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What is the Keto diet and will it help me lose weight?

3/13/2018

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The Keto diet is the newest diet fad that is making celebrities put butter in their coffee and banish all carbs including fruit!  This is the exact opposite of what most of us have been told all these years about weight loss!  So does it work and will it help me lose those extra pounds?

For many years counting calories and focusing on low fat foods was the diet mantra that prevailed.  This was supposed to help you lose weight and help promote cardiovascular health.   As obesity has ballooned, this prevailing theory has been questioned.

First, lets review some basics about metabolism.  The primary fuel of our brain and different organs is sugar, aka glucose.  However, the body stores a limited amount of glucose in the liver.  So, if we are starving or focused on consuming only proteins and fats and eliminate carbohydrates from our diet, our liver will have used up all its glucose stores.  The liver then starts to break down fat into a usable energy source called ketone bodies.  So there are two ways to get the body to start breaking down all its fat stores:  fasting (or starving) is one option and the other is to eat a diet very low in carbohydrates.   In reality, this means eating only meat, cheese, butter, oils and nuts.  All grains, breads, fruits, and sugar are off the table.  Another reason this diet is so effective is because it decreases insulin release.  Increased insulin release promotes weight gain and fat storage instead of breakdown.

This sounds great.  I get to eat greasy food as long as it’s low in carbohydrates and lose weight.  Of course this was the same premise of the Atkins diet.  In the short term, the Atkins diet worked well.  It worked well mostly because it helped control appetite.  However, most studies showed that at the one year mark, it performed equally poorly when compared to other fad diets.  Despite its focus on the science of metabolism, it failed to produce the results desired because people had a hard time sticking to this diet.  Avoiding breads, pastries, and pasta in the long run was more difficult that the dieters had realized.  The average dieter had a hard time maintaining this diet for even six months.

There are two groups of people that have seen a lot of success with the Keto diet.   Neurologists have been using the Keto diet to treat patients with epilepsy.  Researchers noticed in the 1920’s that patients experienced fewer seizures when fasting.  Again we are not sure about the mechanism for why this works.  However, epilepsy patients that are refractory to medication are noted to have fewer seizures on a Keto diet.  Another group that has shown some benefit on a Keto diet are type 2 diabetics.  With type 2 diabetes, the body cannot produce enough insulin to move glucose from the blood into the cells.  By decreasing carbohydrate intake, the body requires less insulin to manage blood sugars.   Type 2 diabetics that have adopted the Keto diet have shown considerable success in being able to not only  reduce their reliance on medication but also decrease their hemoglobin a1c ( a measure of blood sugar).   

If you have type 2 diabetes or epilepsy, talk to your physician about the benefits of the Keto diet.   However, if you are doing the Keto diet strictly for weight loss, your success will really be related to how long your discipline will hold strong- I guess just like any other diet.  No cheating allowed ;)

Dr. Pam
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