Showing posts with label weight loss. Show all posts
Showing posts with label weight loss. Show all posts

Wednesday, March 19, 2014

Hunger. The Primal Trigger!

I was listening to a podcast by Maximusmark and he was interviewing Art De Vany, who I like to call the Godfather of Paleo/Primal! Anyway, they were discussing some of the concepts in Art’s book The New Evolution Diet, and talked about hunger as a motivation for exercise. Art described studies on mice and how when they were well or over fed they were reluctant to move, but when they were hungry they would move much more. A recent study examined this in male rats and found that ghrelin increased food intake and decreased spontaneous physical activity, while agouti-related peptide (AgRP) and neuropeptide Y (NPY) both increased food intake, AgRP decreased, while NPY transiently increased spontaneous physical activity. It seems that intake of about 15-20% below calorie needs improved physical fitness in mice. It seems that it would make evolutionary sense for humans to become motivated to action (often by hormones or neurotransmitters) in order to be able to fight or flight, or procure food, win a mate, etc… This is interesting, because it’s been shown in human children that excess body weight (overweight/obesity) is associated with decreased physical activity but not the other way around. Of course in today’s modern food system, it seems difficult to eat a diet that is not obesogenic (promoting obesity). 
This got me thinking. There is a massive amount of literature on diet and hunger, specifically the satiety (fullness) effect of many foods. One study examined macronutrient composition on satiety and eating behavior as well as weight loss concluded that there were no significant differences between a high carb and a high protein iso-energetic diet protocol, however, this study did not look at carbohydrate restriction, which have been shown to absolutely associate with greater fat loss and satiety in both controlled studies and self-reported populations. Furthermore, it’s been shown that low fat diets adversely affect energy availability in the weight maintenance phase & therefore shouldn’t be used (at all in my opinion) over the long term. Furthermore, a review of all the popular diets concluded that the low carbohydrate diet protocol was the most effective at producing fat loss and metabolic improvement, at least in non-diabetic, premenopausal overweight/obese women.  I know from my experience working with thousands of clients seeking fat loss that most start out being incredibly hungry all the time when they are "dieting".  Obviously, because they are doing it wrong!  In this case, hunger, a primal cue that was essential to our survival, becomes somethings that prevents us from obtaining our goals!  That means that our approach is wrong.

There has been much research into the physiological and biochemical pathways that regulate hunger and attempts by science to control or suppress hunger, more often than not this involves a marketable product. Probably the most interesting thing to me is that a significant chunk of hunger research was done & contributed to by BIG FOOD companies. Now from a business perspective this makes sense because they profit from consumption of food products and any information that helps a company drive users to consume more will make them more profitable. Unfortunately, these "good business practices" by the food industry translates into health concerns for us including but not limited to overweight, obesity, diabetes and heart disease. In essence, the current strategies used by food companies and allowed by governments are making us fat, sick and eventually dead! Therefore, we need to limit our exposure to as many of the “processed foods” as possible.

I have created a list of 4 groupings of foods that I consider processed. Obviously, if you are a Paleo purist, then you will not want to incorporate most of these, but if not, then I would suggest limiting your intake of these processed foods to not more than 3 servings per week and only if you are able to achieve your goal of optimal performance, health and longevity while doing so! There are literally hundreds of thousands of lists of processed foods out there, so rather than re-invent the wheel & add to the confusion, I’ve attempted to add general classifications of foods as well as rules that should tip you off that a particular food is “processed” significantly.
List of Processed Foods:
1) All breads, cereals & pastas - these “plant foods” are mostly GMO & are often milled (finely ground) and then pressed into shaped & cooked. In a nutshell, no pun intended, they are quite highly processed and far removed from their natural state. The only benefit that has been shown by this food group is that the fortification with folic acid has helped to decrease the incidence of neural tube defects and unfortunately, folic acid that is added in many countries has been shown to be associated with increases in colorectal cancer prevalence. This is NOT CAUSAL, but it should raise some flags. 
 
