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keto
Keto

Is the keto diet anti-inflammatory?

Depending on who you ask, you might find anti-inflammatory recommendations that encourage complete elimination of sugar and carbohydrates to decrease inflammation. This reasoning is often used as support for a keto diet ____. As is frequently the case, though, those recommendations are likely unnecessary extremes and everything is case-by-case. For one thing, you can probably achieve the anti-inflammatory benefits you’re looking for while still including well chosen, nutrient dense complex carbohydrates. Secondly, why over-restrict if we can still enjoy some tasty treats in moderation? That’s how we balance meeting health goals and living a life we love! So what does the research actually say about carbs and inflammation?

Multiple studies have linked consumption of concentrated sugar and simple carbohydrate consumption with increased levels of inflammation.1-2 A long time ago I talked in this post about what happens when we eat carbs and how we break them down into blood sugar to use as fuel. Those fuels are stuck in the blood until insulin comes around to let them in to our cells.  Research draws a strong link between chronic inflammation and insulin resistance.3 This is a vicious cycle because insulin resistance means that blood sugars get stuck in the blood without a way out, causing fat storage and inflammation.4 Stored fat then produces inflammatory factors which make insulin resistance worse! Not fair.

So what can we do about it? Well, we can aim to cut inflammation off at the pass by changing parts of our lifestyle and the foods we eat to combat inflammation and give our cells a helping hand with that blood sugar. With regard to carbohydrates, we can do a couple of things specifically:

  1. Focus on eating more complex carbohydrates than simple carbohydrates like sugar. What does that mean? Well, complex carbohydrates are long chains of sugars that take much longer to digest, break down, and enter our blood, thus making our blood sugar much more stable (and preventing inflammation from blood sugar spikes). Simple carbohydrates are individual sugars or tiny chains of sugars that break down very quickly and enter the blood rapidly, causing a sharp spike in blood sugar that is inflammatory. Complex carbohydrates like whole grains, beans, and vegetables are connected with lower levels of inflammation.5 Same goes for high-fiber carbohydrates like fruit.
  2. Avoid eating too much carbohydrate at once. Just like with diabetes, the key to preventing carbohydrate-induced inflammation is keeping the blood sugar from going too high. Eating controlled amounts of carbohydrate throughout the day can help keep your energy up and your inflammation down.

 

  1. http://ajcn.nutrition.org/content/94/2/479.short
  2. https://www.hindawi.com/journals/mi/2013/509502/abs/
  3. https://www.jci.org/articles/view/19451
  4. http://www.jbc.org/content/280/6/4617.short
  5. https://www.ncbi.nlm.nih.gov/pubmed/17391554

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Keto

A Dietitian Reviews the Keto Diet

Do I recommend keto to my clients?

 

You’d have to be living in a mole hole to not have heard of the ketogenic diet. Everyone knows someone who’s on it. What everyone wants to know is whether or not keto is safe and effective. Does the keto diet work for weight loss? Is it dangerous?  Is the keto diet nutritionally balanced? Is it easy to follow? There is SO much to say about keto so I’m going to make this post a quick overview. I’ll make more in-depth posts about these topics along the way (with a lot more references), so check back for more info!

 

What does the research say about the keto diet?

Research about the effectiveness of the keto diet (or similar low carb, high fat diets) for weight management is somewhat mixed. Most of the time, keto-like diets are successful at causing weight loss.1-2 Unfortunately, the research also indicates that the success of keeping that weight off long term (1 year or more) is low (and no better than with other types of diets).3-5

Research on keto’s effects on other health markers (cholesterol, blood glucose, insulin, inflammation, etc) is also mixed. Some studies show the keto diet improves cholesterol markers, others demonstrate that it makes them worse.1,6 Research on inflammation is once again, annoyingly, unclear and conflicting.6-7 For the most part, blood glucose and insulin levels do tend to improve1,6, likely because carbohydrates (and therefore the need for insulin) are largely a non-factor in a ketogenic diet.

