Ketogenic Diet: What is it and How Does it Affect My Body?

Have you heard about the new ketogenic diet trend?  Are you thinking about starting on a ketogenic diet?  Low-carbohydrate and very low-carbohydrate (also known as ketogenic) diets are popular for people that are looking for a quick weight loss, lower cholesterol levels, and improved diabetes management. Before you start here are some facts to consider before you start.

The Facts about the Ketogenic Diet:
The basis of the ketogenic diet is the brain's ability to utilize ketones, as an energy source. If you are a biochemistry or metabolism major you know that ketones are the products of fat breakdown. You may be thinking that is exactly what I want…. my brain tells body to break down fat so that = less fat and more muscle tone, perfect!

Image source: sunuaradiet.atspace.co.uk

Well…… it is not so black and white, and here is why:

Under normal conditions, your brain derives most of its energy from glucose. Under fasting conditions, hormonal changes causes your body release fats and uses it as an energy source.  When fats breakdown in the body it causes elevated ketones in your blood.  This can be dangerous and here’s why.

This state alters your body’s chemistry (pH for you chemistry majors) leading to possible decrease in phosphate in your blood, decrease in brain function and increase in your risk of kidney stones and weakened bone strength (osteoporosis). Ketogenic diets have also been shown to induce a higher percentage of headaches, halitosis (yuck- bad breath!), constipation, diarrhea, general weakness, rash, insomnia, and back pain among participants in one study.

Something else to consider: The ketogenic diet was originally intended to help those with seizure disorders such as epilepsy.  Furthermore, scientists believe further investigation is needed for what happens when people eat this way for a prolonged period. Many clinical trials on the subject center on short-term trials and cannot account for long-term effects. Don’t be the guinea pig!

If weight-loss is what you are looking for then consider a balanced approach to food.  Eat in moderation and focus on plant-based, nutrient-dense foods rich in fiber that provide a wide array of protective antioxidants, vitamins, and phytochemicals, while the scientists figure out if the ketogenic diet is safe long term.  MyPlate is a great resource and a good place to start: http://www.choosemyplate.gov or meet with the UC San Diego FitLife dietitian, Prashila Mistry, MS, RD, CLEC for more information. recreation.ucsd.edu/fitlife-programs/wellness/nutritional-services.html

References:
1. Al-Khalifa, A, Mathew, TC, Al-Zaid, NS (2009) Therapeutic role of low-carbohydrate ketogenic diet in diabetes. Nutrition 25: pp. 1177-1185.
2. Brehm, BJ, Seeley, RJ, Daniels, SR (2003) A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab 88: pp. 1617-1623
3. Veech, RL (2004) The therapeutic implications of ketone bodies: the effects of ketone bodies in pathological conditions: ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism. Prostaglandins Leukot Essent Fat Acids 70: pp. 309-319

Guest blog submitted by: Jalak Patel, MS, UC San Diego Medical Center Dietetic Intern and edited by FitLife Dietitian, Prashila Mistry, MS, RD, CLEC.

What’s the Deal with Gluten?

Nutrition can be a frustrating field to navigate because there is always new information floating around.  One week egg yolks are good for you, and the next they’re bad.  It’s hard to know what’s fact and fiction.  My philosophy on healthy eating tends to be a more realistic, moderate approach, but people often find that boring.  They want something exciting, something with immediate results, and the diet industry is more than willing to accommodate.  Allow me to shed light on one of the more recent fads in nutrition; the Gluten-Free Diet.

Before we dive in, check out the video below from Jimmy Kimmel Live and compare your gluten knowledge to those in the video.

You may already know what gluten is or you may have had a similar definition as those in the video, and that’s okay.  To clarify, gluten is not a synthetic additive or hormone, but a naturally occurring protein found in grains such as wheat, barley, rye, and a cross between wheat and rye called triticale.  Gluten is comprised of two components, glutenin and gliadin, and is responsible for dough’s elasticity and for helping bread rise.  Foods such as breads, pastas, cereals, crackers, cookies, cakes, and certain condiments typically contain gluten.

According to the National Digestive Diseases Clearinghouse, more than 2 million people in the United States are affected by Celiac disease, or roughly 1 in 133 people.  Celiac disease is an autoimmune disorder that affects the gastrointestinal (GI) tract.  When someone with Celiac ingests even a small amount of gluten (even a crumb), his/her body recognizes it as a foreign body.  The person with Celiac has certain antibodies that attack gluten particles, and in this process antibodies wreak havoc on the gastrointestinal tract.  Tissues in the GI tract become inflamed and the villi of the intestine (tiny fingerlike projections that are responsible for absorbing nutrients) become damaged.  Damaged tissue and villi can lead to unpleasant side-effects such as abdominal pain, acid reflux, bloating, cramping, gas, diarrhea and vomiting.  If the person with Celiac continues to ingest gluten, the long-term effects of this autoimmune assault can lead to a compromised GI tract that can no longer absorb and utilize food, leading to chronic fatigue, vitamin and mineral deficiencies, as well as unhealthy, unintentional weight loss.

Some people may suffer from gluten intolerance, which is different from Celiac in that it is not an immune-mediated response.  The symptoms of gluten intolerance appear after eating gluten and can include abdominal cramping, bloating, diarrhea, and flatulence.  Researchers are still trying to determine whether or not gluten intolerance over a long period of time can cause permanent intestinal damage.  A more common condition is gluten sensitivity, which affects roughly 18 million people in the US and tends to be much less severe compared to gluten intolerance.  The GI symptoms that occur with gluten sensitivity tend to be similar to those of Celiac, but gluten sensitivity does not cause damage to the GI tract.

To summarize, check out the video below from ASAP Science that answers the question, 'What the Heck is Gluten?'

The gluten-free fad diet has enticed the general public by stating that going gluten-free is “healthier” and can help with weight loss. First of all, there is nothing “unhealthy” about gluten.  Second, excluding gluten is not going to magically transform your diet.  Many of the specialty gluten-free products have just as many calories, amount of fat and carbohydrates as the gluten-containing products, and they tend to be more expensive! That’s why label reading is crucial.

To maintain a healthy lifestyle it is important to eat a well-balanced diet (think whole fruits and vegetables, whole grains, lean proteins, and healthy fats).  Restricting gluten from your diet probably won’t hurt, but it’s probably not going to help either.  In some cases you may end up taking in more calories and foods with various fillers in place of the gluten while breaking the bank at the same time. If you’re looking for a way to enhance your health; instead of cutting out gluten, try cutting out processed foods and high fat/sugar foods.  Of course, if you do have Celiac or a true gluten intolerance/sensitivity, make sure that you follow a gluten-free diet, always ensuring that the approved “gluten-free” seal is on packaged food products.

The take home message here is, if you do not suffer from Celiac disease, gluten intolerance, or gluten sensitivity, then there are no health benefits of a gluten-free diet.

For more information, check out The National Foundation for Celiac Awareness: celiaccentral.org.

Guest blog submitted by Grace Gontarski, Dietetic Intern at UC San Diego Medical Center and blog edited by FitLife Dietitian, Prashila Mistry, MS, RD, CLEC.