Keto Diet-Friend or Foe?

“Keto here, keto there, keto everywhere!” It is inevitable, whether attending social gatherings, visiting the grocery store or interacting on social media you have probably heard about the keto diet and been tempted by its promises. In fact, the keto diet was the most searched weight loss diet in 2018. But is this diet the weight loss solution we’ve all been waiting for?

The ketogenic diet (better known as ‘keto’) is a high fat (70-80% of total calories), low carbohydrate (less than 50 g of carbohydrates (5-10% of total calories), moderate protein (10-20% of total calories) diet that adjusts the way the body produces energy. On a normal healthy eating plan that typically has 25-35% of total calories from fat, 45-60% of total calories from carbohydrates and 20-35% of total calories from protein, the body relies on burning carbohydrates for energy. On the other hand, in the ketogenic approach the body becomes dependent on burning fat producing ketones bodies to fuel itself. This is where the theory of keto diet for weight loss came from. It is difficult to know when one enters ketosis, unless you check for ketones in the blood/urine. However, it is very easy to leave this state, since the slightest increases in carbohydrate intake may resume regular energy production, adding to the challenges faced on this restricted diet.

Like other weight loss diets with restricted intake, individuals may notice rapid weight loss in the first week (about 2-10 lbs), primarily related to water loss and glycogen stores depletion. Shortly afterwards, the rate of weight loss slows down, similar to other weight loss diets, to about 1-2 lbs/week. Whether this diet is sustainable and improves overall health outcomes is in doubt.

The ketogenic diet is not a new trend. In the 1800’s, scientists discovered its efficacy in treating epilepsy and other similar seizure disorders in kids. Therefore, most available research, especially long-term studies, is concentrated on that rather than weight loss. Long-term studies linked the keto diet with increased risk for kidney stones, osteoporosis, hyperlipidemia, possible nutrient deficiencies and risk for liver abnormalities. Short term effects recorded in adults include constipation, brain fog, irritability, increased levels of both good (HDL) and bad blood cholesterol (LDL), binge eating and relapse, adequate muscle maintenance and building and mild improvements in serum glucose levels.

Well, is it a friend or a foe? As a registered dietitian nutritionist, there is too much risk and not enough research to prove that following the keto diet will lead to greater weight loss and better health outcomes than other less restricted more realistically sustainable diets. Therefore, I would consider losing weight on the ketogenic diet as a foe for now. However, there are some positive sides of this diet that we can learn from to improve our health and wellness that include:

  • Being mindful with the quality and quantity of carbs we eat
  • Practice portion control
  • Overcome fear from fat and work in more healthy fats
  • Listen to hunger and fullness cues.

Please remember that there is no one size fits all when it comes to eating. We are all unique with different health issues, so it is important that we base our diets on what our individual body needs rather than following mainstream food trends.

Thanks to R. Farra, MDS, RD, LD for co-authoring this article with me.

Resources:

HSPH

Cambridge.org

Green Coffee Extract–Weight Loss Truth or Myth?

It is no new news that overweight and obesity rates continue to increase not just in the U.S but also worldwide. With concern for good health and hope to achieve faster and better weight loss results, the use of dietary supplements has also increased among consumers. Current scientific research finds most of the supplements to be ineffective for many reasons. Some may not contain the adequate dosage to produce a positive effect on health, some may be poorly absorbed and others may become inactive in the presence of other substances. One “slimming” supplement worth discussing because of the gained popularity among dieters in the recent past years is the green coffee extract (GCE) dietary supplement. After being endorsed by celebrity health experts and extensively marketed by well-known manufactures, the sales of green coffee extract as a weight-loss aid have skyrocketed.

But what is green coffee extract?
Green coffee extract (GCE) is present in green raw coffee beans. It is also present in the roasted coffee but much of the GCE is destroyed. The major GCE constituent is cholorogenic acid (CGA). It is estimated that 100 grams of raw coffee can provide about 5 to 12 grams of CGA. Besides coffee, CGA can be found in many fruits and vegetables. Research indicates that CGA is highly absorbed and metabolized in humans; however, there is large variation among individuals on how much is absorbed in the body.

Green coffee extract has been marketed as a weight loss supplement in the capsule form under a wide variety of brands using the patented name Svetol. In the U.S market, Svetol – manufactured by the French company Naturex, is listed as an active ingredient on 25 dietary supplements. Svetol is also found in Norwegian Coffee Slender products such as instant coffee, decaffeinated tablets and mints, and chewing gum.

What are some of the suspected benefits of cholorogenic acid (CGA)?
The chlorogenic acid in the green coffee extract is believed to have antioxidant properties and in animal studies, it has been shown to inhibit fat accumulation. In humans, the consumption of caffeinated coffee can lead to long-term weight loss; this is believed to be a result of the effects of caffeine intake possibly working along with green coffee extract on metabolism.

The findings of current research indicate, but not convincing evidence, that intake of green coffee extract fortified with chlorogenic acid may promote weight loss. These results must be interpreted with caution, as the methodology in many studies is poor and further investigation is needed. More rigorous trials with larger sample size and longer duration are required to assess the effectiveness and safety of green coffee extract as a weight loss supplement.

As a consumer, you have the power of your purchasing decision. However, informed choices can prevent you from wasting your money on products that may not give the expected results and that may have long-term adverse effects on your health and body. The best approach to avoid weight gain or promote weight loss, one must use all the calories consumed on a daily basis. Researchers, physicians, registered dietitians and dietary supplement industry agree that eating a variety of whole foods, practicing portion control and exercising regularly is the foundation to maintaining a healthy weight.

Thank you I.I. UTHSCSA Dietetic Intern, March–2013

References
1. Onakpoya I, Terry R, Ernst E. Use of green coffee extract as a weight loss-supplement: A systematic review and meta-analysis of randomized clinical trials. Gastroenterol Res Pract. 2011; 2011:1-6.
2. Vison J, Burnham Bryan, Nagedran M. Randomized, double-blind, placebo-controlled, linear dose, crossover study to evaluate the efficacy and safety of a green coffee bean extract in overweight subject. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2012; 5:21-27.