In a meta-study published in the March 2022 issue of Nutrition and Health, nutritionists at the University of Worcester in the U.K. conducted a statistical analysis of 27 interventional studies to assess how low-carb and high-protein diets might impact testosterone. They also looked at the impact that such diets might have on the stress hormone cortisol, because levels of the two hormones are closely linked, with higher cortisol indicating lower testosterone and vice versa.

A total of 309 healthy adult males participated in the 27 studies included in this meta-analysis.  

The specific focuses of the studies varied, but all measured participants’ testosterone and/or cortisol levels, and all assigned participants to low-carb and high-carb diets. In some studies, the low-carb groups ate high amounts of protein (defined here as 35 percent or more of total calories); in others, the low-carb groups ate moderate amounts of protein. 

In pooling the data, they identified a notable trend among participants assigned to high-protein, low-carb diets: Their testosterone levels decreased by about 17 percent on average. 

Additionally, they found that resting and post-exercise cortisol levels increased during the first three weeks on a low-carbohydrate diet. Beyond that period, resting cortisol rates returned to baseline, but post-exercise cortisol remained elevated. 

Joseph Whittaker, MSc, who led the study, says the findings fit within a still-developing picture of the effects of excessive protein consumption. “The long-term effects of very high-protein diets are largely unknown, but what data we have strongly suggests going above 35 percent protein leads to all sorts of nasty effects,” says Whittaker. “Our study adds low testosterone to this list.” 

“Bodybuilders and weightlifters are most at risk of excessive protein intakes, along with those on extreme weight-loss diets,” says Whittaker, noting that the average person consumes around 17 percent of calories from protein—a much lower proportion than the 35-percent amount examined in the study. 

Low-carbohydrate, high-protein diets have gained popularity in recent years because of their ability to promote weight loss. However, research suggests that these diets may have serious drawbacks in the long term, including an increased risk of chronic kidney disease, elevated cholesterol, and all-cause mortality. 

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

The post New Research Suggests Eating Too Much Protein May Lower Testosterone Levels in Men appeared first on Forks Over Knives.

Keto diets have skyrocketed in popularity over the last decade due to their ability to promote quick weight loss. Typically very low in carbohydrates, modest in protein, and high in fats, the aim of keto diets is to push the body into ketosis—the state in which the body uses fat for fuel. Foods like red meat, fish, nuts, cream, eggs, cheese, oil, and non-starchy vegetables are given the green light while starchy vegetables, fruit, whole grains, beans, and lentils are avoided as much as possible. 

For this latest meta-analysis, a group of physicians, researchers, and registered dietitians analyzed more than 100 peer-reviewed studies on keto diets to identify long-term effects. They found that people who follow such diets have a significantly increased risk of developing heart disease, LDL cholesterol buildup, kidney failure, Alzheimer’s disease, diabetes, and cancer. They also discovered that keto diets are particularly dangerous for people who are currently pregnant or may become pregnant. Low-carbohydrate diets are linked to birth defects, particularly neural tube defects, and gestational diabetes even if the pregnant person is taking folic acid supplements. Additionally, for those living with chronic kidney disease (CKD), the high amounts of protein consumed on the keto diet can place excess stress on the kidneys and worsen the long-term internal damage of CKD. 

So why does this diet have such negative side effects? The study’s authors suggest that it has to do with the nutrient quality of the food being eaten.

“The foods that are emphasized on a keto diet are the very products that cause colon cancer, heart disease, and Alzheimer’s disease,” says study co-author Neal Barnard, MD, FACC, president of the Physicians Committee for Responsible Medicine and an adjunct professor of medicine at George Washington University School of Medicine. “New research also shows that these same foods raise the risk for severe COVID-19.”

This sentiment is echoed by lead review author Lee Crosby, RD. “The typical keto diet is a disease-promoting disaster,” says Crosby. “Loading up on red meat, processed meat, and saturated fat and restricting carbohydrate-rich vegetables, fruits, legumes, and whole grains is a recipe for bad health.”

Originally developed in the 1920s as a treatment for patients with severe drug-resistant epilepsy, the keto diet has been shown to be effective for reducing seizures in extreme cases. Scientists believe the diet decreases seizures by making less glucose available to fuel neurons. And although the study authors concluded that eating keto could be beneficial for seizure management, they say the risks far outweigh the rewards for most  people.

