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09_10_19---Keto-Diet-Questions-Answered-Blog-2

Keto Diet: Your Questions Answered

Chances are you or someone you know has tried the keto diet. This high-fat, very low carbohydrate eating plan is enticing for many because of its promise for quick weight loss. We had the opportunity to ask Dr. Sears some questions about the keto diet and get his thoughts on the plan. See why he says the cons far outweigh the pros and why you may want to think twice before jumping on this trend.

Question: What is the Ketogenic Diet?  

Answer: The keto diet is a high fat, very low carbohydrate diet. This reduction in carbohydrates puts your body into a metabolic state called ketosis. This only occurs when there is not enough stored glycogen in your liver to convert fatty acids completely to carbon dioxide and water (i.e. a clean burn). In ketosis, the fatty acids are not completely burned to make ATP, so you make less energy. Contrary to popular belief, ketones are not a good source of energy for the brain as glucose remains the preferred fuel source for ATP production in the brain. 

Question: What do you consider the pros and cons of this eating plan?

Answer:  With this eating plan the cons greatly outweigh the pros.

Pros:

  • Rapid initial weight loss in three days is primarily due to loss of retained water, but not stored body fat. So, if you are thinking only about weight loss, this could be considered a pro.
  • Less thinking by removing carbs from the diet. 
  • Less hunger by eating more protein.
Cons:  
  • Acetone is one of the ketone bodies produced during ketosis. Acetone is also the primary chemical in nail polish.
  • A ketogenic diet increases calcium loss from bones.
  • High levels of dietary fat on a ketogenic diet will reduce the likelihood of using stored body fat for energy unless you have significant calorie restriction at the same time. 
  • Lack of ATP production on a ketogenic diet makes it easier to become fatigued with mild exercise. 
  • After seven days on a keto diet, eating a single “cheat meal” (one high in carbohydrates) causes damage to the blood vessels.   
  • Lack of polyphenols on a ketogenic diet makes it difficult to activate the genes required to optimize your metabolism by improving the efficiency of the mitochondria in converting fat into chemical energy (ATP). 
  • There is no difference in weight loss on a ketogenic diet compared to a low-fat, high-carb diet in long-term studies. 
  • Careful studies have demonstrated there is no "metabolic advantage" on a ketogenic diet and that the fat loss on the ketogenic diet is the same as a low-fat, high-carb diet with the same number of calories in the short-term.  
  • Lack of fermentable fiber due to lack of carbohydrates leads to compromised gut health and increased likelihood of developing a leaky gut (condition in which bacteria and toxins can "leak" through the intestinal wall), which can become a significant source of inflammation. 
  • Build-up of cortisol levels to convert muscle mass to glucose for the brain which is the preferred fuel source for the brain.  Excess cortisol increases insulin resistance which makes you regain the lost weight body as fat, depresses the immune system making you more likely to get sick, and destroys memory cells in the hippocampus. 

Question: A main component of the diet involves your body going into “Ketosis”. How does this happen?  

Answer: To completely metabolize fat to carbon dioxide and water, you need to have a sufficient level of carbohydrates in the liver stored as glycogen.  The liver glycogen is also the primary storage site for glucose that can be used to replenish blood sugar levels to maintain adequate glucose for the brain.  If the carbohydrate levels are too low in the liver, the incoming fat is not completely metabolized and because of this incomplete fat burning metabolic products known as ketones begin to appear in the blood.  These are recognized as foreign and the body increases urination to remove them. That's why ketogenic diets deliver early weight loss but primarily in the form of dehydration.    

Question: Do people see real benefits or is this just another fad?    

Answer: A true ketogenic diet is also a calorie-restricted diet since it is difficult to consume high levels of fat without carbohydrate. Calorie restriction itself will have benefits by lowering the levels of inflammation, but only if protein, fat, and carbohydrates are relatively balanced as shown in highly controlled clinical studies. In fact, those studies indicate that a ketogenic diet is a pro-inflammatory diet.

Question: Would the keto diet make you gain weight?

