I had a reader email me a blog post request and it’s taken me a while to write it up because in all honestly…I knew this would take some time to formulate all my thoughts into a concise blog post. So this is my attempt š
The ketogenic diet is the next trendy thing in the health and fitness world. And I think it’s fair to call it a trend given the increasing emergence on social media and in the news over the past year. I know a lot of people want to call it a lifestyle…but if it looks like a diet and acts like a diet and has diet in the name….can we accept the reality and call it a diet? It’s a diet. Anything that requires you to count macros, pee on a stick and eliminate entire food groups is a diet. I use to call a lot of ways I ate a “lifestyle” too – but really that was me just being in denial that I was on a diet because I was eating according to rules. No matter what we choose to do in life – because we can choose whatever we want – we have to own and acknowledge what we’re doing and why we’re doing it.
What is the ketogenic diet?
What does that even mean? In essence, the ketogenic diet forces your body into a state called ketosis because you limit your carbohydrate intake to a very low amount. How does it do this? Your body stores energy in a few ways. Two of those ways include storing glucose in your liver and muscles as glycogen. Your muscles and liver can store short term energy for our bodies (more or less depending on your individual body) and when your glycogen stores are filled up, your body stores energy in your fat cells for more long term energy. This is a good thing, our fat cells do a lot for our body beyond providing energy, including good hormonal health. When you eat a very low carbohydrate diet, you are not taking in enough readily available energy for your body. Your body compensates for this shortage and uses its glycogen stores first for energy. After all your glycogen stores are gone, usually within 24 hours, your body then turns to fat and breaks it down for fuel.
Stick with me here. Your body uses fat for energy and also converts some of that fat to these highly energy efficient molecules called ketones. One of the biggest reasons your body needs to create ketones is for your brain. Your body can use fat as energy for many cells in your body, but your brain cannot use fat for energy – fat can’t support the function of your brain. Your brain prefers glucose for energy, but when there isn’t enough glucose on board your body makes ketones from fats and uses those ketones to fuel your bran. This is why if you restrict your calorie intake or time or you have ever experienced an eating disorder, it’s really hard to think and stay focused. Your brain is starved.
Thinking about this from a very high level, even before we get into the science, this doesn’t sound like a way your body is suppose to function. You are forcing your body into a starvation state where it will utilize a metabolic mechanism (breaking down fat for ketones to be used for energy) that is there for survival when your body experiences famine or prolonged periods without food. This is a survival mechanism your body uses because it’s smart and knows how to adapt to extreme circumstances and survive, this isn’t necessarily how your body is suppose to function on a daily basis. If you are actually not starving but eating food (like you would be with eating protein and lots of fat on a ketogenic diet) your body doesn’t have to break down muscle for energy like it would if you were starving yourself or actually experiencing famine. Regardless if you are starving or not, your body is put in a harder working state because there isn’t readily available energy to be used. A state that is used for survival when the environment is not favorable.
Ok, whew. Are you still with me? Now that we can understand more about how our body works let’s talk about what this means for your overall health – physical, mental and emotional.
How does the ketogenic diet affect our bodies
First, it seems most people are intrigued by this way of eating for weight loss and not health. But we have to recognize it as a diet. Any way of eating that applauds weight loss, tells you to count points or macros or calories is a diet. Any way of eating that labels certain foods or food groups as bad or damaging or off limits and other foods or food groups as good or allowed or permitted is a diet. Diet culture is a system of beliefs that equates thinness to health, encourages weight loss as means of success and demonizes certain ways of eating while glorifying others. So no matter what label you want to throw on eating – paleo or vegan or keto or raw or low carb or whatever – if it aligns with any of the above it’s a diet.
This isn’t to shame people who have been on diets, are currently dieting or health professionals promoting diets. We’re all affected by diet culture. I’ve been there, peddling vegan diets like they were the epitome of health and dabbling in paleo eating…I made naive and ignorant claims about certain ways of eating. And while I thought I was in control of my food, my food choices actually controlled much of my life. We’re all in our own personal (and professional) process. Diet culture is sneaky and sometimes we don’t even know we’re stuck in it. But if we can lift our heads and get really honest with ourselves we can begin to recognize these sexy, enticing “lifestyles” as diets and start to question the validity of these claims.
