Keto or Veto?

You may have heard of the ketogenic diet, otherwise known as keto. It’s a diet based around high fat, moderate protein and low carbohydrate intake, usually consisting of about 20 to 50 grams of carbohydrate daily. But what do we know about the effects, both positive and negative, of a keto diet? There may be some key facts to think about before you decide to keto or veto.

What happens to your body on a keto diet?

• The ketogenic diet is mainly used as a treatment for epilepsy (seizure disorders) with positive results thought to be due to the protective effects of omega-3 fatty acids.
• Carbohydrates (carbs) are our body’s main source of energy. In a low carbohydrate and higher fat diet in the keto diet, the body breaks down fat instead for energy. This process creates ketone bodies which are used for energy, specifically in the brain which usually only uses carbs for energy.
• The keto diet basically puts our bodies into a type of starvation since we are starving our bodies of their preferred source of energy, carbohydrates.
• You may experience some flu-like symptoms, also known as the “keto flu”, that usually occur when someone’s body is experiencing ketosis, or the creation of ketones for energy. These symptoms include:
  • fatigue
  • dizziness
  • upset stomach & nausea
  • headache
  • diarrhea
  • abdominal cramping
  • increased constipation (due to the low fiber in a keto diet)
• there is also a diuretic effect with the keto diet which may cause a loss of water and cause dehydration in the body.

Will the keto diet really improve my health and weight?

• Results seem to vary a lot in animal versus human studies.
• Weight loss:

While significant improvements in weight loss, up to 10-20%, have been seen with a keto diet as compared to a controlled diet, the weight loss could simply be due to reduced appetite. There could also be a decrease in lean body mass, aka muscle, as opposed to just fat.

• Fats and cholesterol:

A keto diet could reduce triglyceride levels but have also been reported to increase LDL cholesterol (the bad cholesterol).

• Blood glucose and insulin:

There have shown to be reductions in blood glucose and hemoglobin A1c levels, especially in those with type two diabetes, and therefore reduce reliance on diabetic medications. However, these results were only shown in short-term studies.

• Blood pressure conditions improved with the keto diet, although markers of dehydration were increased too.

Is a keto diet safe?

• Short-term side effects:
  • Reduced fiber consumption due to lack of fruit, vegetables and whole grains could result in constipation.
  • Decreased intake of vitamins and minerals from fruits and vegetables could result in deficiencies.
• There is a lot we don’t yet know about the keto diet, including long-term effects due to the lack of long-term studies. Some possible long-term effects are:
  • lower red blood cell counts and other anemia markers
  • issues in liver and kidney function (such as kidney stones)
  • decreased water content in the body possibly leading to dehydration
  • reduced memory
  • osteoporosis
  • heart disease
• Not recommended for those with:
  • Type 2 diabetes in the long-term
  • pancreatic disease
  • liver issues
  • thyroid issues
  • eating disorders
  • gallbladder disease or have had the gallbladder removed
  • critically monitoring of those with kidney diseases
  • pregnant or lactating women
  • reliance on sodium-glucose cotransporter 2 (SGLT2) medications

Recommendations:

• Following a Mediterranean or well-rounded diet with variety and focusing your plate on non-starchy vegetables, whole grains, fruit and lean protein is recommended by the American Diabetes Association. Focusing on portion control is most important and more sustainable for the long-run.
• Low carb diets should be monitored by medical personnel routinely and adjusted over time (check with your provider to see if vitamin and mineral supplements are needed due to deficiencies in the diet).
• Every body reacts differently to diets, just as every person’s diet should be individualized to them and their needs. Should someone desire to try the keto diet they should seek professional assistance and monitoring with a registered dietitian nutritionist.