Instead of going keto, Barnard suggests a whole food, plant-based diet: “On a low-calorie diet, people might lose weight, but they have to go hungry to do it. On a keto diet, they might lose weight but they feel guilty if they have an apple, banana, slice of bread, or a cookie. On a plant-based diet, you get the best of all worlds: weight loss, delicious food, better overall health, and you’re never hungry.”

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

The post New Study Links Keto Diet to Severe Long-Term Health Risks appeared first on Forks Over Knives.

What Are Carbohydrates?

First, a brief rundown: Carbohydrates are found in the grocery store in one of two forms—refined and whole. Although refined carbs represent only a subset of carbohydrate-rich foods, they’re what most people think of when they hear the word “carb”: white breads, pretzels, pastries, refined cereals, and other highly processed snack foods. We recommend staying clear of refined carbohydrates, as they can increase your risk for fatty liver disease, insulin resistance, prediabetes, and type 2 diabetes; lead to unwanted weight gain; and increase triglyceride levels. 

In sharp contrast to foods containing refined carbohydrates, whole carbohydrate–rich foods such as fruits, vegetables, beans, lentils, peas, and whole grains are some of the most nutrient-dense foods on the planet. For a deep dive into the differences between refined carbs and the carbs found in whole plant foods, see How Carbs Became a Dietary Supervillain by Sofia Pineda Ochoa, MD. 

What Is Carb Cycling?

“Carb cycling” refers not to a specific diet but a general strategy of manipulating the amount of carbohydrates consumed in an effort to achieve a desired outcome. The practice has been fairly common among endurance athletes for years, but recently it has drawn attention from the general public as a potential weight-loss strategy.

The general idea is to eat a high-carb diet on training days to increase glycogen stores in the muscles and liver; then restrict carbohydrate intake to burn more fat on rest days. In this way, carb cyclers are attempting to switch between days of ”carb burning” and days of “fat burning,” effectively flipping a metabolic switch from one to the other. Some carb-cycling proponents advocate taking one day every week or two to “re-feed” by overeating and exceeding one’s daily caloric requirements, in order to overcome the negative effects of being in a caloric deficit.

Periods of “carb loading” can increase glycogen stores in the liver, providing an extra fuel supply during exercise, which is why it’s common for endurance athletes to eat a large carbohydrate-rich meal the night before a competition. However, this approach overlooks an important point: Because glycogen stores in both the liver and muscle are influenced by one’s total carbohydrate intake, eating a healthful high-carbohydrate diet every day is a simpler way to ensure that your glycogen stores are maximized on a daily basis, not only in the days prior to a competition. 

Short-Term Results, Long-Term Risks

One of the main benefits that people report when carb cycling is changing their body composition, losing fat and gaining muscle. In the short term, low-carb diets can indeed be effective for weight loss and can lower fasting blood glucose, post-meal blood glucose, and A1C value. However, in the long term, low-carbohydrate diets dramatically increase your risk of insulin resistance—which, more than any other condition, is the strongest predictor of chronic disease, underlying type 2 diabetes, type 1 diabetes, type 1.5 diabetes, gestational diabetes, coronary artery disease, atherosclerosis, cancer, high cholesterol, high blood pressure, obesity, polycystic ovary syndrome (PCOS), peripheral neuropathy, retinopathy, Alzheimer’s disease, chronic kidney disease, and fatty liver disease. (We go into extensive detail about the mechanisms behind insulin resistance and chronic diseases in our book Mastering Diabetes.)

Additionally, research has found that limiting carb intake can negatively impact athletic performance. And randomized controlled trials have found that low-fat, high-carbohydrate diets can promote weight loss as effectively as a low-carbohydrate diet, especially when whole carbohydrates make up the majority of all carbohydrate energy. So in effect, both low-carbohydrate and high-carbohydrate diets can promote weight loss.

The Bottom Line

For healthy individuals who avoid processed foods and maintain an appropriate calorie balance, short periods of carb cycling will likely not pose serious health risks. However, one concern with any low-carb dietary strategy (including carb cycling) is that eating high-fat, high-protein meals can significantly increase your risk for insulin resistance. 

If you’re looking to lose weight, reduce your risk of type 2 diabetes and cardiovascular disease, and promote better metabolic health overall, consider centering your diet on whole plant foods. 

World-class athletes find that eating a low-fat, plant-based, whole-food diet is an exceptionally effective way to train and compete, without the need for carbohydrate manipulation. 

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

The post What Is Carb Cycling? appeared first on Forks Over Knives.

