Tuesday, May 14, 2013

Low Carb (Ketogenic) Dieting: An Argument for Paleolithic/Low Carbohydrate Lifestyle, Part 1

Low Carb (Ketogenic) Dieting: Part 1

Ketogenic, or low-carb, diets have been around for a long time, and are still terribly misunderstood.  I've decided to take some time exploring this topic in a series of posts.  Between reading copious amounts of literature over the years, and my own personal experience, I feel qualified to discuss, at length, this way of eating.  These will also be some of the very few posts in which I will be citing a number of studies that I have found to be excellent, as well as a lot of anecdotal evidence.

Part of what I've seen over the past year on the paleo and gluten free forums is that a lot of people use these two styles of eating for weight loss, but experience the opposite.  Why is that?  Well, their carbs are often times too high.  When the carbs aren't too high, their protein levels are.  To make matters worse, their fat intake isn't high enough.

Then, you have those who are of normal weight who choose one of these ways of eating just because they've figured out that conventional wisdom has it wrong. They soon find their weight creeping up, bit by bit.

I have also noticed that many athletes (excluding the endurance athletes) start eating this way--and they seem to thrive.  I've read in the forums how they eat and I see why.  They eat more fat than anything.  The endurance athletes usually drop off the map after about two weeks, saying that they feel sick and weak.  Why?  Because they aren't fat adapted.  If you're an endurance athlete, I'll explain why this happens, and how you can make things right.

I've decided to analyze every aspect of the paleo and gluten-free lifestyles, and how you can prevent weight gain, induce rapid weight loss, and not miss more than 2 or 3 weeks of your precious training time, when it is combined with a low-carb diet.  How you can, and should, stay in a ketogenic state for your entire life.  Why it is desirable to be in this fat-adapted state for life.

Finally, starting sometime next month, I will be posting photos of my own progress to a fitter, leaner me.  I will also post some videos of some of my workouts demonstrating that you don't need a gym to do weight training, or even a lot of space.  Before we dive into this series, those of you who are endurance athletes who think it impossible to cut your carbs so low, remember this:  I ran a full marathon (my first) in extreme desert heat, with nothing more than water, in a ketogenic state.  Without stopping.  It can be done.  Greater distances can, and have been done by others.  

The topics I’ll be covering over the next several posts (not necessarily in this order) will be:

·       What constitutes a low-carb diet, and why we should consider this lifestyle.
·       Kudos and problems with the Atkins Diet, and how to make Atkins work for you.
·       Why you want to keep your fat intake high, and why the type of fat you choose makes a difference.
·       Why you want to keep your protein intake moderate, rather than high—the dangers of too much protein.
·       What effect does a ketogenic diet have on sports performance—this will surprise you!
·       Metabolic syndrome, diabetes, autism, seizures, and heart health.
·       Why low-fat/high carb diets are such failures, even for the mere 1/3 of the population that can actually thrive on them.
·       Leg cramps, weakness, fatigue, and headaches:  Low-carb flu, or something else?
·       Cravings and how to beat them.
·       How long is safe to stay in a ketogenic state.
·       The difference between nutritional ketosis, and ketoacidosis.
·       Do calories count?

Wow! Lots to cover, so let’s jump right in.

What is a low-carb diet, and why we should consider it

Before you attempt a low carbohydrate diet, or decide to discard the notion completely, read everything in this series.

A diet low in carbohydrates is one in which carbs are limited such that you reach a state of nutritional ketosis.  This is when your blood ketones reach a level somewhere between 0.5 millimolar and 3.0 millimolar.  Going above this range is not beneficial, and potentially dangerous.  Most people will go into a state of ketosis when they consume less than 50 grams of carbohydrates/day.

The higher the level of ketones in your blood (within the therapeutic range listed above), the faster you lose pounds and inches.  To reach higher levels of ketones, simply reduce the amount of carbohydrate intake.  Reducing much below 20 grams/day is not necessarily a good idea, though, because that would limit the amount of vegetables you could eat such that you would lose out on the benefits of the fiber, vitamins, and macro-nutrients that your body needs.  Besides, it would simply not be sustainable for very long.  I have found that with 20 grams/day, I can burn fat while enjoying a wide variety of fresh vegetables, and stave off boredom.

One thing most people don’t realize—and why so many fail on low carb—is that Atkins, and others like it, are not high protein diets.  They also don’t realize that after the initial induction period of two weeks, that if weight loss drops off, they need to do a few things, the first of which is to decrease your calories. I know, I know.  You are considering this diet because you don’t want to count calories. Well.  Boo-hoo. Sometimes we have to do what we don’t want to do.  That’s life.

The second thing you have to do is add fat.  As counter-intuitive as this seems, it is exactly what you have to do.  So, how do you add more fat while cutting calories when you've already slashed your carbs down to 20 grams/day? You likely will need to cut your protein.  Later, I’ll explain why this isn't a bad idea.

