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The ketogenic diet is a low carbohydrate, high fat diet that provides substantial amounts of protein. One of the key factors in the success of keto diets for weight loss is the suppression of appetite. Athletes who desire improved performance over prolonged periods have found that keto diets can improve aerobic efficiency and increase the anaerobic threshold. High cholesterol is a key factor in developing heart disease, which claims three times more lives than breast cancer and twice as many as lung cancer. So can diet alone be used to bring down high cholesterol – or should we leave it all to statins? Confusingly, countless foods carry labels claiming they can protect your heart or cut cholesterol. These include Flora pro.activ and Benecol yogurt shots, as well as other products containing stanols and sterols. Studies have shown that plant sterols reduce cholesterol levels by seven to ten per cent within three weeks, as part of a diet low in saturated fat. You need to consume 2g in one go alongside your biggest meal of the day, each day, to get the full effect. The high fermentable-fibre content of beans and pulses means that they cannot be digested easily by the gut.
A meta-analysis of 67 studies on dietary fibre and cholesterol levels revealed that consuming more  fibre helped reduce ‘bad’ LDL cholesterol by a small but significant amount. Fibrous foods such as beans  also trick the body into absorbing less saturated fat, which can help control weight and protect arteries from heart disease.
Just swapping white bread for wholemeal can lower cholesterol levels, a manageable step for everyone.
Most nuts, including almonds, walnuts, pecans and peanuts, are good for lowering cholesterol. In 2010, an American analysis of 25 studies on nut consumption and blood fat levels found that eating  a portion every day (eight to ten nuts, or a small  palm-full) reduced overall cholesterol by five per cent and was particularly good for people with high levels  of ‘bad’ LDL cholesterol.
Linda Main says: ‘Nuts are very filling, so not only do they reduce cholesterol, but they can stop you snacking on too many other fatty foods afterwards.
Soya milk, soy nuts, tofu and soya yogurts  may help the liver to take ‘bad’ LDL cholesterol out of the bloodstream. There is some evidence, including a 2011 study, that soy protein can help reduce total cholesterol. Although the effects were modest, some experts say that because soy products such as tofu often replace meat in the diet, they reduce the intake of saturated fat from other sources.
Olive oil and rapeseed oil, which contain mainly monounsaturated fats, neither increase nor decrease cholesterol levels. However, they help to make the  artery walls stronger, meaning that they are less likely  to be damaged by cholesterol.
Studies suggest that replacing saturated fat such as lard and butter with these oils results in a fall in cholesterol. Polyunsaturated fats from sunflower oils were considered to be as good as olive oils, but recently it has emerged that having too much of them causes oxidation, meaning they may increase furring of the arteries.
Analysis of 12 studies involving more than 1,000 people showed that adding beta glucans each day to your  diet via porridge, other oat-based cereals and oatcakes reduced cholesterol by up to five per cent within three months. Cholesterol is a fatty substance produced by the liver and used to build cell walls, create a protective glove around nerves and to make other chemicals such as hormones. Cholesterol gets round our bodies  by combining with protein to form a protective coating around tiny balls of fat absorbed from our diet – termed lipoproteins. The two lipoproteins usually measured are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Diet can reduce cholesterol levels by ten to 20 per cent, which significantly decreases heart-disease risk. To slash cholesterol by as close  to 20 per cent as possible, you’ll need to adopt ALL of the healthy eating elements mentioned above  for at least three months. ABOUT USYNaija is the internet newspaper for young Nigerians, focused on the issues and ideas that matter for an evolving generation. There are several layers to this and, frankly, there are some things we can’t fully explain – I’ll always acknowledge this.
Take a look again at the figure below, which shows you how many calories folks are consuming on each diet and, more importantly, where those calories come from. You’ll note that people on these diets, including the strictest low-fat high-carb diets, significantly reduce their total amount of carbohydrates (therefore reducing the amount of insulin they secrete). The reason, I believe, most of these diets have some efficacy – at least in the short-term – is that they all reduce sugar and highly refined carbohydrate intake, either explicitly or implicitly.
Someone made a great point in response to my post on why fruits and vegetables are not actually necessary for good health.
I know a lot of people who eat this way and, I’ve got to say, these folks do not eat a lot of sugar or a lot of highly refined carbohydrates. While I do plan to write an entire post on this topic of what one can and cannot conclude from an experiment, I do want to at least make the point here: The biggest single problem with nutrition “science” is that cause and effect are rarely linked correctly.
