Four Q&A’s in Nutrition and Metabolism: Ketogenic Diets, Obesity in the U.S., GMOs, & Insulin in Weight Gain

Research a ketogenic diet. Explain the basis of the diet. What is this diet good for and why? Do you think this diet has other applications? Provide research to support your comments.

The ketogenic diet is a diet that uses ketones for energy after glucose diminishes during periods of starvation and when carbohydrate intake is minimal (McGuire & Beerman, 2013, p. 292).  This process can help spare lean body tissue and spare use of amino acids for energy when glucose from carbohydrates is minimized.  Muscles and the brain can utilize ketones for energy, however high levels of ketones can lead to a dangerous condition called ketoacidosis.  Ketoacidosis is a condition that can cause a “variety of complications, lowering blood pH, nausea, coma, and in extreme circumstances, death” (McGuire & Beerman, 2013, p. 293).

The ketogenic diet has been linked to helping sedentary people lose weight, reduced rates of cancer and control of high blood sugar from reduced carbohydrate intake, control of epilepsy, use in endurance exercise, and mental enhancement.  Sugar has been linked to higher cancer rates, by avoiding carbohydrates and using fat for energy, naturally blood glucose will be reduced and therefore cancer expansion or rates as well.  Likewise controlling blood sugar reduces and/or limits diabetes rates, making a  ketogenic diet an option for a diet-controlled method.  It has been linked to epilepsy control, which is not fully understood, but believed to be in relation to the fact the brain uses ketones for energy (McGuire & Beerman, 2013, p. 293).  Dr. Peter Attia, an expert in ketosis and exercise, believes that being in a ketogenic state creates a mental enhancement because ketones are a potent fuel for your brain creating higher levels of “brain regeneration, focus and mental acuity” (Greenfield, 2014, p. .326-327).  The U.S. Defense Advanced Research Projects Agency are researching the ketogenic diet utilizing it as “a weapon in mental and physical performance in battlefield conditions” (Burne, 2012).  All this said it is important to not go into a ketoacidosis state which is very dangerous; even more so for an athlete.  (Greenfield, 2014, p. 328) states a ketogenic diet can be useful for a sedentary person to lose weight, but can be very stressful on an athlete’s body where nutrient stores are utilized at higher and faster rates.

I definitely think the diet can be useful and has other applications, like intermittent fasting.  I personally attempted to utilize an all out ketogenic diet as an athlete and person who is active as an RN at work.  I suffered from adrenal fatigue and muscle wasting after trying this diet because I went into a state where my body was having to utilize amino acids for glucose as described in (McGuire & Beerman, 2013, p. 293).  I think this diet does have many advantages, especially for more sedentary people.  The problem with this diet is that it can be very difficult to follow because of how many carbohydrates are in our staple foods and monitoring ketone production is very important to prevent acidosis.  Intermittent fasting, without going to in depth, minimics ketogenic diets or fasted states, but in smaller doses.  I personally do a 12-16 hour fast 5-6 days a week because of the advantages seen with using fats for energy as well as giving the body time to digest and utilize all the nutrients from the previous day.  I truthfully believe in a diet that can be utilized for a long period of time as a lifestyle.  If you are able to closely monitor your ketone levels this diet can be a great tool.  Personally monitoring the timing and types of my carbohydrates, utilizing intermittent fasting to mimic ketogenic diets in small amounts, and for lack of a better term “listening to my body” has helped me feel better as an athlete and mentally in daily life.  I find it fascinating that diets too high fats, too high in protein, and diets too high carbohydrates are all dangerous.  Moderation and good nutrient sources are so important to understand along with timing of nutrients in daily life.

What do you think has been one of the biggest factors when researching the continuing upward trend of weight gain in the U.S.? Support your answer.

I think one of the biggest factors when researching the continuing upward trend of weight gain in the United States is the continued overuse of processed sugar, grains, and a diet too high in poor carbohydrates from years of emphasis on the old food pyramid.  For years the food pyramid was emphasized with the bulk of the diet coming from breads as the main stay on the food pyramid.  Lots of processed breads are high in sugars and on the glycemic index leading to problems of diabetes, which is linked to many chronic problems associated with it including: obesity, cardiovascular disease, immobility, higher cancer risks, and other chronic problems (Greenfield, 2014, p. 294).  These secondary problems can lead to tertiary problems for example diabetes can lead to obesity and pain with ambulation, which results in a person walking less and then developing a blood clot.  I can’t tell you how many times I have seen clots form in the hospital and the majority that I see are a result of an inability or choice to not ambulate in the hospital.  Over the past 30 years obesity rates have soared with the use of many empty calories consumed from things like soft drinks.  Not all carbs are bad, but many of the processed ones that our society has used are.  It is important to look at the energy density and nutritional value of the food you eat.  “Studies show that people feel more satisfied and tend to consume fewer calories when they eat low-energy dense foods” (McGuire & Beerman, 2013, p. 354).  When people consume soft drinks these are pure sugar and empty carbohydrate sources; meaning they contain calories from the sugar without added benefits of vitamins, minerals, fiber, and other nutrient that we get from nutrient dense sources like vegetables.  “The 2010 Dietary Guidelines for Americans recommend that we maintain a healthy body weight balancing caloric intake with energy expenditure” (McGuire & Beerman, 203, p. 352).  Despite whether you believe in a lower carbohydrate approach to diet or not; there is a direct link to increased obesity and use of processed sugars and carbohydrates since the 1970’s (Food Research and Action Center, 2014).  I believe we must reverse this trend by teaching our youth to not do what we were taught in schools with the old food pyramid.  Things like the new 2010 Dietary guidelines, using the plate instead of the pyramid, and understanding that there is more to food than just calories will help our society if we educate them properly and change our society’s nutritional culture.

