Episode 07: Our Unbiased Thoughts on the Keto Diet
Watch on YouTube
Episode Transcripts
Participant #1:
Hi, guys. Welcome back. Hi. Today we are diving into the keto diet. We're so excited about this one. This diet in general typically sends dietitians running for the Hills, but we're going to do our best to provide our most unbiased opinions using scientific data. We always try to open minded when talking about new trends because it means that people are wanting to better their health. And so it's just not good to be judgmental when discussing this. We're going to try our best not to do that. Exactly. We want to come from it. We want to go towards this with the most scientific view as we can and just discuss what we know and what we researched and what current science is saying and basically help clarify if there's any questions you might have or unfamiliarity with the keto diet. Yeah. So we're first going to jump into describing what the keto diet actually is. This is a diet that is super high in fat, about, like 65% to 75% of your calories from fat, super low in carbs, usually less than 5% of your calories come from carbs, and then it has a moderate amount of protein, about 15% to 20% of protein. And this is a little bit different from the normal what's called AMDR. The acceptable macronutrient distribution ranges. Those are much, much higher in carbs, about 45% to 65% of carbs, and then similar in protein, actually about ten to 35% of protein, and then a lot lower in fat. So the carbs and fat kind of switch. The normal fat distribution is like 20% to 35%. Yeah. And like I said, the biggest takeaway about the difference between the keto diet and your average individuals diet that we recommend is those carbohydrate distributions. And to accommodate for that, the keto diet will include foods that are really high in meat, fish, eggs, cheese, heavy cream, oils, nuts, avocado, seeds, and your low carb green vegetables. And this is to really get that higher fat and protein intake and then foods that typically ketogenic people. The keto diet will try to avoid or eat less of our grains, rice, beans, potatoes, sweets and desserts, milk, cereal and fruits. So the biggest difference between a keto diet and a low carbohydrate diet is a keto diet will aim for about less than 50 grams of carbohydrate per day, which is like one meal for me. Yeah. I was trying to think of like an example.
Participant #1:
I can't think one either a piece of bread is like 15 grams of carbs. Yeah. Banana, maybe. Yeah. And then when we would recommend, like, a low carb diet for someone based on most likely a chronic condition, that's actually 50 to 150 grams per day. So as you can see, there's already a huge difference in just a low carb diet. And then what an individual on keto might be consuming. So very drastic extremes there.
Participant #1:
I guess the reason for why people do the keto diet is because they want to put their body in a state of ketosis and to actually put yourself in ketosis is very challenging. And if you have a cheat day or something, you're not going to actually be in ketosis. It will take multiple days of being in this extreme diet and extreme situation where body will switch over to using ketones as more so the primary energy source rather than glucose. But it does take a long period of time. It's not kind of something that you have to do once or a couple of days where you'll automatically switch. And even then, if you are doing it for multiple days or longer, your body is going to try to combat that and try to change its energy sources. So it's utilizing glucose as an energy source, because that is the body's preferred and primary energy source, where it will be able to function most efficiently. Yeah. That's why often when you do start this keto diet, you feel like what's called the keto flu. And that often contains things like brain fog, fatigue, headaches. And that's because Emily was saying the body is trying really hard to use carbs for energy, what little there is, and when you're using ketones instead, it's kind of like using a backup plan, I guess. And so that makes the body not quite perform optimally, at least for the first. I don't know how long, exactly, I guess. But for a while, when you're starting the keto diet. Yeah. That's why it's especially challenging to start it, and I guess maintain it because of all those your body just isn't accepting it. I guess that can happen with any extreme change that your body might not like. But your body does prefer glucose and carbohydrates as the primary energy source. And this is just the end result of it. And it's good to know that the keto diet was never even made to be used, just like as a regular old diet, especially not for weight loss, which we'll get to in a second. It was actually created for the treatment of epilepsy in children, children who are having seizures, and it's supposed to be monitored very closely by doctors and other healthcare professionals like dietitians to make sure it is being used appropriately and that the patient actually is in ketosis. So just using it as a fad diet, first of all, isn't often done correctly in the first place. And B, it's likely not going to be effective at whatever you're trying to use it for. Yeah. It was made for seizure management, not overall improvements in health. Yes. And we're going to break