2) Sugar and sweeteners - these are highly refined products whether they have a “calorie value” or not. Both sugar and sweeteners have both been associated with weight gain. Furthermore, in my experience, clients who try to lose weight while using sweeteners are often unsuccessful or only successful for the short term. The way I would normally advise a client is that if they are currently using sugar, they need to wean down to nothing eventually. If they want to use a sweetener (artificial or natural) in the process of doing this over say a month or so, then that’s fine. But honestly, it only prolongs the inevitable, which is essentially a feeling of going cold turkey and cravings for carbs, that one must push through in order to reset the palate.
3) Liquid, pasteurized dairy - firstly, we are designed to drink human milk, and only when we are infants. Secondly, we are designed to drink raw milk, with enzyme and healthy bacterial activity, etc… Pasteurization destroys some pathogens but also destroys enzymes and kills off beneficial bacteria present as well as other micronutrients present in raw milk, including decreasing the solubility of the calcium present. This is not surprising due to the heat-lability of many proteins. Importantly, the diet of the milk producing cow needs to be considered. If that cow is consuming grass as it is designed to do, then the milk fats are healthy, whereas if the animal is consuming grains, which it is not designed to eat, then it is often sick and requires antibiotics, so the combination of pesticides, GMO grains and the pro inflammatory fats from the seed oils lead to dirty milk fats, which. If you can find a clean milk source raw or pasteurized, then use it if you like and don’t be afraid to go full fat dairy in that case. Of course, raw milk is currently illegal in North America, although, it’s the norm in other countries. I would never suggest that the current food system with mass produced dairy shift to raw production, as that would be crazy, however, if the food system shifts to more local producers (once again) and you are able to legally acquire it from a local farmer’s cow, then GO FOR IT! 
4) Fruits & Vegetable juices - specifically, I’m talking about store bought ones that are not labeled as raw. North American food safety protocols dictate that any fluid sold in stores that was once living has to be pasteurized including dairy and fruit & vegetable juices. The problem is that many of the protective benefits that are known about fruits and vegetables are believed to be eliminated be pastuerization due to the high heat. That would explain, why studies have shown that people who consume whole fruits and vegetables live longer & are healthier overall, but these benefits are not present in store bought juices because of the heating
I hope that you are able to use this list to help you achieve your goals!
In my opinion, it's not a conspiracy, it's just about making money & that includes the government.  Hopefully, one day, using research into human evolutionary physiology to elicit the response of incresaing consumption of foods, especially in light of the fact that they are destroying our health, will be illegal; but until then we have to stand on guard for ourselves and our families! Let’s not reward food companies for researching hunger triggers & using it against us!
Until next time! Remember to join the MERF movement (I MUST EAT REAL FOOD) & live and play life to the fullest!


Dan T

Wednesday, January 29, 2014

It has to be a lifestyle change!

Hi everyone!

The end of January is upon us & hopefully you're all well into adopting your new lifestyle goals as I am!  Progress report to follow later with pics & metrics.

Anybody who has been playing this lifestyle change game for any length of time knows as well as I do that the odds of making a successful change seem stacked against anyone.

I think it comes down to the framing of the persons' beliefs about what they are attempting to do.  Over the decades that I've been helping people make changes to their lifestyles (the last 10 of which as an RD) I can tell you that one common theme has emerged to those who were successful vs. those who were not.  This belief was that those who were successful were able to mentally wrap their heads around & commit to the fact that they were making a lifestyle change and not just forgoing some things they like for a bit.  Furthermore, these individuals were also able to replace the intent of the original behavior and avoid the usual roadblocks & pitfalls that more often than not occur with lifestyle changes.  As anecdotal as that is, it's based on 10 + years of experience and real results.  Let's call it results based practice.

Let's break down how these people succeeded.

