“I’m addicted to sugar.”
We’ve all heard or thought this before. Considering the American palate for highly processed, overly sweetened foods and the ubiquitous nature of sugar in advertising, we see evidence of a concerning shift. Sugar’s role in the American diet has moved beyond a character actor and into a starring role. Further, as discussed in the previous post, Sugar. How Much Is Too Much?, we consume far more sugar than is recommended for our health. But the question remains—are we addicted?
More please: How sugar affects the brain
While an ICD-10 code for “sugar addiction,” has yet to be established, an increasing body of research tells us that sugar has addictive effects on the brain.1,2 Like sex and drugs, consuming sugar stimulates the release of dopamine, a neurotransmitter that gives us a sense of euphoria and controls the reward and pleasure centers in the brain. But what may have evolved as a survival mechanism has gone rogue.
The caveman sweet tooth
From an anthropological perspective, we are hard-wired for sweetness. The pleasing taste of sweet foods was a conditioned reward, one which could increase early man’s survival odds. In times of food scarcity, a preference for more nutritionally dense foods might have provided the energy required to continue the hunt, outrun a predator, or simply avoid starvation.
Flash forward a few hundred thousand years, and sugar is exponentially more abundant. Consistent intake of concentrated sugar can lead to changes in the brain’s dopamine receptors. Similar to increased drug or alcohol tolerance, over time, more sugar is needed for the same “high.”
Cookies and cocaine
So, the more you eat, the more you want. But, as for being “addictive” per se, animal studies have shown sugar consumption to have drug-like effects. These include sugar-related bingeing, craving, tolerance, and withdrawal. In fact, according to a Connecticut College study, Oreo cookies cause more neural activation in the brains of rats than cocaine.3
For many individuals, the only way to stop over consuming sugar is to stop the cravings. But the only way to end the cravings is to stop feeding them with sugar. So, in addition to cutting out the obvious forms of sugar—candy, baked goods, etc.—it is important to be aware of the less obvious forms of sugar in your diet. Over the course of a day, small quantities can add up, keep your cravings alive, and thwart your efforts to take control of sugar. So become a sugar sleuth. Here are five tips to get you started.
5 Tips for Identifying Added Sugars1. Beware of marketing geared toward dieters
2. Read ingredient labels, especially the first three ingredients
3. Beware of alternate forms and names for sugar
The journey to a healthy relationship with sugar starts with awareness. Watch for the next post in this series, which will feature strategies for taking control of sugar.
It’s not all fun and games when you’re living the low-carb lifestyle—but sometimes, it can be! Read on for a list of low-carb cocktails you can enjoy while following a ketogenic diet plan.
First, here’s a simple rule of thumb: when consumed in moderation, any hard liquor can be considered acceptable by keto standards—either by itself or with plain, sugar-free sparkling water. Many sparkling waters contain zero everything, including calories, sugar, sodium, and, of course, carbs; just make sure you check the label or ask the bartender. For extra flavor, fresh lemon or lime juice is always acceptable.
Whether you’re at home or at happy hour, these seven “ketolicious” cocktails won’t disappoint.
Vodka SodaA simple, low-carb favorite.What you’ll need:
Some like it sweet
You don’t have to sacrifice sweetness in your low-carb cocktail fix. Each serving of this ketogenic simple syrup contains just 2 net carbs.
What you’ll need:
Remember: If you choose to indulge in alcohol, it should always be in moderation. Enjoy responsibly.
With all the keto-friendly cocktail options out there, you have yet another reason never to feel like you’re missing out on anything. Cheers!
The ketogenic diet has helped countless people who have struggled with managing their weight. But it is a diet that has now been split into two different diets: one diet’s been around for over 100 years; the other is a new spin for modern eating habits: How do you decide whether eating clean versus dirty keto is the right diet for you? Compared to the Standard American Diet (SAD), clean keto is not only used to help people lose weight, recent studies have also demonstrated it hosts a variety of health benefits that don’t include weight loss: Clean keto can help increase energy levels, promote brain function, and support athletic performance—for both professionals and amateurs alike.1 Those who have experienced the benefits of clean keto are understandably curious about the latest version of the diet, known as “dirty keto,” and how it holds up against eating clean. Let’s take a closer look.