Answer: There is no such thing as a “metabolic advantage” to a ketogenic  diet. Fat loss is simply a matter of calorie reduction.  A ketogenic diet reduces the minimum blood glucose levels needed for brain function so much that the body is forced to increase the secretion of cortisol which breaks down muscle mass into glucose for maintaining brain function. As cortisol levels build up, this causes an increase in insulin resistance resulting in elevated insulin levels which causes weight to regain. This problem is more apparent in females than in males.  

Question: How does the keto diet impact gut health?

Answer: Gut health requires both fermentable fiber and polyphenols coming from vegetables, fruits, and whole grains. A ketogenic diet will likely be deficient in both. In addition, saturated fatty acids (especially palmitic acid) found in ketogenic diets enable the transport of microbial fragments into the blood which will increase inflammation. A ketogenic diet is usually rich in saturated fats, especially palmitic acid which is the most pro-inflammatory saturated fat.

Fermentable fiber is the source of nutrition for the bacteria in the gut and without adequate levels, the bacteria will start digesting the mucus barrier that is your first line of protection against a leaky gut. Polyphenols disrupt the biofilms used by pathogenic bacteria to evade detection and destruction by the gut's immune system. Anything that disrupts gut health is a leading cause of microbial-induced inflammation. There is nothing magical about a keto diet and careful studies have demonstrated it offers no metabolic advantage. It works for weight loss because it is also a calorie-restricted diet.{{cta('72aca16a-1bab-4262-84b4-f4d2e40c1279')}}

 