down, like the different aspects of health that people do try to use the keto diet for and kind of explain if it does or does not affect any of those different disease States or other. I don't know. What else do we have on there, like performance measures and that kind of thing. Yeah. We'll kind of cover the big I guess the big three. I feel like people think weight loss, cardiovascular health, diabetes, those tend to be three of the most popular disease or condition topics in America that I've noticed. So we'll be sure to cover those. And then, in addition to that, we do have a sports performance section planned because there has been a lot of discussion around if athletes should be on a ketogenic diet. Yes. Exactly. Well, I think the biggest one is definitely using keto for weight loss. So we're going to kind of break down if that works, how it works, and if it should be used as a tool. So first of all, it often does work. That's the experience that I've seen in the short term don't get me wrong. It's often a very short term fix, and it's very restrictive. And the minute you kind of stopped doing this diet and go back to your normal eating habits. So weight comes right back on. And the reason it's so rapid is because you are moving an entire macronutrient. So of course, you're going to be eating less than what your body Burns. And that, of course, leads to weight loss. And it's so rapid because our body uses glucose as glycogen. That's like the storage form of glucose that we use for energy. And glycogen is largely composed of water. And so when we're depleting those glycogen stores, we are losing a lot of water weight with that. So the initial drop in weight that you often see with the keto diet is typically just water weight. It can be very disappointing. But oftentimes whenever there is drastic weight loss very quickly, it tends to be associated with water weight. And that's the case with keto, at least. So when an individual utilizes the keto diet to lose weight, they might be losing weight really quickly for a couple of weeks or even a couple of days, depending on what their current body weight is, how they continue to maintain the keto diet and other external factors that might be affecting their weight. But it can eventually Plateau, which often occurs with extreme weight loss situations or drastic weight loss situations. And this can also lead to potentially an increase in weight loss after the rapid loss of Glycogen stores are renewed and this water weight will return. So I guess I said that wrong. There's an increase in weight once your body catches up with you and the Glycogen stores start to be replenished and the water weight will return because your body is trying to maintain a state of homeostasis and maintain the glucose as its primary energy source. Yes. That's why you do see that rapid loss and then off in a Plateau or even a regain. Yes. Which is why it's not great for long term for weight loss, because also from I guess I don't know. I was supposed to say like a reasonably standpoint, but that doesn't make realistic. There we go from a realistic standpoint. Are you going to live the rest of your life consuming barely any carbohydrates? And that includes your fruits? That includes a lot of your starchy vegetables. That includes your breads, your grains, your sweets, your sandwiches, your casseroles, so many foods that people tend to really enjoy in their everyday life. And then also when going out with social events with friends or family, it's a question of will you be able to manage this for the rest of your life because one of the biggest things with weight loss and Hannah, I think you can see probably better on this since you do work in a weight management clinic. Is are the actions you're taking right now going to be able to help you long term? And are you going to be able to maintain those because your results will only last really as long as you can maintain the diet. Yeah, that's exactly right. I always make that very clear in a first visit with someone because I want to make it clear that we're not doing a quick, easy fix. We're not going to be seeing each other for just like a week or two and then you'll lose £10 that'll set you free. It's going to be really kind of boring and monotonous and not that exciting. If you're striving for weight loss, losing only like, I don't know, a half pound or £2 a week, it's not going to be that crazy rapid drop. So if you are looking for sustainable weight loss, the keto diet probably is not for you because like I just said, it's not going to be a way of eating that is enjoyable long term for most people. Yeah. And if you really don't have that strong relationship with food and want to enjoy food, then it might be easier for you. I do know there are people that don't really care what they eat and they're like, I just want to eat this specific way so I can look a certain way and it might be more manageable for them. But I'd say the majority of people I know enjoy eating food and have preferences about what they eat. Yeah. And you can eat whatever you want and lose weight. Also, if that is your goal. So bottom line, it is not effective. Long term. Yeah. You might see some short term success, but there might be some sadness down the road. Oh, there's absolutely going to be sadness. You don't get to eat bread or anything. That's true. I