Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Ketogenic Diet

Episode Date: June 24, 2018

You've likely heard a lot about the ketogenic diet lately, but have you heard it wasn't created for weight loss? Maybe you did, Justin didn't. Either way, we'll talk about it and so much more on this ...week's episode of Sawbones. Music: "Medicines" by The Taxpayers

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Starting point is 00:00:00 Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, two, three, four. We came across a pharmacy with a toy and that's busted out. We were sawed through the broken glass and had ourselves hot like our own.
Starting point is 00:00:56 Some medicines, some medicines that escalate my cop for the mouth. Wow. Hello everybody and welcome to Salbone, tomato turf misguided medicine. I'm your co-host Justin McAroy. And I'm Sydney McAroy. It's so Justin. Yes, Sydney. There is a trendy popular topic that I've been getting lots of questions about lately. I probably know about it then. If it's trendy and hot, I'm
Starting point is 00:01:22 I'm looped in probably already, but I'll I'll hear you. Well by all means then. If it's trending hot, I'm looped in probably already, but I'll hear you. Well, by all means then. Well, man, I'm not a mind reader. I just, I will probably know all about this hot topic. Well, I get, as you may guess, I get lots of questions actually about weight loss in general a lot of patients who are trying to lose weight and are not sure how to do it. And so as a result, I am usually kept abreast of most of the new kind of fad diets because somebody's always trying them. And a lot of the times this works the way like backwards. I hear about them and then I have to go read about them and figure them out and kind of
Starting point is 00:02:02 come to a conclusion as to whether or not they're dangerous or whatever. And the one that everybody's talking about these days is the ketogenic diet. Yeah, keto. Yeah. You heard a lot about that. I've dabbled in the low carb and slow carb worlds. And so I've heard a lot of chatter about keto diet. And because of my time with Adkins, I know what the name refers to,
Starting point is 00:02:30 but I don't know much about it. I don't know how it differs from other sorts of plans that are out there. It's, I thought this would be a good topic. And we've had lots of people, I should say, suggest this, tweet it and Facebook message and email us about this because it is so popular and wanting to know is it real, does it work?
Starting point is 00:02:49 And as I started to dig into it, the history of it, it's funny, this is one of those things that as I started to read, I thought, I remember learning about this in medical school, but I hadn't really thought about it since then. Okay. So the keto diet specifically differs from these low these other low carb diets I think most interestingly in its origins. How
Starting point is 00:03:11 tough? So the keto diet actually dates back to the 1920s but it was not initially developed as a weight loss plan. What was it? The keto diet started out as a treatment for epilepsy. Okay, I've never, I've never, ever heard that before. Okay, so to take you, to take you way back in the way way, in the way back machine for a second, as far back as have opportunities, there was, there was this physician's notice that there was this association between starvation and a few or seizures in patients who were prone to seizures. Okay. So there was already a connection.
Starting point is 00:03:55 There was something that you could do with your diet that would make you have less seizures, or at least this is what have opportunities observed in the theorized. And there were also certain, as a result of this, there were certain treatment regimens developed for people with epilepsy that mainly were, I mean, they were basically starvation kind of diets, but also eliminated certain foods. Well, if it's a starvation diet, that goes without saying right? Well, some of
Starting point is 00:04:26 them eliminated only some foods so that you were almost starving, but not completely. Okay. Okay. Gaelin also advised specifically like fasting for epilepsy, intermittent fasting for epilepsy. So for a long time, we didn't really know why, but we knew that if you changed your eating patterns in very drastic ways, you could reduce the frequency of your seizures. So in 1911, this is, we're jumping away forward. So in 1911, two doctors in Paris, Goulop and Marie, Dr. Goulop and Dr. Marie, treated 20 epileptic patients with starvation. I don't know the details.
Starting point is 00:05:06 They didn't really talk about the details of how I mean, obviously they got something. You can't starve people forever. You gotta give them something, but they gave them very minimal food intake and recorded that they had amazing success in terms of reducing the frequency of these patient seizures. So this is obviously not a solution. We can't just start people. Yeah. But it did lead to a lot of interest in...
