Is Keto for Everyone? | QA

Is Keto for Everyone? | QA

Question:

Is the Keto diet recommended for everyone?

-Kim

Answer:

NO. A ketogenic diet is one in which carbohydrates are severely restricted (nearly eliminated), fat consumption is high and protein intake is moderate-low. The body’s process of converting its metabolism to fat-burning ketosis is a survival mechanism when carbohydrate supply is inadequate and dietary fat is plenty. [It shouldn’t be confused with diabetic ketoacidosis which also produces ketones, but with extremely high blood sugar.] Despite its short-term effectiveness for weight loss, I rarely recommend a Keto diet. Looking at all the available evidence, my professional opinion is that such an extreme approach is in opposition to a sustainable eating style that supports the whole body across one’s entire lifetime.

Following a ketogenic diet can cause long-term adverse effects such as hepatic steatosis, hypoproteinemia, kidney stones, and vitamin and mineral deficiencies1. Since the ketogenic diet is very high in fat, those with gallbladder, kidney, liver, or pancreatic disease or problems with delayed gastric emptying should not follow it. Just as they shouldn’t be consuming a high sugar/refined carb diet, pregnant or nursing women also should not be on a keto diet. It may be ideal for certain populations, though. Healthcare practitioners may prescribe a classic or modified ketogenic diet for patients with epilepsy2. It may be prescribed for morbidly obese patients in the weeks leading up to bariatric surgery3 and for some patients with Type 2 Diabetes4.  

References: 

  1. Masood W, Uppaluri KR. Ketogenic Diet. [Updated 2019 Mar 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499830/ Accessed 12.26.2019 
  2. Roehl K, Sewak S. Practice Paper of the Academy of Nutrition and Dietetics: Classic and Modified Ketogenic Diets for Treatment of Epilepsy. Journal of the Academy of Nutrition and Dietetics. 2017; 117:1279-1292. 
  3. Leonetti F, Campanile FC, Coccia F,et al. Very Low-Carbohydrate Ketogenic Diet Before Bariatric Surgery: Prospective Evaluation of a Sequential Diet. Obesity Surgery. 25, 64–71 (2015) doi:10.1007/s11695-014-1348-1 
  4. Azar ST, Beydoun HM, Albadri MR. Benefits of Ketogenic Diet For Management of Type Two Diabetes: A Review. Journal of Obesity & Eating Disorders. 2016; 2:2. doi: 10.21767/2471-8203.100022 

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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What is the Best Beginner’s Diet? | QA

What is the Best Beginner’s Diet? | QA

Question:

What is the best method of dieting for a beginner who began going to a gym and wants to lose weight in a quick but safe fashion that it will stay off?

– Joseph

An “ideal” diet plan for a beginner would depend on his or her lifestyle and commitment level. Some people do well with an extreme change – starting with a clean slate and following strict rules – while others get more results from incremental smaller modifications they can live with long-term. A person can start changing their eating habits for the better by beginning anywhere.   

According to the National Weight Control Registry, people that have successfully lost weight and kept it off mostly report following a low fat, reduced calorie diet with high activity levels. About half did it on their own while half enrolled in some type of weight loss program. Actions that losers often had in common were that they: 1) participate in regular exercise, 2) track weight routinely, 3) eat breakfast daily; and 4) watch less than 10 hours of video/TV per week.  

I’d trim out any extras that you can already identify such as late-night eating, second helpings, alcoholic beverages or desserts. As wholesome fresh food is always best, decide if you can dedicate additional time in the kitchen or need to purchase starter meals that you assemble. Whether or not to follow a specific diet plan, macronutrient ratio or preset menus depends on your interest level and food preferences.   

We’ve lots more beginner weight loss advice in the Living Healthy Blog – check how to create your own meal plan and how to achieve quick weight loss. 

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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How Much Protein Should I be Eating? | QA

How Much Protein Should I be Eating? | QA

Question:

I am a 38 year-old male, 250 pounds, 5’11” and I’ve been steadily working out since June and have lost almost 50 pounds, but I’m curious what is the right amount of protein that I should be taking in daily? I work out 5 or 6 days a week on average and work with a personal trainer six times a month. I usually do about 30-45 minutes of strength training followed up by 30-45 minutes of cardio. I’m currently shooting for somewhere between 130-180 grams of protein a day. Is that enough for my goal of losing weight while building muscle? Thanks.

-Steven M.

Great work on your consistent progress, Steven! For your body weight, goals and activity level your current aim for 130-180 grams of protein daily seems on track. That’s between 1.1 and 1.6 grams of protein per kilogram body weight, ideal for supporting muscle growth with an intensive workout regimen. The range midpoint of 155 grams provides 620 calories which would equate to about 30% of energy if your intake was 2000-2100 calories. 

Though you may be counting protein grams and calories, the quality and timing of what you’re eating has as much impact as – if not more than hitting calculated marks. Remember to support your workouts with some carbohydrate and a little protein in your recovery snack. A high-protein yogurt with fruit or granola works as well as a protein shake. For your main meals, lean proteins, vegetables, whole grains and healthy plant fats will promote efficient metabolism better than typical fare. For example, choose a healthy stir-fry (e.g. chicken, carrots/broccoli, cashews, brown rice) instead of a cheeseburger (regular ground beef, cheese, refined flour bun). 

