Trendy Diet #2: The Ketogenic Diet

Welcome back to Feeding Yourself Right! For the next couple of weeks, I will be doing a series on various trendy diets. There is A LOT of misinformation out there, so I have taken the time to round in relevant scientific-based information for you guys for a SHORT and SIMPLIFIED explanation of each diet. And as a special treat, it is translated in French too! So you can share it with your French-speaking friends!

Bonjour et bienvenue à mon blog! Je fais quelque chose de nouveau pour les quelques prochaines semaines : je vous offre une série d’articles sur les diètes les plus tendance… en anglais ET en français! Les médias sociaux regorgent de nouveaux régimes amincissants et à la mode; il est facile de s’y perdre! Alors mes articles sont basés que sur des données scientifiques pour vous donner une RÉSUMÉ SIMPLIFIÉ de chaque diète.  

Trendy Diet #2 : The Ketogenic Diet

The ketogenic diet is a diet that is excessively low in carbohydrates and very high in fats (protein levels remain unchanged). The brain’s main source of energy are carbohydrates. However, if we do not consume enough carbs to meet our brain’s needs (such as by following the keto diet), it will use ketone bodies as an alternate source of energy. Ketones are products of oxidation of fatty acids (fats). This natural physiological process was designed as a plan B when our body is in the fasted state, such as during starvation.

The goal of following this diet is to keep insulin levels to a minimum. Insulin is the bridge that transports blood sugar into your cells. However, when insulin levels are very high, more sugar is transformed into fats. Unfortunately, the Western diet promotes more and more insulin resistance, so more insulin is needed to shuttle sugar into the cells, and more sugar is transformed to fat. With the keto diet, the sugar levels in the blood are so low that insulin production is at its minimum. Instead, the brain uses our storage of fats as a source of energy. To be clear, it is not the consumption of fat that lowers insulin, rather the decreased consumption of sugar. Consuming fat simply replicated a fasted state for your body, putting it in ''survival mode'' and breaking down fatty acids into ketones to feed your brain.

Of all the diets described in this series of articles, this one is the riskiest. For this reason, it is extremely important to be followed by a healthcare professional (a nutritionist, in this case), if you decide that you want to try the keto diet.

	Ketogenic Diet	Western Diet
Carbohydrates	5%	60%
Protein	20%	15%
Fat	75%	30%

Pros

·         Proven benefits in children with refractory epilepsy

·         Extreme weight loss (short term)

·         Satiety (sense of fullness)

·         No caloric restriction

·         Increases HDL and decreases blood triglycerides

·         Decreased inflammation

Cons

·         Possible symptoms : fatigue, nausea, headache, constipation

·         Risk of severe hypoglycemia (low blood sugar); can be very dangerous if not strictly followed by a healthcare professional

·         Very restrictive and low adhesion rates

·         Usually high in sodium (salt)

·         Toxic nature of ketones causes lowered pH levels of the body (body becomes acidic)

·         Risk of vitamin and mineral deficiencies due to limiting major food groups and low variety of food options

·         Possible lean body mass loss (body uses amino acids from muscles to transform them into energy to feed the brain)

·         Little proof about long term weight loss

Stay tuned for Trendy Diet #3: Juice Cleansing!!

Diète tendance #2 : la diète cétogène

La diète cétogène est une diète excessivement basse en glucides et très riche en lipides (quantités de protéines demeurent inchangées). Le carburant principal du cerveau sont les glucides. Cependant, si l’on ne consomme pas assez de glucides pour ses besoins (comme lorsque nous suivons la diète cétogène), le cerveau utilise des corps cétoniques comme carburant alternatif. Ce sont des produits de l’oxydation des acides gras (les lipides). Ce processus physiologique est naturellement utilisé lorsque le corps est en état de jeûne, donc la diète vient recréer cette perception.