Diets lead to disconnection from the body’s internal cues and instincts about food. They lead to disordered and obsessive eating habits and a yo-yo cycle that many people find themselves in for decades or their whole lives, oscillating between being “on track” and then “falling off the wagon” – whether that’s in the types of foods you eat, the amount of food you eat, when you eat or all three. Food and exercise and body thoughts take up so much precious brain space.Ā Diets don’t lead to sustainable, health promoting behaviors. The research is clear that calorie restriction and dieting long term does not work. In the short term perhaps, but our bodies are clever and they start metabolically compensating for macronutrient and/or calorie restriction.Ā We also know from the research that health and weight are two very different things. Although weight can be correlated with health conditions and chronic disease it is not the cause. Causation and correlation are two different things. Just like eating celery won’t prevent you from chronic disease, being at a certain weight or eating a certain food won’t cause a health condition.
As I sat down to write this post my mind was all over the place because you could tease through and debate the scientific research on ketogenic and low carb diets for months. And honestly, we could debate the details of nutrition until the end of time. And sometimes I don’t think that leads to healthy place, debating nutritional minutiae. But can we come to a place of understanding and really take a step back and ask if things are true. There is a lot of conclusions drawn in headlines and articles without supportive evidence. I spent hours digging through the ketogenic research and theĀ one research article that claims improved blood pressure, cholesterol and blood glucose levels was possible in addition to weight loss with a ketogenic diet carries little, if any actual evidence. The subjects were put on a 20 day ketogenic diet, 20 day low carb diet, 4 months of the Mediterranean diet, 20 days of ketogenic diet again and then 6 months of the Mediterranean diet. When I began reading the study and the dietary intervention, you can see that the ketogenic and low carb phases also included an average intake of less than 1200 calories. Beyond restricted carbohydrates, that’s a calorie restricted diet. Second, there was no control group. So what are we even comparing this intervention to? You can’t claim this way of eating lowers blood pressure, cholesterol and blood glucose if you didn’t compare it to anything else. It’s highly likely that health promoting behaviors like moving your body, eating vegetables at dinner and getting good sleep will do these things too.
I’ve heard many women ask about keto and low carb diets helping with PCOS. There are many reasons why low carb diets are not good for PCOS – and underwhelming research to show otherwise. When I was researching, I kept coming across this one study people were using to validate keto diets with PCOS. ButĀ this study has many problems that make this poor evidence.The sample size to begin with was 11 and by the end of the 24 week study peroid, six women had dropped out leaving only 5 women in the study. There was no control group – so again, what are they comparing this dietary intervention to? Another huge thing to note is that the lab measurements in the study were not taken at specified points during the menstrual cycle. So you can’t conclude much.
These are just a couple of the studies but the theme seems to weave throughout. What are we comparing this research to and what are the long term effects? If there does happen to be some reliable research that anyone reading has come across – I genuinely want to read it and am open to discussion on this so please share!
Beyond food
Improving hormonal health, insulin sensitivity, and other biomarkers such as blood glucose and cholesterol is SO MUCH MORE than food. There are many other aspects of life that contribute more to your health than food alone. This research studyĀ (which had a control and intervention group) showed how a yoga program aloneĀ improved AMH, LH and testosterone levels in adolescent girls. All these hormones are typically elevated in PCOS and the yoga improved levels without anything to do with diet or weight. Sleep has a huge effect on how our body copes with blood sugar. This study shows the impacts of poor sleep on insulin.
I think what’s really interested is that there’s researchĀ that shows us the mere act of monitoring your food intake increases perceived levels of stress. And increased stress isn’t a positive contributor to our health. I would think there is a lot of perceived stress involved with monitoring the percentage of carbs and protein and fats that go into your mouth. Social situations become stressful and isolating. Unless every single one of your friends is eating keto and every social event you go to caters to your keto diet you have to constantly be thinking about what you’ll eat. Our social and emotional health has HUGE impacts on our physical health. I know for me, I’d be in a suboptimal mental and emotional state if I was spending so much mental energy and time measuring, weighing and counting my food.
Even if there were some long term positive health outcomes with this way of eating (and any other diet for that matter) that were well studied, the question is….what is the benefit compared to overall healthy living and caring for your body? Eating a wide variety of nourishing foods, eating satisfying foods, engaging in meaningful relationships, moving your body in a joyful way, getting enough sleep and resting your body when it needs to rest vs being productive and busy all the time. Truly caring for yourself and being kind to yourself. Line that way of eating and moving and living up against any diet that involves all this nutritional minutiae of this many grams of that and this one specific food over that and it doesn’t matter. I haven’t found a study to do that yet, but comparing the two, I don’t think you would find significant, long term health benefits to eating in a regimented way.Ā We spend so much time debating the nitty gritty details and I think we’re missing the bigger picture.
