01/14/2019
DO THE "HEALTHIEST" DIETS WORK?
IN DEFENSE OF THE KETO DIET
Someone recently asked me what I thought of Jillian Michael's recent interview slamming the keto diet as unhealthy and illogical. U.S. News and World Report also gives the Keto diet dismal reviews, placing it yet again, near the bottom at 39th of 41 current diet trends in terms of "healthy diets".
So how can I remain such a staunch supporter and fan? It's a fair question.
As many of you know, I lost over 100 lbs almost ten years ago and have kept it off using variations of the Keto, Paleo and HFLC diets. That puts me in the category of roughly a tenth of one percent. Less than one percent of people can lose 20% of their body weight or more, and an even smaller percentage still can keep it off for five years or more.
My weight no longer fluctuates. I don't fear food, count calories or deprive myself at all. How? This is the missing piece.
Statisticians, nutritionists and medical doctors look at diets in terms of health. Which diet is correlated with the lowest heart disease, reduced risk of cancer, and obesity? They look at correlation and epidemiological studies and clump all people in the same category, as though we're all homogenous and it's simply the foods we eat that keep us fat. Prescribe the healthiest diet on Earth, problem solved.
So what's wrong with this equation? Why doesn't it work?
Obesity, insulin resistance, binge eating disorder, bullimia, and Type 2 diabetes are not successfully treatable through this paradigm. They are not diseases of willpower or misinformation about what constitutes a "healthy diet". They are the end result of an addictive process gone awry.
What do all of these diseases have in common? A blunted dopamine response.
Our dopamine receptors are damaged and less responsive, leading to that feeling of low-lying depression, apathy, fatigue...
What's the quickest way to feel better? Eat something that converts to glycogen, raise our serum blood glucose and get our hit. It's no different than the alcoholic or he**in addict craving their fix. In fact, brain imaging verifies this hypothesis clearly.
So what's wrong with the Mediterranean Diet, or the latest "healthiest" diet out there? They focus on whole grains, fiber, and reduced fat, minimizing animal protein and saturated fats, the very foods we can eat safely, without triggering our addiction.
That steel-cut oatmeal with blueberries and skim milk is wonderful for the person who doesn't suffer from food addiction. For the person who does, it's akin to the alcoholic taking that first sip. Blood glucose surges, the dopamine rush ignites, and hunger and craving immediately follows.
I think it's fair to say the biggest threat to health and by far largest predictor of early death is obesity. Take off the excess fat and keep it off, and the details aren't really all that important.
What's missing from Jillian Michael's synopsis is the sad fact that virtually every one of the contestants on Biggest Loser went on to gain all of their weight back and then some. U.S. News and World Report similarily glosses over the fact that Keto remains at the top for quick weight loss and is the oldest diet in existence with proven, long-term safety. (It was used for decades to treat epilepsy prior to the advent of anti-seizure drugs and is still used today).
I'm not arguing that the Keto diet, or Paleo, or HFLC beat out other diets in terms of health. They don't. And they are often abused, relying heavily on nitrate-laden processed bacon, deli meats, sausage, pseudo desserts loaded with artificial sweeteners, and a scarcity of fresh vegetables and fiber. These are all significantly associated with poor health outcomes.
But if you're stuck in your weight loss, binging, have elevating base blood glucose (the precursor to full-blown diabetes), or are simply gaining weight and can't stop, there's nothing that can touch Keto or Paleo because they eliminate the foods keeping you entangled in the addictive process.
The paradigm needs to change. A glass of red wine a night is beneficial to the heart. Should we prescribe it to the alcoholic?
If we want to truly tackle these diseases the mindset and research has to evolve. It's not "Which diet is the healthiest?" It's "Which diet actually works and how can we go about making it as healthy as possible?"