1) They truly understood and committed to a holistic lifestyle change - therefore, they adopted new daily habits in the realm of activity, eating & sleeping. This means that essentially they redesigned their life with their ultimate outcomes in mind.  This requires time & effort & commitment.  Tim Ferris explains the concept of redesigning ones' life extremely thoroughly in his 4 hour book series.  However, you can do it simply by considering what your goals are & then planning out daily behaviors each week that will move you towards your lifestyle goals (i.e. consuming half my plate in low carb vegetables at every meal, etc...).  The other important concept here is that these people embrace a HOLISTIC change and therefore were exercising more and consuming better quality food at the same time.  Each behavior can feed forward on the other.  For example, if you start your day, as I did this morning, with a 6 am CrossFit class, I am much less likely to each a load of crappy food later in the day, because I believe that would undo most of my hard work & don't want to risk that!



2) They also implemented new thinking strategies and beliefs to help them become the best they could be. This keeps their focus on the goal and not the challenges.  This is critical because of our reticular activating system (RAS) that controls our focus (among other things).  This is the system responsible for you noticing the same model of car that you are thinking about buying or same breed of dog that you just got.  Dennis Waitley explained it best when he said it is like the guidance system in a torpedo/missle.  Without it, we just fly around aimlessly.  Unfortunately, the RAS only knows IMPORTANT, not whether it's good or bad (i.e. move towards or away from) and therefore if we focus on the things we are NOT wanting to achieve (i.e. don't eat the cake), our RAS kicks in understanding only that we value CAKE & then we see every crumb of cake from here to Tim Horton's.  The successful people are able to control their mental focus only on the goal or replacement behaviors, which means they did the work to plan out replacement behaviors, etc...

3) One final important distinction is that these successful people reduced their exposure to or eliminated completely processed foods.  This is extremely important because of the fact that processed foods are engineered chemically (that's correct) to stimulate us to over consume them.  It should be illegal, but it's not.  The bottom line is that if you want to maximize your odds for success remove processed foods from your diet while you are trying to burn fat otherwise you will be regularly undoing the progress you have made!

When I say processed foods I am referring to any food that is changed significantly from it's original form before eating. We're talking well beyond junk foods here (those are so obvious I won't mention them here). Examples of processed foods include but are not limited to:

- Sugar - this is a no brainer.  Sugar is refined & this makes it highly processed & therefore highly available carb source to the body, which in fat burning land is NOT A GOOD THING.

- Grain products - think about it, we don't eat any grains right from the ground or off the plant, 95% are ground or milled before preparation for consumption.  This makes them all highly processed.

 - Legume products (lesser extent) - as soon as these become powders & added to other items or pressed into shapes they are essentially as processed as Grain products, but even when consuming them whole they must be cooked for significant lengths of time before consumption, which makes them moderately processed.  A quick caveat is that some people do fine with these included in their diet due to the "safe starches".  However, for fat burning I would include them as a carb and not a protein.

- Dairy (lesser extent) - this is not really true when dairy is RAW from cow, but unless you are getting it directly from your back yard Heffer or a local farmer, it is often illegal (whether just or not) and the market therefore can get sketchy.  If you look at pasteurized milk, what is it, it is de-fatted sugar with some proteins present.  That's it.  Yes, there are some vitamins & minerals present, but they are actually quite unavailable & there's nothing that can't be obtained from other good quality food sources.  I personally have nothing against well raised high fat cheese, grass fed butter or fermented dairy like good quality raw full fat yogurt or Kefir.

Anyway, the bottom line is once you've shifted your thinking/beliefs to make a holistic lifestyle change and then start implementing those daily behaviors, you are making solid progress!  However, limiting your exposure to those processed foods will insure that you are not driven by chemistry to fall back into your old habits/lifestyle.

I hope this info helps you achieve your goal.

Be sure to check out my new website Dietitian Dan T where you can access this blog as well as my new YouTube channel (subscribe today)!  I'm working hard to bring you my view on the latest nutrition research, as well as practical tips to help you achieve your goals & motivation to help kick start your success!

We're expecting our second child in the next week or so, but I will do my best to continue posting blogs & videos as I am able to.  I will probably look a lot more sleep deprived in the next 6 months worth of videos!

Take care & have a great week!

Dan

Monday, December 23, 2013

SMART Goal Setting Review

Tis the season for Setting Goals!

Do NOT sell yourself short! You can achieve what you set out to achieve, just be sure to create the right road map (i.e. behaviors to reach the goal).