Le but de suivre cette diète est de garder le niveau d’insuline au minimum. L’insuline est le pont qui transporte le sucre du sang jusqu’aux cellules. Cependant, lorsque les niveaux d’insuline sont élevés, plus de sucre est transformé en gras. Malheureusement, la diète occidentale peut engendrer de plus en plus de résistance à l’insuline, donc le corps augmente sa production à de très hauts niveaux. Avec la diète cétogène, les niveaux de sucres dans le sang sont tellement bas que l’insuline n’est pas produite. À la place, le cerveau utilise nos stocks de gras comme source d’énergie. Pour être claire, ce n'est pas la consommation de gras qui diminue l'insuline, mais plutôt le manque de sucre. La consommation de gras imite un état de jeûne dans le corps, le mettant en mode de survie. Ainsi, il détruit ses réserves de gras et les transforme en cétones pour nourrir votre cerveau.

De toutes les diètes décrites dans cette série d’articles, celle-ci est la plus risquée, donc il est très important d’être suivi par un professionnel de la santé, dans ce cas-ci, une nutritionniste.

	Diète cétogène	Diète occidentale
Glucides	5%	60%
Protéines	20%	15%
Gras	75%	30%

Avantages

·         Effets bénéfiques démontrés chez les enfants avec épilepsie réfractaire

·         Perte de poids rapide (à court terme)

·         Sensation de satiété

·         Aucune restriction calorique

·         Baisse d’inflammation

·         Augmentation du cholestérol-HDL et baisse des triglycérides sanguins

Inconvénients

·         Symptômes possibles: fatigue, nausées, maux de tête, constipation

·         Risque d’hypoglycémie grave (taux de sucre sanguin très bas); peut être très dangereux si pas suivi de près par un professionnel de la santé

·         Très restrictif et adhésion très limitée avec le temps

·         Habituellement à teneur élevée en sodium

·         Nature toxique des cétones cause la baisse du pH corporel (corps acide)

·         Risque accru de carences en vitamines et minéraux en raison de la limitation de groupes et du manque de variété

·         Perte de masse musculaire possible (utilisation des acides aminés des muscles pour transformer en énergie)

·         Perte de masse grasse peu prouvée à long terme

 Gardez l’œil ouvert pour La diète tendance #3 : Les cures détox au jus!!

Trendy Diet #1: The Paleo Diet

Welcome back to Feeding Yourself Right! For the next couple of weeks, I will be doing a series on various trendy diets. There is A LOT of misinformation out there, so I have taken the time to round in relevant scientific-based information for you guys for a SHORT and SIMPLIFIED explanation of each diet. And as a special treat, it is translated in French too! So you can share it with your French-speaking friends!

Bonjour et bienvenue à mon blog! Je fais quelque chose de nouveau pour les quelques prochaines semaines : je vous offre une série d’articles sur les diètes les plus tendance… en anglais ET en français! Les médias sociaux regorgent de nouveaux régimes amincissants et à la mode; il est facile de s’y perdre! Alors mes articles sont basés que sur des données scientifiques pour vous donner une RÉSUMÉ SIMPLIFIÉ de chaque diète.  

Trendy Diet #1 : The Paleo Diet

The paleolithic era was from 2.5 million to 10 000 years BC. This diet claims that we need to imitate the diet that our hunter gatherer ancestors, before being "contaminated" by the Western diet, because humans have not evolved as quickly as our eating trends have. We can see that their carbohydrate intake was much lower (they didn’t have grain products back then, so their carbs came from wild fruit they gathered). However, they ate more protein and fat!

	Paleo Diet	Western Diet
Carbohydrates	20-40%	60%
Proteins	20-35%	15%
Fat	30-60%	30%

To eat paleo, what you need to do is choose foods that are in their pure form, not transformed. There are different levels of purists when it comes to the paleo diet. For example, certain people refuse to eat peanut butter because they don't think the paleo people would have made it, and will only eat the whole peanuts. In my opinion, I believe that as long as your peanut butter has only one ingredient (peanuts), you're good. 