Honestly, I’d advise using, from the start, a food tracker such as that found at www.caloriecount.com.  You can customize it for a low-carb diet, or just use it, as is.  Enter everything you eat, and at the end of the day, you can see the graphs that give you the percentages of fat/protein/carb consumed each day.  Most of your calories (68-80%) should come from fat.  Yes, you read that right.  If you don’t reach and maintain these levels you will not stay in a continuous state of nutritional ketosis, and you will not burn fat efficiently. Another 15-20% from protein, and only about 4-5% from carbs
If slashing your carbs to such a low level frightens you, let me assure you of this one, simple fact: Carbohydrates are optional.  Again, not a typo.  The only reason one would need to eat any carbs is to stave off boredom, and not have to take a daily truckload of vitamins and supplements.  There is no need to eat carbs unless you don’t get enough fat. (Phinney)

So, why would we want to enter a state of ketosis?  That’s simple: to enable our bodies to use our fat stores as a source of energy, rather than sugar.  This is extremely advantageous for a number of reasons.  The first being that even the fittest athletes (<10% body fat) have tens of thousands of calories at their disposal to use to fuel their activities.  This equates to days and days of readily available energy, provided their bodies are fat adapted, rather than sugar adapted.
In a ketogenic state, the body uses stored and dietary fat as its primary fuel source.  This is good, too, because our blood only carries the equivalent of 2 teaspoons of sugar, in the form of glucose, at any given time.  If we aren't efficient fat burners, we have to continuously refuel with carbohydrates because our bodies and our brains will be competing for the same blood sugars.  Since the brain can only utilize glucose or ketones for energy, the battle for the available glucose in our bodies will rage on—unless we find an alternate, readily available source of energy for muscle, organ, and cellular function.  This means ketones.  When a person is in a keto-adapted state, there is always plenty of fuel for everything.

Add to that the fact that when you are keto-adapted your insulin isn't spiking like mad, creating all sorts of inflammation which, in turn, creates insulin resistance—and eventually type II diabetes, high levels of blood lipids—increased risk of coronary artery disease and strokes, fatty liver disease, and metabolic syndrome, just to name a few.
According to world renown heart surgeon, Dr. Dwight Lundell, it’s inflammation, and not fat, that is causing the epidemic of death due to heart disease and other chronic illnesses.  Fully 25% of all Americans are on these expensive statins and low fat diets, yet the incidence of fatal heart attacks and strokes are not being reduced.  In fact, the opposite is true.

“These recommendations are no longer scientifically or morally defensible. The discovery a few years ago that inflammation in the artery wall is the real cause of heart disease is slowly leading to a paradigm shift in how heart disease and other chronic ailments will be treated.

The long-established dietary recommendations have created epidemics of obesity and diabetes, the consequences of which dwarf any historical plague in terms of mortality, human suffering and dire economic consequences.”  (Dr. Dwayne Lundell, 2012)

His entire article (cited below) is very worthy of a thorough reading. 
For this reason alone—regardless of your body’s composition or state of overweight/leanness—a ketogenic diet makes sense.

Kudos and problems of the Atkins diet, and how to make Atkins work for you

After reading the book, A New Atkins For a New You, I was left shaking my head.  After so much research has been done with regard to dietary phytates, phytoestrogens, lectins, and gluten, the authors are still calling grains—especially whole grains—healthy.  They also advocate the eventual addition of legumes.
What am I talking about?  These next few paragraphs will be a primer on phytates and phytoestrogens, and the negatives associated with them.  As for the gluten, well, most of you know enough about that, so I’ll only go over the absolute main reason for avoiding wheat, and gluten, in particular.

First, phytates.  Phytates, or phytic acids, are substances found in whole grains.  They bind to minerals such as magnesium, iron, manganese, and calcium,  thus, blocking their absorption.  Phytates exist in nature primarily  to ward off pests, including humans.  There is no scientifically sound reason to eat them, and since most of us don’t get enough quality nutrition—especially minerals—we have even more reason to steer clear.  While many foods contain them, even nuts and seeds, we can remove most of them by simply not eating the skins which is where the phytates are concentrated. Removal of the skins from nuts and seeds is done easily enough and without processing--the same can't be said for grains because the outer hull (bran) that contains the worst of these phytates. So, if you really have to break down and eat a grain, processed grains and not whole grains, are the lesser of two evils.  
Second, phytoestrogens. These are, as the name implies,  compounds that behave like estrogen in the body, and are found in whole grains, legumes, and to a lesser extent, nuts and seeds. Soy is the worst, with 3 times the amount of phytoestrogens than the other legumes and grains.  This is still an area that requires a great deal of study since, in my opinion, the human studies have been inadequate (usually 10 or less subjects).  Most other scientists agree with this opinion.  Most other scientists will also tell you that long-term exposure to estrogen (beyond your child bearing years) will increase your risk for breast cancer. (Barbour S. Warren)  So, I’ve decided to err on the side of caution, as should you, and not take the risk that those who are in favor of these compounds really don’t know if they’re right or not.  Also, since I don’t know who paid for all of them, I can’t attest to the veracity of them.  The one I have cited clearly states that more research in this arena needs to be done before anyone can call them good.