If you are living with diabetes, you may have been told to eat a low-carbohydrate diet to control your blood glucose or you may have been told to eat a very low-carbohydrate diet, otherwise known as a ketogenic diet. Regardless of which form of low-carbohydrate diet you may have come across, understanding the pros and cons of low-carbohydrate and ketogenic nutrition for people with diabetes will give you the information you need to choose what’s right for you.

What Is a Ketogenic Diet?

A ketogenic diet involves eating between 30 to 50 grams of carbohydrates per day in order to achieve a metabolic state known as ketosis, in which your muscles and liver derive the bulk of their energy from fatty acids and amino acids instead of from glucose found in carbohydrates. To do so, those adopting ketogenic diets are told to get 70 to 90 percent of their calories from fat—from meat, eggs, sausages, heavy cream, cheeses, fish, nuts, butter, oils, seeds, non-starchy vegetables, avocados, coconuts, and small amounts of berries, while avoiding almost all fruits, starchy vegetables, breads, pastas, legumes, milk, and yogurt.

Are Ketogenic Diets Good for People with Diabetes?

Many people around the world who eat a ketogenic diet are able to lose weight, achieve a flat-line blood glucose profile, greatly reduce or eliminate their need for oral medication and insulin, and reduce their total cholesterol. So why aren’t we recommending this diet ourselves? Because despite these advantages, there are four very important points to take into consideration:

• Evidence-based research conducted in large numbers of people over long periods of time consistently demonstrates that eating more animal products increases your risk for premature death, no matter what short-term benefits may unfold in the process. Similar large-scale research demonstrates that eating more whole plant foods reduces your risk for premature death.
• The short-term benefits associated with a ketogenic diet can also easily be achieved using a low-fat plant-based whole-food diet, as seen in research dating back to the 1920s.
• Low-fat plant-based whole-food nutrition is the only approach shown to reverse heart disease (the leading cause of death of people living with all forms of diabetes), whereas diets high in saturated fat and cholesterol have been shown to promote heart disease.
• There are many examples of long-lived societies around the world who eat plant-based diets, and zero examples of long-lived societies who eat a low-carbohydrate or ketogenic diet with a high intake of animal products.

While the ketogenic diet may seem like a logical approach to reducing blood glucose fluctuations, it is based on the outdated and incorrect carbohydrate-centric model of diabetes, which points a finger at carbohydrates as the cause of insulin resistance and type 2 diabetes, even though overwhelming evidence shows that low-carbohydrate, high-fat diets are actually the cause of insulin resistance and type 2 diabetes. 

Are the Short-Term Benefits of a Ketogenic Diet Worth It for People with Diabetes (or Those at Risk for Developing It)?

Some doctors today are quick to recommend a ketogenic diet to patients with type 2 diabetes based predominantly on short-term studies, such as a 2005 study in which scientists from Temple University followed 10 obese patients living with type 2 diabetes for two weeks and observed a 0.5 percent reduced A1c (a measure of average blood glucose) and a 75 percent increase in insulin sensitivity. 

Indeed, based on the short-term evidence, a ketogenic diet is a very effective tool at promoting short-term improvements in body weight, blood glucose, A1c, and triglyceride levels. In the long term, however, a ketogenic diet is unlikely to provide the same results, and it’s more likely to pose risks, as is the general class of low-carbohydrate diets. In large-scale studies performed over long periods of time, the evidence-based literature consistently shows that low-carbohydrate diets worsen long-term health, increase the risk for many chronic diseases, increase the risk for infectious diseases, and increase mortality.

Take, for example, the 2014 study in which researchers from Loma Linda University summarized the results of three separate Adventist health studies (covering more than 100,000 people): In comparison with their meat-eating counterparts, lacto-ovo-vegetarians were 38 to 61 percent less likely to develop diabetes, and vegans were 47 to 78 percent less likely to develop diabetes. They concluded that vegetarian and vegan diets offer significant protection against death from cancer, heart disease, and diabetes, and that those who chose to eat more meat and dairy products in the long term significantly increased their risk for death.

In a 2016 study, researchers from Massachusetts General Hospital and Harvard Medical School analyzed data of more than 130,000 participants from the Nurses’ Health Study and Health Professionals Follow-Up Study. They found that for those who were already living with diabetes, eating more animal protein raised the risk of all-cause mortality, whereas eating more plant protein reduced that risk. 

