#412 Low Carb, Keto, Fasting: Lifestyle Interventions for Weight Management
Oct 16, 2023
auto_awesome
Dr. Will Yancy, Director of the Duke Lifestyle and Weight Management Center, discusses lifestyle interventions for weight management including the ketogenic diet and exercise. The podcast covers lab work for low carb diets, understanding and exploring low carb and keto eating plans, and managing diet for weight management. The benefits of low carb and keto diets for weight management, as well as the challenges and key take-home points for patients, are also discussed.
The ketogenic diet, also known as a low-carb eating plan, is effective for weight loss and can help manage conditions like type 2 diabetes and high blood pressure.
Incorporating low-carb eating into daily life requires gradual changes tailored to individual preferences, portion control, and mindful eating to achieve success.
A low-carb diet can be adapted for individuals following vegetarian or vegan diets by including fish, shellfish, eggs, tofu, tempeh, and plant-based protein products, while emphasizing non-starchy vegetables.
Deep dives
The ketogenic diet and low-carb eating
The ketogenic diet, also known as a low-carb eating plan, involves reducing carbohydrate intake to below 20 grams per day. This reduction in carbohydrates aims to lower insulin levels, allowing the body to burn fat instead of storing it. The diet primarily consists of protein sources like meat, poultry, fish, and eggs, as well as leafy greens and non-starchy vegetables. Nuts, seeds, and berries are limited, and there is no need for fancy keto products or supplements. The diet can be customized based on individual needs, with some individuals able to achieve ketosis at higher carbohydrate levels. It is important to have regular follow-up with patients, especially those with diabetes or on high-dose diuretics, to monitor progress and make necessary adjustments.
Benefits of low-carb and keto eating
Low-carb and keto eating can have significant health benefits. In addition to promoting weight loss, these eating patterns have been shown to lower blood pressure and insulin levels, as well as help manage and even reverse conditions such as type 2 diabetes. Patients with diabetes may see their insulin needs reduced, and those on diuretics might require adjustments to their medication. Follow-up appointments are necessary to closely monitor patients' progress and make medication adjustments as needed.
Incorporating low-carb eating into daily life
Incorporating low-carb eating into daily life can be a challenge, particularly when family members have different dietary preferences. It is crucial to understand a patient's eating habits, including potential skipping of meals and emotional eating patterns. Gradual changes tailored to individual preferences, such as reducing carbohydrate intake to levels lower than 50 grams per day, can still lead to positive outcomes. Portion control and mindful eating can also play a role in achieving success, even if patients do not strictly adhere to the strictest ketogenic phase. Support and regular follow-up are essential components of implementing a successful low-carb eating plan.
Considerations for vegetarian and vegan diets
While it may be more challenging, low-carb eating can be achieved for individuals following vegetarian or vegan diets. Fish and shellfish can be included for pescatarians, providing complete protein sources. Other protein options for vegetarians and vegans include eggs, as well as non-animal sources like tofu, tempeh, and plant-based protein products. Emphasizing vegetables, particularly non-starchy options, is crucial in these diets. Regular follow-up and adjustments based on individual dietary restrictions are essential to ensure nutrient adequacy and optimal health outcomes.
Diet and Nutrition on a Low-Carb Plan
Eating whole foods, emphasizing proteins and vegetables, and reducing processed foods is crucial for a low-carb diet. Animal-based proteins like meat, poultry, fish, eggs, dairy products, and plant-based proteins such as soy and quinoa are excellent sources of protein and essential amino acids. For vegans, soy and quinoa can be go-to options, while increasing the consumption of carbohydrates from legumes, nuts, and whole grains. When it comes to alcohol, moderation is key. Choosing low-carb options like dry wines, light beers, and low-carb liquors is recommended. However, alcohol still adds calories and can lead to overeating, hindering weight loss efforts.
Cholesterol and Saturated Fats on a Keto Diet
Contrary to popular misconception, a ketogenic diet does not primarily consist of high-fat foods like butter and mayonnaise. The focus should be on consuming whole foods and proteins, rather than adding extra fat. Saturated fats from dairy products, skin-on poultry, and certain oils like palm and coconut oil can raise LDL cholesterol levels. However, the impact varies among individuals. Some people, known as hyper responders, may experience a significant increase in LDL cholesterol, while others may see a decrease. It is crucial to consider overall health markers such as HDL cholesterol, blood sugar levels, blood pressure, and weight loss benefits when evaluating the impact of cholesterol levels on a low-carb diet.
Recommend lifestyle interventions for weight management with Dr. Will Yancy, Director of the Duke Lifestyle and Weight Management Center and Interim Chief of Division of General Internal Medicine at Duke (@DrWillYancy). Learn about the ketogenic diet, lower carbohydrate diets, and exercise, and their impacts on your patients.