the biggest risk of fasting or keto dieting is the fact that you’re often depriving your body of the protein it needs to build and maintain muscle mass. “To build muscle, older people need more protein than younger people,” Prado says. “With the ketogenic diet, you have a maximum amount of protein you can eat — usually only 15 percent of your calories.”
So if you’re eating 2,000 calories a day, you’d be allowed only about 300 calories, or about 75 grams, worth of protein. That’s considerably less than what Prado recommends for the average 180-pound person who wants to avoid frailty, falls and fractures.
One 10-week study of a group of men over 70 found that those who ate the recommended daily allowance (RDA) of 0.8 grams of protein per kilogram of body weight (about 65 grams for a 180-pound person) lost muscle, while those eating twice that amount added muscle around their midsections and improved their leg strength.
Cutting protein to “go keto” means potentially sacrificing muscle mass — and that’s a big trade-off to burn a little bit of belly fat.
Talk to your doctor first, and approach keto diets carefully and cautiously.
07-10-2019 07:07 AM - edited 07-11-2019 01:53 PM
Bottom line: Talk to your doctor first, and approach keto diets carefully and cautiously.
@novamc1 Well, the bottom line is our Drs recommended this lifestyle!
For those who really don't understand a keto/low carb lifestyle and just read articles with hype, should do their own research on the subject.
My DH's Dr recommended him to go very low carb to 60 carbs or less a day...not quite Keto (30 carbs a day). DH was diagnosed as a type 2 diabetic Sept last year. Since then he has lost 85 lbs and his blood sugar numbers are now normal. Not just because he has lost weight, but because he doesn't eat the high carbs anymore. He is also off the diabeties and cholesterol meds too.
I also found out I was pre-diabetic and since I have now lost over 50 lbs, my blood sugar levels are normal too. We both check them every day.
Eating this lifestyle has totally eliminated my GERD, severe heartburn and acid reflux. There are also other health issues between both of us that have improved.
It has been ages since DH and I have felt as good as we do now. What is really upsetting is all those 'in charge' won't speak the truth. DH and I wish we had taken this lifestyle seriously years ago and not had believed it was just a trend/fad. If we did, we wouldn't have developed the health issues we did. We believed what the gov agencies pushed, what the top health institutes pushed with the food pyramid...eating LOTS of grains, pasta, etc....and lots of fruits. What that did was put our blood sugar out of control late in life. Our bodies couldn't take that type of eating any longer.
After reading a few books and watching a few videos, the wool has been lifted from our eyes. There is plenty of info out there for those that care to learn/be informed themselves...and I can assure you it will be an eye opening experience.
All I can do is pass on info that helped us with our health issues.
There are millions of folks who live this lifestyle for heath reasons. For those who want to become informed...and at least learn about a low carb/keto lifestyle, I started a thread back in March with a lengthy post with several references (link below):
07-10-2019 07:49 AM
07-10-2019 08:33 AM
07-10-2019 08:36 AM - edited 07-10-2019 08:39 AM
07-10-2019 08:42 AM - edited 07-10-2019 09:03 AM
Whenever a diet plan requires the words ‘carefully’ &
‘cautiously’, respect that. It’s dangerous...and avoid.
Cause lots of inflammation & damage to your
Even in the original post it states, ’(glucose) the primary sugar that powers all your body’s cells’. So why would one want to deny the body of that?
2 questions to ask if wanting to go Keto:
-Are you a young child? No.
-Do you have epileptic seizures? No.
Losing weight & attaining better health is so simple.
Why do people make this so hard?
There’s no yellow ‘CAUTION’ tape around the
So to answer the OP question, ‘is Keto for you’
the answer is not just NO, but H*LL no.
Just eat: 🥬🍏🍓🥦🌽🥔🍊🍠
07-10-2019 09:27 AM - edited 07-10-2019 10:06 AM
Clint Carter needs to do more research about what this diet actually is and the research supporting it especially in terms of brain health.
To say it is high fat, low protein and nothing else is ridiculous. It's high unsaturated fat like olive oil not bacon or cheese which are saturated, lots of vegetables and some protein usually in the form of seafood not beef which again is saturated aka the Mediterranean diet.
And to say there is no evidence about brain health is beyond poor journalism. The brain does not prefer sugar and milk chocolate and ice cream are not health foods. The brain uses sugar primarily because it's a cheaper, faster way to get energy and more readily available because of the poor way most of us eat. The body doesn't make ketones is you're constantly eating carbs and sugar. At least he got that part right.
The reason Alzheimer's is called Type 3 diabetes is because the brain does not like sugar as a primary fuel source. You are eroding your neural pathways in much the same way you are eroding your arteries and causing yourself high cholesterol and heart disease with the plaques your body makes to try and repair the damage and decreasing your insulin sensitivity (hello type 2 diabetes) as well.
AARP should be ashamed of this type of article. A modicum of research would have at least balanced it out a bit and given a clearer more correct picture.
And one last caveat about MCT oil. If you are at genetic risk for Alzheimers meaning you know you have the APOE4 gene or even if you don't know and just have a family history, do NOT take MCT oil.
It actually becomes a risk factor for those people with APOE4 because again it is a saturated fat. It is only recommended by the top Alzheimer's researchers as a crutch to get you into ketosis initially but should be rapidly eliminated since APOE4 peeps do not clear out saturated fat well hence the success with keto in people with neurological diseases like Alzheimer's and Parkinson's and MS.
And June was my one year anniversary of intermittent fasting using the 8 hour eating window every day. Easiest and most effective thing I have ever done for my weight and my health.
07-10-2019 09:37 AM
Susanlouise: congratulations on your and your husband’s success! I know I personally will never go back and don’t regard this as just how I eat now: meat and veggies. Easy.
I wanted to mention that the article talks about the keto flu but doesn’t say it goes away and is replaced by clear thinking and a feeling of well being, at least that’s how I feel!
@Athome2 Thank you
DH and I will never go back to the conventional way of eating ever again too.
Besides feeling so much better...mentally & physically, we keep thinking about the hundreds of $ saved monthly...nearly $850 of $1,000 (OOP) on meds neither of us take anymore. Just the Crestor alone DH was taking the price was off the charts...then add on his 2 diabetic meds, all the meds I was taking for GERD, severe heartburn, acid reflux, etc.
When anyone is able to get off meds, common sense tells me they are healthier
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