Most mainstream diabetes recommendations encourage eating more animal protein as a means of losing weight and “stabilizing blood glucose,” but large-scale research shows exactly the opposite.

A more recent paper showcasing the effect of a ketogenic diet in 262 people living with type 2 diabetes demonstrated that only 14 percent of patients were able to maintain a ketogenic diet over a 2-year period. In addition, after 2 years patients had an elevated fasting glucose, elevated fasting insulin, elevated A1c, elevated total cholesterol, and elevated LDL cholesterol, despite significant reductions in their use of oral medications and insulin. 

The Takeaway

If a ketogenic diet was the only way to improve your metabolic health in the short term, then the benefits would certainly outweigh the prospect of no improvements at all. However, practically all “diets” work in the short term, because diets prompt you to pay attention to the quality of the food that you’re eating, how much you’re eating, when you’re eating, and how you feel between meals. The difference between dietary approaches becomes much more apparent over the course of time, and those that create long-term sustainable habits and provide lasting metabolic fitness will always beat out those that are unsustainable as well as those that negatively impact your long-term metabolic health.

And this is exactly why we strongly caution you against adopting a ketogenic diet without understanding that the short-term metabolic improvements can easily trick you into believing that it is a smart long-term option, when the evidence-based research demonstrates that people who reduce their intake of carbohydrate-rich foods and substitute more fat-and more protein-rich foods from animal sources are at a greater risk for chronic disease and premature death.

Now for the good news: Unlike ketogenic diets that haven’t been studied in depth for long periods of time, almost a hundred years of evidence-based research has demonstrated that a low-fat plant-based whole-food diet is an excellent option for simultaneously maximizing your overall metabolic health, reversing insulin resistance, and dropping your chronic disease risk.

Adapted from MASTERING DIABETES by arrangement with Avery, a member of Penguin Group (USA) LLC, A Penguin Random House Company. Copyright © 2020, Cyrus Khambatta and Robby Barbaro.

The post The Truth about the Ketogenic Diet and Diabetes appeared first on Forks Over Knives.

If you’re reading this story in the hope of seeing drastic before and after photos, I’m afraid you’re going to be disappointed. However, if I could wear my body inside-out, I think you’d find my transformation pretty damn impressive (if I say so myself)! My story is about how a drastic change in my nutritional approach—going from keto to plant-based—allowed me to regain control of my insulin and blood sugar levels and, ultimately, to thrive again.

Health-Conscious History
I’ll start by introducing myself. My name is Drew Harrisberg. I’m an exercise physiologist, diabetes educator, sport scientist, and most importantly, I’m a happy and healthy guy thriving with type 1 diabetes. I’ve not only accepted living with it; I’ve learned to love it and manage it so that it doesn’t manage me.

The diagnosis came unexpectedly when I was 22 years old. It was a moment that changed my life forever. I remember making a conscious decision that I would become an expert in managing my disease and that I would share everything I discovered with the world. So the journey began. I went back to university and completed my second degree to add to my exercise physiology title, this time in diabetes education and management.

Since being diagnosed with diabetes, my life has been one big self-experiment. The cool thing is, I’ve been the subject and the lead scientist. I’ve made countless mistakes and discovered just as many solutions.

My first nutritional triumph came very soon after my diagnosis, when I transitioned from the conventional food pyramid to a mostly plant-based, low carb (50-150 grams per day), Paleo approach. About 70 percent of my diet consisted of low-carb, non-starchy vegetables; nuts; and seeds. Animal foods (meat, fish, eggs, and dairy) made up only about 30 percent of my diet, but I had some animal products with every meal. I ate very minimal fruit (just berries) and almost no grains, legumes, or nightshades. I followed this way of eating for the first seven years of my diabetes journey, and it did help me to achieve some great results: My insulin requirements dropped significantly, my blood sugar levels were tightly controlled, and some physical ailments, such as chronic sinusitis and shin splints, disappeared and never came back. My overall health improved.

Recently, my desire for personal development led me down an entirely different road. All the buzz about the ketogenic diet had me interested, so I decided to try it out in the hope that I could further reduce my insulin requirements and achieve even better blood sugar control.

