Evidence-based vs. Internet-based keto diet

Many misconceptions about the ketogenic diet are spread on the Internet, an expert told attendees at the fall conference of the Obesity Medicine Association.

“It’s confusing out there. It’s so terrible.” Eric Westman, MD, MPH, FOMA, an associate professor of medicine at Duke University and founder of the Duke Keto Medical Clinic, said during a presentation. “I listen carefully to patients who say ‘I’m doing this and it doesn’t work’ and I say, ‘I bet you’ve learned how to diet of Dr. Google ”.

The keto diet, when followed correctly, “works for everyone,” according to a speaker at the fall conference of the Obesity Medicine Association.

Westman spoke of a class where he taught several thousand participants about an “evidence-based, low-carb ketogenic diet,” in which people can eat as much meat, poultry, fish, seafood, and eggs as they can. that they are what he called “comfortable.” full up.” The diet also includes eating up to 2 cups of raw leafy vegetables; 1 cup raw vegetables without starch; limited amounts of foods such as cheeses, creams, oils and olives; and moderate amounts of low-carb snacks, such as sugar-free Jell-O, pepperoni slices, and low-carb cured meats.

Westman said all class participants had knowledge of the Internet ketological diet before taking their class. In addition, 75% of participants had been on the keto diet for some time, while the rest of the participants had only recently started it. According to Westman, surveys conducted after completing the class indicated that 94% of participants learned something new about the keto diet in class.

At the Obesity Medicine Association meeting, Westman discussed the top 10 differences between Internet-based keto diet teachings and lessons learned during his evidence-based and low-grade ketology diet class. carbohydrates.

Table of Contents

Measuring ketones “not necessary”

Many people on the keto diet believe they should measure ketones, according to Westman.

“We never asked people to measure ketones, but a lot of people do,” he said. “It simply came to our notice then the keto diet It’s so complicated. ”

“No need” macro calculation

Westman said downloading apps or using other devices that contain substances like protein is not an essential component of the success of the keto diet.

Medium-chain triglyceride oils, ketone drinks and pills “not needed”

While these products or products that contain them may increase ketone levels, their calorie count and fat content should also be considered, Westman said. He added that patients have told him that they tried 350-calorie keto-friendly cupcakes, but that they have eaten several.

“It’s not really ketogenic friendly if you have 900 calories from small cupcakes,” Westman said.

Fasting “not required”

While Westman acknowledged that intermittent fasting can help people lose weight, he said there is not enough data to recommend it.

“It simply came to our notice then. We don’t know the safety parameters in that regard, ”he said.“ I’m talking about data from random trials over the last 20 years. Show me an article with fasting as the main intervention with 50 people for 6 months and I will comment on it “.

In contrast, evidence supporting the benefit of the keto diet for patients with various forms of CVD, as well as diabetes, obesity, and polycystic ovary syndrome, has grown over the past century, Westman said.

Nuts, almond flours are not good

“You really can [limit yourself] to a handful of nuts all day? “Westman asked rhetorically.” Or are you like me? Get a tub of nuts and ask yourself, “Oh, where have they gone?”

According to Westman, studies have shown that these products are “trigger foods” for many people. Therefore, nuts and almond flour are not recommended in the keto diet.

Vegetable intake should be limited

Because vegetables contain carbohydrates, their consumption should be limited daily, according to Westman. The maximum amount of carbohydrate intake in the ketogenic diet often ranges from 20 to 50 g per day.

Clean carbs are not as “strong” as total carbs

Some products will include both clean and total carbs, Westman said. However, “clean carbs … frustrate people who are fixing diabetes or have a couple of hundred pounds to lose. Just switching from clean carbs to total carbs may be enough to make [the keto diet] work. ”

Artificial sweeteners are not “banned”

“Artificial sweeteners are like maintaining methadone or suboxone to eliminate opioids,” Westman said. “I don’t know of any health benefits from having these things, but I do know the damage of sugar, so I use it as a workaround.”

Clean food “not necessary”

Clean foods, which have undergone changes during processing and are often found in newer farmers and restaurants markets, are beneficial, but they often have a prohibitive cost as a long-term staple, Westman said.

“I do not advocate that people go to all kinds of restaurants. But compared to something like a drug or an operation to get something, [clean foods] they are much less risky, “he said.

The intake of cheeses, fats and oils should be limited

While it is true that some cheeses, fats, and oils may have little or no carbohydrates, this information must be balanced with how many calories a particular food has, Westman said. For example, while most butters have very few carbs or none, a small amount has a lot of calories and therefore can negate some of the low carb benefits, he said.

Message to take home

The key to the success of the keto diet is to control the amount and type of food you eat daily, Westman said. Specifically, it involves looking at the carbohydrate content of foods and beverages and eating so many foods that contain “less than one.” [carb] or zero, ”he said.

“I’m convinced after delivering food to people and seeing people in the metabolic chambers that keto works for everyone, when it’s done right,” Westman continued.

Westman, E. The “evidence-based” versus “Internet-based” ketogenic diet. Obesity Medicine Association: Overcoming Obesity.

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