The desire to follow the paleo diet comes especially from the idea that transformed products lead to more inflammation and insulin resistance. These two things are the main factors that can lead to metabolic syndrome and numerous chronic diseases (diabetes, cardiovascular disease, etc.) Low risk (especially if done with little exceptions to avoid some of the cons such as nutritional deficiencies), it can definitely at least be partially integrated into daily eating habits.

Pros

• Eliminates processed foods
• Lower sodium intake
• Higher fruit and vegetables intake
• No calorie counts
• Lower A1C (indicator used in diabetes), blood triglycerides, LDL, inflammation, weight, BMI, waist circumference
• Increased HDL

Cons

• Risk of calcium and vitamin D deficiencies
• Excludes major food groups
• Potentially higher cost
• Low long-term scientific research
• Limited knowledge on the ACTUAL eating habits of paleolithic people and the consequences of their lifestyle on their health

Stay tuned for Trendy Diet #2: The Ketogenic Diet!!

Diète tendance #1 : la diète paléolithique

L’ère paléolithique se situe entre 2,5 millions à 10 000 ans av. J.-C. Le postulat de cette diète est qu’il faut imiter la diète de nos ancêtres chasseurs-cueilleurs, précisément avant d’avoir été « contaminé » par la diète occidentale. Si on doit cuire, ce n’est pas paléo! On voit une baisse de recommandations de glucides car ils étaient moins accessibles par nos ancêtres (les produits céréaliers ne faisaient pas encore parti de leur alimentation, alors il n’y avait que les petits fruits cueillis). Cependant, ils mangeaient plus de protéines et de gras!

	Diète paléo	Diète occidentale
Glucides	20-40%	60%
Protéines	20-35%	15%
Gras	30-60%	30%

Pour manger paléo, il faut choisir des aliments dans leur forme originale, sans transformation. Cependant, il y a différents niveaux de puristes. Par exemple, certaines personnes refuseraient de manger du beurre d'arachides car ils disent que les gens paléo n'en avaient pas, donc il vont seulement manger des arachides entières. À mon avis, ton beurre d'arachides et correct en autant qu'il n'y a qu'un ingrédient (des arachides). 

Le désire de suivre une diète paléo vient surtout de l'idée que les aliments transformés causent plus d'inflammation et de résistance à l'insuline. Ce sont ces deux facteurs qui peuvent mener au syndrome métabolique et plusieurs maladies chroniques (diabètes, maladies cardiovasculaires, etc.). Une diète avec peu de risques (surtout si faite avec quelques exceptions pour éviter des désavantages comme les carences nutrititionnelles), elle peut certainement au moins être partiellement intégrée aux habitudes alimentaires.


Avantages

• Élimination des aliments ultra-transformés
• Apport réduits en sodium
• Apports plus élevés en fruits et légumes
• Aucune restriction calorique
• Diminution du A1c (indicateur utilisé en diabète), des triglycérides sanguins, du LDL, de l’inflammation, poids, IMC et du tour de taille
• Augmentation de HDL 

Inconvénients

• Risque accru de carences en calcium et en vitamine D
• Exclus des groupes alimentaires complets
• Coût plus élevé 
• Connaissances limitées sur les habitudes alimentaires RÉELLES des gens paléolithiques et les conséquences de leur mode d’alimentation sur leur santé
• Peu de recherches scientifiques à long terme

 Gardez l’œil ouvert pour la diète tendance #2 : La diète cétogène!!

Hydrogenation and Transformation

You might have heard that two weeks ago, September 17^th 2018, Canada officially banned trans fats (yay!!). This raised many questions on what are trans fats and why are they banned. And how should we feel about this.

What are Trans Fats?

Before answering this question, let’s dive back into basic chemistry. Butter is a saturated fat, which means that the fatty acid chain is FULL of hydrogens (saturated), which makes the chain straight and compact. The chains pile up nicely, making butter hard.

Oils are what we called unsaturated fats. Their fatty acid chains are NOT full of hydrogens, so the chains have kinks in them, making them more difficult to stack. The chains don’t pile up as nicely, so oil is liquid.