I am, to be clear, not implying this is the case for this trial, but I want you to understand why it’s important to read papers fully. This trial, The Lifestyle Heart Trial, prospectively randomized a group of not-so-healthy patients into two treatment groups: the control group and the experimental group (or what we’d call the “treatment” or “intervention” group). First off, and perhaps most importantly from the standpoint of drawing conclusions, compliance was reported to be excellent and the differences between the groups were statistically significant on every metric, except total average caloric intake.
Take a moment to look over the rest of the table (or just skip reading it since I’m going to keep talking about it anyway). Though not shown in this table, the experimental group also reported less chest pain severity (though chest pain frequency and duration were not statistically different). Let’s take a leap of faith and hypothesize that the dietary intervention (rather than, say, the social support) had the greatest impact on the measured parameters in the subjects.  It’s certainly the most likely factor in my mind.  But what, exactly, can I conclude? People don’t like to be hungry, and if they are reducing their caloric intake by reducing fat intake, they seldom find themselves satiated. Semi-starvation reduces basal metabolic rate, so your body actually adjusts to the “new” norm and slows down its rate of mobilizing internal fat stores.
I argue that reduction of fat intake has nothing to do with it and that the reduction of total calories has a transient effect. It’s *really* tough to study this stuff properly, especially compared to studying things blood pressure lowering pills, which are complex in their own right, but MUCH easier to control in a study.
A nutrition department of a university accepts funds from a company that makes confectionery. Do you think the Academy’s supporters want to hear that if you eliminate their products you will no longer need to rely on the products provided by the biggest supporters of the Diabetic Association? Pretty much solely because of their report, Suzuki was forced to eventually withdraw the Samurai from production in the US although they later won the lawsuit that was filed as a result of the forged report by showing videos from the actual testing of the car conducted by CR.
Ironically, the fact that CR had to admit it was faked somehow wasn’t plastered all over their magazines and the front pages of a bunch of newspapers. At that point, everything they publish became suspect and may as well line a birdcage somewhere. Peter, I have a coworker who has recently lost 80lbs over the course of a year on weight watchers. Looking forward to your next post, and of course people's comments for the current one! I will discuss all of this in great detail, hopefully in the coming month, when I do a post on PUFA (polyunsaturated fatty acids). Anyway, it’s nice to discover someone who takes the Taubes viewpoint on things, and also takes the time to actually post online about it with some frequency, so thanks!
Oh absolutely, I was mostly referring to the fact that most of the excess carbs we eat are converted to palmitic acid, which is a SFA. There was an (1) average protein, low fat group (65% CHO), (2) High protein, low fat group , (3) Average protein, high fat, and (4) high protein, high fat (35% CHO). Thanks very much, Bob, both for the kind comments and for sharing the other data with folks. This section provides all sorts of references for you to use while you are beginning your journey on the low FODMAP diet. But there are SO many other helpful resources in this section for dietitians or individuals that want to learn more about the low FODMAP diet. Just hover over the FODMAP Basics tab to find great information that will help you navigate the low FODMAP diet.
Probiotic supplements WITH chicory root or inulin would be a potential issue not probiotics in general. Thanks Kate, So foods from the fruit group and sweeteners that are “safe” should be limited to 1 serving per meal or sitting?
Fruits should be limited to one serving per sitting or meal OR spaced out at least 2-3 hours.
Samantha, Yes soy lecithin should not be an issue on the low FODMAP diet to the best of my knowledge. I also had a couple of strawberries today that upset my stomach but I think they were overripe.


Although it has recently gained a great deal of popularity, the keto diet has been used for treating various illnesses for thousands of years. A ketone is an organic compound composed of a carbonyl group bonded to two hydrocarbon groups. It may take 3 to 4 days after commencing the ketogenic diet before the body reaches ketosis. A study performed in 2006 compared ketogenic diets with nonketogenic diets used for weight loss. The diets provide metabolic flexibility that can enhance endurance in an aerobic environment.
Well, perhaps not specifically you, but thousands of Britons have this news broken to them by doctors every day. The good news is that lowering your cholesterol is the biggest thing you can do to reduce your risk.
Much of the health advice on the matter, including that on the NHS Eat Well site, is vague, leading to many misconceptions and myths.
