Keto diet and diet comparisons: Mayo Clinic Radio

Welcome back to Mayo, Clinic radio, I’m dr. Elizabeth Cozine and I’m Traci McCray. According to dr. Google. The most searched question of 2018 was what is the keto diet? Keto chauffeur ketogenic is a high-fat, very low, carbohydrate diet.The idea of getting most of your calories from fat, forces your body to use different energy pathways. Instead of carbs for energy, the body burns fat, entering a state called ketosis. This is what could go wrong. It sounds like a great plan, but a little dangerous to me, that’s why I’ve not tried it. Well, here to discuss the benefits and the drawbacks of the keto diet, is, Mayo, Clinic dietician, Kate, Zaretsky. Welcome back to the program, Kate.

I’ve, worked with Mayo Clinic for 19 years and when I started and was working more so in pediatrics. This was a diet that we used in the hospital. We then sent children home on this diet, to help control their seizures, and that is how I was introduced to the new ketogenic diet. So when people started talking about being on the keto diet, and I’m doing the keto diet too. I asked several people, if they had seizure disorder. History said no. I thought about my own experience. You know I would spend an entire day, doing calculations of how much fat, how much carbohydrate, even how much protein and the ketogenic diet, as it’s used to control seizures. It’s really done in very strict ratios, and you’re very cautious about weighing and measuring and being very precise, with the amount and the types of foods. Making sure that you have the response, to help that child. So, a ketogenic diet, you’re saying, is maybe different then what people consider is a key factor to a keto diet.

Yes, I think what we’re seeing today, where people are describing to me, while I’m doing the keto diet. Often I was like well, how are you doing it. And often times, their description shows them eating fat and protein in large quantities. And eating very few carbohydrate-rich foods. In my opinion, that sounds more like a modified Atkins type diet, where you’re allowing ample quantities of protein and fat. and just not limiting it. The carbohydrates – and I know that’s where people are now. You know talking to more people and reading more about it, there are people who are looking at this in true carbohydrate restriction. But, maybe some protein restriction, I think might make a difference. That we’re maybe seeing across the board, although, I’m not sure people fully understand what that means. People are using this for weight loss. Right? And I think you know they really have their ideas. And I think one thing to understand, is, there are differing degrees of Quito ketogenesis. You know being in ketosis, oftentimes, it’s measured by people checking their urine, ketones. And so people will get test strips to test their ketones.

You know that’s the difference we see between and what I think about ketosis. Sometimes I get a little nervous. I think well, gosh we don’t really actually want you in ketosis. But could you tell us about that? I think – this is something that is unknown, when people are saying well, I’m, going to put myself on a ketogenic diet and being ketosis. Because, when you really think about what ketosis is, it’s an alternative pathway, that our body has to use in times of emergency. And times when your brain in particular, needs energy. And for some reason there’s not food, like carbohydrate, which provides the fuel, that your brain prefers. When that’s not around, your body has a kind of backup system to make sure you survive. So it’s able to produce these ketone bodies to keep you functioning right.

It’s something that historically has alarmed us, in terms of not necessarily wanting people to be in ketosis. It can be very dangerous. Ketone bodies are considered toxic. Your body has two ways of getting rid of them. You either exhale them through your breath or you urinate them out. It is a stressful kind of process on your body, because it is trying to rid itself of these ketone properties. Well, when we were getting started, the doctor Cozying, you and I, both said – we know people who lost hundreds of pounds. I know socially, people that are patients of mine, who have weight loss. And I feel great. And so for them, they consider that to be quoted successfully.

Possibly, we’re talking two different languages here. Ketosis and those ketones things, that is not someplace where you want to be health-wise. There’s got to be a middle ground here, mm-hmm. And I think there’s probably a gap in really understanding the scientific research. What does this mean for somebody long-term? I think there’s some emerging data in the short term, that people can lose weight on a ketogenic or a very low carbohydrate diet over the course of a few weeks. In two months, like most restrictive diets, what the literature says, is, that after six months these diets are very difficult to sustain. Because, people miss eating fruits, vegetables, pastas, breads, and other foods, that have carbohydrate, which most foods include. It’s a very restrictive diet, that it is difficult to sustain for long period of time.

