I have such a love-hate relationship with research. On one hand I am amazed by the ability to conduct extremely controlled studies (controlling the environment, persons, and situations during a research study in order to test only what you intend to), the technology, and the ability to constantly question and challenge the status quo. On the other hand, research is often biased. It is impossible to get rid of all confounding variables (those things that are out of your control that might impact your results), and the findings presented to the public tend to be selective (one reason the low-fat myth lives on).
It's been a while since I talked about a research study, but two studies I recently read frustrated me because they provided conflicting evidence for the same diet. It reminded me that we can't always take what we read and hear as the absolute, especially when it comes to diet and health.
the ketogenic diet
A ketogenic diet is essentially an extremely low carbohydrate diet (think ~30 g per day which is the equivalent of two pieces of fruit or 2 slices of bread). The goal of a ketogenic diet is to restrict carbohydrates so much that the body switches to using other sources for energy. When this point is reached and maintained for some period of time (different for everyone) the body goes into a state called ketosis (best identified by urine ketone measurement). It takes careful planning to follow this diet and it is not the same thing as saying you are cutting out bread/pasta/high-density carbs. Remember, fruits and vegetables are carbohydrates, but even these must be restricted to some degree in order to achieve ketosis. The most common use of the ketogenic diet is in the management of seizures in children, and now adults. The idea that this diet might offer health benefits to all individuals is widely disputed. Some people swear by this diet, boasting weight loss, improvement in blood lipid profile (cholesterol) and increased energy, while some say it is dangerous. Of course, the research is just as conflicting...
I came across two articles this week. These are just two of many ketogenic diet studies that have been published over the last several years, and the results suggest different outcomes.
In this study researchers put obese subjects on a ketogenic diet for 24 weeks. The subjects lost weight and showed significant improvements in their biochemical blood markers (including triglycerides, HDL and LDL cholesterol, and blood sugar). This study suggested that the ketogenic diet could be used safely for an extended period of time to improve weight and health of obese individuals.
In this more recent study, a smaller sample size of obese and overweight men followed 4 weeks of a high carbohydrate diet and then 4 weeks of a ketogenic diet. The results were not as drastic as predicted. Researchers thought the ketogenic diet would lead to greater improvements in body composition and energy expenditure. The study found there was a small increase in metabolic rate after the ketogenic diet but weight loss was comparable between the groups. This study concluded that the ketogenic diet did not induce greater weight loss than an equal calorie high carbohydrate diet.
Depending on which study you read, your beliefs about this diet would likely be drastically different (for instance this summary of the more recent article may influence your views). I could argue for or against following the ketogenic diet. I could support the ketogenic diet and say the first study showed benefits because people were on the diet for longer and there were more subjects. I could say the second study did not show the benefits expected because subjects were given meals that were not consistent with their typical intake and they exercised which led to comparable improvements from both types of diets and did not last long enough to allow the ketogenic diet to show its benefit. I could also argue against the ketogenic diet and say just add exercise and cut back on what you eat to have improvements in weight and health.
Regardless of what you think when you read about these studies, it just drives home the point that self-education and yes, even self-experimentation are the best resources you have for finding out the best approach to weight loss and improved health. If you hear about a weight loss approach, don't take it to be the truth, look into the evidence for yourself. Research tends to support the need for more research as there is so much complexity when it comes to our body, metabolism, and weight loss.
Wondering my take on the benefits of the ketogenic diet? Well prepare to be disappointed. At this point I do not feel strongly for or against this approach. I know that the ketogenic diet helps a lot of children find relief from their epileptic seizures so from a medical standpoint it is a great tool. For others hoping to kick start weight loss I just can't advocate for this diet - at least not yet. I know many people have weight loss success and improved health by adapting this method. I also know people who would never be able to stick to this type of diet for the long term, regardless of what benefits it might offer them.
I really enjoyed this new analysis which looked at the combined results of many diet studies and found that we can and should eat (healthy) fats [known as a Mediterranean eating pattern] without needing to set limits, and in conjunction with protein and carbohydrates. I enjoyed this presentation of the research because it did not stress a specific, calculated regimen. Instead, it suggested that the inclusion of more fat rich foods such as fish, full fat dairy, oils, nuts and seeds can offer many health benefits. The best way to increase your healthy fat intake is to focus on whole, real foods, and cut back on the processed foods.
As I always say, and will continue to say: the key to weight loss is finding something that works for you and is sustainable for you. There is no perfect approach to a healthier lifestyle. Everyone is different, but everyone can benefit from including more real foods into their day.
So yes, research is important, yes it moves us forward, but take new findings with a grain of salt because there will always be research out there to contradict it.
Have you heard about the ketogenic diet? Do you follow a strict diet regimen? What are your thoughts after reading this?
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(you too can enjoy avocado brownies without regret)
Til next time.