Thirdly, we have lectins, which are also found in whole grains, and are carbohydrate binding proteins.  What’s so bad about them, then, if they bind to carbohydrates? Well, because they also bind to insulin receptors, the human intestinal lining, and are linked with worsening leptin resistance. (Tell) (David L J Freed) (Tommy Jönsson)

Then we have our beloved “wheat.”  Since this particular grain no longer resembles the wheat our parents and grandparents consumed (genetically), let alone the original wheat from thousands of years ago (einkorn wheat), most people simply cannot tolerate wheat, let alone the gluten that is found in it.  What really blew my mind when reading the Atkins book was the fact that they push vital wheat gluten, the absolute worst part of the wheat.

Gluten, which is found mostly in wheat, barley, and rye, is a compound of gliaden and glutenin.  Those who have the worst response to these two compounds have a condition called celiac disease, and even the smallest amount—yes, even a crumb of cookie—causes them horrific health problems.  It is believed that 1% of the population suffers from this, though it can’t really be verified because not everyone gets tested.  Ok, so you likely aren’t a celiac.  Guess what? It is estimated that about 30% of the population tests positive for Antigliadin, or IgA. (Guyenet)  This is an antibody sent from the gut to ward off IgA.  So, because you have this immune response to fight something off, you’ve just increased your level of inflammation.  Eat enough of the stuff and you get chronic inflammation.  Bad news.
So, for a bunch of people who like to call themselves “trailblazers” in the nutritional arena they, like those they supposedly go against (pushers of the conventional wisdom), have fallen into the same damned trap when it comes to grains.  Grains, especially whole grains are NOT good for you.  They serve no useful purpose.  Period.  I just wish the good folks at Atkins would wake up with respect to this.

Now, don’t take my previous rant as an attack on the much beloved, Dr. Atkins, as I DO consider him to have been a trailblazer.  The thing is, he didn't have all of this information about grains and the hazards of gluten at his disposal.  He got the rest right though, and I am positive that if he were alive today he would be telling us all about the perils of whole grains in our diets.

One really excellent take-away that I did get from the book (and I got many) was that there is no such thing as the so-called “golden opportunity” with respect to low carb diets.  If you are not familiar with this phrase, it implies that you have one shot, and one shot only, at making Atkins work for you.  Well, that’s a lie.  Oh, so you've experienced it for yourself?  So have I.  But guess what?  It’s because we were doing it wrong, that’s why.  I have read a number of success stories on the Atkins web site (http://www.atkins.com/Program/Success-Stories.aspx) of people who were on and off the Atkins diet numerous times and still lost massive (>100 lbs) of weight, because they finally got it.

What were the rest of us doing that caused us to stop losing after the initial induction?  Cutting fat, increasing protein, not paying attention to total caloric intake, eating processed foods, consuming sugar alcohols by the truckload, etc., etc...

Next time, we’ll discuss these very pitfalls.
Until then...

Works Cited

Barbour S. Warren, R. A. (n.d.). Phytoestrogens and Breast Cancer. Retrieved from Cornell: http://envirocancer.cornell.edu/factsheet/diet/fs1.phyto.cfm
David L J Freed, A. (n.d.). Do dietary lectins cause disease? Retrieved from US National Library of Medicine ,PubMed: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115436/?tool=pubmed
Dr. Dwayne Lundell, M. (2012, March). World Renown Heart Surgeon Speaks Out on What Really Causes Heart Disease. Retrieved from Prevent Disease: http://preventdisease.com/news/12/030112_World-Renown-Heart-Surgeon-Speaks-Out-On-What-Really-Causes-Heart-Disease.shtml
Eric Westman, J. V. (2010). A New Atkins For a New You. NYC: Fireside/Simon & Schuster.
Guyenet, S. (n.d.). Gluten Sensitivity: Celiac Disease is the Tip of the Iceberg. Retrieved from Whole Health Source: http://wholehealthsource.blogspot.com/2008/12/gluten-sensitivity-celiac-disease-is.html
Howard BV, M. J. (2006, January 4). Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial. Retrieved from PubMed.gov: http://www.ncbi.nlm.nih.gov/pubmed/16391215
Phinney, J. V. (2011). The Art and Science of Low Carb Living. Beyond Obesity LLC.
Phinney, J. V. (2012). The Art and Science of Low Carbohydrate Performance. Beyond Obesity LLC.
Tell, P. C. (n.d.). US National Library of Medicine . Retrieved from PubMed: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC433288/
Tommy Jönsson, S. O.-H. (n.d.). Agrarian diet and diseases of affluence – Do evolutionary novel dietary lectins cause leptin resistance? Retrieved from BioMedical Central: http://www.biomedcentral.com/1472-6823/5/10


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