Starting point is 00:05:35 So there's something to it. I mean, there's something to obviously not a long-term tenable solution, but there's something to the idea of dietary changes in reducing the frequency of seizures. Yeah, there's something to the idea of dietary changes in reducing the frequency of seizures. Yeah, there's something that happens in your body when you enter a state of starvation that somehow reduces the frequency of seizures. So in the early
Starting point is 00:05:56 1900s, a lot of other physicians in the US started based on these results started following suit and trying to experiment with different diets to see what would happen. There was a burnarmic fadden and Hugh Conklin in Battle Creek, we've talked about Battle Creek before, that's where the... Where the Kellogg's were from, yeah. Yeah, and they dabbled in strange diets as well. And they both tried this with their patients and they thought it was helping.
Starting point is 00:06:25 Again, there was no specific plan at this point. We're just talking about like drastically reducing food intake, you know, just not eating very much at all. Because we still weren't sure what it was about the starvation that made people stop anything. Right. Conklin was kind of studying under McFadden. He was kind of the guru of this at the time.
Starting point is 00:06:49 And McFadden specifically would advise intermittent fasting for basically everything, like any medical condition. I've heard, I know we're not talking about IF right now, but I've heard a lot about intermittent fasting. Yeah, me too. Maybe you told me about that one next. We could do that next time, but he was actually, and he basically was practicing this way back in the
Starting point is 00:07:11 early 1900s, so he would advise that you fast anywhere from three days to three weeks. That's a very large range. That's almost like this. Well, it depended on the condition that you were suffering from. All right. So some, some you only had to fast three days, some you had to fast for three weeks. And it may have actually been kind of an accident that he fat, he had such great success with seizures because he was telling everybody to fast for everything. So eventually you're going to get
Starting point is 00:07:42 something work, something work. He also by the way had a magazine, this doctor, I think that's not actually true. Actually, I said of the false dichotomy that if you use a treatment on other things, it'll fix something eventually. There's lots of things we talk about that don't fix anything. Well, that's true. That's true. That is not, that is a, you know, I guess if you do that enough odds are eventually some treatment might work for something.
Starting point is 00:08:04 If it does, maybe, possibly, maybe, if he used enough or not too much, this is not the way we practice medicine. Nor would I advise you to really do anything. That's that's a wild sort of approach all around. I just a side note on this McFadden guy. He also had a magazine that he published for quite a while called Physical Culture. And the whole idea was like humans are puny and we need to teach them how to be big
Starting point is 00:08:33 and strong and beautiful. Charles, that was kind of stuff. Yeah, and we can do it through diet and exercise. It's like this. Well, yes, but I mean, this was all very much like we will improve the human species. We'll make you bigger, stronger, yes, but I mean, this was all very much like we will improve the human species. We'll make you bigger, stronger, faster, eat these weird diets and do all these wild exercises. I imagine lots of like squats.
Starting point is 00:08:54 That's weird that that would need to be an ongoing magazine, right? It's like kind of like men's fitness that's been going on for so long. Like certainly by now, there's enough information there for us to get fit, right? Like, certainly, you have to cover it. He had to keep hammering away, like inspiring housewives to look good for their husbands or whatever the message was back in the early 1900s. So this kind of research, probably in like a less flashy way, was being repeated by Drs.
Starting point is 00:09:27 Lennox and Cobb at Harvard, and they were really interested as to why starvation might do this. I mean, it's not just that you can't eat. Like there's something that happens metabolically when your body is in a state of starvation that must be causing this. And so they began to study the starvation state and they found that when you, when you don't have glucose sugar for energy, then you start to break down fats. Right.
Starting point is 00:09:58 Right. And what do they make? Energy. Well, yes, I thought you would know this.ones. There you go. Yes, ketones. ketosis ketosis ketosis. You're making ketones because you are breaking down fats. When I was on the Agons, I had to get ketosis strips from a weird mom and pop pharmacy. You don't put like a fine on your head. It's him. He got PLS strips and I believe you can find them pretty much anywhere now.
Starting point is 00:10:27 Well, it's a different era I said. Back then I had to go out to the food and pour him for my sprouted grain, Elijah bread. I was on a store shelf all around ya. I was at the Kruger. Well, it's at the the nice Kruger. It's a Shijish Kroger, not regular Kroger called the Chacha Kroger, Chacha Kroger, Gucci Kroger. Gucci Kroger. That
Starting point is 00:10:51 Gucci Kroger, they have like all kinds of Spotted grains. Yeah. They're like mid-tier to low-tier Krogerers. You're not going to find that. So there was a time looking for cheese either folks. You want cheese? You got to go to Gucci curge. Go to Gucci curge. That's right next to the sushi place. Yeah, Gucci curge. You know, you know, you know, you know, you're Gucci curge because I got a sushi prison in there.