Genetically Modified Organisms (GMOs) are currently a nutrition hot topic. After reading the relevant research, what is your stance on GMO’s in the food supply? Support your answer.

Genetically modified organisms (GMOs) are relatively new in terms of nutrition and can be a great tool or a dangerous weapon in the nutritional health of people.  Genetically modified proteins and foods can enhance the nutritional value of plants, proteins, and other nutritional parts of food.  However modification can denature proteins and other components which can lead to higher risks of gastrointestinal issues, cancer risks, food allergies, and other issues.  I believe like any food source, you must trust the source of the food.  For example, even an apple can have hundreds of preservatives, fertilizers to enhance growth, and be genetically very different from an organic (non-GMO) apple.    So my stance is proceed at your own risk.  My golden rule of eating is “Eat Real Whole Foods”; so right now I wouldn’t trust GMO foods because I try to eat whole fruits and vegetables, fermented grains and dairies, carefully picked protein sources (including protein powder that is carefully selected), minimal supplements, and nothing boxed or mixed in a bottle for the most part.  According to (Tufts University, 2013), as of right now, adding GMO to the new nutrition labels is not part of the plan and is of a great deal of controversy.  The goal of the FDA’s new nutritional facts label is “providing information that people can use to make their own choices” (United States Food and Drug Administration, 2014).  I feel that it is important that the FDA require foods that are genetically modified to be labeled so.  GMOs can be a great tool and in the future as more research and good GMO sources are confirmed, then I may use and even recommend.

Understanding that insulin stimulates lipogenesis do you believe that by simply controlling insulin (reducing spikes) weight loss can occur? Support your answer.  

Insulin stimulates lipogenesis so preventing excess release of insulin (spiking) can help with weight loss, however energy in compared to energy out still needs to be less.  Insulin promotes the uptake of excess glucose by adipose tissue where the glucose is stored as what we know as body fat (McGuire & Beerman, 2013, p. 290).  So by minimizing spikes we can lower glucose uptake by adipose tissue.  It is important to remember that we can use other nutrients for energy other than carbohydrates because the energy source of the cell is ATP; therefore we can use ketogenesis (fat-burning) as an alternative source.  To lose body fat ketogenesis has to occur, otherwise weight loss is either lean tissue and/or fluid weight.  Understanding what and when carbohydrates stimulate insulin response is key to controlling preventing the insulin spike response.  Carbohydrates with a higher glycemic index and load need to be eaten minimally or only at certain times, as discussed in (McGuire & Beerman) chapter discussing carbohydrates (2013, p.133-135).  So eating foods with a lower glycemic index and load can help promote weight loss from controlled blood glucose.  During and shortly after exercise skeletal muscles can take up glucose without insulin and help prevent loss of muscle tissue (McGuire & Beerman, 2013, p. 138).   Personally, I use intermittent fasting to enhance fat-burning and eat a diet with low sugar and low grains, with the majority of my higher glycemic index and glycemic response carbohydrates coming after exercise.  It is also important to keep in mind that excess protein and poor fat choice intake can stimulate weight gain .  So hypothetically speaking, simply controlling insulin spikes can make weight loss occur, if the person is understands how to control the spikes.  Other things that can help control insulin response outside of exercise and diet control include: fiber intake, vinegar use, and ability to release glucagon which can cause rebound hyperglycemia.  Properly timing carbohydrates, eating the right low glycemic carbohydrates, understanding insulin response, and knowing that energy used still has to be greater than energy in, all factor into losing weight.

Burne, J. (2012, November 26). Could this elixir hold the key to weight loss? experts hope it’ll also treat diabetes, epilepsy and alzheimer’s. Retrieved from http://www.dailymail.co.uk/health/article-2238842/Could-elixir-hold-key-weight-loss-Experts-hope-itll-treat-diabetes-epilepsy-Alzheimers.html

Food Research and Action Center. (2014). Overweight and obesity in the U.S. Retrieved from http://frac.org/initiatives/hunger-and-obesity/obesity-in-the-us/

Greenfield, Ben. (2014). Beyond training: Mastering endurance, health, & life. Las Vegas: Victory Belt Publishing, Inc.

McGuire, M. & Beerman, K.A. (2013). Nutritional sciences: From fundamentals to food. Belmont, CA: Wadsworth.

Tufts University. (2013). Should You Worry About GMOs?. Tufts University Health & Nutrition Letter, 31(9), 4-5.

United States Food and Drug Administration. (2014, August 1).  Proposed changes to the nutritional facts label. Retrieved from http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm385663.htm#Summary

Velasquez,-Mieyer, P.A., Cowan, P.A., Arheart, K.L., Buffington, C.K., Spencer, K.A., Connelly, G.W., & RH Lustig. (2003, February).  Suppression of insulin secretion is associated with weight loss and alternated macronutrient intake and preference in a subset of obese adults. International Journal of Obesity Related Metabolic Disorders 27 (2): 219-226.. doi: 10.1038/sj.ijo.802227

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