The answer for very many people is yes, you CAN reduce your levels significantly through making changes in your diet. These naturally occurring molecules, which are found in plants, block the absorption of dietary cholesterol, which is then excreted with other waste. Around 5g will come from oat-based products and you can get the rest from just a slice of high-fibre toast and two tablespoons of beans. It may also stop LDL causing inflammation in the arteries, a key risk factor for cardiovascular disease. A 2002 study found that consuming this amount of olive oil each day decreased total cholesterol by eight per cent in six weeks. The beta  glucans form a thick gel inside the digestive tract  and bind to cholesterol in the gut, helping to prevent cholesterol from being absorbed by the body. This is equivalent  to a small bowl of porridge, three oatcakes and two slices of oat bread.
The purpose of this coating is to hold fat together, so we don’t have ‘oil slicks’ of fat in our bloodstream. LDL is like a juggernaut – big clumps of fat and protein that trundle along the arteries and can only be cleared from our system by the liver. It is much smaller in size and hoovers up fat deposits from the artery wall as it moves around the body. In the West, more people have high cholesterol than  in countries with a low-fat diet, such  as Japan. If you have a family history of premature heart disease or raised cholesterol, you should tell your GP as soon as possible and would be eligible for tests before the age of 40. It becomes a bigger worry the older you are, if you smoke, have high blood pressure, a family history of heart problems and don’t exercise. If it is a lot higher, they may tell you to take statins because these drugs are likely to reduce cholesterol by 20 to 40 per cent – a massive drop.
It is an arm of the RED brand, which is the continent's largest omni-media group focused on Africa's youth. That said, many of the successes (at least weight-wise, though hopefully by now you realize there is much more to health than just body composition) of popular diets can be explained by a few simple observations. You can argue that those who are overweight probably consume an even greater amount of carbohydrates.
Even the Ornish diet, which is the most restrictive diet with respect to fat and most liberal with respect to carbohydrates, still reduces carbohydrate intake by about 40% from what people were likely eating pre-diet.
No one on the Ornish Diet or Jenny Craig Diet is eating candy bars and potato chips, at least not if they are adhering to it. The point was, essentially, that telling people to eat 5-6 servings per day of fruits and vegetables can hopefully drive a beneficial substitution effect.
I have no intention of engaging in a battle with proponents of plant-based eating or no-saturated-fat diets.
Stated another way, it’s one thing to observe an outcome, but it’s quite another to conclude the actual cause of that outcome. In other words, for every intended difference between the groups a difference existed, except that on average they ate the same number of calories (though obviously from very different sources), which was not intended to be different as both groups were permitted to eat ad libitum – meaning as much as they wanted. Ornish’s study?  I think the reduction in sugar and simple carbohydrates played the largest single role in the improvements experienced by the experimental group, but I can’t prove it from this study any more than one can prove a low-fat vegetarian diet is the “best” diet.  We can only conclude that it’s better than eating Twinkies and potato chips which, admittedly, is a good thing to know. And, the majority of the benefit folks receive comes from the reduction of sugars and highly refined carbohydrates. Case in point…they recently reported that olive oil is not good for you because it does not contain omega 6. 3, has a good point about some plans (including WW) having the advantage of group support, which I think is a very major confounder.
It is wonderful to watch these people glow once they have found some sort of solution to their weight problem. One of my favorite things to say to people who are scared of saturated fat is that even on an entirely plant based diet, (ala Ornish Diet), if they are restricting their caloric intake, their bodies will be running on the saturated (animal) fat that they have stored on themselves. For example the degree of unsaturated fatty acids in our membrane bilayer probably plays a role in our insulin sensitivity, just as one example.
But most importantly, please work with a dietitian knowledgeable in the low FODMAP diet to ensure you are following it correctly and meeting your nutritional needs. I want to make my own yogurt as its cheaper than buying the expensive low lactose probiotic yogurts and the packet stuff is gluten free too and still doesn’t have additives and gelatin and all the other crap yogurt seems to have added to it!
There are two types of fats: saturated fats that primarily come from animal products and unsaturated fats that are found in plants.
There are two types of simple sugars: monosaccharides such as fructose, galactose and glucose and disaccharides which are formed from two monosaccharides. When ketone levels are elevated, the body will attempt to lower them by excreting them in the urine or breathing them out. It was concluded that nonketogenic diets were as effective as ketogenic diets and that the risks associated with ketogenic diets were not warranted. In the absence of carbohydrates, the body will adapt to burn ketones that are produced in the breakdown of fats. No food  is prohibited, so you can still eat cheese, red meat and chocolate, within the limits of a low-fat diet. To find out what we should – and shouldn’t – be eating to lower cholesterol levels, we spoke to leading diet and heart health experts. It is not clear how nuts lower cholesterol, but it might be because they contain plant sterols as well as monounsaturated fats that protect blood vessels from damage.