Be sure to check out my YouTube channel coming in 2014!

www.dietitiandant.com -click on the Video tab.

Sincerely,

Dietitian Dan T

SMART GOAL SETTING

In the spirit of the Holidays, please enjoy my segment on how to set SMART goals.  Adopting this effective strategy should help to optimize your chances of successfully setting and reaching a goal rather than the business as usual New Year’s Resolutions, as you will see.  ENJOY!

Every New Years we do it...  Take a look at our lives and decided to change… something! January has the highest number of people starting lifestyle change plans, etc… However, it also has the highest percentage of these individuals who drop out, or quit!  Therefore, we examine how to set goals in a way that maximizes our chances of following through! 

SMART Acronym:
1)     Specific – Must answer the six “W” questions:
a.    Who – is involved?
b.    What – do I want to accomplish?
c.    Where – Identify a location.
d.    When – Establish a time frame.
e.    Which – Identify requirements and constraints.
f.    Why – Specific reasons, purpose or benefits of accomplishing the goal.
Example: SMART Goal regarding health = Do cardio training for 45 minutes 3 days / wk and resistance training for 45 minutes 3 days/wk at XYZ fitness club VS. Get in shape.

2)     Measurable – Concrete criteria for measuring progress towards the attainment of each goal you set & regularly scheduled progress checks.

3)     Attainable – You begin to figure out ways to achieve your goals.  Develop attitudes, abilities and the skills to reach them.  This “development” occurs only when you see goal achievement as possible for you.  Stair steps/Stage wise – over time what was once inconceivable to you becomes well within your achievement.

4)     Realistic – A goal must represent an objective toward which you are both WILLING and ABLE to work.  TEST of Realistic = DO you BELIEVE that the goal is attainable?

5)     Timely – A goal should be grounded with a time frame.  This increases your sense of urgency and can help you tap more of your resources to achieve the goal.

Other tips for Lifestyle Change Goals: 

A) Include adhering to your lifestyle habits as an outcome (i.e. I will consume 8 servings of fruits and vegetables per day; or 5 vegetables and 3 fruits per day; or I will do 3 cardio and 3 resistance training workouts this week (for 30 – 45 min each)).  This is critical, because change in measured parameters may take some time, but this way you know & are recognizing if you are on track behaviorally or not.
B) Research your desired outcomes and be sure to discuss them with a health professional who can help you set a realistic target and timeframe, as well as help you overcome obstacles and use effective, proven strategies.
C) Share your goals with peers who can support you and hold you accountable to your standards.
References:

1) Adapted from: Psycho-education.  2006.  Dr. I. Patelis-Siotis, McMaster University, Hamilton, Ontario.
2) Wikipedia entry on SMART/ER - http://en.wikipedia.org/wiki/SMART_criteria.

Thursday, August 8, 2013

Macronutrient Partitioning



Today, I want to chat briefly about the concept of Macronutrient Partitioning.  This refers to the breakdown (percentages of total calorie intakes) of carbohydrates, proteins and fats that we eat.  This is a general overview of the topic.  If you want more details, I would suggest that you check out this blog post on Robb Wolf's site and consider this ebook, which is very well researched and describes the topic in quite easy and practical terms, it's called carb backloading.

Why consider this? Simple. If how much we ate was the only driving force, then circulating hormone levels would not need to be considered.  This is NOT the case, and as you will see, macronutrient composition can alter hormonal circulatio, which then can determine how the macronutrients are utilized in the body.
All macronutrients are necessary for overall health, optimal performance and maximal longevity!  Here we look quickly at the role of each macronutrient in the body.