Starting point is 00:11:16 It's like a little island where they make people stand in it makes sushi. What's called sushi island? Sushi island is a much more pleasant metaphor. Thank you. Right next to it. They have an aggress. They're right. It's right next to the fancy cheese island and the No one man loose the loose nuts stand. Yeah, no one man's fancy cheese island. The fancy cheese island is an island under itself
Starting point is 00:11:39 Sushi Island is man 24 hours a day. I'm assuming So There was a Dr. Wilder at Mayo. Everybody's doing this research at this point now, right? Everybody's all excited. They're like, we found ketones. What do they do? We don't know. Let's try this.
Starting point is 00:11:51 So he proposed that you could probably treat patients better by eating food instead of starving. Love that. And focus on foods that will produce the ketones. So starvation produces ketones, breaking down fats, produces ketones, eat fat, break it down into ketones, that's better than eating nothing. That seems like- That seems like kind of a hacky solution, but is that right? Yeah, a diet that does that is ketogenic. So the more fat you eat, you break that down preferentially.
Starting point is 00:12:21 Okay. Yeah. If you don't, I mean, now the only way to do this though is, and we're gonna get to this, so actually that's the next thing, is through a very restrictive diet. So on Atkins, do you remember how many grams of carbs you could eat? 20 at the start. Uh-huh. In induction, that was for two weeks. Okay.
Starting point is 00:12:42 And then it built there for like 30, and then I think 50 was like long term, and then I think it was like a hundred once you got to like your goal weight. So the diet that Wilder started using that was the original ketogenic diet. This is the original KD was one gram of protein per kilogram of body weight,
Starting point is 00:13:18 10 to 15 grams of carbohydrates per day. Y'all, that's great. Like, that's like, um, and then the remainder of your calories will be in fat. I mean, you could clear that with carrots and cauliflower. I mean, like, that's nothing. There's 20 grams, by the way. You can only get an induction phase to give you some idea. I think you can, you're supposed to only get from like leafy greens and vegetables and stuff like that. So there's like, it is, it is a tough, tough row. And this, and this isn't, this, this ketogenic diet is the basis for what? I think that's standard regimen that a lot of the books, because there are endless books on the ketogenic diet. I was trying to find the first one that was selling it as a weight loss diet as opposed to a treatment for epilepsy.
Starting point is 00:14:01 And I have, I don't know. I just, I ran out of patients for books about the ketogenic. They I have, I don't know. I mean, I just, I ran out of patients for books about the ketogenic. They're endless, endless books about this. But I think the general idea is that you're supposed to eat like 70, 70% fat, 25% protein, and 5% carbs, is like the general breakdown. No, thank you.
Starting point is 00:14:20 Based on this regimen. And this original regimen, by the way, was only developed for children. Really? It was a way to reduce seizures in children. One of the vaults. The easy answer is this. Adults couldn't do it.
Starting point is 00:14:35 Countries. It was a lot easier to give these diets and study them in children because parents were administering them. So you could trust the, I mean, these were parents who usually had kids who, their seizures were frequent and debilitating and they weren't, at the time we didn't have a lot of great treatments anyway.
Starting point is 00:14:55 So they weren't responding while the treatments. And so they were desperate for something that might work. And so they were willing to do the hard thing and do this diet. A lot of adults just would not stick to it. It does require us to breed a race of super parents to parent to parents. But if the kids have to eat whatever their parents give them, it was a lot easier to control. And they also noticed things like improvement in cognitive function and behavior they reported.