Resources:

1. Arsyad, Aryadi, et al. “Long-Term Ketogenic Diet Induces Metabolic Acidosis, Anemia, and Oxidative Stress in Healthy Wistar Rats.” Journal of Nutrition & Metabolism, June 2020, pp. 1–7. EBSCOhost, doi:10.1155/2020/3642035.
2. Bruci, Adriano, et al. “Very Low-Calorie Ketogenic Diet: A Safe and Effective Tool for Weight Loss in Patients With Obesity and Mild Kidney Failure.” Nutrients, vol. 12, no. 2, Jan. 2020. EBSCOhost, doi:10.3390/nu12020333.
3. Brouns, Fred. “Overweight and Diabetes Prevention: Is a Low-Carbohydrate-High-Fat Diet Recommendable?” European Journal of Nutrition, vol. 57, no. 4, June 2018, pp. 1301–1312. EBSCOhost, doi:10.1007/s00394-018-1636-y.
4. Kosinski, Christophe, and François R. Jornayvaz. “Effects of Ketogenic Diets on Cardiovascular Risk Factors: Evidence from Animal and Human Studies.” Nutrients, vol. 9, no. 5, May 2017, p. 517. EBSCOhost, doi:10.3390/nu9050517.
5. Choi, Yeo Jin, et al. “Impact of a Ketogenic Diet on Metabolic Parameters in Patients with Obesity or Overweight and with or without Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials.” Nutrients, vol. 12, no. 7, July 2020. EBSCOhost, doi:10.3390/nu12072005.
6. Lifestyle Management: Standards of Medical Care in Diabetes – 2019. (n.d.). Retrieved from https://care.diabetesjournals.org/content/diacare/42/Supplement_1/S46.full.pdf
7. Gordon, B. (n.d.). What is the Ketogenic Diet. Retrieved January 22, 2021, from https://www.eatright.org/health/weight-loss/fad-diets/what-is-the-ketogenic-diet

Healthy Meal Prepping on a Budget

This article was published in Spectrum Blodgett Hospital’s National Nutrition Month publication:

Can I eat healthy if I’m on a tight budget? It all depends on how you shop and plan. Below is a comparison of two different meals around $5. The difference between these two meals is that one provides one meal for one person with extra fat, sugar and calories. The other is around the same price and can provide multiple servings and contains more nutrients. A fast food double cheeseburger, medium fries, and medium soft drink can cost around $4.77. While grocery store-bought whole wheat spaghetti noodles, pasta sauce, frozen broccoli, and a half gallon of skim milk can cost around $5.82.

               

Try using these budgeting tips while you shop:

• Instead of eating out, plan your meals the week before, make a double batch and freeze the extras for lunches and busy nights
• Shop local farmers markets like Grand Rapids’ own Fulton Street Farmers Market & buy seasonal produce (you can visit the Fulton Street Farmers Market by clicking here)
• Save money by checking out a store’s online deals
• Set your grocery bill limit and add up each item on your phone as you shop
• Buy only what you need of fresh fruits and veggies to avoid spoilage
• Buy frozen or canned fruit and veggies (looking for food canned in water instead of syrup or juice and rinse before use)
• Buy whole grains in bulk, such as oats, quinoa, brown rice and whole wheat noodles
• Go for the low-cost proteins: peanut butter, lentils, beans, eggs, canned fish, whole grains
• Prep to-go snacks: yogurt parfaits, dried fruit and nuts, popcorn, whole fruit and veggies with hummus or peanut butter

 

Try this simple and nutritious recipe:

Crunchy Chicken Salad:

Portioned Recipe Total Cost: $3.65

5 Servings ($0.73/serving)

• 2 cups cooked chicken (or tofu) – $2.99/lb.
• ½ cup celery – $1.49/each celery heart
• ¼ cup green peppers – $0.79/each
• ¼ onion – $1.09/lb.
• ½ cucumber – $0.59/each
• ½ cup grapes – $1.99/lb.
• 1 small apple, diced with peel on – $1.99/lb.
• ¼ cup plain yogurt – $0.89/each 5.3oz container

Instructions:

1. Chop celery, green pepper into small pieces, peel and chop 1/4 of an onion, and chop half of a cucumber.
2. Chop the apple into pieces with peel on.
3. Cut grapes in half.
4. Put all ingredients into a large bowl and stir.
5. Serve on a lettuce leaf, with whole wheat crackers or on whole wheat bread.

