“Different versions of the ketogenic diet have cropped up over the years, but the basic premise behind them are the same,” Dr. Sandon said. “It is a restricted carbohydrate diet that is typically high in fat and protein.”

Dr. Sandon states that one of the benefits of the ketogenic diet is that you can lose weight fast, but once you have lost the weight, it can be hard to keep it off.

The keto diet is a high-fat, low-carb diet that is said to maximize weight loss and boost muscle growth. As you limit your carb intake, your body goes into ketosis and resorts to burning stored fat in the body, thus allegedly leading to weight loss.

What is ketosis? Dr. Sandon explained that ketosis is a natural state for the body that it enters under times of long-term, inadequate calorie intake. Your body will also enter this state during starvation. Your body can go into ketosis when you are avoiding foods with carbohydrates in them.

“When there is not enough carbohydrate to provide the body with energy, then fat gets broken down and ketones get made to use as a source of energy,” said Dr. Sandon. “This is the state of ketosis.”

People who suffer from seizures may be prescribed by their doctors to follow a keto diet to help control seizures, but their diets are medically supervised. Their carbohydrate intake must remain low to be effective. However, there is some concern about how long your body can enter a state of ketosis before it causes harm. According to Everyday Health, it is not recommended to partake in the ketogenic diet for more than six months at a time.

“A short time spent in ketosis will likely not hurt you,” said Dr. Sandon. “However, long-term is not likely to be healthy as this type of diet does not provide all the nutrients we know are needed for optimal health. Also, if you are in ketosis for an extended period of time, you are likely not providing your muscles and bones with enough nutrition to keep them strong and healthy.”

According to Dr. Sandon, depending on the ketogenic diet plan, you may be required to limit your carbohydrate intake to 20 grams, or less, per day. “More lenient ketogenic diets promoted for weight loss might allow around 50 grams of carbohydrates per day and typically follow a gradual increase up to a certain amount, maybe 130 grams per day,” said Dr. Sandon.

In addition, the diet calls for eliminating some favorite foods. “No special treats like ice cream, chocolate or potato chips,” said Dr. Sandon. “I do not recommend avoiding these foods.”

Something to keep in mind if you are debating starting the diet are the side effects that may come from it. These side effects include tiredness, headache, irritability and long-term nutrient deficiencies. If you are diabetic, you are at risk for low blood sugar.

If you choose to partake in the ketogenic diet, you have no reason to fear ending it. There are not any associated health risks for converting back to a normal, balanced diet. According to Dr. Sandon, by ending the diet, you will be better off mentally and physically.

The keto diet is a popular diet that requires carbohydrate restriction. The diet causes the body to enter a state of ketosis, which can promote weight loss. However, there are side effects and concerns about getting all necessary nutrients.

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We recently received a question from a reader asking “What type of foods should be eaten as part of a healthy diet and to help reduce weight?” To answer this question, we reached out to Brenda Roche Wolford, M.S., R.D. – Nutrition, Family & Consumer Sciences Advisor at the University of California.

“The good news is the key to a healthy diet and maintaining a healthy weight is not as complicated as some make it out to be. In fact, it’s as simple as eating more fruits, vegetables and whole grains,” she said. “Throw in some legumes (beans, peas and lentils) and you’re well on your way to a heart-healthy diet. These types of foods are great sources of vitamins, minerals and naturally occurring compounds – called phytochemicals – that have disease-fighting capabilities.”

How do these foods promote weight loss?

Wolford: “Fruits, vegetables, whole grains and legumes are high in fiber. Fiber is important in maintaining a healthy weight because it adds bulk to your diet without adding additional calories. These high-fiber foods help you stay fuller longer. They also have the added benefit of helping to reduce the risk of chronic diseases such as diabetes, heart disease and certain types of cancers.”

Do they have any other benefits?

Wolford: “Fruits and vegetables also have a high water content, which helps play a role in weight control. The high water content increases the volume of what you are eating, without adding extra calories. Similar to fiber, this helps you feel fuller longer. The high water content of fruits and vegetables makes them great low-calorie options to incorporate into meals and snacks.”

Any other advice for healthy eating?

Wolford: “Substituting fruits and vegetables for higher calorie foods, such as high-fat meats, cheeses, and refined grains, will help you achieve a healthier weight. A great rule of thumb is to make half your plate fruits and vegetables, as recommended by the 2010 USDA Dietary Guidelines for Americans and depicted in the new MyPlate icon.”