One Step Forward, 10 Steps Back
Initially, that’s exactly what happened. After two months on a ketogenic diet, I was lean, fit, had great focus and concentration, could go long hours without eating, had stable blood sugar levels, and had lower insulin requirements. At this point, it seemed like keto was a magic bullet, and I was a huge proponent of this way of eating. But after two months, everything took a horrible turn for the worse. I became the most insulin resistant I have ever been. I lost all metabolic flexibility. Sure, I was a very efficient fat- and ketone-burner, but it was at the expense of the ability to tolerate any glucose whatsoever. Not only could I no longer eat the smallest amount of carbs without a massive blood sugar spike but also I was resistant to the insulin that was meant to bring my levels back into the normal range. It would have been easy to blame my high blood sugar levels on the tiny amounts of carbs I was eating, but that would have been a mistake. Here’s why: Even if I didn’t eat anything and my liver dumped glucose into my bloodstream, I couldn’t fix my high blood sugar levels, because I was resistant to the insulin that I was injecting. It felt like I was on my way to developing type 2 diabetes (type 1 is more than enough, thank you). It was a very frightening reality and a huge wake-up call.

I came to an eye-opening realization: The ketogenic diet is a short-term, Band-Aid solution. By removing carbs from the diet, you’re simply removing a trigger that leads to symptoms (hyperglycemia) without addressing the actual cause. Then when you add carbs back in, your body can’t tolerate them, which makes it seem like carbs are “bad” for you, but really they’re the victim of something else. After spending hours and hours down a rabbit hole of research, it turns out that high amounts of intramyocellular fat accumulation cause the cell to become dysfunctional, leading to insulin resistance and impaired glucose tolerance. I’ve seen numerous keto advocates demonizing carbs because they personally can’t tolerate them. Once again, it may seem like the banana caused your blood sugar to go up, but what it really did was trigger a symptom that was caused by a much deeper problem. After becoming aware that the large amounts of saturated fat I was eating (from eggs, chicken, meat, and full-fat dairy, and coconut oil) was making me insulin resistant, I knew I had to make a change.

Getting to the Root of the Problem
Having made the connection between poor health outcomes and saturated fats, I was hesitant to return to a Paleo diet. I realized that perhaps when I’d previously done well on Paleo, I was just “getting away with it” because of the healthy plant foods that I was eating. Were my positive results on Paleo due to the 30 percent of my diet that was animal products or the 70 percent that was plants? I suspected it was the latter. The only way to truly find out was to start a strictly plant-based approach and track the changes.

So, I decided to embark on a journey to see if removing those foods altogether and eating more carb-rich plant foods would reverse the metabolic damage I had caused. I immediately embarked on a strictly whole-food-plant-based journey.

I dropped my fat intake from 75 percent of daily energy to less than 20 percent. I removed all animal foods and oils. Rather, I focused on getting healthy fats from avocados, nuts, and seeds. I also added whole grains and legumes back into my diet (both of which I hadn’t eaten in nearly seven years since following a paleo approach) and an abundance of all types of fruit. Within 48 hours my insulin sensitivity started to return to normal. Within 1 week my carbohydrate intake was the highest it had been since being diagnosed with diabetes, and my insulin intake was reducing day by day.

As I write this story, I’ve been strictly plant-based for 30 days and the results have been astonishing. I’ve achieved my best ever insulin-to-carb ratio, and it feels like I’ve regained control of my health. What started as a plant-based journey toward personal development and health has turned into something so much bigger. The positive impact I’m having on myself, the people around me, the environment, and animals gives me so much fulfillment and joy. I cannot wait to see where this journey takes me over the long-term.

Ready to get started? Check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path. To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer.

The post Why I Quit The Keto Diet appeared first on Forks Over Knives.

Carbs: A Brief History

Some hundreds of millions of years ago, plants developed the ability to take energy from the sun (along with carbon dioxide and water) and make carbohydrates. The process, called photosynthesis, allowed plants to store energy in the form of carbohydrates.

This evolutionary step completely transformed the planet because it allowed the flourishing of organisms that lacked the ability for photosynthesis, since they were now able to obtain energy by eating carbohydrates in plants.

The human body, which does not have the ability to make food from the sun, also happens to use carbohydrates as its main energy source. For example, our brain and red blood cells depend specifically on glucose (a carbohydrate) for normal functioning and energy.

Carbs also serve as an important energy reserve in the form of glycogen in our muscles and liver, allowing us to maintain steady energy levels and also to have energy for sudden strenuous activities (such as sprinting). Thus, carbohydrates enable the body to adapt to a diverse range of situations.

How, then, did we come to vilify carbs? Most plant foods are naturally high in carbohydrates, so if we shun carbs, we’re shunning some of the healthiest foods that exist. We’re also shunning our bodies’ main source of energy. So how did this all come about?

