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Keto? Intermittent Fasting? Working on my metabolism…

My hubby and I have decided to do the Keto diet for a while. For us, Spring is a season for a reset, considering improvements in diet and lifestyle, after a winter away trying delicious new foods (and the local wines!). We’re also trying to keep our “feeding window” to 8 hours a day, as recommended on the Intermittent Fasting Diet, and have reduced our alcohol intake. One side of our family is encouraging us, citing research that has found both diets are beneficial for health and longevity. The other side of our family thinks we’re nuts… too extreme. What… no potatoes??? No breakfast???

Why are we doing this?

We’ve both been gradually gaining weight over the years—nothing severe yet, but a trend that would become a problem in the future if it continues. This is in spite of plenty of exercise (we walked over 400 km (about 250 miles) this past winter while in Spain) and cutting desserts, late night snacks, soda pop and more. My metabolism is so slow my body temperature sometimes dips below 35c (95f).

So, why these 2 eating patterns? What are the pros and cons? Why have we decided to move to a more extreme diet for a while?

Intermittent Fasting (IF)

You know how they used to tell us that “breakfast is the most important meal of the day”? Well, the breakfast cereal companies certainly thought so… But we now know that your digestive system goes into clean-out mode, removing sludge from inside the intestines, about 4 hours after you’ve eaten. Avoiding food intake for a period of time, creating a fasting period each day, allows this process to continue long enough to make your digestive system work better. So, extending the overnight fast by delaying breakfast is one way to do this.

Think of it as giving your digestive system time to clean out the sludge after the digesting work is done. “Grazing”, eating or snacking all day long, means the digestive system is constantly busy with new food. I guess it would be like having no time to clean your house if you had quintuplets… 😊

This restricted-time eating is referred to as Intermittent Fasting, and can be done by drastically reducing food intake to 600 calories a day for 2 days a week, or by keeping eating to an 8-hour (or less) window each day. The latter style seems to suit our lifestyle best: eating brunch in the late morning, an afternoon snack if we’re hungry, then an early evening dinner. This eating style could alternatively include breakfast, lunch and an early dinner, all within 8 hours. Avoiding food for at least 12 hours a day can be of some benefit too which, essentially, involves simply avoiding snacks in the evening (a common recommendation these days).

So, in addition to the goal of weight loss, we are using Intermittent Fasting (IF) to improve our digestion, and it encourages us not to snack in the evenings as well. A cup or two of coffee in the morning is all we seem to need as we read the morning news, and clear liquids are fine to consume any time of the day during your fast. During a full day fast, if doing the 2 days a week Intermittent Fasting, it is recommended to keep total calories below 600 to count as a fasting day.

Ketogenic Diet (Keto)

My sister (also a retired pharmacist) knows more about the Keto diet than anyone I know, and shares what she learns enthusiastically. She’s spent lots of time reading and watching experts’ videos about the diet’s pros and cons, its health benefits, and recipes to make the diet easier and more tasty. While the Keto diet focuses on eating whole unprocessed foods, there are lots of tested recipes available for baked favourites, including desserts, sauces, snacks, and more to keep your diet interesting. Many traditional foods, like potatoes, can be substituted with other veggies, like cauliflower or cabbage, and flavoured with spices, herbs or cheese to make them interesting and delicious.

Besides weight loss, however, the Keto diet is reported to help repair mitochondria, the tiny bodies inside our cells that create energy. This is a 3rd goal for me. In the Keto diet, the mitochondria are reprogrammed to use fat for energy, rather than glucose, as the supply of glucose-containing carbohydrates is drastically reduced. In the process, ketones are produced, hence the name “Ketogenic” for the diet.

Although I can’t explain the chemistry (which bugs me a bit…), this change helps damaged mitochondria to repair themselves in the process. My sluggish metabolism suggests to me that my mitochondria are not working well. Also, a new theory for the cause of cancer is that mitochondria become damaged in a way that allows them to produce high amounts of energy, enabling these cells to grow non-stop, a classic characteristic of cancer cells.