 

Recipe from: https://choosemyplate-prod.azureedge.net/sites/default/files/cookbooks/HealthyEatingonaBudgetCookbook.pdf

 

 

New Year, New Resolution

Is my New Year’s resolution going to stick?

This year you may be making a goal or resolution, as many people do, to improve your health, lose weight, or exercise more, knowing you’ve had little success in the past. With diet culture growing and growing it wouldn’t be hard to believe if many of you have already tried more than one popular diet without success. A study looking specifically at new year’s resolution success and people’s beliefs about the changeability of their health status and body, found that a person’s perception of their health being something they can change is associated with their confidence and their persistence in achieving that goal. This shows that it is important for people to think of goals and their health as changeable instead of set in stone, so that they are unwavering in their motivation in the face of setbacks. Your body might fluctuate in weight, but you are still healthy and you still have the ability to reach your goals (2).

But how can I do my best to reach my goals?

The Academy of Nutrition and Dietetics recommends four main steps to reaching your goals (4):

1. Assess your current food choices and lifestyle. Why do you reach for certain food items? Or why is it you think you should be eating others?
2. Start by making small goals that you can realistically achieve such as going for a 15-minute walk 3 times a week or eating 4-5 servings of fruits and vegetables daily, until those goals become a routine. Make exercise fun by including your family and friends, such as joining a workout class or playing outside with your pets or kids, can be a great way to improve your health.
3. Make sure goals are measurable by asking how much or how many? Hold yourself accountable by keeping track of your progress in a notebook.
4. Seek counseling if necessary. Dietitians and psychologists may be of assistance to you if you are having trouble with this process. It is a dietitian’s job to educate their clients about the pros and cons of the fad diets and assess medical concerns, stress and sleep that may make it difficult to lose weight (1).

Remember that it is important to keep a routine by including consistent meals and snacks and focus on your health instead of the scale (3).

 

 

 

Resources:

 

1. Godwin, A. M. (2015). The Nurse Practitioner. New Year’s Resolutions: NPs and Weight Loss. file:///D:/Student%20Data/Downloads/New_Year_s_resolutions__NPs_and_weight_loss.2.pdf

2. Schreiber, M., Job, V., & Dohle, S. (2012). The Impact of Implicit Theories of Health on Maintaining New Year’s Resolutions. Social Cognition Center Cologne. Retrieved from https://www.ehps.net/files/powerawards_posters/schreiber_job_dohle_-_implicit_theories_of_health.pdf

3. Klemm, S. (n.d.). Make Resolutions Stick: Focus on Family. Retrieved from https://www.eatright.org/health/lifestyle/seasonal/make-resolutions-stick-focus-on-family.

4. Ellis, E. (n.d.). Eat Right this Year. Retrieved from https://www.eatright.org/health/lifestyle/culture-and-traditions/eat-right-this-year.

 

 

What’s the Deal with A1 Milk and Type 1 Diabetes?

I was recently informed by my wellness preceptor, who is a type 1 diabetic, that there are different types of milk, A1 and A2, and that there could be a relationship to type 1 diabetes based on the type you drink. Having never heard this before, this caught my attention. So, I decided to do some digging into the research behind it.

Let’s first talk terminology. Cows’ milk contains two main proteins, casein and whey. Casein is the largest group of proteins in milk and beta-casein in particular is the second most common form of casein in cows’ milk. The A1 and A2 classifications are the two most common genetic variations in milk, only differing by one amino acid (1). Higher concentrations of beta-casein A1 comes from breeds that originated in Northern Europe like the Holsteins cows that are the most common dairy cows in the U.S., as seen in the photo below. Whereas higher concentrations of beta-casein A2 come from breeds of cows originating in the Channel Islands of Southern France (2 & 3). The milk produced by our common dairy cows contains both A1 and A2 variations. The A2 milk that is being produced and promoted only carries the A2 variation of beta-casein (2).