cannot imagine that. No. All right. So moving on to our next pillar of health that we will be discussing socio ketogenic diet is cardiovascular health. And there's very limited long term evidence associated with the ketogenic diet and the research that we've seen so far, and some of this evidence does show improvements in type two diabetes and obesity, which will then in turn have an effect on cardiovascular factors because all those conditions do have some type of Association with each other and can affect each other if there's management done in one specific area. There was also evidence that indicated that or there was some evidence that indicated that there could be an increase in your LDL cholesterol and triglycerides LDL, you might know is like the bad cholesterol that you don't want builds up because it can lead to plaque build up, potentially arthritosis or arteriosclerosis and triglycerides is also associated with that. And that's kind of if you've ever gotten a lipid panel done, which you mostly have most likely have at some point in your life, these are the two factors that affect this. So this is kind of a negative component that they've seen associated with cardiovascular health. That isn't 100% concrete, I'd say. But there is some evidence that doesn't dictate you could be at risk of worsening your lipid panel, which is not good. Yeah. And I do want to touch real quick. Also, on how like at the beginning of all this, you are talking about how some evidence does show improvements in type two diabetes and obesity. But again, it's important to remember that those are just short term results that are being seen. There hasn't really been any long term studies showing that this keto diet helps with diabetes and obesity, which then helps with cardiovascular disease. So far, there is not a lot of evidence leaning towards it being a good thing in the long term in the long term. Short term? Sure. Yeah. Fine. But long term. No, probably not. So, speaking of diabetes, type two diabetes, like I was just getting at the keto diet has been shown in the short term to help with improved blood glucose levels and also a one C I know where I work. Some doctors do tell her patients to follow the Keto diet, which is very frustrating because that's a digestion strategy. And then they often come to me and my coworkers, my other dietitian co workers, and they're very confused about why we often don't recommend it. So it is still just not really agreed upon the effectiveness not really agreed upon on different providers at this point. It's kind of just certain providers have different thoughts and opinions and uses of the keto diet. But anyway, the studies are pretty controversial. Some data does show improved blood glucose levels, and some don't. It's not really definitive at this point. Not really a fun answer, but science. Yeah. And they're still doing more research on it. So in a couple of years or so, we'll definitely know more, and that might not be what you want to hear right now, but we're just giving you what we know at this moment. Yeah, science. So then the next section we are going to talk about is keto diet related sports performance, which is personally one of my favorite parts, because I feel like oftentimes sports performance isn't just the professional or collegiate athlete. It's also your individual self. If you work out often exercise and you want to change your diet to improve your athletic performance as well as if you have body composition goals in mind. Stuff like that. And kind of one of the biggest things we've seen keto talked about is the loss of lean muscle. Or I guess people talked about more so loss of fat. That was what they were aiming for with the ketogenic diet. But we actually found that there's research to show that when you're on keto, you could experience losses of muscle mass, which we don't want you to be doing because you need muscles. We don't want you to not have any muscle, keeps your metabolism up, keeps your bone strong by being able to work them respectfully and efficiently. And this muscle mass is made up primarily of protein, water, and glycogen, so it's difficult to determine if the lean body mass loss is related to the restriction of protein or carbohydrates. When you're working out your carbohydrates are not only a primary source while you're living your everyday life, but especially when you're exercising because it relies on your glucose system or system. I'm trying to think of the different systems tapping into my inner HK classes. I know they're like, I think there's an ATP creatinine cycle. It's been a while bear with us when your body is exercising, it will rely on your quick energy glucose stores and then as over time goes on, this is typically seen with endurance athletes, those that perform for 45 to 60 minutes longer or at least that period of time. Their Ng will switch over to their fat store and their something oxidation cycle,
Participant #1:
aerobic energy oxidation, fat, beta oxygen now I'm the same terms anyway, but basically you could lose lean muscle mass, and they're not entirely sure why with keto, but that is something they've seen, and you do not want to lose muscle mass, especially if you work out often. And I kind of touched into a little bit. But with endurance performance, there's also conflicting results with this. This will work in the research doesn't show, and it assumes that your body is working to enhance muscle fat oxidation to improve endurance performance. But there was actually some other research that I was looking into and found that there was a slower recovery time from endurance athletes, and in addition to a lower or impaired peak aerobic capacity for how long they could maintain energy and what their times were looking like and their speed overtime and stuff like that. So very conflicting with both lean muscle mass or at least what is causing the lean muscle mass and then endurance performance. It's very conflicting because your body needs so much glucose and carbs normally with endurance performance. And the last one is strength performance. This is kind of what you can think about with your weight lifting, different weightlifting competitions, your quick energy, the anaerobic energy like sprints stuff like that. And they found that individuals who followed a keto diet had a lower peak power in the Wingate test, which is a measurement test of how efficient someone can utilize a certain amount of energy and power in a certain amount of time, and it's normally focusing on that shorter term quick energy. And then they also found that individuals like you to diet have lower average power too. So overall for sports performance, it's not looking very good for the keto diet at the moment. So at the time, we can bring on a sports dietitian on here in the future as well. But the research shows that keto will not have any significant improvements on your sports performance or athletic performance, and it could potentially be detrimental and negatively affect it. Yeah, crops are just way too important for literally all types of exercise, whether it's more aerobic or anaerobic. So keto probably isn't the best bet, even though we're being unbiased, keto still is not sounding too great. I know I'm not any personal experience, not that I've gone on keto ever leaving that out or speaking Fax Fax hashtag Fax hashtag science. Well, speaking of us talking about how we're not bashing on the keto diet, the next section is the negatives of the keto diet. I'm sure we can find negatives about every diet, though that's very true. That's very true. I already had mentioned the keto flu that first initial brain fog and things that you get when you do start this diet just because of your body trying to work super duper hard to function without a nutrient that's usually functioning with. So that is the first big negative of the keto diet. Second one is pretty big and I hear this one a lot as well. And that's constipation. The major thing we're missing out on with the keto diet, along with carbs is fiber, which is a carb. And we're not having those foods like fruits and veggies and beans and whole grains that do have all that fiber in there. So I hear all the time from patients and clients that have done keto that they say how constipated they've been, and it's pretty hard to get back from that too, is what they always tell me, which is no fun. I also love when I talk about patients and clients poops and then eat lunch ten minutes later. It's always a good day work dietitian thing. Yeah. Don't ever be afraid to talk about your poop with me because I literally won't even be faced by it. Yeah, it's kind of a norm. Another
Participant #1:
negative. The keto diet that we found is protein is very limited related to this method in the body called gluconeogenesis, which is the production of glucose. Or it's the production of new glucose from non carbohydrate sources. And this is when the body will use protein. If there's insufficient cards, which will lead to a loss of muscle mass and can affect your metabolism. Because when your body is experiencing natural nutrient metabolism, the first priority is utilizing glucose as an energy store, and they'll go through like, glycolysis and electron transport chain, all that fun stuff to produce ATP. But if there isn't enough glucose, then it's going to start turning to those other macronutrients and protein is one of them, and we need protein already for so many other different factors, such as, like tissue synthesis, your normal metabolism. I'm blinking like everything else, but protein is very important. I know we've talked about this in a previous episode, but by taking away protein and utilizing it for a system or a function that it doesn't normally do, we are depriving it of its primary functions, and that's what can lead primarily to muscle loss of muscle mass is the big one. Yeah. So people think of the keto diet as being just low in carbs, but it also has to be just like moderate protein, because if protein is too high, then the body won't get into ketosis because it's using protein instead of fat through gluconeogenesis. Ketosis is literally like the last resort. A buyer does not want to be using ketones for energy. So this is just truly not optimal for the body. But that is why protein also has to be kind of limited, and it really is just fat is kind of the main source of energy that you're eating. It's hard to achieve. Hard to achieve since you are eating such a high fat diet. Oftentimes, high cholesterol levels in the blood. High triglyceride levels in the blood can also be an issue when you're eating a keto diet. It's hard just to eat those unsaturated fats. The healthy fats in the body.