Throwing the Baby Out with the Bath Water

There’s a world of difference between eating fruits, vegetables, and whole grains, and eating doughnuts, candy, and other processed foods.

In this vein, there’s a kernel of truth in the low-carb message: Refined sugars, white bread, and other processed foods high in carbs are unhealthy. Indeed, they are. But it’s not because they are high in carbs; it’s because they are processed foods that have had all of their nutrients stripped out.

However, fruits and other plant foods that are naturally high in carbs (such as vegetables, whole grains, and legumes) contain fiber, phytonutrients, antioxidants, minerals, and vitamins that are critical for good health—from protecting our eyesight by helping prevent macular degeneration to helping fight infections and cancer. Yet in the minds of many, these immensely healthy foods have been grouped with white bread and table sugar.

By telling people to avoid or significantly limit carbs in general, the low-carb movement has erased the crucial distinction between unprocessed and processed foods—creating an entirely new paradigm that goes against everything we know about nutrition and health.

Long-Term vs. Short-Term

If you eliminate carbohydrates from your diet and put your body into a state of ketosis, whereby it’s forced to burn fat to make ketones for energy, it can lead to short-term weight loss. But keeping your body in a state of ketosis is neither sustainable nor healthful, and it does not fulfill the long-term promise of effective weight loss. Indeed, observational population studies show that high-protein, high-fat diets are associated not only with more health problems but also obesity.

When looking at long-term and sustained weight loss without mandated exercise or calorie restriction, the most effective eating pattern has been shown to be a whole-food, plant-based diet (low in fat and high in unprocessed carbohydrates).

The Rise of Atkins

The low-carb idea first became well known in 1972 after Dr. Robert Atkins began publishing his Diet Revolution books, which sold more than 15 million copies and established the Atkins brand and marketing empire.

Atkins is considered the “father” of the low-carb movement. He pushed the remarkable idea that if people ate fat and protein and eliminated (or significantly minimized) carbs, they would be more slender and healthy. Calories were deemed unimportant, allowing people to embrace some of the unhealthiest foods while still following a “diet.”

It’s not hard to see the appeal of this movement, which persists to this day. Gluttony is permitted and encouraged, and people think they are sticking to a diet while loading up on fried chicken, butter, bacon, eggs, steak, and cheese.

The chair of Harvard’s Department of Nutrition said that the Atkins diet was “nonsense” and “dangerous.” The prestigious Medical Letter on Drugs and Therapeutics called the diet “unbalanced, unsound, and unsafe.” But no amount of criticism stopped the diet’s popularity and the newfound fear of carbs it perpetuated.

The Zone and Other Atkins Spin-Offs

Seeing how Atkins hit the financial jackpot, it didn’t take long for a slew of other “low-carb” spin-offs to follow suit.

In the 1990s, we saw the rise of the Zone Diet, which claimed to achieve both weight loss and “hormonal balance” with a so-called “40-30-30” approach, whereby you obtain a relatively low 40 percent of calories from carbs (so still low-carb), 30 percent from protein, and 30 percent from fat. The Protein Power diet was a high-protein/low-carb approach, with significant vitamin and mineral supplementation (perhaps to compensate for the deficiencies of avoiding high-carb fruits and vegetables).

The blood type diet was an even more unusual idea, where people with different blood types would follow dramatically different diets (which is akin to someone recommending different diets based on different eye or hair colors—sounds curious enough, but has no real science behind it). Interestingly, it recommended a meat-free diet for those with blood type A but a meat-heavy low-carb diet for those with blood type O, which is the most common blood type in the U.S.

The 2000s produced even more low-carb variations. The South Beach Diet emphasized “leaner” meats, but still limited carbs to no more than 28 percent of daily calories. The Paleo diet, popularized by an exercise physiologist, is another “high-protein/high-fat/low-carb” diet, but with an emphasis on avoiding processed foods and dairy. It’s based on very subjective assumptions about hunter-gatherer life in Paleolithic times, with provocative and sweeping claims that animal foods comprised up to 75 percent of the human diet (despite evidence to the contrary), and that these questionable estimates should dictate what we eat today (despite being at odds with mainstream medicine).

These diets and their promoters have enjoyed immense commercial success. The author of The South Beach Diet, for example, has sold more than 17 million books and generated large revenues from online services and major licensing deals. The founder of the Paleo diet gained a huge share of the weight-loss market, with cookbooks, Paleo-themed magazines, “Paleo-approved” protein bars, and other products.