Starting point is 00:15:21 So not just a reduction in seizures, but like the kids said they could think more clearly. Um, I don't. That was not my experience. In severely reducing my carbohydrates, I could think, I could think very clearly about cheetos. I could think I can almost visualize them perfectly in my mind. I did not remember much clarity from those days. Now, at this point, when all these studies started to show improvement and this this diet was formally written down as the keto diet, it just exploded in popularity because again at the time there really
Starting point is 00:15:58 weren't great. There were very few medicines at all for seizures, and they made a lot of kids really kind of drowsy and out of it and they didn't always work and So the ketogenic diet became the standard treatment for all kids with epilepsy as in like first line treatment every textbook that you would read from like 1941 to 1980 if you go to epilepsy would tell you ketogenic diet. And, you know, like I said, there was evidence that it would work, not in every single kid, not every single time, but it definitely was found
Starting point is 00:16:38 to be successful in his, in 1972, there was a Livingston who was a doctor who did a lot of research in this area and treated a lot of patients with epilepsy at Johns Hopkins. And he went over a thousand children with epilepsy that he followed for a decade. And from that, we're using the ketogenic diet, he said that 52% had complete control of their seizures and then an additional 27% had improved control of their seizures Wow on this diet, so Pretty good evidence that this could work Why did it work? We're still not entirely sure
Starting point is 00:17:17 That's comforting Well, yeah, but I mean the more important thing is that it does good true But we're still not entirely sure what the ketones do to the brain to reduce the frequency of seizures. There's some sort of some, I don't know, it changes the nervous conduction in some way. There's been the people who proposed that it changes, it alters the pH of the inside, the neurons in some way. Either way, the point is that somehow these ketone
Starting point is 00:17:46 bodies, when they cross the blood brain barrier and get up into the brain, reduce the frequency of seizures. We know that this can happen, but as time passed, new and more effective medications were made. And it became a lot easier if you're child, especially if you had to transition into an adulthood. You know, if you still had epilepsy as an adult, then you needed to control that. It became very hard to maintain that diet. Once you were out of my feed.
Starting point is 00:18:20 Like, yeah, a teenager who, for the first time, can go to a fast food restaurant on their own. It gets a lot harder to control. So, medications kind of took over. And as we had better medicines that wouldn't make everybody drowsy and loopy and we had medications that you could take on a regular basis and still feel awake and functional and think straight. The diet began to kind of fall out of favor. Because it was hard. Sure, yeah, it's extremely difficult.
Starting point is 00:18:46 Yeah, it's a very hard diet to maintain. There were efforts to try to make it a little more palatable. There was a specific diet where there was called the medium chain triglyceride oil diet, which was basically a way of introducing other fats that you could add to these weird, pureed shakes that you would have to make to get the right mix of calories and everything into kids.
Starting point is 00:19:12 And this was a little bit more palatable, but overall, if you could take a pill and that would control your seizures, a lot of people began to prefer that. And as fewer kids were put on the diet, fewer dietitians were trained in it. And as you can imagine, this is a very difficult diet to explain to parents. So it's not like only eat this many carbs a day. It's much more restrictive than that.
Starting point is 00:19:35 So if you don't have dietitians who are very well versed in how to communicate that to parents, then you're going to have more trouble using the diet. And so then fewer people are using it correctly. So then the effectiveness seems to wear off. So doctors stop prescribing it. And pretty soon it was kind of like people forgot about it. It became, it became this like third tier thing. So if you've got a patient that you've tried on medication and you've tried on another
Starting point is 00:20:00 medication and you're still not getting anywhere, then you might consider adding the ketogenic diet at that point as opposed to, you know, 30 years before that when it was the number one primary mainstay of childhood epilepsy treatment. Well, it couldn't have gone away this because I hear about all the time. That's right. It came back. Go on. Well, before I do, let's go to the billionaires. Let's go. So the keto diet was just starting to, to somehow going to come back.
Starting point is 00:20:40 That's right. So everything changed in the 90s. This is why the the keto diet did not fade into, well, I guess the kind of thing that we cover on the. The saabones, yeah. Into saabones history. A date line special revived it. It told the story of young Charlie Abrahams, who was the son of Hollywood director Jim Abrahams, who's responsible for airplane, in part, partially responsible, I guess. He's a writer? A writer?
Starting point is 00:21:12 Yes, all right. Yes. And then he directed some stuff, too, I think. Okay. And then naked gun movies. Oh, right now. Yeah. And his son, Charlie, was being treated for epilepsy
Starting point is 00:21:23 with little success. And so his family learned, when trying to just find anything that would work, learned about the ketogenic diet and they used it and Charlie had a huge improvement and a symptoms. And they kind of became advocates for it after that. So they started the Charlie Foundation to spread the word and to educate more people about the possibility that if they had a child who was resistant to a lot of medications, and they couldn't seem to get the seizures under control, this could really improve their life. And so in pursuit of spreading the word about this diet in 1997, the movie First Duno Harm was made
Starting point is 00:22:05 starring Meryl Streep. And I think this is the one that he directed it. And this would told the story of his son and how they use the diet. It's almost kind of unfortunate. I shouldn't say that. I don't mean it as unfortunate, but the fact that people found a diet and obscurity that is actually useful from ancient wisdom, even though it mean it as unfortunate, but the fact that people found a diet and an obscurity
Starting point is 00:22:25 that is actually useful from ancient wisdom, even though it's the 20s, but still, that you see that fallacy so often in like a bunch of blue and alternative medicine, like it's a little concerning to me that this one time it worked, they found an old diet that nobody used to use more and instead of a gun, it was actually useful. Well, this is...