There are extreme health circumstances that call for extreme therapies. Ketogenic diets have been well studied in the treatment for epilepsy. Gluten free diets have been well studied in the treatment of Celiac disease. Those are extreme health conditions that could warrant dietary changes to better one’s health. But the majority of us thankfully don’t have to face these health conditions.
These types of eating and promises are really tempting and enticing. I’ve been there too, gripping onto quick fixes and black and white ways of controlling because that brings more instant gratification. We don’t have to deal with our emotional and psychological relationships with food and our bodies if we just follow some rules. Diet culture is hard to detect – it’s engulfs us. We’re all swimming in it. And unlearning all these messages we’ve been taught is really really hard. Digging through that hard and painful stuff, letting go of control and learning to trust your body’s intrinsic ability to tell you what it needs is hard. That’s not black and white, it’s really grey and murky.
But we know this way of eating and moving intuitively, of learning to care for yourself and enjoying your life…that’s what leads to long term health. Not all the nutritional nitty gritty details that we hyperfocus on in an effort to find the one thing that we’re missing. Often, we’re actually so focused on the tiny details that we overlook the big picture that actually matters.
If you find yourself triggered by alluring diets or ways of eating or exercising or somebody else is sharing how amazing they feel and how great ____ Ā is… ask yourself this, “Is that in line with my values?” “Is that was really matters to meĀ in life?” “Do I want to spend my days counting and measuring my food or obsessing over the nuances of nutrition?” If that works for them, that’s okay and they can do that. But that doesn’t mean it should or can work for you. We all get to freely make our own choices.
This is a GREAT article. Thank you!!
Very informative. Dr. Joel Kahn just offered a similar perspective on Rich Rollās podcast. I think you would enjoy.
I’ll have to check it out – thanks!
Robyn hi! Many people are using this idea that babies are in a ketosis state while breastfeeding to promote the keto diet.
Do you have some resources to refute this statement?
Thanks
Thank you so much for this article! I can tell you put so much time and thought into it.
Do you have advice on how to help family members understand that extreme diets are not the way to go when it seems to be “working” for others? My aunt and uncle have been on A ketogenic diet for a few months and have lost crazy weight. Not only that, one has claimed to have no more arthritic pain in their hands. The other claims to be “diabetes free”. My parents efforts to make small, long lasting life style changes are not giving them the same results (at least not as quickly) and they are so tempted to try out the keto diet.
I think that’s really hard. These sorts of conversations can be really emotional and touchy. I think the best thing we can do is listen with empathy and understanding and live by example. I think the key thing you wrote was “as least not as quickly” and I truly believe that is the difference between “diets” and lifestyle change. Lifestyle change isn’t instant gratification and a quick fix…but it is sustainable and long term. It so easy to latch onto that long hanging fruit, but just like everything else in the diet world…it just doesn’t work long term and the research shows us that. Hope that helps!
Robyn, thank you for writing this. I have a few friends doing this and have looked into it with much the same return info you shared. It’s yet another “diet” and the idea of that give me a huge amount of anxiety. I stick with my everything in moderation and adding more movement to my lifestyle. This was a great read. Again, Thank you.
I’ve learned to kind of tune people out when they start talking about diets like this and preaching all the health benefits…too often before I’ve let it annoy me and then started arguments about how UNhealthy it is. Anything with so many rules around food is a DIET, I don’t care what kind of “lifestyle” disguise they put on it. Bye Felicia!
Also, fully unrelated, but the soup pictured somewhere in the middle of this post looks sooooo good
haha my mom made that š
Robyn, thank you for being such a strong voice. I love that you advocate for living life by your own values. Itās so easy to fall into the āshouldsā and comparisons, and your blog is a consistent permission to stay in my own lane. Thank you for this article and for all you do!
Love that – “stay in my own lane” I’m remembering that too!
Thanks for putting in the time to research and write this article! I agree- Keto diets are very trendy right now. I’m going to post this for my friends to read who are currently on this diet. You’ve inspired me to start my own blog a few months back, and your gentler, “big picture” idea of health is just like mine. I too believe we need to stress way less about food, exercise, and our bodies, and instead trust that our body knows what it wants and needs. We shouldn’t be using diets and exercise as a way to obtain the “perfect” body/lifestyle, but rather open up to the idea that we’re all different and that THAT’S OKAY. We need to live in our truths.
Yes yes yes! You worded that so perfectly.
Instead trust that our body knows what it wants and needs…. open up to the idea that weāre all different and that THATāS OKAY. We need to live in our truths.”