With all of the conflicting information, it’s no wonder everyone is so confused about the keto diet. In a future post, I will go much more in-depth about what the research says and what conclusions we can pull from it.

 



 

Is the keto diet dangerous?

This answer is a little convoluted (you’re shocked, I know). Short-to-moderate length studies looking to evaluate the safety of the ketogenic diet have mostly unearthed no dangerous results (other than those mentioned above).1 However, few of those studies have looked at the long-term effects of the ketogenic diet (or similar very low carb diets) on metabolism.2,8 By far and away, my largest caution with the keto diet is its long-term effects on metabolism. This is also the main reason I do not recommend the keto diet for my clients and I am not following the keto diet during this feature.

Eating so few carbs mimics a “famine” situation, causing your body to rely more on its body fat stores than on blood glucose. So far, that sounds great, right? But your body expects this to be temporary (think caveman days – in Spring/Summer, the carbs will come back!). After a while, if carbohydrates don’t increase, your body resorts to a more sustainable long-term plan. Your body knows it can’t keep burning through the fat stores – it would rather slow down metabolism and try to preserve its fat stores as much as possible. This nearly always leads to fatigue, brain fog, feeling cold, and a weight loss plateau. Often at this point people become frustrated with the lack of results and begin to eat more carbohydrate. Your body is jazzed – “Spring/Summer is here! We survived! Boy, that was a long one. Next time, we will be even more prepared for Winter.” Translation: we will store more fat. These shifts are backed by documented hormonal changes in mice and humans,4,8-9   and are linked with the weight regain mentioned earlier.

The take-home message: In the long run, very low carb diets like keto teach your body how to store fat more effectively.

 

Is the keto diet nutritionally balanced?

The answer is a big it depends. I would venture to say that the average keto diet is not nutritionally balanced. I would follow that up by saying that it is possible to eat a nutritionally balanced keto diet, but it takes a lot of intention. Here are some of the nutritional weaknesses I see in keto diets:

  • Fiber – Fiber is a type of carbohydrate that composes the structure of certain plant-based foods. Since fiber doesn’t break down into blood glucose, it is not actually limited on the ketogenic diet and will not interfere with ketosis. At the same time, it comes in primarily carbohydrate foods, so the carb limitations often make it quite tricky to get enough fiber while avoiding other carbohydrates. It can be done with certain high-fiber foods such as nuts and seeds, avocados, and berries.
  • Vitamin C – While you can certainly get vitamin C from certain keto-friendly vegetables (hey, peppers!), a lot of the best vitamin C sources are fruits, which are very limited on a keto diet. You can definitely make a point to eat vitamin-C containing foods, but you have to make the point to do so.
  • Saturated fat – These are the types of fats that are primarily found in animal foods. Being a high-fat diet, unless someone is being very intentional in their food choices, a keto diet is typically quite high in saturated fats. While there are some debates around the appropriate recommendations for saturated fat,10 most keto-dieters I’ve talked with are eating WAY more than even some of the higher evidence-based recommendations. High saturated fat intakes are associated with high levels of cholesterol and increased occurrence of dementia.11-12 Keto dieters can buffer this impact by limiting intakes of high fat meats (sausage, bacon, ribs, hot dogs, etc) and dairy in favor of lean and grass-fed meats and reduced fat dairy. Focus on including a variety of plant-based fats like nuts, seeds, avocado, and olive oil.

 



 

Is the keto diet easy to follow?

This kind of depends (do you see a theme here? It seems nutrition rarely has a clear answer). Some people absolutely LOVE meat and veggies and aren’t so big on the carb-y stuff, and keto totally rocks their world. Others – most, if we’re honest – enjoy at least some carbohydrate foods (or the option to eat them without ruining ketosis) on a regular basis. With ketosis, it’s kind of an all-or-nothing thing. You either need to be in and mostly stay in ketosis or regularly meet your carbohydrate needs. Bouncing back and forth or riding the low-carb-but-not-quite-low-enough-for-ketosis train is generally not an enjoyable ride. Many clients complain about low energy, brain fog, fatigue, and weight fluctuations, particularly coming in and out of ketosis. Digestive disturbances come up frequently as well.