Some evidence, and what I recently heard, is that the A1 beta-casein variation can promote development of Type 1 Diabetes. Type 1 diabetes is usually diagnosed in children, even though older and older people have been diagnosed more recently, and is a lack of insulin production from the pancreas to move blood sugar into the cells from the bloodstream to use as energy (2). Type 1 Diabetes is both a genetically disposed autoimmune disorder and can also be affected by diet and immune function. This disease can lead to further health complications like nerve issues and other chronic autoimmune disorders like Celiac disease.

I looked at a few articles, one published in 2018, and one published about 20 years ago in 1999. The article published in 1999 collected data from 11 countries, including the U.S. They looked at the average current and previous intakes of dairy protein in those with type 1 diabetes. The results show there was not much change in the dairy protein consumption before compared to while having a diagnosis of diabetes. Overall, the data point out that while there could be an association between type 1 diabetes and the particular beta-casein variant, it’s necessary to look at not only total milk intake but also the time of introduction and role of the individual milk protein variants. Therefore, more research needed to be done at this time before deciding whether type 1 diabetes could be related to a certain milk protein consumption (4).

The other more recent study I looked at in detail was conducted in 2018. This study assessed mice who were already genetically susceptible to type 1 diabetes. The mice either received a nutritionally balanced milk-based diet with either A1 or A2 beta-casein component. To test for genetic susceptibility in further generations, mice were bread for a total of five generations. However, the study stated that this included some brother/sister breading. Blood glucose testing was performed on all mice. The results showed at first there was no significant difference in A1 versus A2 intake and diabetes incidence between the first two generations. But when it came to the third generation, diabetes incidence doubled in the A1 group compared to the A2 group, and this incidence kept increasing with the generations (5). The graph below, from this study, shows the increase in diabetes in the mice over the course of three generations.

This study outlined the recommendations from the World Health Organization (WHO) that state women are advised to exclusively breastfeed an infant for at least the first six months and continue for as long as possible for optimal health. However, when the baby is finally weaned, results indicate that there may be an association between A1 beta-casein milk and type 1 diabetes incidence in later generation in those who are already genetically susceptible to the disease. Further research needs to be done to clarify if timing of introduction of the A1 milk in childhood and to what extent other environmental factors could add to the development of diabetes such as infections, pollution, vaccines, location of residence, family environment, and stress. Cows’ milk still proves to be the best nutrition after breastmilk (5).

If you are looking into trying out A2 milk, it can be bought through the A2 Milk Company. I found 59 fluid ounces of vitamin D A2 milk to be around $5 while Dean’s Dairy Pure 2% 64 fluid ounce regular milk is about $2.58. The choice is yours but remember that your family genetics and history as well as lifestyle habits still play a role in your development of the disease and more research is needed for a distinct recommendation.

                               

 

 

Resources:

 

1. Kaminski, S.; Cieslinska, A.; Kostyra, E. Polymorphism of bovine beta-casein and its potential effect on human health. J. Appl. Genet. 2007, 48, 189–198.
2. https://www.healthline.com/nutrition/a1-vs-a2-milk#definition
3. https://www.canr.msu.edu/news/history_of_dairy_cow_breeds_holstein
4. https://link.springer.com/content/pdf/10.1007%2Fs001250051153.pdf
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163334/pdf/nutrients-10-01291.pdf

 

How to Use Every Bit of Your Pumpkin

Recently my article was published in the Cherry Health newsletter about reducing your waste while simultaneously getting some extra nutrients from your pumpkin!

A good way to get your money’s worth in addition to being earth-friendly and reducing your food waste is to use as much of your food as possible. When we buy a pumpkin with the intent to carve it for a spooky jack-o-lantern we don’t always have a use for all the other parts. Here are some ways you can utilize all of your pumpkin:

1. Carve the pumpkin for your family-fun jack-o-lantern! While carving, harvest all of the innards and seeds and store in your refrigerator until further use as soon as you can.
2. Toast the pumpkin seeds as a snack!
3. Use the pumpkin guts for a pie. Pumpkin is rich in fiber and protein for feeling full longer, and beta-carotene and potassium that help your muscles and eyes work their best.