1)    Carbohydrate.  This category of nutrient is primarily used for energy.  Interestingly, the body has the ability to create carbohydrates given the right substrates and it can adapt to ketone bodies as fuel as well. This category includes mainly fibre, starch and sugar.  Fibre is primarily indigestible although some has been shown to be broken down by bacteria in the colon to release fatty acids for fuel.  Sugar is the simplest form of carbohydrate energy and is quickly absorbed and enters the blood as glucose.  Table sugar is actually sucrose which is a 50/50 blend of glucose bound to fructose molecule.  Fructose is preferentially stored in the liver and has been shown to lead to central adiposity.  The structure of glucose is shown to the right and is a primary fuel source for anaerobic activity (think high intensity glycolytic activities) via glycolysis and Kreb’s cycle and the electron transport chain one molecule of glucose directly creates a net of 2 ATP (energy molecules).  Glucose is blood sugar and entry of this into the blood stream stimulates secretion of insulin by the pancreas to regulate the circulating levels of this in the blood (CITE).  Most food labeling requires sugar be listed because of its rapid effect on blood sugar (and insulin) levels, however, a large amount of starch, although not as rapid-acting can definitely raise blood sugar (and insulin) for longer periods of time, which can change structure of adipose tissue to become more efficient at storing fat (vs. burning it).



2)      Protein.  These are essential nutrients for the body, as they are building blocks of every tissue and are also used for energy sources.  Certain amino acids are essential as humans cannot synthesize them; all others can be made from the essential ones or by breaking down ingested proteins.  Conditional amino acids are not usually necessary except during times of stress, illness and specific inborn errors of metabolism.  By far the best biological availability and quality of proteins are found from animal sources.  Vegetarian options can suffice but are less than optimal.  Branched chain amino acids can be broken down into Acetyl-CoA and Succinyl CoA and enter Kreb’s cycle to produce energy as the body requires.


3)      Fat (Lipid).  This group includes fats, waxes, sterols, fat-soluble vitamins (A,D,E,K), mono-, di- and tri-glycerides, phospholipids and others.  Their main roles include energy storage, signaling and structural components of cell membranes.  Fats provide the richest source of energy for aerobic respiration, in which two carbon units of fatty acids are released and enter Kreb’s cycle and subsequently the electron transport chain to create energy (i.e. palmitate (C16:0) oxidation results in 106 ATP (13.25 ATP per 2-carbon chain)).




We need to understand the effects of each macronutrient profile on hormone secretion and subsequently on body composition.

A)     High carbohydrate, low fat: This is the USDA, HC norm and given today’s sources of carbohydrates (i.e. highly refined) has been associated with increases in insulin (to the point that the body can become resistant insulin resistant) and increased body fat particularly around the abdominal area (i.e. surrounding the visceral organs).  This is the most dangerous form of obesity and is directly associated with metabolic syndrome.

Elevated insulin:
-          Promotes fat storage and stops fat burning.
-          Promotes protein synthesis and decreases protein hydrolysis.
-          Therefore, it promotes growth of both fat & muscle tissue.
-          Can cross the blood brain barrier and when dysregulated it has been implicated in neurodegenerative diseases (i.e. Alzheimers) and psychiatric disorders (i.e. Schizophrenia).

B)      High fat, low carbohydrate: This is a ketogenic diet.  It can take up to 4 weeks for the body to adapt to ketone bodies as a primary fuel source.  This directly oxidizes and burns stored body fat.  Circulating insulin levels are low and therefore the body is shifted into fat burning mode away from fat storing mode.  Many different tweaks have been shown to improve fat burning ability and further hamper fat storing expression (i.e. exercise type & volume, timing and amount of carbohydrate intake, amount and type of protein intake, etc…). 

Therefore, it would seem that for optimal health, performance and longevity we would be best served by doing the following.

1)      Protein:
a.       Aim for around 1 g/ lbs of your ideal body weight daily
b.      Choose the best sources (animal vs. vegetable; grass fed vs. grain fed; consider fats included with protein) 

2)      Fats:
a.       Aim for 2 g/day of omega-3 (DHA + EPA combined).
b.      Not more than 8 g omega-6 per day.
c.       Get adequate monounsaturated fats (olive, avocado, hazelnut and macadamia nut and oils).
d.      Saturated fats (animal sources + coconut oil).  When carbohydrates are lower, these can be your primary fat sources.  These are the most stable for cooking and least oxidizable.