Starting point is 00:22:43 I'm glad, obviously, for the people that had helped, but it's just... I was gonna say this. No, no, I was gonna say this at the end, but I think this is a good place to make this point. There are a lot of people who will tell you that food alone can be medicine, that you could control all of your medical problems
Starting point is 00:23:01 through diet, and I would push back and say, well, no, that's not entirely true. But I think that that's why sometimes medicine can be frustrating for people for, you know, sometimes, especially like chronic medical conditions or difficult to control medical conditions can be frustrating. Because what I'm going to tell you, and I think this is the right thing. I think this is the truth. This is why I'm saying it, is that the answer is usually somewhere in the middle, it's gray. Medications are needed for some things. Yes, diet can improve some other things.
Starting point is 00:23:37 Everything's not one or the other. Food is not the only medicine and medicine is not the only medicine. There are times for both, and there are times that you can use them together and improve situations. That's a lot less satisfying than just having one thing you can advocate for. Food is medicine. But that's the truth.
Starting point is 00:23:58 Sometimes a diet regimen like this can really work for a medical condition. So people got way back into the keto diet because of Merrill's flick and the situation. And what was also happening at this moment in history is the low carb craze. Yeah, that's not right then. Yeah, so you can see, so all of these patients got back into it. So first, a lot of people whose family members or who personally had epilepsy begin to get interested in the ketogenic diet for that condition as a result of this film and the date line special. Okay. And the number of studies on the
Starting point is 00:24:36 ketogenic diet just shot through the roof. Like, if you look at the years between, you know, when the first anti-abolpticic medications that are really effective came out and this movie, if you look in between there, there were a couple studies, maybe a year being done on the key to giant diet. If you look after this date line special and then the subsequent movie, tons of studies came out to see if it really would work. And then of course, they were finding that it could still be effective. Yes, again, still just for epilepsy.
Starting point is 00:25:10 Because it's, and I'm going to say this several times, this is a medical treatment. It's not just a diet. This is a treatment that you should take as seriously as if you were taking a medication. Because it is a medical treatment. Okay. And there are, there are side effects. There are some that maybe you consider not such a big deal, like constipation or diarrhea or getting nauseous and vomiting sometimes. And those could improve over time. And also, if you have a dietician who's helping you kind of tailor your meals, you know, to something that might not make you so sick, you can also get some things like vitamin deficiencies from this diet that can lead to osteoporosis in some cases, thinning of the bones.
Starting point is 00:25:50 Another problem that you can see is not what you think, you actually can get elevated cholesterol at the very beginning, which it is a high fat diet, so maybe you would assume that, but you can see some really out-of-wack cholesterol profiles in people who are on this short term. Now, for a lot of patients, this will iron itself out long term and you'll actually see improvement
Starting point is 00:26:12 in the cholesterol over time, but transiently, you can see some really high bad cholesterol on this diet. And also, even though all these things I mentioned can be manageable, it's really hard to do. Yeah, I can mention. And if you don't stick to it, it won't work. And I don't mean like, I mean, I'm on Weight Watchers and I have times where I'm like, I'm going to just eat half this muffin and I'm not going to count it because I need half this muffin right now. And that's fine. That's not going to hurt anybody. But if you're not sticking to this diet, it will not work.
Starting point is 00:26:46 And you have to stick to it to the letter. And I should note historically, a variation on this was used. We've mentioned this on the diabetes episode. That idea that starvation would improve diabetes was also very prominent for a while, which is why you're going to see this get tied into a treatment for diabetes. The problem with that, of course, is that we do not want type 1 diabetics going into ketosis. It can be very dangerous for them, right? Yes, that is called diabetic ketoacidosis. DKA is a very dangerous state and can be fatal, which is why I would not recommend this for a type 1 diabetic. Okay. So, how did this become a diet trend?