The reduction in cholesterol may be as much as five per cent, but scientific proof  for this is limited. This is why it’s important to know how much LDL and HDL are in your blood, as the ratio between these two types of fat is what really matters when it comes to risk. Eating foods high in saturated fat, such as butter, cream, processed meat such as sausages and fast food, means that our cholesterol goes up. The result gives volume of cholesterol in a measurement called millimoles per litre of blood – or mmol. Doctors will prescribe statins to anyone with a 20 per cent chance of developing cardiovascular disease in the next decade.
For some, a healthy diet does not have a great effect.  Once your cholesterol has  reduced, you’ll have to keep up  the good work and stick to your new eating plan.
But for the purpose of simplicity, let’s assume even the folks who go on these diets are consuming the national average of approximately 450 grams of carbohydrate per day (in compliance with governmental recommendations, as a percent of overall intake). If you tell someone who eats Twinkies, potato chips, and candy bars all day to eat more fruit (and they do), you’ve almost guaranteed an improvement in their health if they eat bananas and apples instead of the aforementioned junk food. I’m reasonably confident that the proponents of these diets are good people who really want to help others and have nothing but the best intentions. Ornish was the principle investigator on a trial published in the journal The Lancet in 1990. In other words, there were not enough subjects in the study to determine a difference in these “hard” outcomes, so we can’t make a conclusion about such events, only the changes in “soft” outcomes.
Good science, bad interpretationGravity and insulin: the dynamic duoIf low carb eating is so effective, why are people still overweight? His clinical interests are nutrition, lipidology, endocrinology, and a few other cool things. Eg, the criticism of the Ornish Lifestyle Heart Trial is excellent (and I LOVED the kitten-stroking quip), and really could and should have stood alone. After short diologue with her on the particulars of her daily intake I quickly realized her consumption of carbohydrate was significantly reduced and eliminated almost all fructose. I have been following the FODMAP for about a month but we have a freezer full from our garden and was wondering if they were ok to eat?
I only have a small amount of yogurt with my breakfast but its still a good source of morning protein, calcium needs and those wonderful probiotics that help our tummies too! In 1910, the first studies were performed on fasting as a treatment for epilepsy in France.


When insufficient carbohydrates are available, fats are broken down to supply carbon needed for energy production. A person in ketosis will often have a sweet, fruity scent to their breath due to the body expelling a ketone called acetone.
Other studies have found that ketogenic diets were not only effective for weight loss but included additional health benefits. This build-up – called atherosclerosis – causes artery walls to narrow so blood cannot get through, resulting in blood clots that can trigger a heart attack or stroke. The target is to have an LDL reading below 3mmol and a total cholesterol reading (which takes into account the HDL and LDL) of 5mmol. Popularity, of course, was determined by a number of factors, including compliance with current government recommendations (sorry Atkins), number of people who have tried the diet, and reported success on the diets. That doesn’t mean bananas and apples are “good for you” – it just means they are less “bad for you.” Here’s the kicker, though.
But that doesn’t mean we can or should overlook the errors being made in drawing their conclusions.
I’m not discounting soft outcomes, only pointing out the distinction for folks not familiar with them.
They never factor in that the chicken was breaded or that when someone ate steak or fish they had a large amount of bread of potatoes along with it. The M stands for monosaccharide or the sugar, fructose, when present in foods in excess of the glucose content–found in some apples, pears, watermelon, honey and agave syrup! A chemical reaction takes place between the oxygen in the body and carbohydrates, fats, and proteins. Fats are metabolized much more slowly than carbohydrates and are not as efficient at providing energy.Proteins are composed of one or more chains of amino acids. Most keto foods are in their natural state since processed foods are often high in sugar and starch. Low carbohydrate diets lower the amount of triglcerides in the blood and may help reduce the risk of heart disease.
In addition, keto diets have been found to reduce the amount of fat in the abdominal cavity more effectively than other diets.
Therefore, a diet that eliminates carbohydrates and sugars will essentially starve the cancer cells. In healthy people, this quickly minimizes a blood sugar levels that would otherwise become toxic.