3)      Carbohydrates:
a.       Keep your total intake to around 100-150 g per day (depending on your body composition goal).
b.      Eliminate sugar and refined grains (i.e. all grains are refined).
c.       Consume your main carbohydrate loads post workout (especially strength training) up to 4 hours after and focus on starchy vegetable carbohydrates primarily. 
Citations

Monday, July 8, 2013

Are Low Carb Diets the Devil?


Hi everyone,

A quick disclaimer to go with my post.  I hope you find the information useful!
 
Remember, I do not know your case at all.  Be sure to discuss this with your doctor or a health care provider who does know your case well, before attempting.  I am providing you with information to better understand a nutrition protocol and how it might be useful to you, but am in no way suggesting you do it.  As such, I am not responsible if you do try this unsupervised and bugger yourself up.  Use your common sense, and discuss this with someone who can help you do it safely.

As a registered dietitian, we are often taught that Atkins was a loon & that low carb diets are the bane of health & longevity. Well, after delving into the research & examining this topic for myself, and also experimenting with this practice personally (n=1 experiment) I can say, that they are definitely NOT the devil & they might actually possess some incredible therapeutic benefit!  Read below & draw your own conclusions.


What is Ketosis
State of elevated levels of ketone bodies throughout the body (including the blood).  These are formed by ketogenesis when liver glycogen stores are depleted. Two major ketone bodies used for energy are acetoacetate and β-hydroxybutyrate.  Both are readily used by most of the tissues of the body except the heart & one portion of the brain.  Interestingly, humans have evolved a method of creating glucose from broken down proteins (certain amino acids).  While semantic debate rages on about why we evolved this capability, the fact is we have it and as a result, we really don't need much direct carbohydrate intake to live healthfully!  The only caveat I will add now is that if you have to perform physically demanding and performance dependent activities on a regular basis, then you will need to add more carbohydrates (complex, safe starches are excellent for this) in the 3-4 hours post activity.

Common Concerns:

As a health professional, the most common concerns that I've read about, heard or even stated as fact myself (incorrectly, I might add) are here:

1)      Ketosis is harmful – The fact is if glucose cannot be broken down (i.e. insufficient insulin levels) then the body metabolizes fat, which will increase blood ketone levels leading to ketosis.  The ketoacidosis situation arises when these ketone bodies continue to elevate due to the complete lack of insulin and the fact that sugar is being consumed and remaining unused in the blood stream.  This leads to high levels of ketone bodies and high levels of blood glucose concomitantly, which decreases the pH of the blood (increases acidity) leading to metabolic acidosis in which enzymes, tissues and organs can fail leading to coma and subsequently death.  Obviously, that is something that we would all like to avoid like.  However, it’s critical we understand that an otherwise healthy person who is making insulin readily can undertake a well-designed low carbohydrate diet safely.  They will be in ketosis, which can be extremely beneficial.

2)      High Protein diets and kidney failure – it’s believed that higher protein consumption increases risk of kidney damage.  This has been disproven by several well-designed long term studies. The only caution I would mention is that people suffering from failing kidney function already or those at high risk for kidney failure (i.e. long term poorly controlled diabetes) or gout might require limited protein intakes.  Otherwise, there is no known upper safe limit for protein intake.

3)      Cognitive burnout - My Brain & nerves needs sugar as a fuel – This is true, to an extent. Parts of the brain can burn only sugar as fuel, however, the body can create sugar via gluconeogenesis (in the liver) from proteins, which is one of the reasons why protein intakes are elevated in low carbohydrate diets.  Furthermore, the only studies that I've seen linking low carb intake to poor cognitive performance vs. high carb intake were in subjects that were NOT fat-adapted.  In other words they did not undergo the 2-4 week adaptation/detox phase in which their body decreases carb burning pathways & upregulated fat burning ones, making us efficient at fat burning.  Anyone, detoxing would not perform well on cognitive test.