Starting point is 00:27:28 Well, people who couldn't stick to the ketogenic diet in its entirety started trying other low carb diets that weren't necessarily as restrictive. And we're at just the right time for the Atkins diet. So the Atkins diet was very popular. It was a low carbohydrate diet. And it was easier that is you can imagine than the ketogenic diet. And it also could send you into a state of ketosis. It's pretty, yeah. Yeah, because I mean eating low carb doesn't necessarily put you in ketosis. Really? I mean, you can get in ketosis, but you have to, I mean eating low carb doesn't necessarily put you in ketosis really I mean you can get in ketosis, but you have to I mean I was I was I have to check to see if you
Starting point is 00:28:10 I was using the barometer of success probably not the right word, but I use this a metric of success I'll say that if I was in ketosis, I knew I was doing a good job If you were in ketosis, it means that you have succeeded in getting yourself into ketosis. That is about all I will say. And the striptone purple, so that's you. So you have definitely succeeded in that. And so all these low carb fans who like people we were using the ketogenic diet couldn't stick to it.
Starting point is 00:28:40 And so kind of went into adkins or one of the other, you know, what South Beach and you've done slow-carb and all these other very low glycemic index diets, variations on low-carb started to try out those people who were trying out these other low-carb diets started in their searching, finding evidence of the ketogenic diet. And as you have already said, if you were doing adkins, you were told that you needed to get into a state of ketosis. That was important. And so now you have this diet that's called the keto diet.
Starting point is 00:29:13 Just put you right there. That seems even better, right? That sounds better. And for a lot of people, I don't even think they know necessarily what they're doing. I'm supposed to be in ketosis. I'll check my urine to see if I'm in ketosis. If something puts me into ketosis Like, I'm supposed to be in ketosis. I'll check my urine to see if I'm in ketosis. If something puts me into ketosis faster,
Starting point is 00:29:26 I'm doing good. So I'll do this diet, this keto diet. And so we heard these stories back, I think around like 2012 is where you can find like the origins of this becoming this weight loss fad. And there was this article about brides who were trying to make these keto smoothies and Take them through in like tubes through their nose because they're so gross
Starting point is 00:29:50 I mean, it's not like no sugar. Yeah. I don't Shake with those sugars like so heinous. Yeah, that's what a lot of these like The a lot of people who were trying to do this diet I mean if you can just imagine some like some kind of fat, some kind of like coconut oil, I think is a popular one. Some kind of like heavy duty fat, and you can throw in some like protein powder. I don't, is there any kind of milk you can do on this? Any kind of like almond, nut milk,
Starting point is 00:30:21 or soy milk? I don't know. I don't know. I mean, but like you would have to blend up this and it would have zero sweetness. Yeah. Imagine something that looks and like you look at it and you think this should be of vanilla milkshake and then there is zero sweetness to it and it's full of fat. Oh, okay, I'm done.
Starting point is 00:30:39 Yeah, I mean, so these are hard to ingest. And so then the ketogenic diet became this diet that people were using for weight loss and everybody was going keto and now there are like a billion cookbooks and descriptions of how to do the diet. And there are ways to do it. Kind of like you said with Atkins where you can do like an induction phase
Starting point is 00:31:01 and then like, but generally speaking, you're supposed to keep yourself in ketosis to lose weight. And to keep yourself in ketosis, you don't just eat low carb. Yeah, you have to. I mean, it's extremely low carb. Like I said, I mean, if 10 to 15 carbohydrates a day, that's really tough. That's incredibly tough. And you have to eat lots of fat, which...
Starting point is 00:31:27 No, this sounds like a hard pass. Which, and it sounds like, you know, like I said, there was a lot of concern, and this was true with addkins too, that if people were eating all this fat, that their cholesterol was going to go through the roof, and there is some evidence that maybe early on it does. Long term, I don't have good evidence to tell you that's dangerous. So if that helps. But generally speaking, you still have to eat a lot of fat and I don't particularly enjoy that. Does it work? Well, if you're going to eat this low carb, yes, you will lose weight.