These low-carb entrepreneurs tapped into something very powerful: people’s desperation to lose weight. But they have done so by introducing serious confusion about basic nutrition, to the detriment of people’s health.

The Real Skinny on Weight Loss

In short, low-carb/high-fat diets are not good strategies for sustainable or healthy weight management.

One reason is that it’s metabolically a lot easier for our bodies to use carbs for energy, and to store fat as fat. Certainly, if you’re eating too many calories in general, then carbs can and do get metabolized into fat. But it costs our bodies a large percentage of calories to do so: About 28 percent of energy content of carbs is needed to convert them into fat.

In addition, it’s much harder to overeat whole plant foods that are naturally high in carbohydrates (such as fruits and vegetables) because they are typically less calorically dense than high-fat foods and come packaged with lots of fiber, which provides satiety (i.e., you feel full before you eat too much). By contrast, high-fat/low-carb foods can easily trick our brains into overeating because they are more calorically dense and lack fiber.

A Lesson from History?

Low-carb advocates sometimes claim that we’ve tried limiting fat before and it didn’t work—that it actually made Americans fatter. Specifically, they point to a U.S. Senate report published in 1977 that recommended increasing plant foods while cutting back on high-fat meat and dairy.

But the basis for this argument is simply not true.

First of all, the 1977 recommendations specified that no more than 30 percent of calories should come from fat—which is not “low-fat” by any measure. Second, even that modest recommendation was not followed by most Americans; instead, fat and calorie consumption continued to increase.

A Better Lesson From History

It’s no big surprise that Americans are not the healthiest population: We weren’t in the 1970s and we still aren’t today. So, who are the healthiest populations and how do they eat?

The healthiest populations in the world have thrived on carbohydrate-centric diets with corn, wheat, rice, or barley as the main staple, plus lots of vegetables and fruits. These populations are sometimes referred to as “Blue Zones.”

One example is the Okinawans of Japan. Their traditional diet derived close to 85 percent of calories from carbohydrates, with about 60 percent of calories specifically coming from sweet potatoes.

This emphasis on whole unprocessed foods high in carbs served the Okinawans very well. They were not obese, had much lower rates of diseases that plague the West, and were the longest-living people on the planet until they changed their diets. Older Okinawans who continue their traditional way of eating are still among the oldest living people on the planet.

Increased Cardiovascular Risk

Those who follow a low-carb diet have been found to be 50 percent more likely to die of cardiovascular disease and 51 percent more likely to die from cerebrovascular disease.

Cardiovascular disease involves the hardening of the arteries and formation of cholesterol plaques in our vessels, which can cause blockages, blood clots, or tears in our vessels. The disease can manifest in the heart, as it often does; in the brain, where it causes strokes; or in other parts of the body. It’s the world’s leading cause of death, and the only diet that’s been found to stop and reverse it is a whole-food, plant-based vegan diet.

There are numerous factors that help explain the strong association between animal food consumption and cardiovascular risk. For example, eating animal foods in general (including poultry, eggs, dairy, and fish) results in our bodies’ producing higher amounts of a substance called trimethylamine N-oxide (TMAO). TMAO directly injures the lining of our blood vessels and makes them prone to develop atherosclerosis.

That may be why cardiologist Dr. Kim Williams vigorously promoted a plant-based vegan diet during his tenure as president of the American College of Cardiology, and once famously said, “There are two kinds of cardiologists, those who are vegan and those who have not read the evidence.”

Dr. Robert Atkins himself sadly had a history of congestive heart failure and a heart attack, according to a medical report that was accidentally leaked from the New York medical examiner’s office following his death. His widow and the Atkins organization have always denied it.

It’s worth noting that those following a low-carb diet were also found to be 35 percent more likely to die of cancer.

Takeaways

It is extremely important to eat a varied and large amount of whole plant foods every day, something that is exceedingly difficult (if not impossible) to do if you’re displacing plant foods with animal foods in a misplaced effort to avoid carbs.

Yes, refined and processed foods (including processed carbs) are to be avoided. But don’t replace them with meat, eggs, and cheese. Replace them with foods that actually promote good health, such as vegetables, fruits, legumes, whole grains, and, yes (gasp!), potatoes, sweet potatoes, and bananas, too.