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062524---Keto-Blog

Ketogenic Diets and Aging

Chances are, you or someone you know has tried the keto diet at some point in time. This high-fat, very low-carbohydrate eating plan appeals to many due to its promise of rapid weight loss. In this blog, Dr. Sears explores some of the latest scientific findings on ketogenic diets and provides caution before hopping on this trend. What is a Ketogenic Diet? The ketogenic diet is a high-fat, very low-carbohydrate eating plan. This significant reduction in carbohydrates to induce a metabolic state is called ketosis. This only occurs when there is not enough carbohydrates in your liver to completely convert fatty acids to carbon dioxide and water. The normal conversion generates the chemical energy (ATP) that keeps us alive. In the absence of ketosis, each fatty acid generates 108 molecules of ATP when oxidized in the mitochondria. Ketone bodies make less ATP when they are metabolized by mitochondria. How much less? About five times less. This is like switching the gasoline in your car from high-octane fuel to low octane fuel as ketone bodies increase in the blood. Furthermore, contrary to popular belief, ketones are not an ideal energy source for the brain, as glucose remains the preferred fuel for ATP production in brain cells. Lack of blood glucose is a highly stressful situation for the brain. This is why the body secretes the stress hormone cortisol from the adrenal glands during ketosis to breakdown protein and convert the amino acids into glucose for the brain. This explains why even under complete starvation for 38 days, the blood glucose levels never dropped below 68 mg/dL. This is still considered as a normal blood sugar level. Where did this blood glucose come from if there was none in the diet for 38 days? The answer is neo-glucogenesis primarily using lean body mass. Ketogenic Diets Pros and Cons Interest in ketogenic diets rises and falls about every 20 years. They’re very low-carbohydrate diets that claim that carbohydrates make you fat and keep you fat. This is simply not true. It is not carbohydrates per se but a disrupted metabolism that makes you fat. To be more specific, it is the inhibition of AMPK, the master regulator of your metabolism that makes you fat. Why? As AMPK activity increases, you burn stored fat faster. Frankly, I’ve always been amazed by the re-emergence of ketogenic diets. Eighteen years ago, I published the premier clinical study demonstrating that, under equal calorie intake in which all the food was provided to the subjects for six weeks, the Zone Diet was better than a ketogenic diet in reducing total weight, excess body fat, and inflammation. Now, a recent study revealed some more very concerning findings about the long-term effects of ketogenic diets. This new study indicated that following a keto diet causes a rise in senescent cells, popularly known as “zombie cells.” Zombie Cells are damaged cells that no longer divide but don't die. That’s bad enough, but zombie cells continue spreading inflammation throughout the body. As the number of zombie cells increases in your body, they become a living nightmare. Why? Zombie cells accelerate aging because they cause the earlier development of many chronic diseases. In this study they found that zombie cells in the animals began to appear while they were on a ketogenic diet. The zombie cells then disappeared when researchers changed the diet to a “non-ketogenic diet” (i.e., the Zone diet). And when the animals were given a Keto diet again, the zombie cells reappeared. Notice a trend? If you want to hear more about this study you can listen to our recent podcast at Dr.Sears.com. Based on earlier blogs, this adds to the list of downsides for following a ketogenic diet versus the Zone Diet. PROS Rapid initial weight loss: This is primarily due to the loss of retained water from the glycogen stores in the liver, which is rapidly used up to maintain blood sugar levels. Since these glycogen stores in the liver contain significant levels of retained water, much of the initial weight loss is water rather than stored body fat. If your main goal is loss retained water, this can be seen as a benefit. Of course, going to a sauna would also work. Reduced hunger: Ketogenic diets are rich in protein. Any increase in protein intake can help reduce hunger. CONS Production of acetone: One of the ketone bodies produced during ketosis is acetone, which is also the main chemical in nail polish. Increased calcium loss: A ketogenic diet can lead to higher calcium loss from bones. Limited fat utilization: High levels of dietary fat reduce the likelihood of using stored body fat for energy unless you also significantly restrict calories. Reduced energy levels: The lack of ATP production on a ketogenic diet can lead to easier fatigue during mild exercise. Damage from cheat meals: After seven days on a keto diet, a single high-carb cheat meal can damage blood vessels. Lack of polyphenols: This makes it difficult to activate genes that optimize metabolism by improving mitochondrial efficiency in converting fat into ATP. No long-term weight loss advantage: Long-term studies show no difference in weight loss between a ketogenic diet and a low-fat, high-carb diet. No short-term metabolic advantage: Careful studies demonstrate that fat loss on a ketogenic diet is the same as on a low-fat, high-carb diet with the same caloric intake. Compromised gut health: A lack of fermentable fiber from carbohydrates can lead to poor gut health and an increased risk of developing a leaky gut, which can cause significant inflammation. Furthermore, short-chain fatty acids (SCFA) are the metabolic product of fermentable fiber. These SCFA are powerful epigenetic signaling agents that enhance gene transcription. Ketosis generates a different type of hydroxylated short fatty acid (3-hydroxyl butyrate, that has no effect on gene transcription. In addition, the lack of SCFA has significant negative consequences on the gut-brain axis. Cortisol build-up: To produce glucose for the brain, cortisol levels increase to breakdown protein to make sufficient glucose via neoglucogenesis. Excess cortisol can lead to insulin resistance that cause regain of some of initially loss body fat. In addition, increased cortisol levels cause a depressed immune system as well as destruction of memory cells in the hippocampus. The initial benefits of following the ketogenic diet result in some initial weight loss (primarily water weight rather than fat loss), long-term studies show no significant differences in overall weight loss. Now new findings show a ketogenic diet may lead to significant adverse health consequences by accelerating the formation of zombie cells. Call me crazy, but I feel the key to longevity and wellness comes down to better metabolic control instead of living in a constant state of ketosis. Following Metabolic Engineering® for a lifetime provides that pathway of losing body fat without ketosis. References 1. Johnston CS, Tjonn SL, Swan PD, White A, Hutchins H, and Sears B. “Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets.” Am J Clin Nutr 2006 83:1055-61. 2. White AM, Johnston CS, Swan PD, Tjonn SL, and Sears B. “Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study.” J Am Diet Assoc. 2007 107:1792-1796. 3. Sung-Jen Wei, Joseph R Schell, E Sandra Chocron, Mahboubeh Varmazyad, Guogang Xu, Wan Hsi Chen, Gloria M Martinez, Felix F Dong, Prethish Sreenivas, Rolando Trevino Jr , Haiyan Jiang, Yan Du, Afaf Saliba, Wei Qian, Brandon Lorenzana, Alia Nazarullah, Jenny Chang, Kumar Sharma, Erin Munkácsy, Nobuo Horikoshi, David Gius. Ketogenic diet induces p53-dependent cellular senescence in multiple organs. Sci Adv. 2024 May 17;10(20):eado1463. doi: 10.1126/sciadv.ado1463. 4. Owen OE, Felig P, Morgan AP, Wahren J, Cahill GF Jr. Liver and kidney metabolism during prolonged starvation. J Clin Invest. 1969 Mar;48(3):574-83. doi: 10.1172/JCI106016. 5. Chriett, S., Dąbek, A., Wojtala, M. et al. Prominent action of butyrate over β-hydroxybutyrate as histone deacetylase inhibitor, transcriptional modulator and anti-inflammatory molecule. Sci Rep 9, 742 (2019). https://doi.org/10.1038/s41598-018-36941-9. 6. Silva YP, Bernardi A, Frozza RL. The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication. Front Endocrinol (Lausanne). 2020 Jan 31;11:25. doi: 10.3389/fendo.2020.00025. 