Hydrogenation is the process of chemically shooting hydrogens into an unsaturated fat to saturate it. This is frequently done in the food industry because it’s a cheaper way to have harder fats used for better texture and a much longer shelf life. The food industry loves long shelf lives. The classic example: replacing butter with margarine made of hydrogenated oils.

Theoretically, this transformation would make oil turn into butter. However, the reaction done in the lab does not fully represent what is found in nature. It is very difficult to fully saturate a fatty acid chain, so you inevitably get partially hydrogenated fats, which are partly unsaturated while still having a semi-soft texture and longer shelf life as desired. The bonds created through this reaction are in the ‘’trans’’ formation, as opposed to being in the ‘’cis’’ formation found in nature.

Fully hydrogenated fats do exist and are also called hydrogenated oils. They are harder than trans fats and do not have the characteristic ‘’trans’’ bonds that partially hydrogenated fats have, so they do not lead to the health risks associated with trans fats.

Where Can We Find These Trans Fats?

Trans fats became extremely popular in the food industry in the 1950s, with Crisco shortening as their leader. They can be found in a plethora of transformed foods, such as commercial baked goods (cookies, pastries, doughnuts, muffins, frosting), fried foods (french fries, fried chicken, chips) and many snack foods (crackers, microwave popcorn). Over the years, as people became increasingly aware of the negative effects of trans fats, foods with labels reduced or avoided their use. However, they are still commonly found in foods with no labels, such as a muffin at Tim Horton’s or a cheeseburger and fries at McDonald’s.

Other Names Used to Identify Trans Fats

• Partially hydrogenated oils
• Hydrogenated oils
• Shortening
• Mono- and diglycerides
• Anything deep fried

 Trans fats are also naturally found in low levels in dairy products. However, no adverse health effects were found to be related to these trans fats.

What Are the Health Risks of Eating Trans Fats?

If I had to name one thing that is most destructive for your body that you can find in your food, it would be trans fats. An overwhelming amount of data exists on how harmful they are, and yet, it took decades to finally get rid of it.

The biggest issue with trans fats is that they are extremely inflammatory, and inflammation is the first step to every chronic disease, like type 2 diabetes or cardiovascular disease, for example. Trans fats raise LDL-cholesterol levels, more specifically the small dense LDL particles. These are especially damaging to your blood vessels (as seen in the cholesterol article, found here). Trans fats also lower the protective HDL particles that clean up your arteries.

In 2002, the Institute of Medicine stated that there is absolutely no safe level of trans fats in the diet; any increase in intake increases the cardiovascular disease risk.

So Now What?

After a decade of struggling to get trans fats out of our food, they are officially banned. Industries have two years to use up their stock, change their recipes and replace them. However, for the time being, they can still be found in many transformed foods. To avoid them, here are two things that you can do:

1) Read the nutrition facts table. Food labeled as ‘’trans fat free’’ must have less than 0.5g of trans fat per serving. Note that this means that if there are 0.4g of trans fats in your chips, the package can say 0g per serving, and if you eat two servings, then you just ate 0.8g of trans fats, while any amount is harmful. But the package still says zero.

2) Read the ingredients list. Scan the ingredients list for any of the synonyms listed above. If you find a food item with any of these ingredients, leave it at the grocery store.

In two years, we won’t need to worry about trans fats anymore. Hopefully the US FDA will follow in our food steps.

We’ll just have to wait to see what the market will invent to replace trans fats, and probably need to avoid whatever they come up with as well.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974200/

https://www.theglobeandmail.com/life/health-and-fitness/health/what-you-need-to-know-about-trans-fats-and-why-they-are-being-banned/article36317373/

https://www.consumerreports.org/cro/news/2013/04/q-a-is-fully-hydrogenated-oil-better-for-you-than-partially-hydrogenated-oil/index.htm

https://www.drgangemi.com/health-articles/diet-nutrition/zero-grams-trans-fats/

Six Easy Tips To Healthier Eating

After much demand, I wrote an article explaining the ins and outs of cholesterol, boiling down numerous scientific studies and pathway explanations into one article to clarify what cholesterol is and what it does in your body. But it was a very heavy article with technical explanations, so what did it even mean? Have no fear, this week’s article is on how to PRACTICALLY use the information we have learned to improve our eating habits and lifestyle. The best part? These six easy tips are good whether you have cholesterol problems or not.* They’re simple goals that are good for everyone!