It’s easy to get the right proportions of nutrients (plus lots of antioxidants and phytonutrients that promote health and prevent disease) simply by eating a well-balanced and varied diet of whole plant foods. And, as no small added benefit, eating a plant-based vegan diet is also an effective and sustainable way to manage your weight.

Ready to get started? Check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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For those who are unaware, the keto, or ketogenic, diet excludes all carbohydrates to the point that the body derives energy from another macronutrient: fats. Followers of the keto diet do not eat whole grains, legumes, or fruit because of the carbohydrate content of these foods: Even some vegetables contain too much starch to be allowed in the diet. As a result, the body extracts energy from fats consumed in the diet, which creates ketone bodies as a byproduct of metabolizing fats, hence the name.

No Human Population Has Survived in Ketosis

Don’t let keto evangelists tell you the Inuit survived and thrived on a nightly fare of seal blubber, whale sirloins, and caribou jerky while being in the purportedly nirvana-like state of ketosis. (“Keto flu,” the common phrase for the symptoms of malaise, nausea, and fatigue that keto dieters regularly experience, is more indicative of the unpleasant truth.) The Inuit certainly ate those things; farmers markets are scarce in the Arctic because, well, there aren’t vegetable farms in the tundra. But they also evolved to avoid ketosis altogether: A mutation occurred several thousand years ago to prevent ketosis in this population. The mutation is now found in more than 80 percent of Greenland and Canadian Inuit. Because the keto diet increases acid levels in the blood, it is hypothesized that ketosis reduced the ability to tolerate further acidosis during times of illness, injury, or complete starvation, thereby increasing the chance of death. That so many Inuit have the mutation strongly suggests that ketosis was perilous for the aboriginal inhabitants of the Arctic—and likely is perilous for anyone else on the diet as well.

Deficiencies in Vitamins A to Z

It should come as no surprise to anyone that the ketogenic diet causes vitamin and mineral deficiencies. After all, there are large food groups that followers simply cannot eat, such as whole grains and most fruits. The rules for maintaining ketosis are so strict that an extra helping of broccoli might push you over the carbohydrate limit.

The only people who should be on a ketogenic diet are children who have refractory epilepsy, for which the diet has been used as therapy to reduce seizures for nearly a century. Researchers have been studying the side effects of the diet in this population, including vitamin and mineral deficiencies. In one study, researchers found deficiencies in every vitamin and mineral analyzed except for vitamin B12, which is commonly found in fatty foods of animal origin. The severity increased with increasing ketosis. In some cases, deficiencies in selenium were so severe that children died.

Until Death Do Us Part

Study after study has shown an increased risk of death with low-carb diets, and the keto diet maintains utmost supremacy in carbohydrate restriction. In a recent study published in The Lancet, those eating low-carb diets and relying primarily on animal-based foods, such as lamb, beef, pork, and chicken, were associated with a higher mortality. We already know that eating animal-based foods, such as dairy and meat, increases the risk of dying. The keto diet, in particular, also worsens levels of both good and bad cholesterol, which puts one at risk of dying from heart disease. The foods that the keto diet excludes—fruits, vegetables, legumes, and whole grains—are some of the healthiest foods around. It’s no wonder the risk of dying goes up when you leave these foods off the plate.

Does Keto Keep Its Promises?

Keto’s claim to fame is its almost mythical ability to treat diabetes and obesity. However, long-term studies show no benefit for diabetes. Although studies of short-term duration (less than a year) frequently show a benefit in the treatment of diabetes, a meta-analysis of studies lasting more than a year showed no difference in glucose levels of those on the ketogenic diet compared with controls. And for weight loss? A paltry two-pound advantage over a low-fat strategy, after one year of counting carbs. Two pounds of weight loss is not enough to make you look that much more svelte. There are saner—and safer—ways of losing two pounds over the course of a year, like eating a whole-food, plant-based diet.

I’ve Got 99 Problems, but Carbs Ain’t One

Even if you believe the keto diet works for weight loss, there are plenty of other reasons to avoid it. In reviewing the literature of the documented side effects in epileptic children on the diet, I found that patients suffered from no shortage of side effects, including kidney stones, restricted growth, fatal cardiac arrhythmias, pancreatitis, higher cholesterol levels, and many more. The diet seems to be worth utilizing only if one happens to be a child with refractory epilepsy—and even then, children discontinue the diet because of its numerous side effects.

The ketogenic diet has swept the country up with the hope of a miracle diet, but, in the end, it may only bring us down with disappointment. Let food be thy medicine, but not if you need actual medicine to support thy food.

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