I largely agree with you here, but I would really love for you to write your thoughts on veganism/vegetarianism. You literally called both of these “diets,” but fail to point out that there are different kinds of diets. Straight up if you google the word “diet” the first definition is “the kinds of food that a person, animal, or community habitually eats”, and the second definition is the more demonized definition you talk about a lot: “a special course of food to which one restricts oneself, either to lose weight or for medical reasons.”
I think it’s a bit unfair to label vegan and vegetarian diets the same way as ketogenic diets, because while I know there are people who use them for weight loss or as an ED strategy or whatever, a lot of people make the decision purely for ethical reasons. There is no evidence to support that, in a regular healthy person (i.e. no mental or physical disorders), a properly executed vegetarian diet can be “harmful.” This of course is understanding that you have to be clever to ensure your body intakes enough vitamins and minerals it would otherwise mostly get from animal products, such as vitamin D and zinc. It would just be nice for you to acknowledge these as perfectly valid, healthy lifestyle choices that need not be lumped in with all “diets.”
100% yes
Hi Mallory! As you read to the end of my description of diets it ends with, āif it aligns with any of the above itās a diet.ā so foods choices made purely for ethical/religious reasons wouldn’t align with that.
I agree! Iām a plant based eater who has lost 0 pounds and actually gained to what I perceive as my set point. Iām happy. My body feels good. And I eat whatever I want when I want. Just because I donāt eat animals doesnāt mean Iām on a diet.
Otherwise this article was great! I sincerely worry about the long-term health implications of low carb on cognition & memory.
Hi Tara! As you read the whole paragragh you’ll see that I end the sentence with, “if it aligns with any of the above, it’s a diet” so food choices made for reasons outside of diet culture are separate. Glad you enjoyed the article!!
Intuitive eating vegan here! I think vegan diets donāt fall into Robynās definition when they arenāt restrictive. There are no vegan foods I donāt eat. I also recognize the reality that animal foods are not inherently unhealthy when eaten in moderation. My veganism is about living a life of compassion. I extend that compassion to myself when I feed myself norishing and delicious foods that make me feel good. Sometimes thatās a cup of tea and three cookies after work. Sometimes thatās a lentil salad with greens.
Hi Elise! Thanks for echoing what I ended that paragraph with and sharing!
Hi Liz! I hear you! I’m not speaking to the ethical or religious side of food choices. The end of the paragraph says… “if it aligns with any of the above itās a diet.” so I’m not lumping that into the same category at all.
I think the one thing missing is a support group fir people. I donāt mean pay to join group, but a not for profit support system to get the type of information you just gave…Retrain our think about ādietingā, about body image and what society says is healthy.
Thank you for the article-Jodi
A great article and very freeing. thank you!
love all the research and pointing out the flaws because a lot of people get really hung up on “studies” on a surface level without really understanding the design and intervention. i cant wait to share this article with others!
really appreciate taking time to point out a diet, when it is a diet.
This was above and beyond the greatest thing. Everyone in America needs to hear this! Thank you!
Love, love, love this!! No matter what it was, anything I did with food to try & control my weight or be āhealthierā (which usually stilll fell under the catagory of thinner) only lead to less happiness!! There is a new trendy āthis is the oneā diet that will always come out, but as for nutrition, pretty much everything proven by studies that seems a little off is almost always found later to be untrue. Studies are flawed & biased, you have to be so careful about what you believe!!
I think you’re right that when it comes to the details, opinions are always changing as to what is “good” and “bad” – more support that lets focus on the bigger picture!
I *love* that you’re actually picking apart the science here. The diet industry preys on the fact that not many people understand how proper study design works, and it’s really become a problem!
5 people is an ABYSMAL sample size, and I also want to point out that that study was partially funded by the Atkins Foundation (wonder how THEY wanted the results to shake out?). The study funding is reported right at the bottom of the article, so we should be checking that out too (“we” meaning all of us, not just you Robyn haha). The funding source isn’t always an issue! There is a lot of really awesome, unbiased science happening, even through these types of collaborations! But if you ever see a really crappy study and wonder how/why it was even published, the funding source will typically give you your answer. No matter how bad the design is, if the results came out in their favor they will get it out there.
I actually didn’t know how inconclusive the research on keto is, so this was informative. Thanks Robyn!
Yes! It’s unfortunate and such a shame that the diet industry preys on people’s vulnerabilities. Such a GREAT point on who is funding the studies! That’s actually why we see so much research on pharmaceuticals vs nutrition because there is so much more funding from drug companies for those studies. Thanks for pointing that out Mary!
Robyn, this is an amazing! Thank you so much! I find myself easily enticed by clean eating and other fads, and I have to remind myself what life in my ED was like and that’s not the life I want to live! Thank you for doing the research and helping me experience freedom!