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050824---Tofu-Blog

Tofu: Tips and Recipes Ideas

I have been eating tofu for a very long time, much longer than the 30 or so years I have been following the Zone Diet. Back then many of my favorite recipes came from the Tassajara cookbooks by Edward Espe Brown, the celebrated chef from the kitchen at California’s famous Zen Mountain Center, and cookbooks by Louise Hagler, a.k.a. Wendy Louise, a well-known authority on vegetarian cooking who is associated with a community in Tennessee known as The Farm. Those books are still among the best resources for tofu recipes. My mantra has always been if you don’t like something, don’t eat it. Keep this in mind if you’re new to tofu, start slowly by combining it with flavors and foods you like.    Tips and Suggestions    Firm-sprouted tofu is my preference for the Zone Diet. Unlike traditional tofu, which contains significant amounts of both protein and carbohydrate, sprouted has almost no carbohydrates. It’s lighter tasting, refreshing, and very filling.   Freezing tofu results in a chewy, sponge-like texture. I don’t recommend freezing, but some people prefer it when using tofu to substitute for meat in a recipe.    Baked tofu comes in a variety of flavors and makes an excellent quick meal with some vegetables and fruit added. It’s also great in salads.     Tofu made it into the book “The Top 100 Zone Foods” by Barry Sears.    Some recipes call for draining the tofu first. I find that usually isn’t necessary.   Tofu takes on the flavor of whatever is added to it.    Add nutritional yeast flakes to give a cheesy flavor to vegan tofu scrambles and dips. It’s also rich in protein and vitamin B12.   Cherry Vanilla Tofu “Ice Cream”   Tip: This doesn’t freeze or store well, so prepare only the amount you plan to serve immediately.   Using an immersion blender or a food processor blend equal parts of frozen dark cherries and firm tofu, plus some vanilla extract (preferably alcohol-free for best flavor). Serve immediately.  Tofu Scramble  This is great for breakfast, lunch, or dinner, and we’ve even brought it on long day hikes for a snack.   Crumble some firm tofu and stir in a generous amount of seasonings, taking care not to overdo it with the salt. Heat in a well-seasoned or nonstick skillet with a little Zone-friendly oil to the desired doneness.    Optional: If time allows, sauté some chopped onion in the skillet before adding the tofu and seasonings.    My favorite seasoning combination for this dish at my house is onion powder, garlic powder, turmeric, paprika, some oregano or thyme, nutritional yeast flakes, salt, and ground black pepper. The yellow color of the turmeric makes it somewhat like scrambled eggs.   Tofu Veggie Almond Pasta Salad   Dressing: Thin some smooth almond butter by stirring in some water, a little vinegar, and either soy sauce or Bragg’s Liquid Aminos (an unfermented soy sauce found in the health food section of most grocery stores).    Toss together cooked Dr. Sears’ Zone PastaRx Fusilli, tofu cut into cubes, matchstick cut red bell pepper, chopped green parts of scallions (a.k.a. green onions), and the almond butter dressing. Serve immediately or chill to serve later. It will keep well in the fridge for two or three days.   Use your imagination and see what you can come up with.  Experiment and have fun with it. Try using tofu to make cheesecakes, whipped desserts, tofu chocolate pudding, tofu “cream” based soups, tofu pot pie (think chicken pot pie), tofu burgers, tofu burritos, Buffalo tofu (like Buffalo wings), layered Mediterranean dips, tofu “meatballs”, grilled tofu, and more.    Enjoy! 

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