Each year, it seems a new diet fad is born. “Keto,” “paleo,” “low-carb” and “low-fat” are a few weight-loss diet fads making the rounds on social media and appearing on grocery store shelves. Losing weight tops many New Year’s resolution lists, but the clinical process is more complicated and individualized than simply adopting the diet trend du jour.
Obesity typically brings with it added risks for developing Type 2 diabetes, hypertension, low back pain, heart disease and certain cancers, among other health issues. So, for example, when someone is diagnosed with high levels of triglycerides or cholesterol — especially LDL or “bad” cholesterol — it might be ill fitting to advise such a patient to undertake a diet rich in fats.
One-size-fits-all diet fads typically fail because they are not apt for addressing individual and personal health complications that accompany being overweight or obese. Moreover, psychologically, when we rely on self-control, or willpower, to help us get through a challenging health disorder such as obesity, our self-efficacy is greatly affected. Willpower is a limited resource. When exercised often to achieve weight loss, it becomes exhausted, and before you know it, you’ve binged on the carbs your fad diet restricted you from consuming.
Creatures of Habit
Human beings are creatures of habits that are formed over time. Therefore, before considering adopting a diet plan, one must ask: Can a specific diet plan become a daily habit, a lifelong practice?
The clinical fact about weight loss is that losing weight is not the hard part; keeping the lost weight at bay is one of the most difficult tasks. When adopting a fad diet, one might lose the desired weight in a short period of time; however, if the chosen diet is not a daily habit — a lifelong one — once a pre-diet eating pattern is resumed, the lost weight will be regained, often twice the amount that was expended. When diets are short-term and have extreme restrictions, they can temporarily fix the symptom but cannot address the root cause of weight gain in the long term.
Moreover, the number seen on your bathroom scale is narrating only half of the truth. Body weight is a composite of fat and muscle mass along with water, connective tissue and bones, among others. Therefore, while a diet might affect the number on the scale, it might or might not reduce body fat. Instead, biochemically, it might have reduced lean muscle tissue, thus leaving you feeling weak, fatigued and at risk for other health disorders in addition to the possibility of regaining the weight.
The Battle of the Diets
There’s an ongoing battle in the world of health and nutrition, with Team Fat demonizing Team Carbs and Team Low Calorie trying to abolish all things food in the name of health and wellness. It is likely you know someone who speaks about one or the other at the dinner table, at work or in social gatherings. But none of these diet jargons is new. Versions of diets that restrict fats or carbs have floated around for centuries under different names. For example, the popular “keto” diet is an adaptation of the “Atkins” diet, which promoted high levels of fats, including saturated fats, and restricted consumption of carbs, even the complex ones that are necessary for the body.
There are pros and cons to every dietary plan. The key to finding one you can adhere to will depend on your personal medical and health needs. So, let’s use keto as an example.
The Keto Diet
Carbohydrates are the preferred source of energy for the human body, especially the brain. The keto diet is based on the premise that if consumption of carbohydrates is restricted, that might force the body to burn fat. However, the concept, biochemically, is more complicated than simply burning fat in the absence of carbs. In comparison to a traditional diet plan in which it is recommended that we derive 45 percent to 65 percent of our daily caloric needs from carbohydrates, a keto diet reduces the intake of carbs to between 5 percent and 10 percent of daily calories and boosts consumption of fats to more than 70 percent of daily calories.
Keto is not carte blanche to consume high-fat fried snacks; instead, clean keto includes good fats such as omega-3 fatty acids found in flax seeds, avocado, salmon and chia seeds. By no means does a diet rich in saturated fats and trans fats result in any health benefits. Similarly, when a keto diet is practiced under the supervision of a health professional, the restricted carbs are mainly the ones that are simple in nature, such as sugars, candy, doughnuts and desserts. However, avoiding complex carbs such as whole grains, certain vegetables and fruits can lead to severe micronutrient deficiencies, mainly vitamins B and C, and minerals such as zinc and iron, among others.
Aside from promoting low-carb intake, keto diets are also notoriously high in proteins. High-protein diets create an excessive burden on the liver and kidneys. High-protein foods are also high in purines, which are broken down into uric acid. Elevated levels of uric acid in the bloodstream might lead to needlelike uric acid crystals in joints, with gout as the painful outcome.
Last, high-protein diets are one of the culprits in the formation of kidney stones, commonly seen in patients who consume high-fat, high-protein diets on a regular basis. Anyone consuming higher-than-recommended amounts of proteins can also be susceptible to developing gout regardless of carbohydrate intake. Because the keto diet is exceptionally high in both proteins and fats, susceptibility to developing gout might be higher in this population.
When followed under the supervision of a health professional and modified to address individual health needs, keto can be a gateway to adopting a low-refined-sugar dietary routine. It can also allow you to consume higher amounts of good fats, thereby reducing risk factors for many lifestyle-related health disorders.
A keto diet, when done improperly, can cause health issues such as cardiovascular disorders, neurological disorders and weight fluctuations. One of the major cons would be the cost and effort required to maintain a keto diet long-term.
A keto diet can induce health disorders including, but not limited to, reduced athletic performance, bone density disorders, extreme fatigue, low consumption of antioxidants, cognitive disorders, imbalances in blood lipids, nutrient imbalances and deficiencies, thyroid disorders, added stress on the liver and kidneys, disruption of hormones and gastrointestinal disorders. Those on a keto diet can also experience the “keto flu,” which is a form of clinical fatigue resulting from metabolic imbalances.
To Diet or Not
Whether the goal is to lose weight, fight inflammation or achieve glowing skin, the truth is that diets in general offer short-term benefits, much like pharmaceuticals. Following unsupervised diets is no different than consuming unprescribed medication; both can lead to detrimental side effects.
Weight loss is a complicated science, and one-size-fits-all treatments without personalized alterations can cause more harm than good. Although diets such as keto eliminate processed carbs (the primary culprit in the battle of the bulge), they also emphasize consumption of higher-than-recommended levels of proteins and fats, leading to potential stress on the kidneys, liver and heart.
The bottom line is that diets will come and go. The way to master long-term weight management and overall health is to adopt an eating plan that is nutritionally sound, financially viable and, most important, doesn’t leave you feeling unsatisfied psychologically. Find an eating plan that is a habit and not a diet, one that your health professional approves for your personal health goals.
Dr. Suman Ahuja completed her education at Columbia University College of Physicians and Surgeons in New York and at Texas Tech. She has a a doctorate in Clinical Nutrition with an emphasis on
obesity treatment and prevention.