So glad it was helpful for you Katherine! Keep rooting in your values!
AMAZING. Love that you touched on the emotional aspect of this, too! And this is sooo true: “And while I thought I was in control of my food, my food choices actually controlled much of my life.” Thank you thank you for such insightful and evidence-based posts!
Soup recipe please!! Also, great explanation of this bizarre trend!
My mom made it a longgg time ago so no idea haha – sorry! š
Thank you for this post! As an RD, I have been very curious about keto being used for other conditions, aside from epilepsy (which, like you, I’ve learned about in schooling). I was genuinely curious about keto for diabetes and have read a few studies about how keto can help to reverse (not cure) diabetes, when done under medical supervision (specifically, titrating insulin down is not something someone should just do on their own with keto as you risk hypoglycemia). The studies I have read talk about encouraging people to eat to satiety and do NOT restrict calories. I recognize this is a fine line/grey area. I don’t have diabetes, but work with people with diabetes all the time; it can be an overwhelming condition to manage. I suppose there is no perfect answer, but I do believe that the current ADA recommendations for diabetes are not ultimately helping the situation and it is interesting to look at how food politics over the years have (and continue to) inform diet recommendations for diabetes. I agree keto shouldn’t be used loosely. However, I think it is interesting to look at it specifically for people with diabetes (knowing the co-morbidities that are at risk long-term) – and I recognize this patient population is probably not a majority of your blog audience, which is why I’m being very specific. Also, here is one of the studies I read which I think was quite informative.
https://link.springer.com/article/10.1007%2Fs13300-018-0373-9
Love your blog, Robyn!
Iām currently on a ketogenic diet, and from all the research Iāve done on it and what is recommended, it is not cutting a lot of calories. My calorie deficit is 20% on a 1900 calorie a day consumption. I eat every last calorie, and donāt go hungry. I find each meal to be satiable to the point where I no longer mindlessly snack.
My favorite meal is cooked bacon, sausage, and sautƩed Brussels sprouts, asparagus, and collard greens.
Hi Laura! Thanks for bringing this up – I think it’s important to discuss. I did a talk back in the fall on bridging the gap between clinical nutrition and IE/HAES because I do fully believe in the therapeutic effect of food. It’s a delicate dance to help people make empowering health decisions for themselves through a weight neutral approach that utilizes diet neutral language. I 100% agree with you that our traditional nutrition education and counseling for diabetic patients simply does not work. But I think the overarching conclusions of any diet (no matter if it’s counting carbs, vegan or keto) for treating chronic disease is that these very black and white, regimented ways of eating do not work long term and the hyper focus on nutrition leads us to neglect ALL other things that contribute heavily to health – including psychological and emotional health, sleep, stress and socioeconomic status.
Thanks for sharing the study! With this, they are comparing keto to traditional diabetic education which I agree with you doesn’t work — that’s where the HAES and health promoting behaviors (vs focusing on weight and dieting) comes into play as an alternative that we know from the research does lead to long term positive health outcomes – it just doesn’t happen as quick and isn’t as instantly gratifying. There’s some other variables in this study that can skew results because the keto participants met with a health coach AND had social support via an online peer community. Unfortunately, all these studies on keto aren’t long term – just 1 year period.
Those are my thoughts – thank you for generating this conversation and doing so in such a healthy way where we can share and understand each other. I think you bring up interesting points!
Actually keto diet is very effective at treating medication resistant epilepsy. I am on keto. I donāt count calories. I donāt track my macros. I can tell if I am in ketosis based on how I feel physically and emotionally (better). I think itās sustainable and easy for me to stay on keto because my metabolism was damaged by all the low fat/high carb BS that was fed to my generation growing up. On keto my body is no longer waging an internal battle with itself based on blood sugar and insulin levels. I donāt get hangry. I donāt crave junk food. For the first time that I can remember in decades, food does not cause me any anxiety. I donāt even think about it anymore. I eat when Iām hungry. Thatās it. Just no carbs (aside from non root veggies and berries anyway). Itās simple, satisfying and itās working . Iāve been on it for eight months and lost 38lbs. Not drastic overnight miracle fix, but consistent steady weight loss.
I also canāt help but wonder how yo can say eating is about behavior and personal choice. As a dietician you must know hunger and satiety are controlled by the endocrine (hormonal) system. I donāt see how you can expect a person to simply make a mental, intellectual decision that all of a sudden they are going to stop feeling compelled to eat. You could no sooner tell someone to stop growing facial hair, etc., or stop any other hormonal processes….