Pumpkin pie:

Ingredients: 

• 2 cups mashed, cooked pumpkin
• 1 (12 oz) can evaporated milk
• 2 eggs, beaten
• ¾ cup packed brown sugar
• ½ t. ground cinnamon
• ½ t. ground ginger
• ½ t. ground nutmeg
• ½ t. salt
• Pre-made pie crust OR homemade

Instructions:

• Preheat oven to 400 degrees F
• Prepare pie crust or simply place into pie pan
• In large bowl, beat pumpkin with evaporated milk, eggs, brown sugar, cinnamon, ginger, nutmeg and salt with an electric mixer or immersion blender.
• Pour into prepared crust
• Bake 40 minutes or until a knife is inserted 1 inch from the edge comes out clean.

More information available here.

To view the published article click the link below:

https://www.cherryhealth.org/2019/10/how-to-use-every-bit-of-your-pumpkin/

Nutrition in the News

A way to be educated about nutrition and health by reputable and accurate sources that happen to be in a newspaper or article!

 

How to get your daily dose of the sunshine vitamin

Written by: Ellen Miller

Have you noticed the days getting shorter and nights getting longer? As we enter the winter months in Wisconsin, it’s important to pay close attention to our vitamin D intake as it provides many necessary functions to our bodies daily. According to the American Heart Association, 85 percent of people aren’t getting enough vitamin D.

 

As kids, we were all told that vitamin D will help make your bones strong. While maintaining strong bones is a big part of why we need vitamin D, there are many other valuable roles, like helping calcium and phosphorus to be absorbed for bone and muscle functions.

 

In addition, there has been data found that proves a link between enough vitamin D and the reduction of cancer risk. The DRI, or Dietary Reference Intake, is about 600 IU per day, which is about 1 cup of fortified milk, an egg yolk, 3 ounces of Swiss cheese, and 3 ounces of portobello mushrooms.

Signs of a lack of vitamin D, or a deficiency, aren’t always obvious. Common signs of being deficient are tiredness, aches and pains. Severe signs are bone pain and weakness, and frequent infections.

 

To get your daily dose of vitamin D there are three methods: the sun, food or a vitamin.

 

For sun exposure, all that is needed is 15 minutes in direct sunlight in midday for at least two times per week without sunscreen. It’s recommended that exposing a larger part of your body, such as your back, would be better for absorbing the most vitamin D from the sun.

It may also be harder to get natural vitamin D when you live further away from the equator. For instance, in Wisconsin we can’t produce vitamin D naturally from the sun from the months of November through March. The amount of vitamin D you get also depends on one’s skin color. The darker your skin color, the harder it is for you to absorb vitamin D.

 

The second way to receive enough vitamin D is through food. The best sources of vitamin D are fatty fish like tuna and salmon, or cheese, egg yolks, and some mushrooms.

Fortified foods are what to look for in everyday foods like milk, cereal, orange juice, yogurt, cheese and some soy beverages. It’s important to keep in mind that vitamin D is a fat-soluble vitamin, which means that it will be absorbed better with healthy fats.

 

The third way to receive enough vitamin D is through a vitamin. People who may need supplementation are infants who don’t receive vitamin D in breastmilk, the elderly, darker skinned people who don’t absorb vitamin D quite as well, and people with chronic medical conditions like osteoporosis.

 

It’s important to talk to your doctor first to see that a supplement is necessary, and then be tested for vitamin D blood levels accordingly. When picking out the proper vitamin D supplement, D3 is the most resembling of the sun’s natural vitamin D.

 

Vitamin D is useful for more than just building our bones nice and strong — it’s a part of muscle strength, immune system and many more functions that relate to everyday life. Now is the time to start building your supply of vitamin D.

Article can be found in the Racine Journal Times