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Keto Diet: Rad or Bad?

By: Risa Caldoza-De Leon MD, FPAPSHPIKeto Diet: Rad or Bad?

Many strong women (and men) have fallen in the battle of the bulge, me included. The enemy (think blueberry cheesecake and cherry soda) is all too powerful, the lure too strong, that it’s easier to admit defeat and dig in (for now) than say no and walk away. As much as I would like to blame my female hormones, stress, and sleep-deprivation for my shameful defeat, the truth is: I simply love my salt and sweets. It’s “the body is willing but the mind is weak” thing. Which is why the bangin’ curves of my dreams remain just that, a dream.

The traditional Filipino diet is higher in total fat, saturated fat, and cholesterol than our other Asian neighbors. The top five most commonly consumed foods were rice, salt, cooking oil, coffee, and bread, according to the 2013 survey conducted by our Food and Nutrition Research Institute (FNRI). A year after that, the World Health Organization (WHO) reported that almost three out of 10 Filipinos were overweight, and one out of 10 was obese. We are indeed a nation of sugar-burners.

The good news is that half of these numbers said they were trying to lose weight, as found by Nielsen’s Global Health & Wellness Survey. How? By relying on the tried-and-true methods to lose weight— diet and exercise. But some six percent of Filipinos revealed that either they take diet pills, bars, and shakes or medicine prescribed by their doctor. They also don’t shy away from using other methods to shake off the extra pounds.

Here enters a new world of diet protocols, with names like the Atkins diet, morning-banana diet, werewolf diet (yes, you read that right!), the Israeli diet which sounds like it could kill you, the Master Cleanse, the Paleolithic diet, the alkaline diet, the baby food diet, the Hollywood cookie diet, and the list goes on. Jumping on this weight-loss train to sexiness is another heavy hitter, the Ketogenic Diet or Keto for short. Hollywood stars like Megan Fox, Kim Kardashian, Adriana Lima, and Gwyneth Paltrow have been said to be fans of this high-fat, low-carb diet plan. Even our very own Ruffa G. and Billy Crawford have gone keto, too!

No keystones unturned

A ketogenic diet is not something new. A very low-carbohydrate diet was the standard treatment for diabetes throughout the 19th century. And before anti-seizure meds became mainstream in the 1940s, Dr. Russel Wilder at the US Mayo clinic designed the ketogenic diet in 1924 for his patients with epilepsy. Not only did it lessen seizures (one in seven kids stopped having seizures completely), it also lowered glucose levels and improved insulin resistance. A century later, their tool has become in vogue, a hot trend.

In this weight-loss craze, 80 percent of what you will eat is fat, 15 percent protein, and a mere five percent carbs. Just to compare, a usual diet contains 55 percent carbs, 30 percent fat, and 15 percent protein. The desired ratio in the keto diet is 5 grams of fat for every 1 gram of carbohydrate and protein. In keto for example, bacon, which has a ton of fat but not a lot of protein is a preferred food over chicken breast, which is high in protein with very little fat. Eating fat ad libitum? What heaven for me!

The gist of this diet plan is if you don’t eat carbs, which is the brain’s preferred fuel source, your body will break down fat instead. Please take note that WHO recommends that majority of dietary energy comes from carbohydrates. Turning into a fat-burning machine will push your body to enter the metabolic state called ketosis. Ketones are small fuel molecules the liver produces from fat when you eat very few carbs. The ketones that don’t get used for energy pass through the kidneys and out through urine.

Think of it like converting your car's gas engine to a diesel engine – you’re just using a different fuel type. It takes two to three days of fasting to burn through your glycogen (the sugar your body converts into energy) stores and shift to using ketones. The fastest way to get to ketosis is by not eating anything, but obviously, you’ll be dead before you get that 24-inch waist. Ketosis is a highly individualized process, and some people need a more restricted diet to start pumping out ketones.

Some studies show that ketosis is not only effective in reducing body weight and the risk factors for various chronic diseases, but it also has a significant influence on staving off your hunger pangs. It can make you more alert, too. There is evidence that a keto diet may help in Alzheimer’s disease and purging your body of cancer cells. High-endurance athletes laud the diet because it can ease the fuel burden load and help them win that 100-mile race. Even deep-water Navy SEAL divers are using the diet to prevent oxygen toxicity when they’re out on their sea missions.

Ketosis should not be confused with the life-threatening condition called ketoacidosis or diabetic ketoacidosis (DKA), which is a complication of type 1 diabetes. DKA results from very high levels of ketones and blood sugar in the blood.

Forewarned is forearmed

Not everyone is a fan of this restrictive diet. In 2015, the American Heart Association (AHA) stressed that it doesn't recommend a high-protein diet for weight loss, because it restricts us from eating healthy foods that are required to meet our nutritional needs. The American Dietetic Association (ADA) categorically endorses the high-carbohydrate diet recommended by the US National Academy of Sciences.

Magic, it is not. Some drawbacks include constipation (you’re eating more fat and less fiber) or its counterpart diarrhea. You may want to cover your mouth too because the keto diet may cause the dreaded keto breath. This is due to the byproducts of ketones such as acetone that is being released in the breath as the body burns fat.

According to a survey by the Physicians Committee for Responsible Medicine, 40 percent of people following a low-carb diet reported having bad breath. Some people may complain of sleep problems, nausea, and vomiting. More so, your cholesterol and triglycerides level may skyrocket during the first several months of going on a diet. Don’t panic, studies show that lipid levels will return to normal by 12 months. Then there is the protein deficiency because you emphasize so much fat and just moderate protein. Aside from that, there’s also the threat of keto flu and its unpleasant symptoms which include headaches and general weakness during the adaptation phase when your body might be having “carb withdraKetogewals.” It really takes guts (excuse the pun) to use this weight loss method!

Although a ketogenic diet is relatively safe, it is hard to sustain for most people. Women who are pregnant or breastfeeding as well as those with diabetes and high blood pressure should take extra precautions if they’re considering this low carb diet. However, it is not recommended for patients with kidney problems.

Diet causes drastic changes to one’s metabolism so please see a physician before undergoing any type of weight-loss program. Remember that the success you have in any common diet is based on whether you follow it day-in and day-out, and not the diet itself.

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