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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Should You Go High-Protein on Days You Don’t Exercise? | QA

Should You Go High-Protein on Days You Don’t Exercise? | QA

Question:

Hi there! I am an LA Fitness member and would love to get some advice from a dietitian regarding my exercise/nutrition plan. 

I’m 31-year-old female and have always been lean – genetics/high metabolism I guess. While I know this is what many women want, my problem is that I feel “too skinny.”  I’m starting to try heavier weight training and increasing my protein intake, while striving to maintain a balanced diet. I have young kids and can only make it to the gym 1-2 days per week. So, my main question is: on days that I don’t exercise, should I still try to eat higher protein? Or is that only on gym days? 

Also, if you could verify my calculations… I’m currently around 120lbs and would like to be closer to 130lbs. So, I’m aiming for roughly 2,100-2,200 calories/day and about 125 grams of protein per day. 

Any other advice is greatly appreciated!  Thanks,  

– Shannon

Answer:

Lucky for you Shannon, carrying and lifting growing tykes is like having a built in progressive resistance program! Well… for a few years at least, until it becomes unnecessary and impractical. While it still works, you should pick up and carry toddlers with proper posture and body mechanics. According to physical therapists and chiropractors, don’t balance your child on one hip but hold him/her in front of you with his/her legs wrapped around your waist.  

In regards to your calculations: functional and structural protein use tops out at around 2.0 gm/kg/day with any excess being used for energy. Consuming about 110 gms protein daily should be sufficient, with a little less on rest days and more on workout days. Following the correct protein timing surrounding your weight training workouts is as important to help stimulate muscle growth. 

You actually need a good amount of carbohydrate and fat to provide the fuel for muscle building. Your total energy goal seems realistic, though your actual metabolism doesn’t follow an equation so your true calorie need may be higher or lower. Why not simply try to add 300-500 calories daily rather than keep track of five times that much? Simple foods like a turkey sandwich or apple with graham crackers and peanut butter could provide this energy. 

If you’re still having difficulty gaining lean mass, focus on energy dense foods (with little moisture or air) to get the most in every bite and consider adding a weight gainer shake. Cleaning your kids’ plates is also a great way to get extra calories! 

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

Ask our Dietitian

Have a nutrition question? Our registered dietitian is ready to help!

Email nutrition@lafitness.com or submit your question below and it may be featured in an upcoming article!

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Nutrition Planning with GERD and an Unhappy Thyroid | QA

Nutrition Planning with GERD and an Unhappy Thyroid | QA

Question:

Hi, I was wondering if you would be able to help my girlfriend with her diet.  We’re both LA Fitness members.  She’s an avid swimmer and eats pretty healthy (usually eating far less than what I normally intake). She has a thyroid issue and suffers from GERD, acid reflux. She was swimming several times a week and doing weights, yet not really losing any weight. And, if she can keep food down it’s a good day for her. She takes stuff for GERD but stopped taking her thyroid medication as she wasn’t getting any change. She was going to try one of the app diets, but her mom passed away this year and canceled on that. So, I was wondering if there’s a diet you would recommend for her, to first get her stomach back on track and possibly help her to lose the weight she wants to drop. Thank you for your help. 

– John B 

Answer:

It’s imperative that your girlfriend follow up with her physician on an appropriate course of action regarding her thyroid condition since she stopped taking her medication. Thyroid function determines cellular metabolism and doctors test hormone levels, not body weight, to indicate medication effectiveness. 

I’ll assume she requested your assistance, otherwise advice offered by you regarding her diet and weight may not be accepted! (Always a good idea to be clear on a significant other’s intent in sensitive matters.) If she already eats healthy and has had a recent stress, then simply reducing portions may be reasonable versus following a structured diet plan.  

For gastroesophageal reflux disease (GERD), the International Foundation for Intestinal Disorders* recommends a diet that includes non-citrus fruits, lean proteins, complex carbohydrates, and vegetables except tomatoes and onions. Low-fat dairy foods, non-mint chewing gum, and small amounts of oils, avocado and nut butters are generally well tolerated. Avoid alcohol, caffeine, carbonated beverages and chocolate.  

There is no specific menu plan to follow for losing weight with acid reflux. If your girlfriend is absolutely ready to begin new eating habits, then she may resume her intention of using an app and make adjustments for GERD accordingly. Consumer Affairs recently posted their top 10 weight loss apps of 2019 based on user ratings. And last year Kaiser Permanente shared their reviews of 10 nutrition and diet apps of 2018. That’s twenty apps for her to choose from though not all offer meal plans. 

Best of luck to both of you for 2020 from Living Healthy! 

* https://www.aboutgerd.org/diet-lifestyle-changes/diet-changes-for-gerd.html Accessed 11/22/2019 

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

Ask our Dietitian

Have a nutrition question? Our registered dietitian is ready to help!

Email nutrition@lafitness.com or submit your question below and it may be featured in an upcoming article!

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