People at high risk of heart disease – those with high blood pressure, who are overweight, older and may have family history of the disease – are told to get their total cholesterol lower, to 4mmol, with an LDL of 2mmol. We’re led to believe that the reason such folks get leaner and more healthy is because they are eating more fruits or more vegetables or more grains or more [fill-in-the-blank], rather than because they eliminated the most egregious offenders from their diet. Ornish personally, and I can only assume that he is a profoundly caring physician who has dedicated his life to helping people live better lives. But as always, I STRONGLY encourage folks with access (or folks who are willing to purchase it) to read the paper in its entirety. Simple carbohydrates are metabolized first because they enter the blood stream very quickly. They are primarily used to build and replenish the body with vital structural components such membranes, hemoglobin and cardiac muscle. One case was reported in 1995 where a ketogenic diet was used to treat two girls with brain cancer. In people with type 2 diabetes, the cells don’t recognize insulin, making it difficult to control blood sugar levels.
For people who don’t want to read the study completely, or who may not have much experience reading clinical papers, I want to devote some time to digging into this paper.
The end conclusion is the whole thing must be bad and therefore needs to be reduced or outright expunged from the diet.
I recall hearing Gary talking about his discussion with a participant from the Biggest loser on Larry King and the rapant weight gain after the show. Each of the three is metabolized in the same manner but carbohydrates are burned first, followed by fats, and then protein.
Complex carbohydrates are metabolized much more slowly, providing a sustained yet less dramatic increase in energy.
The blood glucose levels and glucose uptake at the cancer site was decreased by 21.8 percent after 7 days of commencing the diet. Scores for total cholesterol above 8mmol will mean the person is at medium to high risk of cardiovascular disease (CVD), depending on age and blood pressure.
It’s hard to tell if this change was statistically significant by inspection, so you glance at the p-value which tells you it was not.
That is one big difference I’ve noticed between studies cited by writers who want to condemn the entire diet consumed by Americans vs those who look at it with a more in depth eye and realize that certain components are the problem not the whole diet across the board. Russell Wilder at the Mayo Clinic developed a treatment plan for patients with epilepsy using a ketogenic diet. Any carbohydrates that aren’t used are either stored in the liver as glycogen or converted to fat. In the absence of carbohydrates and fats, muscle will be broken down to provide protein for energy production.The average western diet consists of approximately 5 to 15 percent protein, 10 to 20 percent fat and 65 to 85 percent carbohydrates. The blood becomes more acidic and it may damage vital organs such as the liver and kidneys. One showed substantial relief of symptoms, and progression of the disease was halted for 12 months.
Even a reading of 5 or 6mmol may be too high if you have other risk factors, such as rheumatoid arthritis.
Why did the people in the China Study who ate more plants do better than those who ate more animals (assuming they did)?
Well, for starters, reading abstracts, hearing CNN headlines, or reading about studies in the NY Times doesn’t actually give you enough information to really understand if the results are applicable to you. Urine tests are also frequently used to monitor ketone levels in those with diabetes, eating disorders or people on a ketogenic diet. Any of the three fuels that are not used for energy production will either be excreted or stored as fat. Others point to studies that provide evidence that ketosis produces no harmful effects even with prolonged use. The diets are an effective means of lowering blood pressure and can decrease the probability of stroke, kidney failure and other diseases. Parenthetically, if you actually want the answer to this question, beyond my peripheral address, below, please read Denise Minger’s categorically brilliant analysis of the study.
Beyond this reason, and let me be uncharacteristically blunt, just because a study is published in a medical journal it does not imply that is worth the paper it is printed on. Around the same time, physicians at Johns Hopkins Department of Pediatrics, Howland and Gamble, noted that “prayer, a water diet and three to four weeks of fasting” reduced seizures in one pediatric patient. In a ketogenic diet, the percentage of carbohydrates is substantially decreased and fats are increased. Green leafy vegetables including lettuce, spinach, kale, collards and cucumbers good keto food as are high fiber vegetables such as broccoli, cauliflower and cabbage.
The caloric intake is also limited to ensure the body maintains its preference for metabolizing fats. Some sweeter vegetables such as tomatoes, peppers and summer squash are allowed but must be limited due to sugar content. Steve Rosenberg, once told me that a great number of published studies are never again cited (I forget the exact number, but it was staggering, over 50%). The ketogenic diet simulates starvation similar to fasting by eliminating carbohydrates and forcing the body to burn fats. Translation: whatever they published was of such little value that no one ever made reference to it again.
The thing is, it is possible to eliminate wheat and still eat way too many carbs (can we say ice cream?).
Livingston at Johns Hopkins found that 1000 patients following a ketogenic diet confirmed that their seizures were under control. Treatment using ketogenic diets began to decline with the development of anti-seizure medications. Pancreatitis may occur in individuals who cannot process large amounts of fats in their diet. I’m now happily in ketosis, and the best part is, I know the WHY of weight loss now, how totally liberating and hope giving.



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