For more information on healthy eating, check out these posts:

• What does the new MyPlate icon from USDA mean for consumers?
• To diet or not to diet? New study says pick wiser foods for a healthy weight.
• Do Fatty Foods Cause Brain Damage?

Originally published Aug. 7, 2012

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Are substitute shakes good at providing substitute nutrition?

Cundiff: “Protein shakes and drinks should not be a substitute for real food. Depending on an individual’s health status, there is the risk of consuming an excess of protein at one time, food allergies, GI distress and possible increased vitamin/mineral intake causing interactions with medications.

“I’m always an advocate for food first, but if an individual finds themselves not getting adequate balance with their nutrition due to a variety of health needs, this could be used to help balance out nutrition intake. “

What are your thoughts on substituting meals with shakes (protein or others)? And why might someone choose a liquid substitute over a more traditional meal?

Cundiff: “Food first always, but with life being as busy as it is, I think protein shakes or higher protein smoothie type drinks are a good way to quickly consume protein. The first reason is convenience. Protein drinks are easy to put together or are available in ready-to-drink forms in a variety of settings from grocery stores, convenience stores and gyms. Other reasons would be as a post-workout recovery drink to aid in muscle recovery, use in in a weight loss program or used for weight gain.”

Protein shakes and drinks should not be a substitute for real food.
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What are the health benefits and risks of substituting?

Cundiff: “Many protein drinks provide a quality, highly absorbable protein when protein-dense foods are not easily accessible. Along with protein, there are other added vitamins and minerals, which can contribute to our daily nutrient needs. Other health benefits would be for individuals who are trying to maintain or gain weight secondary to an illness or medical treatment. There is always the risk of consuming ‘too much of a good thing.’”

What are some things to look for or avoid when choosing a substitute drink or protein shake? Any specific ingredients?

Cundiff: “First, I recommend looking for a drink with a complete branched-chain amino acid profile. This means the protein in the drink is a complete protein providing all the essential amino acids. For example, whey protein is a complete protein. There are also many plant-based protein beverages available too.

“Second, I recommend looking for a drink that has around 20 to 30 grams of protein per serving. This would the right amount of protein to be considered a meal. If you are looking to use it as a snack, aim for around 10 to 15 grams. Finally, always pay attention to sugar content and try to limit excess added sugars, less than 10 grams of sugar per serving is my recommendation. Look for ingredients representing food you recognize and be cautious of extremely high protein content (greater than 30 grams) and a plethora of added sugar ingredients.”

Is there a “proper way” to consume substitute drinks or protein shakes?

Cundiff: “As a nutrition expert, I call these my ‘in-case-of-emergency’ foods. If you are traveling or you need something quick, protein drinks are a choice I recommend over high fat/calorie snack foods or fast-food dining options. I do not recommend protein drinks for kids under 18. As far as not using it properly, I do not recommend consuming more than one a day (meaning it should not replace actual food for meals).”

Are substitute drinks and protein shakes a good way to lose weight or help someone transition to a plant-based diet?

Cundiff: “It could be an aid in starting off a weight loss program but it is not ideal for sustainable weight loss. And again, I recommend food first, but if someone is transitioning over to a more plant-based diet and is not meeting their protein needs, this could be a short-term way to meet those needs.”

Is there anything else you think people should know about substitute drinks and protein shakes?

Cundiff: “I always recommend individuals contemplating using protein drinks to seek out a registered dietitian to discuss their current nutrition needs. An RD will be able to review their daily intake and determine if they would benefit from a higher protein drink.”

Substitute drinks and protein shakes can be a great quick substitute, but real food is usually a better option for your meal.

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Can vinegar fight colds and sinus infections?

“Apple cider vinegar is acidic and the concept is that drinking it will neutralize the atmosphere in the body preventing bacteria and viruses from surviving, thus preventing the development of the infection,” said registered dietitian Connie Diekman.

Sounds great, but there is a flaw.

“The problem is that the scientific evidence behind that theory has not been shown in humans yet. Studies have been done but the body of evidence is not there so while this may not be harmful, it may not be helpful,” said Diekman, who is a board certified specialist in sports dietetics and Director of University Nutrition at Washington University.

Does drinking vinegar “detox” the body?

There is no scientific evidence for this, Diekman said. “In fact your kidneys and liver are the key to removing toxins in the body and other than taking care of them, they don’t need any help.”