Thanks for including all the research here and tying it in with PCOS and women’s health. Even in our profession, there’s huge debates about the ketogenic diet and it can be so difficult to convince others that it still is a “diet.” Also, what I’ve found through my clients who ask about it/try it is that it’s really difficult to follow in the long term. And DUH, quality of life is truly impacted if you can’t go out and have birthday cake with your friends, IMO.
Such great points to bring up Sarah! I think the claims on PCOS are really really important to question because women with PCOS are heavily stigmatized by society and so the keto diet is that much more alluring in this vulnerable state.
I’ve been reading since 2013, but this is my first time commenting.. Thanks for the amazing leadership on all things food freedom, I have benefited from your blog and spirit tremendously.
I meant to ask you a Q on your live IG chat this afternoon but sadly missed it due to work meetings!
I recently moved in with a partner who follows the keto diet. Meanwhile, I’m recovering from an ED (about a year into it). Since he’s re-adopted the keto habits after taking a break for a while to enjoy the foods in our new city, I’m finding myself more triggered. As an active guy, he has a hard time meeting his nutritional needs as it is! Moreover, being around a combination of intermittent fasting and low to zero carb eating has been more of a test in recovery than I expected! I feel myself restricting as I recognize he “gets away” with it.
I don’t want to backslide, but I also don’t want to force him to change his habits. Additionally, I’m not well enough versed in the literature and nutritional training you exhibited in this piece to get into the big “keto isn’t worth it” discussion.
Do you have any advice for me?
Kate thank you so much for commenting!
This is such a hard and vulnerable place for you to be in. I can understand how this would be really triggering for you. Could you share this with him? I know that might be hard to do or scary but sharing food is such a huge part of a relationship and being able to openly dialogue about this together might be really helpful. Nick was really paleo and into intermittent fasting when we started dating. Fortunately, I was in a rather healthy place with food and my body but it was still unhealthy for our relationship as a couple so together, we’ve come to a place where we enjoy all foods at any time by having that open dialogue. I would come at it from a place of how it affects you and not from a “what you are doing is wrong” direction – that way you can come from a place of how you feel.
XO
Thanks for breaking down those studies – the BANE of any health care professional’s existence …it’s so frustratingly easy to manipulate the public with data that isn’t sound.
haha it can be tedious but also fascinating!
Hey Robyn! long time reader, but first time leaving a comment! ļ I had been hoping you would write about this topic, and I definitely appreciate your views! I was a little hesitant about leaving a comment at first, because I have been following the ketogenic way (the word diet makes me cringe, but I get why people use it) for a little while now. I wasnāt trying to lose weight, which I feel is probably the main reason for a lot of people. My fiancĆ© was going to the doctor pretty frequently, and after one of his visits he told me that the doctor told him he was at risk for diabetesā¦That scared me wayyy more than it did him! So I started google searching things like ānatural and preventive ways to stop diabetesā. It led me to a ted talk by Dr. Sarah Hallberg which I found really interesting! I had never heard the term keto before this. So I started reading everything I could about this doctor, and the crazy cool thing about her is she lives locally!! Sheās an IU doctor with a practice in Lafayetteā¦and does food demos and talks around town, huge keto advocate, and just really sweet! Because I wanted my fiancĆ© to try this, I decided I would do it with him. Which I think doing it together makes it easier! And surprisingly it hasnāt felt restrictive (but I can totally see why some would call it that)ā¦I was a pretty healthy eater before this. And I loveee cooking, and have enjoyed putting things together I wouldnāt normally do. Even with my sweet tooth, I have been able to bake a lot of low carb desserts. Maria Emmerichās recipes have helped so, so much! I didnāt know what to expect for myself, as I thought I was pretty good health wise. But I can now sleep sooooo much better, and thatās probably the best thing that has happened since eating this way. And as an avid long distance runner, Iāve noticed I been feeling better overall on my runs. Which is interesting, because eating this way totally goes against everything every coach has told me. For now though, it seems to be helping, and if keto prevents diabetes, itās definitely worth sticking with, at least for us.
Hi Isabel!
Thank your for your comment in sharing your experience! I think everyone is 100% free to make whatever food choices that work for them and what they want. If a way of eating leads to a place of wonderful emotional, psychological, social and spiritual health in addition to physical health and healthy relationships…then who am I to argue with that. Only the person eating a particular way can evaluate the healthiness of that way of eating in all those realms. š
Hey Robyn! While i think you’re pretty on point with this post, just curious if you can address the growing number of people who are using diet to heal or manage chronic disease. I personally chose this route because my alternative would be a lifetime of drugs that potentially don’t work! You sort of mentioned it regarding the epilepsy research but i would love to hear your thoughts on aip, wahls, scd, gaps diet etc. And just your thoughts on using food as medicine in general. Could talk for days on this but I’ll leave it at that. Thanks girl!
