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Weighing the pros and cons of keto

HTF Columnist I’ve had the topic of the Keto Diet come up in weight-loss related conversation more frequently of late. This approach tends to pop in and out of favor and seems to be gaining in popularity again. The Keto (short for Ketogenic) Diet is a high fat – adequate protein – low carbohydrate diet that was originally explored (and eventually established) as a therapeutic protocol for epilepsy in the 1920s at the Mayo Clinic. Prior to keto, fasting was used to control epilepsy, a therapeutic protocol for epilepsy dating from 400 BC. Keto waned in popularity as anti-convulsive medications were developed starting in 1938, however the modern iteration of keto remains a widely advocated treatment option for drug-resistant epilepsy.

If you’ve heard of keto prior to today, chances are it was in the context of weight loss. A wildly popular variant of the keto diet that you may be familiar with is the Atkins Diet (named after its chief proponent, Dr. Robert Atkins). Dr. Atkins’ commercial success in 2003 derived from him implying the impossible WAS possible: that you can eat a lot and still lose weight.

In brief, extremely low carbohydrate / high fat intake triggers an adaptation in our bodies that consumes fat (in lieu of carbohydrate) to use as energy. It’s worth noting that starvation also triggers this adaptation. Anyway, keto diet proponents extend this biochemical fact – as it is a fact – and assert that the potential for enhanced fat usage equals fat (weight) loss. Nope.

Fat (weight) loss occurs when our energy expenditure exceeds our intake. I’ve said this before: weight management (loss, gain or stable) is a simple math problem. If you use 2,000 calories per day in energy yet eat 3,000 calories per day, you gain .3 pound per day. Conversely, use 3,000 calories per day in energy yet eat 2,000 calories per day, you lose .3 pounds per day.

Then why do people get so jazzed about keto? Here’s where the initial excitement comes from. People in the U.S. tend to eat a diet with lots of processed carbohydrate. A carb-rich diet tends to increase retention of water. A high fat / protein diet tends to cause us to shed water. Water loss for an obese individual in the first week of a keto diet can be over 10 pounds. That initial success can create a lot of enthusiasm. While that’s not necessarily a bad thing, discouragement often ensues as individuals realize that eating unlimited bacon is not the golden path to svelte fitness model that they thought it was.

I’m not against keto. I’m not against any whole food choices. Rather, I just want people to be better informed. And for what it’s worth, I use what can be described as a “keto-lite” approach (50 – 100 grams of carbs per day) when I’m trying to be more disciplined in meal planning.

So, if you’re going to experiment with keto there are some things to be aware of. I’ve already mentioned the initial water-loss. Nothing to worry about, but also not really grounds for jubilation either. And it’s not unusual to experience “keto flu.” The symptoms show up for me when I’m consuming less than 30 grams of carbs per day. As our bodies adapt to the lack of carbs, there is a lag while energy production switches over to fat, a period of time where we may feel flu-like symptoms. You may experience fatigue, head ache and general lethargy. It feels a bit like a mild virus and can last for a few days.

Other short-term, generally mild side effects can be constipation, acidosis, and hypoglycemia. A keto diet can also raise blood lipids and cholesterol and may increase the occurrence of kidney stones. And finally, a keto diet tends to be deficient in micronutrients, however that’s just as true with the average American diet too.

I’ve got nothing against keto. Rather, I am merely trying to convey that a keto diet is not the panacea it is often made out to be. Chances are you will lose a surprising amount of weight in the first week when rigorously adhering to a keto diet due to changes in fluid retention. Then, if you’re not eating less than your body uses, will either remain at that weight or perhaps quickly gain the weight back.

I’ve suggested using one of the many free online tools to calculate and track calories. However, if you’d like something even easier, multiplying your target (goal) weight by 10 will give you some idea of what your daily total calorie intake should be. For example, if your goal weight is 150 pounds, then 150 pounds X 10 equals 1,500 calories per day, which should allow you to lose weight at a modest pace. Obviously, this is not a precise method and everyone has unique physical attributes however, it’s a reasonable guideline to start with.

A higher multiplier equals slower weight loss (assuming you are still eating at a deficit) and a lower multiplier equals a more rapid weight loss. Keep in mind that National Institutes of Health minimum intake guidelines are 1,000 calories for women and 1,200 calories for men. Do not go below these intake levels unless directed and/or monitored by your medical professional.

It’s been a while since I’ve stated my core recommendations, so here they are again: get plenty of sleep; eat whole foods; stay hydrated; get social; be physically active as often as is practical for you; and get out there and play! Consult with your healthcare professional before starting any weight loss or exercise program.

Tom Duffy is the owner of Good Sports Fitness, a wellness, fitness and athletic conditioning business based in Babbitt, MN. Email: tom.duffy@gmx.com .

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