Can vinegar lower blood sugar?

Dr. Carol Johnston, RD, Professor and Director of the Nutrition Program at Arizona State University, previously shared about vinegar’s effectiveness at lowering blood glucose. We checked back with her for an update.

“Several trials published in 2015 continue to demonstrate the antiglycemic effect of vinegar ingestion in adults with insulin resistance and adults with type 2 diabetes,” Dr. Johnston said. “These trials revealed that glucose uptake by muscle was enhanced by the vinegar ingestions. Hence, the acetic acid in the vinegar may be acting by multiple mechanisms to reduce blood levels of glucose. These trials also demonstrated a reduction in blood triglycerides, an exciting finding.”

On a related topic: Can vinegar help with weight loss?

Dr. Johnston said studies have been conducted that show increased fat oxidation (or breakdown of fat) associated with ingesting acetic acid. “However, since the density of fat is low, this oxidation did not translate to much weight loss. This is an area that needs further research to understand the health relevance.”

Health benefits of vinger are still more folk remedy than scientifically proven remedies.
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Can vinegar improve indigestion or acid reflux?

Dr. Johnston: “To my knowledge, there are no published reports examining the impact of vinegar on acid reflux.”

Diekman offers a word of caution to never consumer vinegar straight. “It should always be diluted to prevent such strong acid from hitting your teeth, gums and esophagus. When consumed with other foods this acidity is mixed with the other foods, changing the negative impact,” she said.

Is apple cider vinegar the best type?

Diekman: “Types of vinegar vary in how they are made and how they taste, but in fact, you can substitute them for each other. Apple cider vinegar tends to be a bit sweeter than white so if you want that more tart, pungent taste you might prefer white. Bottom-line – taste is the key.”

What is the “mother” and does it add nutrients to vinegar?

Diekman: “The ‘mother’ in apple cider vinegar occurs as a result of the fermentation process that makes the vinegar. The cloudy look of many apple cider vinegars is due to the fact the food manufacturers did not filter the fermented vinegar and left the remnants of that process. Some feel this makes the vinegar better in taste but it really is about preference.”

Does vinegar have any other health benefits?

Diekman: “Apple cider vinegar provides great flavor to many dishes but the health benefits are still more folk remedy than they are scientifically proven remedies.”

Use vinegar in your cooking and enjoy its flavor while understanding just what it can and can’t do for your health.

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What experts have been saying for decades is that it’s just not that simple. It really is an equation of calories in and energy exerted (calories out). But there’s some new research (not to make things more complicated…) indicating that the type of calories consumed may also be important in managing weight and appetite.

Researcher Alison Gosby, PhD, from the University of Sydney, claims that focusing on protein intake could be an important factor. In the study, men and women were divided into groups and provided with diets containing either 10%, 15% or 25% protein. At the conclusion of the study, it was discovered that both men and women who ate a diet with 10% protein consumed 12% more calories than they did on a 15% protein diet.

Gosby and other researchers have a belief about protein. If the level of protein in the diet is too low, ”We keep eating in an attempt to attain our target level of protein,” Gosby told WebMD. Some believe that low protein diets are helping to drive the obesity epidemic. And from 1961 to 2000, research shows that the amount of protein in the diet has decreased from 14% to 12.5%.

In the study, when subjects were given a diet with 10% protein, the men and women consumed more carbohydrates and fatty foods. When the 15% and 25% protein diets were provided, there didn’t seem to be a difference in total calories eaten.

When asked what she thinks about this study, Connie Diekman, a registered dietitian and the director of university nutrition at Washington University, said that though it is a short-term study, “It provides a bit more support that consuming protein helps us feel full longer. Including some [protein] each time we eat can help us make better food choices and trim what we eat the next time we eat.”

So how do we ensure we’re getting a diet with 15%-25% protein? First and foremost, Gosby recommends avoiding foods high in fat and simple sugars – just like the dietary guidelines recommend – since these foods can increase the likelihood that people will overeat and gain weight. If you’re on a 2,000-calorie-a-day diet, 300 calories should come from protein, since each gram has 4 calories, your total intake should be 75 grams of protein. Diekman offers this guide: Six servings of whole grains give you 18 of your 75 grams of protein, while 3 cups of dairy give you 24 grams.

_{“My Yummy Steak!” by momo is licensed under CC BY 2.0.}

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