My average client finds keto to be a social and nutritional bummer, because it restricts a lot of foods – particularly delicious and commonly social foods. It can also be a challenge for some to consume enough fat to promote ketosis and meet caloric needs. I can’t even count how many clients and friends have followed keto for a few weeks or months, convinced it was going great, only to decide it was too restrictive and they weren’t enjoying their food quality of life or feeling their best. The same high dropout trend is commonly seen in studies about low-carbohydrate diets.3 When deciding about a diet, be sure to take the nutritional and safety factors into account as well as your personality, favorite foods, and family/friends.

 

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References

  1. Dashti, Hussein M et al. “Long-term effects of a ketogenic diet in obese patients.” Experimental and clinical cardiology vol. 9,3 (2004): 200-5.
  2. David S Ludwig, The Ketogenic Diet: Evidence for Optimism but High-Quality Research Needed, The Journal of Nutrition, nxz308, https://doi.org/10.1093/jn/nxz308
  3. Phelan, S., Wyatt, H., Nassery, S., DiBello, J., Fava, J.L., Hill, J.O. and Wing, R.R. (2007), Three‐Year Weight Change in Successful Weight Losers Who Lost Weight on a Low‐Carbohydrate Diet. Obesity, 15: 2470-2477. doi:10.1038/oby.2007.293
  4. Cardillo, S., Seshadri, P., Iqbal, N. The effects of a Low Carbohydrate vs. Low Fat Diet on adipocytikines in severely obese adults: a three-year-follow-up on a randomized control trial. Eur Rev Med Pharmacol Sci vol. 10 (2006): 99-106.
  5. Foster, G., et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med (2003); 348:2082-2090
    DOI: 10.1056/NEJMoa022207.
  6. Rosenbaum, M., et al. Glucose and lipid homeostasis and inflammation in humans following an isocaloric ketogenic diet. Obesity. 2019 Jun;27(6):971-981. doi: 10.1002/oby.22468. Epub 2019 May 8.
  7. Shen, Y., Kapfhamer, D., Minnella, A.M. et al. Bioenergetic state regulates innate inflammatory responses through the transcriptional co-repressor CtBP. Nat Commun 8, 624 (2017). https://doi.org/10.1038/s41467-017-00707-0
  8. Goldberg, E.L., Shchukina, I., Asher, J.L. et al. Ketogenesis activates metabolically protective γδ T cells in visceral adipose tissue. Nat Metab 2, 50–61 (2020). https://doi.org/10.1038/s42255-019-0160-6
  9. Cooper, E. The Metabolic Storm: The science of your metabolism and how its making you fat. Seattle Performance Medicine. 2015. 2nd edition.
  10. Enos, R., et al. Influence of dietary saturated fat content on adiposity, macrophage behavior, inflammation, and metabolism: composition matters.
  11. Enos, R., et al. Influence of  The Journal of Lipid Research. doi: 10.1194/jlr.M030700 (2013), 54, 152-163.
  12. Greenwood, C., Winocur, G., High-fat diets, insulin resistance and declining cognitive function. Neurobiology of Aging. Volume 26, Issue 1, Supplement (2005) 42-45. https://doi.org/10.1016/j.neurobiolaging.2005.08.017.
  13. Barnard, N. D., Bunner, A. E., Agarwal, U. Saturated and trans fats and dementia: a systematic review. Neurobiology of Aging. Volume 35, Supplement 2 (2014) S65-S73. https://doi.org/10.1016/j.neurobiolaging.2014.02.030.



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Keto

Keto Diet 101

What is the ketogenic diet?