A potential added benefit is that cancer cells have been found to prefer glucose for energy over ketones produced from fat. Cancer cells have long been known to consume large amounts of glucose (sugar), called the Warburg Effect, noted by Otto Warburg, back in the 1920s. The Keto diet decreases their preferred energy supply, slowing growth of cancer cells, as well as making them more susceptible to standard cancer treatments and protecting them from damage during treatment. The diet has been found in preliminary studies to be an effective add-on treatment for various cancers. I’m reading that Phase 1 trials are underway to gather data and details of how this diet-based treatment can best be used.

The Keto diet was originally designed for children with epilepsy that was not controlled with medication. It works well to eliminate seizures in these children and many have been on the diet for years. A recent study found reduced rates of cancer in this population, supporting further study into use of the Keto diet to prevent as well as possibly treat cancer. Dr. Thomas Seyfried explains the chemistry that supports this theory (see link below). Another study found the diet protected against damage and enhanced the effect of standard chemotherapy and radiation cancer treatments.

So far, research is showing the keto diet can be helpful in treating glioblastoma (an aggressive type of brain cancer), prostate, breast, stomach and liver cancers, but research is continuing. If you are receiving treatment for cancer, you should talk to your doctor before making any dramatic change in diet, of course.

Potential downsides

Kidney stones are known to occur at a higher rate when on the keto diet, but whether stones are created more readily when using this diet or if existing mineral buildup is simply being cleared away has not been investigated, to my knowledge. I suspect the latter, as I endured this when I first started the diet–a miserable experience–but this suspicion is not based on data. Either way, drinking plenty of fluids reduces the chance of this occurring.

Also, the diet is low in some essential salts (“electrolytes”), and supplementing or, at minimum, salting your food with a blend of salts that includes potassium-, and magnesium-, as well as sodium-containing salts, is a good idea to prevent deficiencies. Some sea salts or “half-salt” you find in grocery stores fit this description. There are also recipes available to mix your own salts, and electrolyte replacement powders used for treatment of diarrhea (which also causes electrolyte loss) are another choice. Check the labels or ask your pharmacist. “Charlie-horse” muscle spasms are an early sign that you are lacking electrolytes.

For me, I’m hoping this diet change will improve my overall metabolism. I’ll be able to detect whether this happens by checking that my body temperature returns to the normal range. When successful, people who have been on a fairly strict Keto diet for several months will report a normalization of their metabolism, allowing them to maintain weight loss with a much less strict diet. In the weight loss department, I’ve been losing an average of 1 pound (0.5 kg) a week in the past 2 months since we’ve been back home. This is considered a safe, gradual weight reduction that is more likely to be sustained in the long term.

I expect this will be a diet I will follow strictly for a few months and that I will then be able to return to a more moderate diet that includes fruit, potatoes and bread in controlled amounts. However, added sugar is known to cause many health problems, including weight gain, inflammation, changes in gut microbes, increased risk of cardiovascular disease, diabetes, fatty liver disease, and more. I plan to continue to avoid or limit foods with added sugar to occasional treats to avoid these health risks.

And, while avoiding fat (especially saturated fat) continues to be ingrained in the advice of many institutions, other health experts are pointing out that when calories from fat are limited, we replace them with sugars (carbohydrates) resulting in increased carbohydrate consumption in the diet of those who strictly avoid fats. They are suggesting that the current high rates of obesity and chronic disease could be tied to this shift in diet that occurred so many years ago. Although treatments have improved for both these diseases, improving survival, the occurrence rate is still too high. The typical North American “Western” diet is obviously not a healthy one. Meanwhile, the Mediterranean Diet, with its emphasis on fresh whole foods that contain fewer carbohydrates, is recommended by many health experts.

So, as Spring evolves into Summer, are you thinking about how you could improve your health? Here in Canada, we are looking to spending more time outside and enjoying fresh local produce. It’s an easy time to move to a healthier lifestyle! And, although many suggest following the Keto diet is difficult (and I suppose ANY change can be hard), there is lots of help (and recipes!) available on the internet to help make it easier. Two of my favourites are “All day I dream about food” and “GnomGnom”… Check them out… and the “science” below too!