Participant #1:
You are also often eating a lot of saturated fats, so like our butter. I'm sure you've heard of the bulletproof coffee, which just sounds disgusting. But anyway, I always see keto people doing like bacon and eggs, which nothing wrong with that, but just a lot of saturated fat there. And if you're doing that all day every day can definitely do a little bit of dirty work to your arteries. Yeah. Which will lead to other health issues which we don't want. Yeah. The last kind of bit which can result from any extreme restriction diet is disorder eating, and this is kind of disordered. Eating is a prelude normally into eating disorders. The biggest difference between eating disorders and disordered eating is eating disorders are diagnosed conditions by a doctor, and then they'll typically work with a registered dietitian and a therapist in addition to a behavioral health team. And this is a disease normally of the mind. I would say like 95% the mind, and it's associated with factors that do affect your eating. And that's why it's considered an eating disorder. But disorder and eating are habits that aren't diagnosed, but they can be risk factors leading to eating disorders. And they're very common, unfortunately, because of how normalized dieting is. But by restricting your body so much with the keto diet, it can lead you into obsessing over your health, obsessing over what you're eating, restricting yourself unnecessarily thinking that or even like taking your emotions out on food stuff like that. And that's a really big risk, especially with these really restrictive diets, because we don't want you to develop eating because it has the potential to be very damaging to your health. And we don't want those affecting your mental health as well. So the verdict kind of the bottom line about the keto diet if it's sustainable for you might be a fine tool for you to use a fine diet for you to follow. But for most people, it's important to remember that all foods can and should be enjoyed in moderation. Carbs themselves do not cause obesity or diabetes or any other chronic condition. And the best diet for you is one that you can stick to long term that you enjoy, and one that meets your body's unique needs. There is a lot that goes into your general health, and food is not the only thing. And taking an entire macronutrient normally won't fix those problems you're seeking to fix. Yeah, it will just make you sad, because carbs are good and delicious. We love carbs. Yeah. Show my carb shirt today, man. Got to rerecord. No,
Participant #1:
you're wearing for another one. We'll have another one. I'm sure we'll discuss carbs more than one. Yeah.
Participant #1:
Okay. Should we get to the bonus question? Yeah, this is a good one. I don't know why, but I feel like we've discussed it already, but we haven't documented it, so I don't know what happened in my head that we've already went over this, but the bonus question of the day is, do we prefer chunky or creamy peanut butter better? Emily, would you like to begin? I will begin the discussion. So my defense is I prefer chunky peanut butter because I don't really like peanut butter as it is. And I know that's very I like peanut butter, but I don't like eating it a lot. And I think that's because I don't like peanut butter and jellies, which is another what I think they're the boringest food in the world. How does it not cooked before? What? I don't know. I never ate, like, as a child, I didn't like peanut butter and jelly. I ate sandwiches with deli meat or mustard and stuff like that. I didn't like PB and J. My mind was blown. If you were the one when I first met you, I don't know that we would be here today. Still talking. Just kidding. I'm just kidding. But seriously, that's mind blowing. Yeah. So when I typically do eat peanut butter, it's like peanut butter on waffles or peanut butter toast. And I like having the crunch in it. But I also couldn't tell you the last time I eat peanut butter. So that's why it's been months since I've eaten butter, which is weird. I use it sometimes, like making sauces and stuff or marinades, but then I use normally, like, creamy because I don't want chunks of peanut butter in my whatever sauce. My mind is blown. I literally had peanut butter this morning, like I had peanut butter. I know that's very normal. People love putting that in, like, breakfast and oatmeal and stuff like that. I have, like, four jars of different kinds in my cabinet. I love people. No, I love looking at the jars. I just don't. That was not the question. I know. Tune in for next week's episode. Real Scope. If you like looking at jars or not,
Participant #1:
that's a controversial one. Okay. Sorry. Wait. Your turn. Your turn. Okay. I love all peanut butter, and it actually depends on what I'm using it for. But my Goto is usually creamy. That's what's usually in the house. But I do like to use crunchy for, like, a little bit more texture. Kind of like what you were saying. I guess on a PB and J, I probably choose creamy. Probably creamy, but I like to add crunchy to things like Oatmeal, so I could just add more texture to it. I don't discriminate against nut Butters. I love all the nut Butters crunchy, creamy, pistachio, whatever. So good. I can't believe you don't like it that much. This is the first one we did. I think it's one of the things I didn't know your answer to already, too. I definitely didn't know. I thought you were a chunky person. We don't know.
Participant #1:
Episode Three Emily, don't comment on someone's weight. I know. Yeah, we don't discuss these before, but I still usually know your answer but today I didn't know your answer. I was genuinely surprised. Wow. All right. Well, that's interesting. Yeah. Let us know what type of peanut butter you prefer. Also, let me know if you like peanut butter and jellies. Most people do, but I want to feel seen. Let me know if you don't like peanut butter and jelly. I mean, I'm not going to feel bad either way. Honestly, you shouldn't. Your opinions are valid. I just can't believe it. Yeah, I feel like the ones who don't like peanut butter are the ones who have an allergy to it. But anyway, my mind is just wrapping around this as quick as I thought it would. All right. Thank you guys so much for tuning into this episode, and we will see you next week. Yeah. Have a good one. Bye bye.