4)      High fat diets and high cholesterol – It’s still (erroneously) believed that a high fat diet leads to cholesterol elevation.  This has been disproven by several well-designed studies and it has been established that refined dietary carbohydrate is far more likely to lead to metabolic syndrome and dysregulations in cholesterol that significantly increase risk for heart attack or stroke.  Furthermore, overt blood cholesterol values are less meaningful than once believed.  More telling tests including LDL-particle size, which unfortunately is not routinely available, is one of the best to determine cardiovascular risk vs. LDL number.

5)    Low carb diets will increase risk for Cancers due to low fruit & vegetable intake – It’s (erroneously) believed that high animal protein, high fat diets increase risk for cancer.  There are two active hypotheses.  The first is that animal protein causes cancer.  This comes from studies that showed an association between animal protein intake and cancers, however, on further examination, the data analysis is suspect. For example, whenever pizza (with peperoni) was consumed all the calories were counted as animal protein and including lunch and cured meats as animal protein sources would definitely skewed results, especially in light of the huge body of evidence linking sodium nitrates and the like to stomach & bowel cancers (strongly).  The second hypothesis implicates lack of vegetable matter in this; however, it is carbohydrates that are being restricted, not vegetable matter.  Whenever I am counseling someone on a ketogenic protocol, I recommend that people consume low carb vegetables with every meal and use fruit sparingly.  In the end, clients consuming a low carb paleo diet often consume more plant matter compared with the usual North American diet.  In fact, dietary carbohydrate especially from refined grains, sugars, etc... and excess fat mass have been implicated in causation of many cancers.  Even more research, has demonstrated a treatment enhancing effect by using a ketogenic diet.  Specifically, the theory is that a tumor uses glucose as its primary fuel source, and is unable to utilize ketone bodies, whereas humans can adapt to ketone bodies.  There are many studies showing that a ketogenic diet during cancer treatment helps to eliminate tumors faster and more effectively than traditional treatments alone, likely because it starves the tumor.  Specifically, most of the research on ketogenic diets improving cancer outcomes have examined endothelial derived cancers (i.e. bowel and breast, etc...).

What are the Benefits of a Low Carbohydrate diet?
1)      Decreased hunger - more insulin stability and presence of ketone bodies both act to increase satiety.
2)      Long-duration fuel supply - decreased dependency on quick burning sugars allows for longer lasting, more stable energy levels.
3)      Decreased exposure to highly toxic refined grains & other processed foods - the processing used in preparations of grain products, juices & sugars, etc... act to increase our exposure to many chemicals the effects of which in the long term are unknown.
4)      Reduction of over-stimulation to the brain (i.e. with seizure disorders, depression, bipolar disorder and schizophrenia) - this has been examined for years in children with epilepsy, but more recent studies have found success in subjects with other brain disorders. This is likely due to reduction of readily available, fast burning sugar, so the brain is better able to regulate the use of energy even in hyperactive firing areas.

Okay, I would like to give this a try, how the hell do I do it?

How do I achieve Ketosis?
In order to enter into ketosis, the average person needs to consume < 100 g of total carbohydrates per day.  Metabolic individuality might mean that some will enter ketosis slightly above or below that, but that seems to be a reasonable goal amount for carb intake to be below for ketosis.  This is carbohydrates from all sources, but I strongly suggest eliminating highly refined carbohydrates (I.e. sugars) and grain products (especially wheat), and possibly even dairy for at least 60 days to see how you look, feel and perform (depending on your specific individual goal) and then reintroduce as tolerated, if desired.  This could provide many further benefits in addition to ketosis.  This means that your only sources of carbohdyrates for those 60 days will be low carb vegetables, starchy vegetables and limited whole fruits.  Many of you might recognize this as a low carb paleo diet.

Why is Ketosis safe for most of us?
Human evolved over millions of years before agriculture (only about 10,000 years old) with a cyclical pattern of eating, often famines followed by feasts, etc… Furthermore, there was only a brief time relative to today that fruits & vegetables would have been plentiful (i.e. late spring/summer & fall).  This means that over-winter and even into spring there would have been limited amounts of carbohydrates available at all.  We had to adapt to a long lasting fuel source to allow us to survive over winter.  This is likely why fat evolved and metabolically why we can adapt to ketone bodies as a fuel.
Interestingly, even today there are many documented cases of human societies today that exist in a long-term ketogenic state. After a 2 to 4 week period of adaptation, human physical endurance is not affected by ketosis, according to studies - meaning that we do not necessarily need a high carbohydrate intake in order to replace depleted glycogen stores for exercise. This makes the argument more compelling that; in fact, we are designed to thrive at certain levels of ketosis.