Also just spreading the word to another healthcare practitioner, but I’m using gaps/scd diet to heal from ulcerative colitis. If you ever run across an ibd patient check it out! Scd is being used at Seattle children’s hospital and it is backed by research but my gastro had never heard of it. But this disease and other autoimmune issues are on the rise so it’s really interesting to see so many treating them with diet.
Thank you for your comment, great question Francesca!
I 100% agree with you that there is the reality of chronic disease. Being an RD who started the first year of her career in the diet/weight loss mentally and fully believed in the power of a plant based diet as the end all be all at one point…I still do have a deep appreciation and knowledge of the therapeutic effect of food. So I hear you.
This post I wrote in December might be insightful (https://www.thereallife-rd.com/2017/12/intuitive-eating-and-dieting/) and I also did a talk on bridging the gap between clinical nutrition and IE/HAES on this very question your asking – I think it’s so valid and something we need to discuss more! I think where we take a wrong turn is when we start focusing on extreme diets and miss out on really helping people make sustainable, health promoting behavior change. BMI/weight is totally separate from health. HAES is a weight neutral paradigm – so it’s not that anyone can be healthy at any size and there aren’t foods that are more beneficial for our physical health than others that are more beneficial for our mental/emotional health, but it takes the focus off weight and strict black and white diet rules and instead focuses on healthy behaviors and delivers that gentle nutrition and a diet/weight loss neutral language. This approach goes beyond food into the psychosocial realm (the effect of fat and weight stigma on people is so deep) and into sleep, emotional health, stress etc in addition to food + exercise. Socioeconomic status plays a huge role in health in addition to ethnicity and race. We have to take all that into consideration vs focusing on food alone.
Except under extreme, life threatening conditions do I think there is room for a diet – things like cancer, epilepsy etc. But for these chronic disease we think of (like heart disease, diabetes, autoimmune disease etc) focusing on health promoting behaviors and ALL REALMS of health is very important. There is “gentle nutrition” that can me applied (in a weight and diet neutral way) after people have worked through ALL the other principles of IE to come to a neutral, full permission, non weight loss mentality. That’s when you get to long lasting, sustainable changes. But that takes a lot of work and time. Hope that helps!
What a big topic to take on Robyn – wow. Thank you. Sometimes (often) you write things where I just feel this overwhelming sense of community and gratitude. I feel like there’s a divide – the community of people in this blog world who are fighting against diet culture, and then the rest of the world engulfed in diet culture. I can’t judge anyone for what they do, especially since the media makes it next to impossible to believe anything like Intuitive Eating and HAES even exists, but being part of THIS community – the one that reminds me what true health really is and that living in accordance to MY values – makes me just really grateful.
“We donāt have to deal with our emotional and psychological relationships with food and our bodies if we just follow some rules.” —- so much this.
I’m sure the Keto diet has millions of backed up benefits etc. etc. etc., but for me, your reminder that learning to live and move in a way that feels good to me outshines any diet or set of regulations with a fancy name to it.
Cora I’m so glad you are part of this community!! <3
This article is amazing and you have put together thoughts about the Keto diet SO WELL. I can see myself referring back to this article again and again for my clients. Very thorough! When I originally learned about WHY low carb diets create weight loss and that, in a sense, it’s our bodies consuming themselves, I was shocked! So many individuals equate weight loss with health and I think this article does a great job in explaining why that is most definitely not the case. Great read!
Weight loss and health are certainly two different camps. So glad you enjoyed Amber!
This is one of the best things Iāve read in a while. Smart, thoughtful, respectful and real.
YES. THANK YOU. I have drug resistant epilepsy and have to keep a strict ketogenic diet to help reduce my seizures. Reduce…..not eliminate. Ketogenic is no joke. For those of us who are on it for the reason it exists…. MEDICAL TREATMENT. When you are put on this diet by a doctor you are also under the care of a nutritionist to be sure that everything internally is going okay and they actually watch your weight so that you don’t lose too much. Please don’t enter this blindly by what you find on doctor google. Like Robyn said “Ketogenic diets have been well studied in the treatment for epilepsy. Gluten free diets have been well studied in the treatment of Celiac disease. Those are extreme health conditions that could warrant dietary changes to better oneās health. But the majority of us thankfully donāt have to face these health conditions.” Also on an unrelated note when I have to pass up food offered to me because it’s something that my keto macros won’t allow me to have I say “thank you I wish I could have that but I’m on a MEDICAL diet and cannot.” I hope this fights diet culture, gives others freedom around me, and helps the ease an awkward moment in a social situations.