It’s feature time again, folks, and it’s finally time to talk about the diet everyone is going on about – keto! The keto (aka ketogenic) diet has gained a lot of popularity in the last few years as a weight loss diet, and proponents tout that you can lose weight quickly without cravings.1 Interestingly enough, the ketogenic diet started as a therapeutic diet for children who suffer from epilepsy. The high fat content of the diet is linked with decreased occurrence of seizures in these kiddos.2

Keto curiosity is rampant! Questions about the keto diet top the list of FAQs from my weight loss clients. Even those who don’t directly ask about keto are often asking about how to limit their carbs to encourage weight loss. Over the next few weeks, I’ll be posting info about the keto diet – what it is, how it works, and the pros/cons of the diet. I won’t actually be following this one (we’ll talk about why throughout the feature), but we’ll be diving into the research and practicality as always!

 



 

What is the keto diet?

The keto diet is a high fat, moderate protein, low carbohydrate diet.2 The diet is designed to cease your body’s reliance on carbohydrates (broken down into glucose) for energy and instead shift to your body’s alternative fuel source – ketones. In the absence of glucose (aka blood sugar), your body begins to convert fat that you’ve eaten and stored body fat to ketones, which your brain can use for fuel! If you were privy to the Atkins kick, you may be noticing some similarities between the two. You’d be right! The keto diet is something of a reincarnated version of Atkins.

The keto diet includes plenty of vegetables and many high fat and protein foods such as:

  • beef and pork
  • poultry
  • fish
  • processed meats like bacon, sausage, etc.
  • cheese
  • avocado
  • nuts and seeds
  • butter and oils

To limit carbohydrates (usually to around 20-60 g per day), the diet restricts consumption of the following foods:

  • fruit
  • beans
  • certain vegetables such as corn, peas, carrots, and potatoes
  • bread and grains (pasta, rice, cereal)
  • milk and yogurt
  • sugar, honey, and syrups

Keeping the carbohydrate intake low keeps the body from coming out of ketosis, therefore promoting fat loss.

 



 

Stay tuned – we will talk more about the research behind keto and pros/cons of following the diet in future posts!

 

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1. https://www.ketocustomplan.com/articles/effective-way-to-lose-weight-for-good?gclid=Cj0KCQiAs67yBRC7ARIsAF49CdVbbQxjjPg12rojwtotjqps5FjOVRHPjVaDQGWeSIsQ_EA2HF2Y23IaAn7TEALw_wcB

2. https://www.eatright.org/health/weight-loss/fad-diets/what-is-the-ketogenic-diet

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Down Home Dietitian

Diet culture is determined to tell you that you have to be miserable to be healthy.

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I am OVER confusing advice, disgusting diets, and boring exercise.
Healthy doesn't have to be hard!
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Becki Parsons, MS, RD, CEP
Are you ready to start dating healthy changes? Pro Are you ready to start dating healthy changes? Prospective clients always want to know what it's like to work with me and what their plan will look like (understandably)! Everyone's plan ends up different, so I can't tell you what your plan will look like beforehand...I haven't gotten to know you yet! But I can tell you that we will work to match your personality, schedule, budget, goals and more to healthy changes so they are streamlined and aligned with your lifestyle. We are looking for a long-term relationship here...but that means dating first! 
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You don't know why they are the weight they are. You don't know why they are the weight they are.

You don't know what struggles they may face.

If you think it's just "eat less, move more," you're missing a big part of the picture.

If you think they are eating more than they "should," keep in mind that you can't know that by observing one meal or even a few.

If you think it might be nice to compliment someone on their weight loss, I totally get it. I love to cheer someone on! But unless you are REALLY informed on their situation, keep in mind that you might be:

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January 2021 I injured my back, causing an extrude January 2021 I injured my back, causing an extruded L5/S1 disc (think REALLY bad bulging disc) that led to sciatica. At the time, I had to stop doing all of my regular workouts including weightlifting, and focus on walking and rest for several months. Sitting, especially for long periods, became very painful. Since a lot of my job involves virtual appointments and computer work that was obviously a big bummer, to say the least.