LIMIT  SWEET & PROCESSED FOODS

Foods that are high in sugar and/or are very processed also need to go through the liver, keeping it too busy to take care of your LDL. Once again, this leads to LDL accumulation in your blood vessels and LDL damage, which leads to the cardiovascular health risks we’ve often heard of.

PHYSICAL ACTIVITY

Aim to do physical activity as often as possible to help increase your HDL synthesis. The recommendation for adults is 2h30 per week (30 minutes 5x/week), but I’m telling you to do what is doable for YOU and improve from there. If you only have 5 minutes of spare time, then start with 5 minutes, and increase your intensity when you become more comfortable with the exercise. 

LIMIT ALCOHOL

Alcohol needs to be processed by the liver, which puts LDL on standby. The LDL particles need to wait their turn to be absorbed and processed, leading to LDL accumulation in your bloodstream and LDL damage. Limit your alcohol intake to 1-2 drinks per day.

 OMEGA-3
Omega-3 is anti-inflammatory and an antioxidant, which reduces the level of damage that your LDL can have. Aim to have fish-based meals twice per week, the fattier fish the better (salmon, trout, sardines, tuna, mackerel, herring).

FIBRE
Fibre is not absorbed by your body when you eat it. However, it does attach to cholesterol found in bile in your gut and gets rid of it in your stool. Then, your liver will make new bile salts by increasing its LDL receptors and reducing overall LDL blood levels. Fibre is found in plant-based foods, such as fruit (eat the peels!), vegetables, and legumes (lentils, beans, chickpeas, etc.) Make sure half your plate is filled with veggies, include legumes for protein and have a fruit for dessert! Easy!

ANTIOXIDANTS
The danger with LDL is not their actual number but their level of damage, such as by oxidation. Antioxidants are found in everyday foods that reduce this amount of harmful damage. More specifically, we are talking about vitamin A, C, E, magnesium, zinc and selenium. They are found in your colorful fruit and vegetables (kale, broccoli, eggplant, peppers, berries, asparagus, onions, apricots, leek, etc.)

* The explanations found in this blog article were written as a follow-up on the cholesterol article and are thus incomplete for the general public. However, the tips are still valid!

Cholesterol: the Good, the Bad and the Ugly

Welcome back to my blog! In my last article (An Eggcellent Idea, check it out!), I promised you all an article unveiling the facts about cholesterol. So let’s start with what I think you guys already know, and let me know if it sounds familiar:

There are two types of cholesterol: HDL and LDL. HDL is good cholesterol, so we want high levels (H-igh for HDL), while LDL is bad cholesterol, so we want low levels (L-ow for LDL). If our blood levels of cholesterol are high, then we need to cut out dietary sources of cholesterol.

Sounds about right?

Wrong.

First Things First, What Is Cholesterol?

Cholesterol is a molecule that makes up part of your cell membrane to ensure structural support and membrane fluidity for nutrient transport. It is also used for myelin synthesis (the protective sheath around your neurons), brain plasticity (your brain’s ability to change or reorganize it’s neural pathways according to the stimulation it receives), bile acid production (to digest fats), hormone synthesis (testosterone, estrogen, progesterone, cortisol, vitamin D), etc. Needless to say that cholesterol plays a very important role in your body.

But I didn’t mention LDL and HDL yet. Actually, they aren’t even cholesterol at all. They are low-density and high-density LIPOPROTEINS, which are protein-based carriers of cholesterol, triglycerides and other fat-soluble molecules, since fat-soluble molecules don’t mix in your blood. Think of it this way: oil and water don’t mix, but cholesterol is like oil and your blood is 92% water, so the oil needs a carrier to be transported across the water.