Great post! I wrote this a few years ago and actually re-shared it the other day!
http://www.aebailey.com/food//2015/03/the-trifecta-that-destroys-our.html
EXCELLENT post, Robyn!! I know “ketone” is the new buzzword right now, and I definitely call BS on it. Thank you for your wisdom and attention to flawed research!
What a great post, Robyn! At the end of the day we need to listen to OUR own bodies, over any diet theory out there. Sadly, it’s hard to do with so many new ways of eating come out so often. But if we can keep on reminding ourselves that in the end, we have to figure out what works for ourselves and not force ourselves to eat in a way that (might) works for others.
There is an area of the brain that needs glucose, however, your body still produces enough for that function, even while in full ketosis. You will have greater mental clarity while doing this lifestyle change. This is the same type of “diet” or lifestyle that our ancestors would have been on. They did not have the processed sugary foods, nor did they always have food readily available for consumption. They would hunt and gather, therefore their bodies would be deprived of constant glucose intake and would go into ketosis. Like you stated above, this would put your body into “survival when your body experiences famine or prolonged periods without food.” Exactly how our ancestors would have lived.
Ketosis is a cleaner healthier energy source. You’re not cutting calories, just limiting your carbohydrate intake and increasing good fats for optimal brain health and function. Also, the Ketogenic Diet is not meant as a long term lifestyle change. You follow it for 2-4 weeks and then do cycling ketosis where you follow the carb restriction for 3 consecutive days of the week. Once you reach ketosis, your body is better able to “cycle” in and out, giving your optimal performance and mental clarity.
Also, did you know that cancer cells can only feed off of glucose? When you starve your body of glucose and use ketones for energy you literally kill the cancer cells. They are not capable of using any other source for food other that glucose. Are cancer centers telling their patients about this lifestyle change? No, there is no money in a lifestyle change for them, just the treatments. They’re giving them the chemo treatments and feeding them carb filled, GMO filled “food”. Look at every cancer center in the country right now, they all have a fast food restaurant and always a Dunkin Doughnuts. Great cancer feeding food right there.
If you would like more information, I encourage you to watch: Ketosis – The Key to Optimal Health by Dr. John Bergman (Dr. Michael VanDerschleden presenting) on his YouTube Channel AND The Ketogenic Diet and Cancer by the same.
Hi Amy! Thanks for your comment. My first years as an RD I worked in alternative/integrative medicine and treated many patients with cancer – many aggressive cancers. Cancer is an extreme circumstance and I do believe food can be a powerful part of the treatment. Just like there are medically indicative diets for extreme conditions like epilepsy and celiac disease. Those are separate from the point of this blog post as I wrote about. I hear you on your explanation of the validation for the type of eating – but there is no long term evidence to support all these claimed benefits of the ketogenic diet. And what are we comparing the ketogenic diet to in all these claims? I think that is where I’m finding the gap in the research to be and where the research is far from compelling. Our ancestors also had much, much shorter life spans and were in entirely different environments than we are today. It’s like comparing apples to oranges. Hopes that helps!
Great tips as always! Definitely an eye-opener to me. I’m guilty of having a bad diet, maybe that’s why I’m not feeling that great. I’m not that familiar with the terms mentioned here but I get the entire picture because of your awesome explanations. Thanks for this!
I’m glad you found it helpful Geraldine! And know that there is no such thing as a bad diet š Give yourself some compassion and kindness š
It was a pleasure to read you. Thank you for taking the time and effort to share those thoughts and insights!
Hi Robyn,
I know I’m a bit late on reading this post, but I wanted to say a huge THANK YOU for writing this. As a Type One Diabetic, I hear the keto diet hailed as this miracle not only for weight loss (since diabetics are taking a weight-positive hormone), but also for blood sugar management and long-term A1C results. It’s impossible to escape the keto diet in the diabetes community and it’s really unfortunate that there’s so much hype out there about it. My mother (who’s also a Type 1) used to work in the medical field and saw people die from the Atkins Diet, not to mention how unsustainable the keto diet is long-term. Everything I’d researched on the keto diet in relation to Type 1 seemed flimsy and too much of a fad. Since my disease is an incurable, life-long disease, I don’t find the keto “lifestyle” sustainable, nor have I seen it that effective for tighter A1C control. Thank you again!