Cutting out carbs, well for me, that means pasta and bread. But, it also can mean fruits and vegetables. I think, if you really start looking at what foods have carbohydrates, you find most do. Even dairy products have carbohydrates, such as, things like almonds. I’m gonna eat almonds on my ketogenic diet, or my low-carb diet. But, depending on the quantity of what you eat, it will impact the degree of ketosis that you’re experiencing, And then I think another piece of this is, the idea that from a survival standpoint, our body is able to convert protein into carbohydrate. What our body wants to run off of, I think looking again at the question of carbohydrates, a healthy carbohydrates is what we want to eat. The majority of the foods that nature provides for us, probably about 80 to 85 percent really does have carbohydrate. The answer is to reduce carbohydrates, rather than eliminate them. And to look at the quality of your carbohydrate.

The answer I think is to eat more wholesome carbohydrates, like green vegetables, instead of a bag of Doritos. The quality and the quantity of the type of carbohydrate in portion sizes, rather then sharing a bag of Doritos, that I would Love to share with you. Is there any long-term data on the keto diet? I have not seen real long-term data. I don’t know if there’s much data beyond the year of the data I’ve seen in regards to weight loss. People might lose weight in the initial six months. But, by the years mark, there really isn’t a statistical difference in the amount of weight loss, compared to other diets.

We’ve, been talking about the keto diet with Mayo Clinic dietician, Kate Zaretsky. We’re gonna take a short break when we come back. We’ll, compare the keto diet with other popular diet, plans, the Mediterranean and Mayo Clinic diets.

Welcome back to Mayo, Clinic radio, I’m Dr Elizabeth Cozine and I’m Traci McCray. We’ve, been talking about diets with mayo, clinic dietician, Kate, Zaretsky. If people are interested in improving what they eat, you always have to be in favor at the beginning of the year, to turn over a new leaf. Every day is a chance to turn over a new leaf. Let’s talk about some other diets that possibly would be a little bit better to choose, instead of keto. Maybe we don’t even call them diets. I think that’s a great suggestion. We’ve seen that, with our Dietary Guidelines for Americans, that comes from the USDA, the last iteration that was released, they started looking at diet patterns. Looking at patterns and the way people eat, rather then simply to call it a diet, that’s important. Because, we don’t know what the perfect diet is, and wouldn’t know, even if one exist. We do have some evidence that says, there’s may be ways or styles of eating certain foods, within these patterns, which may be beneficial to long-term health.

When I meet with people, I like to say, tell me about what you’re currently eating. I think every day is an opportunity to say how am I going to approach eating today. And when we eats a certain way, it becomes a habit and a lifestyle that improves the quality of our life. Hop on that spectrum somewhere, if you want to eat more fruits, vegetables, whole grains, and meats or fish to meet the recommendation that can improve diet of eating better. Is the Mediterranean diet the same, or simply similar. When you start getting into say the Mediterranean diet, and even the Mayo Clinic diet and others, they have been recognized in terms of their long-term health benefits.

What are some of the types of foods in the Mediterranean diet? People may think of fish and olive oil. I think those are two that come to mind right away. Fish, in terms of olive oils, related to healthy fats. Also, when you look at the Mediterranean diet and lifestyle, there are many fruits and vegetables, whole grains, beans, legumes. Those types of whole foods, are more plant-based foods.

I don’t hear Doritos. Not that D word. I’d say you know, the diet has similar healthy qualities. The DASH diet stands for the Dietary Approaches to stop hypertension, and so similarly it – and I mean maybe a bit of history, the Mediterranean diet coming out of that region has a similar purpose. Why are people who live in that region not dying of heart disease and living long full lives comparatively speaking, to their Western neighbors and northern neighbors. This is kind of a reflection to the answer to the Mediterranean type of diet. Looking at the types of foods that are eaten, we took the approach to look at nutrients. What nutrients are we getting from certain food groups? That may be beneficial in terms of lowering your blood pressure, and these nutrients have been specifically examined. As a result, we’re eating less salt.