Remember it’s a total lifestyle that’s critical.  So in addition to the diet alterations, be sure to get the rest of your lifestyle in order.
  1. Get adequate and the best quality sleep you can nightly;
  2. Activity: Be sure to do some (lower intensity) exercise every day and then twice per week add in lifting heavier things (i.e. weights, bands, body weight), and once per week move as fast as you can (i.e. wind sprints).
Great sources for more information on activity for health, performance & longevity are Robb Wolf's site & Mark Sisson's site.  They also have some great info on primal/paleo eating as well.
So here's the protocol, I'm doing & that I have recommended that I see clients get the most out of.

Nutrition Strategies for a Ketogenic Diet 
  1. Decrease your total carbohydrate intake to less than 100 g daily. 
  2. Avoid highly refined carbohydrates (i.e. sugar and refined flours) because these will spike insulin and that will stop fat burning & stimulate fat storage.
  3. Exclude all grain products (especially wheat) for at least 60 days.
  4. Consume adequate vegetable matter.
  5. Limit yourself to less than 2 fruit servings per day.
  6. Avoid fruit or vegetable juices.
  7. Consume at least half your plate of low carb vegetables at each meal on average.  This provides at least 6 servings of highly nutrient dense vegetable matter per day.
  8. Include safe starches: potatoes (especially sweet potatoes, and other starchy tubers – these will provide carbohydrates to be readily converted into glucose by the body, but also come very complex starches that can be utilized by healthy gut flora (i.e. pre-biotics).
  9. Consume adequate protein.
  10. Depending on your individual needs, you will need differing levels of protein – usually 35% of total calories are good.
  11. Choose either grass fed, humanely raised animals or if you use conventionally raised then be sure to consume high omega 3 animals at least 3-4 times per week (i.e. oily fish).
  12. Don’t fear FAT!  You will be consuming around 50% of your calories from fat.  This is the most energy dense nutrient source, but it also has many health benefits.  In a ketogenic adapted person, this becomes your main fuel supply.
  13. Choose mostly anti-inflammatory fats – specifically foods high in omega-3 fats (animal sources like oily fish, pastured meats, cream & butter) and monounsaturated fats (like pastured meats, cream & butter, olives, avocadoes and their oils) and also saturated fats (pastured animal fats and coconuts and their milk (full-fat) and oil).  These are all highly anti-inflammatory.
  14. Use nuts sparingly due to high omega 6 fats.  Macadamia and Hazel nuts (philberts) have lower omega 6 content vs. monounsaturated fats.
  15. Adequate hydration – You will need to consume adequate water per day to ensure that you allow for adequate removal of byproducts associated with protein breakdown & ketosis.  Although some guidelines suggest 3-5 L per day, the best indicator is that your urine color (see chart below)



So I hope that you find that information useful and now you can bring that information with you to your health care provider.  Remember, I do not know your case at all, be sure to discuss this with your doctor or a health care provider who does know your case well, before attempting.  I am providing you with information to better understand a nutrition protocol and how it might be useful to you, but am in no way suggesting you do it.  As such, I am not responsible if you do try this unsupervised and develop issues as a result.  Use your common sense, and discuss this with someone who can help you do it safely.

If you do decide to talk to someone and move forward, remember that it is critical to keep a journal about how you are looking, feeling & performing each day to be able to see and record the changes that are happening in your life.  This way you'll know if this approach is moving you towards your goal or not.


Till next time.

Dietitian Dan T

Citations
http://www.ncbi.nlm.nih.gov/pubmed/12047499
http://www.ncbi.nlm.nih.gov/pubmed/19245705
http://www.appforhealth.com/wp-content/uploads/2011/07/Urine-chart.jpg