Photo by Dana DeVolk on Unsplash

#ketodiet #IntermittentFasting #healthydiet

References:

The Big Fat Surprise – Check your local library, or available online at Amazon.ca or Amazon.com

The Warburg Effect: How Does It Benefit Cancer Cells—Pubmed Central, NIH, National Library of Medicine

Ketogenic diets as an adjuvant cancer therapy: History and potential mechanism—Redox Biology 2014

Cancer as a Metabolic Disease: Implications for Novel Therapies—Dr. Thomas Seyfried, Boston College

Ketogenic Diet in the treatment of cancer—Where do we stand?– Molecular Metabolism, March 2021

Cancer Treatment With the Ketogenic Diet: A Systematic Review and Meta-analysis of Animal Studies—Frontiers in Nutrition, June 2021

The Sweet Danger of Sugar—Harvard Health Publishing

Ketogenic Diet in Cancer Prevention and Therapy: Molecular Targets and Therapeutic Opportunities—Current Issues in Molecular Biology

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Cause of death: Fast food

I’m sure you’ve learned that fast food isn’t the healthiest diet for us, but new results from the world’s largest nutrition study suggests the problem could be more than the high amounts of fat, sugar, salt and other additives many fast foods contain. This, and other studies, suggest the way these foods are processed may also be a factor in the unhealthy results and increased risk of chronic diseases that can manifest when we eat too many processed foods.

I’ve always been a person who likes to search for the cause of a health problem, not just treat the symptoms, and we know that people’s risk of various diseases increases when they move to North America. This suggests a problem with our lifestyle or diet, but nutrition and lifestyle research is notoriously difficult to get right. A properly done study needs to control as many factors as possible to be sure the effect they observe is really due to what the study is suggesting, and not from some other background difference. People don’t eat the same food every day and could never be expected to follow a strict diet for 10 years or so, just to prove a point for some researcher!

But the NutriNet-Santé, started in 2009, has found a way to accommodate a large part of these problems… they are using a phone app to collect nutrition data and characteristics of the 171,000 people in the study. It is easier and more accurate to note what you’ve eaten on your phone right away than to remember later when you’re being interviewed by a nutritionist. Participants can even scan the barcode of foods, when available, and supply information about food packaging, cooking practices, how the food was produced, their physical activity, tobacco, drugs, environmental factors, and exposures at home and at work.

As well, with the subjects’ permission, they are able to connect all this information with medical and insurance records, and keep a database of blood, urine and stool tests to monitor and analyze gut microorganisms. Obviously, they must have powerful computer systems to analyze all this data…

Another positive factor in this study, is that it’s completely funded by public institutions. One hazard of many earlier studies is that the researchers received financing from food producers, albeit sometimes provided as an unrestricted grant. But who wants to bite the hand that feeds them? There is always pressure to soften, ignore or even change results that look bad for the funding company…

The NutriNet-Santé study looked specifically at the relationships between nutrition, health, lifestyle factors and mortality; and it examined factors that influence diet patterns, for example, economic and cultural factors.

The results?

We can expect information to be generated from this study for years to come, but an early result is a connection noted between high intake of “ultra processed” foods and increased risk of cancer, heart disease and stroke, mortality, symptoms of depression, obesity and gastrointestinal disorders.

To get an idea of the impact, a 10% increase in ultra-processed foods in the diet was associated with more than 10% increase in risks of overall cancer and breast cancer.

What is “ultra-processed” food?

Food processing is everything you do to food the change it from its original state. There are several levels of food processing:

  • Unprocessed or minimally processed foods (like nuts, seed whole grains, legumes, fresh or frozen whole/cut up vegetables and fruit, eggs, fresh meat, fish and milk)
  • Processed ingredients (like flour, oils, butter, starches and sugars)
  • Processed foods (like canned vegetables, salted nuts, cured meats, cheeses, fresh-baked bread)
  • Ultra-processed foods (like carbonated/energy drinks, packaged snacks, ice cream, chocolate, candies, mass-produced baked goods, cereal bars, sweetened yoghurt/drinks, chicken/fish nuggets, sausages, burgers, hotdogs, and instant soups/noodles)

One way to see the difference between processed and ultra-processed foods is to look at the ingredient labels. Both types can contain processed ingredients, but ultra-processed foods also contain ingredients you are unlikely to have in your kitchen, like hydrogenated oils, additives (like food colours, flavour enhancers and non-sugar sweeteners, and stabilizing ingredients (like preservatives, anti-caking agents, emulsifiers and humectants) … basically ingredient names you wouldn’t readily recognize.