How Does LDL Get A Bad Rep?

For this next part, I will borrow an analogy from a book called Genius Foods, by Max Lugavere. I will cite it at the end of this article and I strongly recommend reading it.

Imagine two highways. Highway A has one hundred cars on the road, each with one passenger, while highway B has 5 buses with 20 passengers each. As you know, highway A will be more prone to accidents and traffic. Which highway would you choose to take to work? I would definitely choose highway B.

In our body, cholesterol passengers all start on highway B, in big buses. As the buses empty out, when the cholesterol passengers reach their destination, they shrink to be more like cars, making them “small and dense”, thus becoming like highway A. Now this isn’t an issue if the lipoproteins go back to the liver to be recycled, avoiding congestion. The issue arrives when the LDL particles become oxidized (oxygen sticks to them and changes the molecule, like a rusty car) or glycated (sugar sticks to them), damaging the molecules OR that there is an issue with your liver reabsorbing them altogether because it is too busy processing concentrated carbs, alcohol, toxins or oxidative stress. Then, the small dense LDL particles clog up your bloodstream, making it look more like highway A, leading to plaque formation.

How Do I Reduce My Cholesterol?

As I mentioned in my last article, your liver makes 80% of the cholesterol that you need. Studies have repeatedly shown that the cholesterol you eat doesn’t significantly change your blood cholesterol levels at all! For this reason, what we want is to avoid our LDL particles becoming damaged or our liver being too busy to recycle them. This involves eating plenty of antioxidants, which are in most fruits and vegetables, such as dark leafy greens and berries. You also want to keep your liver happy by reducing sources of toxins, alcohol, but also very high levels of carbohydrates that it would need to process. Eating good sources of fibre (also found in most fruits and vegetables) will also give your liver a chance to slowly process the food you eat instead of overloading it with work. And most of all, you’ll want to reduce the amount of processed foods that you eat. The more whole the food is, the better.

High-DL

As for HDL, they are like clean-up trucks that pick up excess cholesterol and bring it back to your liver to be converted into bile and sent away. There are a few ways to increase your HDL levels, including eating sources of monounsaturated fats (extra virgin olive oil being the best example, but also coconut oil, avocado oil, macadamia nuts, etc.), reducing alcohol intake and EXERCISE. EXERCISE. EXERCISE.

So it isn’t as much the level of LDL that is harmful, but the type of LDL particles that you have (small dense LDL being unwanted) and the ratio of LDL to HDL that is in your body (wanting as low a ratio as possible). And as a quick side note, saturated fats increase both your LDL and your HDL, but bending the ratio in your favor by increasing your HDL more.

When medical doctors ask to lower your LDL and raise your HDL, they are asking for you to move a mountain because HDL production is actually controlled by your amount of LDL. The more LDL you have, the more easily your body will produce HDL. You can’t do both. The important part is to have a lower LDL to HDL ratio. And if you increase your HDL, your total cholesterol will also increase, which your medical doctor might also ask you to reduce simultaneously. For a mathematical explanation on this topic, please read this very interesting article.

The next time your medical doctor talks about raising good and lowering bad cholesterol, do me a favor and reply that LDL and HDL are not cholesterol, but cholesterol carriers!

*** Disclaimer: As usual, recommendations made on this blog are for the general healthy population. If you have any doubts regarding your nutritional health, I strongly recommend that you consult a registered dietitian. Stay tuned, as I will be graduating from McGill university and be a registered dietitian recognized by the OPDQ in December 2018!

Sources:

Lugavere, Max. (2018). Genius Foods. Harper Wave. 388 p.

https://www.health.harvard.edu/heart-health/how-its-made-cholesterol-production-in-your-body

https://www.truemd.com/general-health/the-role-of-cholesterol-in-human-body-metabolism/

https://listaka.com/10-foods-rich-anti-oxidants-incomplete/

http://fatproteincarb.blogspot.com/2017/01/cholesterol-most-misunderstood-lipid.html