I've really missed weight lifting over the last year or so, and I could not wait to get back to it. But if you've ever dealt with chronic pain and injury, you know that re-injury is certainly not something anyone is interested in. I waited a very long time to get back to lifting and make sure that I rehabbed my back properly with PT and bodyweight exercises before I started again.

Getting back to it has been awesome, but it certainly has its challenges. I have to choose my core work very carefully and limit my high impact exercises (I avoid jump roping for more than a couple-minute warm up, for example). I'm lifting much lighter weights than I used to, which can feel defeating after I had worked so hard. Prior to my injury, one of the goals I had been working towards was to increase my chin-ups. It was a hard-fought victory to get to three chin-ups, and I was pretty darn sure I was going to be starting again at square one when I got back to it. I put it off trying it for longer than I had to because I didn't want to know...lol. 🙈 I could not believe that over a year later, I'm still able to do two! Thank you body, for having my back. I've got yours too. 😉

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This is one of my favorite things to hear from cli This is one of my favorite things to hear from clients, because it's often when we are focusing elsewhere that the weight loss happens. It is seriously 75% mindset and mental shifts, and 25% habits. It doesn't have to be hard!
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I have and will put my heart and soul into serving I have and will put my heart and soul into serving my clients - and I LOVE doing it! ♥️ 

I actually went to school intending to be a crime scene investigator. I had interned at the coroner's office throughout high school and had my eyes set on Eastern Washington University's forensic science program. I think I had known for a while that I was leaning away from that but when you're a senior and everyone is asking about your plans, it's nice to have an answer to give them. 😆

Once I got to @washington_state_university I changed my major to Nutrition and Exercise Physiology. I LOVED that program - the perfect balance of science and serving people. I was shocked to learn how many different settings dietitians work in: food service, workplace wellness, hospitals, clinics, sports teams, schools, military, community health...

Coming out of school I honestly wasn't sure which way I wanted to take my career, but I DID say that I would NEVER want to open a private practice. 😆 I am so grateful to have had the experiences I had that led me to change my mind. Being an entrepreneur is hard and messy and absolutely awesome. 🤩
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It is not my job to: - Tell you what you "shouldn It is not my job to:

- Tell you what you "shouldn't" eat.
- Tell you what you "should" eat.
- To restrict your favorite foods.
- To force you to eat foods you hate.
- To give you a pre-made meal plan that is one-size-fits-almost-none
- To tell you how much exercise you "must do."

Outside of deadly allergies, celiac disease, dangerous addictions, and rare medical situations, there is almost never a food you can never have.

It is my job to tell you:
- How different foods are digested, absorbed, and metabolized, and how that relates to your lived experience, symptoms, or medical conditions.
- That healthy doesn't have to look a certain way.
- To get to know you well enough to recommend healthy strategies that may likely be good fits for you.
- To clear up what research does and does not say about food and exercise and health.

So often people fear RDs as "the food police." I'm sure they are out there, as every profession has their own bad apples, but most of my colleagues are awesome and will partner with you to live your best healthy life. 😊

Have you worried about these things when thinking about trying nutrition counseling?
Some movement is WAY better than none...in fact, r Some movement is WAY better than none...in fact, research shows that going to some movement from none brings the greatest health benefits. Don't expect yourself to show up over and over to do activity you hate - where's the happy in that? 

I am personally a cardio machine hater...they are great tools and an awesome fit for some people! I am not that person. I spend every step watching that stinkin' timer and thinking, "when...can I...get off...this...is so...boring!"

Think outside the box and try something you wouldn't have considered a "workout," but that will keep you coming back because you love it! It's amazing the doors that fun and enjoyable movement can open!

Ever tried geocaching? It's one of my faves! What are your favorite fun movements?
Food is meant to be enjoyed, absorbed, and metabol Food is meant to be enjoyed, absorbed, and metabolized, not obsessed over. That is all! 😁🍓
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