Also in combination with having more calcium, magnesium and potassium reflective. The foods that give you those nutrients, coming from Dairy Foods, most obvious calcium, are from other plant foods like leafy greens, broccoli, or even almonds, and potassium, primarily coming from fruits and vegetables, as well as magnesium, nuts, seeds, and cocoa. These are good sources of healthy foods. I had mine on the tip of my tongue. Okay, I’m really interested in veganism and I’ve been reading a lot about the blue zones. And those are the areas of the world, where people live long.

Beyond just the Mediterranean diet, there are parts of Japan where the life expectancy last into, I think it’s into the late eighties or early 90s. And they found that these people have relatively low stress, and tend to eat more of a whole food plant-based diet, consuming very few animal products on a regular basis. I’m just curious what you think about that. I think that is a really interesting way to look at nutritional research. It’s difficult to get really good long-term data in nutrition. And I think when we start looking at the ways people eat and their lifestyle choice, it reflect an outcome. Looking at thin areas, like blue zones, give us some insight into these diets. And I think, when you again look at the idea, that people in these blue zones are eating more plant-based foods and incorporating more Whole Foods. Even, if we go to northern regions of the world, where they’re eating more fish, as part of their diet, but not as many plants foods.

I think in terms of vegetarianism or veganism, the idea that you can eat a very nutritious, well-balanced diet. And you can meet all your nutrient needs, with plants for the most part. The nutrients that we pay a little closer attention to is b12. The other one is iron. Just because, it’s a little more difficult to absorb. And also, we want to make sure you’re getting enough vitamin D.

How is it been at your house? Well, I was telling Tracy that we did a little vegan experiment at my house. It was quite gassy, but you know, we were big veggie eaters. It wasn’t a huge lifestyle shift, but when I did it for reasons now, even though, I’m not trying to lose weight. I wanted to see what it was like, because I recommended these patterns of eating to people. I wanted to see, is this a change that I could potentially make known in Minnesota, during the middle of winter. And it was fun. It was kind of stimulating to try some new diets. The gas got better and we’ve settled on a low animal product – lifestyle. Just sustainable – fewer– less than what is usually eaten. Certainly, infrequently the eating of red meat, chicken, and fish, than was ate before the change. It’s possible you can change your taste buds. I know some think, there’s no way, I can ever give up steak or any food I like. But, there’s a way. You can start to change your taste, buds, and begin to modify what you eat. That is a fact.

And yes, we all have preferences. And that’s okay! This is what makes us unique as individuals. But, there’s a name for everything. It’s called flexitarian diet. The idea that, if you still wanted to have a steak, chicken, fish or whatever it might be, you could still once in a while do that. But, the base of your diet, the majority of it, is centered around a planned diet. The source that is intentionally based on often eating plants. I think it sets you up for the kind of baseline that shows what your health picture is going to look like. I’m actually getting my kids to look at the labels and ingredients in foods. It taken me a long time. By kids are in their teens now. But, I can say, they will actually look at the labels. The less ingredients on a label, the kids are starting to notice it’s better, and that makes a difference. And it’s funny because they’ll comparing two yogurts. One has three ingredients and the other has a lot. It shows the difference in the product you are choosing. If you select a Greek yogurt, with a lot of ingredient or only a few–the question, is, which is better?

I think we want to say, absolutely, the one with fewer ingredients and the right words, is, understandably the one to select. We also have the privilege of living in a country, where the food is safe. Even though, some food contain preservatives, it’s there to maintain the safety. I think there’s also something to be said for that. When we sometimes see big words listed in the ingredients, it doesn’t necessarily mean it’s, a bad thing. But, it does makes you pause and think twice about eating the food. I think it’s a good thing to eat food that is natural.

I have no doubt we could keep talking about diets and asking questions. But, we have to be done. We’ve, been talking about diets and healthy lifestyle choices with Mayo Clinic dietitian, Kate, Zaretsky thanks so much for joining us.

Thank you.

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