The NOVA Food Classification System helps people to understand what types of food processing diminish the quality of our food. You will find a summary of the system in the Reference links below.

Why is processing bad for our food?

Much of the problem with highly processed foods has been attributed to the addition of unhealthy ingredients, like high amounts of sugar, salt, colour and fat to “improve” flavour and appearance and preservatives to make the food last longer on store shelves. Processing also often removes important components of food our bodies need, like fibre and vitamins.

But a second factor, not considered until more recently, is what the food is exposed to during processing. Plastic is everywhere and contact with food during processing, as well as what it’s packaged in, can result in transfer of harmful chemicals into the food. Many of these are known to block or mimic hormones (termed “hormone disruptors”), increasing risk of hormone-driven cancers. Plastic and plastic-coated packaging (like coated cardboard and film-lined cans) also provide opportunities for addition of chemicals to food. And you’ll recall my blog from Oct 29th discussing PFAS “forever” chemicals in food packaging and non-stick cookware that are also a source of chemicals added to food. Here’s the link, in case you missed it… PFAS… “Forever chemicals” .

A new study done in the southern US found measurable amounts of harmful chemicals in many foods from several popular restaurant chains. These chemicals have been linked to disruption of hormone systems, fertility problems, and learning and attention problems in children. They are known to be stored in the body and even low exposures can accumulate over years to harmful levels. Some researchers have suggested they may be contributing to the obesity epidemic in North America…

So, how do you know what to buy?

Experts advise us to steer toward whole, non-packaged foods… avoid the center aisles of grocery stores where most packaged processed foods are located. Buy food that is still in its original form as much as possible. Read the food labels on packaged foods and put back the ones with long lists of ingredients that are difficult to pronounce.

But, of course, this takes time, and who wants to spend time reading all that fine print?

So, an alternative is a new labelling system, called Nutri-score or 5-Colour Nutrition Label (5-CNL), designed to make it easier to choose healthier foods with just a quick glance. It’s a nutritional logo based on a 5-colour scale (dark green to red) with letters A to E. A dark green A is best, and a red E is worst.

It was designed in France and, so far, it’s being used in Europe but not yet in North America. However, since it’s being endorsed by the World Health Organization (WHO), don’t be surprised if we start to see these labels on foods here. The idea is to make it easy to choose healthier food by simply checking a colour/letter, rather than analyzing a more complex food label. Nice to have an expert do the analysis for us too!

But, of course, food manufactures will need to be required to use this labelling. We need to ask our regulators to consider requiring this system to speed up its adoption. Studies have shown that using this labelling makes a significant improvement in the quality of foods shoppers choose.

Another thing it does is encourage manufacturers to create healthier foods. I mean, who wants to have a red “this is unhealthy” label on your product? Of course, these are still edible foods, but the labelling will encourage less consumption… and fewer sales. Money talks!

Scientific studies have demonstrated that consuming more “A’ rated products will lower risk of developing a number of chronic diseases, like cancer, cardiovascular diseases, obesity, or metabolic syndrome (a combination of high blood pressure, high cholesterol, and high blood sugar due to insulin resistance).

Have you changed the way you shop for food in recent years? If not, do you plan to start looking at ingredients in packaged foods when you’re buying groceries? Let me know in the comments…

Spread the word… contact your Health Minister!

If you know someone who could use a shortcut to better health in the future, forward this blog to them to start them thinking about how they could improve their diet and their health.

I have also drafted a short document you could use to contact the Health Minister in your jurisdiction, to make them aware of this simple program and how it could be used to save tax dollars while improving population health. Feel free to use it or change it, however you like… Here’s a link to it:

References/Credits:

What have we learned from the world’s largest nutrition study?—Medical News Today

The NutriNet-Sante Study—U.S. National Library of Medicine

Nutri-Score—Wikipedia

Some fast-food items contain plastics linked to serious health problems, new report shows—Washington Post

Ultra-processed food and why it’s bad for you – Choice.com

The NOVA Food Classification System – Educhange.com

Photo by Ashley Green on Unsplash

#healthydiet #NutriNetSante