Starting point is 00:32:00 Sure, because you can't eat anything you like. That's a secret of low carb. You see, no one will tell you is, if you can't eat anything, like. That's a secret of low carb. You see, Garrett, no one will tell you is if you can't get anything, eating anything that tastes good, you will lose weight. And this is the grand debate about low carb diets, right? Are you losing weight because, as Justin said, you're not getting to eat the things you like. Is it also because you're eating low calorie as a result of low carb? Carbs pack a lot of calories. It's hard for you to get in.
Starting point is 00:32:28 If you stick to one of these diets, it's very difficult to get in the same amount of calories as you would if you were eating carbohydrates. It's just hard to do. We don't want to eat that much lunch meat. Yeah, you don't. Well, I mean, it's true. And so, is it really a low calorie diet and you're just doing it in a roundabout way? Probably not just that.
Starting point is 00:32:49 There's enough evidence to suggest that something else is happening when you do a low carb diet. Well, I also found it's a little easier to control, like just being control of cravings and eating and stuff if you're not on that sugar train. That insulin spikes are where a lot of the interest lies. If you're not spiking your insulin in response to eating sugar all day, are you reducing cravings? And then you're reducing that insulin is a storage hormone. Every time you eat something sweet, your body releases insulin, it makes you store fat, is that the key to weight loss is stopping those insulin spikes. I don't know why I'm saying that's the that's the question And that's why people theorize low-carb works better
Starting point is 00:33:31 The thing is there are small studies that suggest that it can help with some medical conditions like type two diabetes Those same studies have been done with any low carb diet, though, and type two diabetes. I mean, eating, and I think that makes sense. If you are a diabetic, a type two diabetic, people tell you to eat less sugar and watch your carbs. So, it makes sense why that might help. If you're a type one diabetic, I would be extremely cautious with anything like this. I would not voluntarily put yourself in ketosis. Okay. Obviously with things like high cholesterol, maybe the long run at
Starting point is 00:34:08 helps, which could that help with cardiac risk, heart attack risk maybe, maybe. But when they put them head to head in big studies with other diets, they don't always necessarily, ketogenic certainly doesn't necessarily outperform other low carb diets routinely. So can any low carb diet do this, probably? And there are even some studies that suggest that you can get the same result by eating low calorie. So is it the magical key to weight loss? Probably not, because as I already mentioned,
Starting point is 00:34:39 it's incredibly hard to stick to, and most people don't. And nothing is, I mean, you gotta eat in a way that works for you. This has to be something you can sustain for your whole life. Or you'll gain the weight back. And weight loss is much less important than health. Being healthy and eating well and eating things
Starting point is 00:35:00 that make you feel good and give you energy. And- To fight crime. Carbohydrates are good. They're also good. eating things that make you feel good and you know give you energy. And- If I cry. Carbohydrates are good. They're also good. A lot of people aren't willing to talk about that. Sydney, that's a great point. They taste yummy and I agree.
Starting point is 00:35:12 I mean, I limit my carbohydrates as part of the diet we're doing right now because it helps me lose weight. But I do eat some because I like them. And every once in a while, I eat a donut because I love donuts. And you don't tell your phone. You don't tell your phone. I don't tell my phone about that donut. But that's for me and that's what makes me happy and I think everybody's got to find that balance.
Starting point is 00:35:33 But I would just stress again, the ketogenic diet, especially if you have certain medical conditions, could make you ill. It is a treatment. It is a medical treatment. I. It is not a fat diet. And I would not approach it lightly. And I would certainly ignore celebrities like Courtney Kardashian, who have claimed that doctors told her she needed to do the ketogenic diet because she had excess lead and mercury in her system. And this would help her get it out. those are not good doctors. That's not a thing I You can you really think somebody told her that?
Starting point is 00:36:08 Maybe she was like half-listening. I don't know these were not doctors. I don't know which of them that she is is she this Smart one I don't know the Kardashians. I know card I know Kardashians are a thing, but I don't know which one is which folks that's gonna do it for this week Thank you so much for listening. Thanks to taxpayer troops that are song medicines is the intro natural program Hey, if you want a new podcast listen to check out bubble. It's new short run Sci-fi comedy series that Max fun is doing you can find it wherever find podcaster soul just search for bubble and Think you get a kick out of it. Anyway folks, that's gonna do it for us. Thank you so much for listening.
Starting point is 00:36:46 We'll see you next week until the My Name is Just Mac Roy. I'm Sydney Mac Roy. And as always, don't jill a hole in your head. Alright! Maximumfund.org Comedy and Culture, Art and Stone Listener Supported

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