The ke­to­genic back­lash

The Hamilton Spectator - - HEALTH - BAR­BARA QUINN The Mon­terey County Her­ald

A reader took of­fence to sev­eral of my state­ments in a re­cent col­umn on ke­to­genic di­ets. Here are some ex­cerpts, as space al­lows, fol­lowed by my re­sponses:

Reader: “Greet­ings, Bar­bara, You write: ‘Very low car­bo­hy­drate “ke­to­genic” di­ets se­verely limit the in­take of sug­ars and starches (carbs) which are mostly found in plant­based foods such as fruit, veg­eta­bles, legumes (beans) and grains.’ You con­ve­niently omit­ted the more ne­far­i­ous di­etary cul­prits of highly pro­cessed and man­u­fac­tured food, HFCS, sugar, among oth­ers.”

BQ: By def­i­ni­tion, car­bo­hy­drates are car­bon, hy­dro­gen and oxy­gen mol­e­cules that form sug­ars and starches when plants are ex­posed to en­ergy from the sun. (Cows that eat plants can pro­duce an­other car­bo­hy­drate con­tain­ing food, milk.) Car­bo­hy­drates are also the only source of di­etary fi­bre in our di­ets.

I doubt any­one would ar­gue that we need to limit overly pro­cessed car­bo­hy­drates. My point was that ex­tremely low car­bo­hy­drate di­ets can overly re­strict health­ful plant-based foods as well as the bad boys.

Reader: “You write about the ‘buildup of acids in the blood called ke­tones that hap­pens when the body is starved of car­bo­hy­drates.’ You ne­glect the full def­i­ni­tion of ke­tones which are ‘fatty acids’ ... as ke­tones are NOT acids but or­ganic com­pounds.”

BQ: Ke­tones (or ke­tone bod­ies) are not fatty acids. They are formed when fatty acids are bro­ken down for en­ergy. Ac­cord­ing to Med­line Plus Med­i­cal Dic­tio­nary, ke­tone bod­ies are ace­toacetic acid, ace­tone, and a de­riv­a­tive of hy­drox­y­bu­tyric acid, ie. or­ganic acids.

Reader: “And in what bio­chem­i­cal uni­verse could the body ac­tu­ally starve from lack of carbs? They are the only macronu­tri­ent un­nec­es­sary for hu­man sur­vival.”

BQ: The one nu­tri­ent ab­so­lutely nec­es­sary for hu­man sur­vival is glu­cose, a sugar most eas­ily de­rived from the break­down of car­bo­hy­drate foods. Ac­cord­ing to the In­sti­tute of Medicine, “glu­cose is the only en­ergy source for red blood cells and the pre­ferred en­ergy source for the brain, cen­tral ner­vous sys­tem, pla­centa, and fe­tus.” De­prived of glu­cose, brain cells die. For­tu­nately as I men­tioned in my col­umn, the body is amaz­ingly adap­tive. When glu­cose is not avail­able from car­bo­hy­drate foods, protein and fat can be used by the liver to make glu­cose ... a car­bo­hy­drate.

Reader: “Why do we need any more sugar/ carbs in our diet when our body can pro­duce any glu­cose re­quired on its own?”

BQ: Ex­perts agree we need more added sugar in our di­ets like we need a hole in our heads. Nu­tri­tion is more than en­ergy, how­ever. Foods such as whole grains, veg­eta­bles, fruit and legumes are rich in di­etary fi­bre and other nu­tri­ents es­sen­tial for op­ti­mal health. Let’s not throw out the baby with the bath­wa­ter.

Reader: “You write: ‘Stud­ies have shown that, for the first six months, low car­bo­hy­drate di­ets pro­duce greater weight loss than other di­et­ing meth­ods. Af­ter a year, how­ever, the over­all suc­cess of low carb di­ets is sim­i­lar to other plans, pos­si­bly be­cause the diet is so dif­fi­cult to main­tain.’ ALL DI­ETS have sim­i­lar re­sults ... and no diet is im­mune from fail­ure ei­ther. As Ja­son Fung M.D. says: “All di­ets work. All di­ets fail. The trick is find­ing a way of eat­ing that works for you. There’s no such thing as a diet for all.”

BQ: I to­tally agree with you on this point. Emerg­ing sci­ence is be­gin­ning to see how our unique ge­netic codes may one day de­ter­mine our in­di­vid­ual diet needs. And as I men­tioned in my pre­vi­ous col­umn, ev­i­dence is be­gin­ning to ac­cu­mu­late on the ther­a­peu­tic ef­fects of the ke­to­genic diet for cer­tain med­i­cal con­di­tions. Thanks for writ­ing.


The ke­to­genic diet are very low-carb.

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