Keeping it clean. The clean keto diet is based on the idea that eating a fixed macronutrient breakdown of mostly healthy fats, high-quality protein in moderation, and restricted carbohydrates (less than 50 grams per day) provides your body with the fuel you need to lose body fat without hunger, weakness, and fatigue.2 The reduction in carb intake puts your body into a metabolic state called “nutritional ketosis.”3 During this nutritional ketosis, your body no longer relies on glucose as a primary energy source. Instead, your liver converts fat into ketones–which are a great source of fuel for both your body and brain. Ketones also increase the brain-derived neurotrophic factor (BDNF), which works to support your brain’s existing neurons while encouraging new neuron and synapse growth.4
On the clean keto diet, you get most of your calories from healthy fats found in foods like avocados, grass-fed butter, olives, olive oil, coconut oil, nuts, and seeds. However, keep in mind that some nuts and seeds are better than others. You’ll want to choose those that are high in fats and lower in carbs; brazil nuts, almonds, walnuts, chia seeds and flaxseed are all good options. You can also eat all of the nonstarchy, leafy vegetables you want, as well as other low-carb vegetables like broccoli, peppers, cauliflower, green beans, asparagus, cucumber, and zucchini. In moderation, eat protein in the form of grass-fed meats, pasture-raised poultry, cage-free eggs, and wild-caught fish. Finally, if you want to reach for something sweet, 90% dark chocolate is your best option.
On the list of what not to eat? For starters, remember that the clean keto diet restricts the intake of carbohydrates to achieve a shift from glucose to ketones as a primary fuel source. In order to avoid food high in carbs, limit fruit consumption—as it’s higher in sugar content–and forego fruit juice altogether. You should also avoid grains or starches such as rice or pasta, beans or legumes, root vegetables, and any low-fat or diet products, as they are typically highly processed and high in carbs.
Let’s talk dirty (keto)Dirty keto follows the same macronutrient breakdown of fats, protein, and carbs as clean keto, with one major difference: It doesn’t matter which foods those macros come from. That is to say, on the dirty keto diet, instead of choosing good fats, like wild-caught salmon, grass-fed butter, and avocado, you eat a fast-food burger (without the bun), processed cheese, and pork rinds.
Can you lose weight by following the dirty keto diet? Possibly. But the benefits halt there—and there are remarkable health drawbacks from the dirty keto diet that you should be aware of, too. For starters, this keto diet is missing vital micronutrients like vitamins, minerals, and enzymes that are necessary to your overall health. Furthermore, processed foods are usually high in sodium, which can lead to bloating and inflammation. You’re also more likely to regain the weight you lost and experience more cravings and less satiety. Dirty keto foods can trigger these cravings, bloating, and feelings of withdrawal which are symptoms commonly associated with what is known as the “keto flu.”
You are what you feed your brainIn a healthy digestive system, the cells that form the paper-thin lining of the small and large intestines are packed very closely together. In fact, they’re so close that under normal, healthy conditions, only digested food (solutes) and water—can and should—enter the bloodstream. But when there is intestinal inflammation or inappropriate dietary intake, the tight junctions of the gut lining can easily be disrupted and become too porous. Diets high in chemical-laden processed foods—such as those often consumed on the dirty keto diet—can damage the gut lining and force it to become more permeable. These same factors also affect the balance of both the trillions of beneficial and harmful bacteria in the gut. When this balance is disturbed, harmful bacteria can get the upper hand and cause an increase in gut permeability.
The result is intestinal hyperpermeability, or “leaky gut.” This condition can allow toxins, bacteria, undigested food particles, and other undesirable gut contents to enter the bloodstream and circulate to the rest of the body, including your brain. Not only does your gut affect your mental state in how you feel physically, but the reverse is also true: Your mental state affects your gut and gut health. This makes following the clean keto diet a better choice for your brain’s health.
While dirty keto follows the same macronutrient breakdown as clean keto, there are marked differences in the two diets and their respective impacts on the body (and brain). A dirty keto meal can be a placeholder while you’re in a pinch, but it shouldn’t be part of an ongoing healthy eating regimen. Instead, by following a clean keto diet, you’ll not only find success losing weight and gaining energy, but you’ll also provide your brain with longer-lasting, healthier fuel.
Consider these general diet descriptions:
So is a vegetarian or vegan ketogenic diet possible? Short answer: yes.
The ketogenic diet differs from other diets in that it is not based around food groups you can or cannot eat; rather it is based on the macronutrient ratio your body requires to enter a state of nutritional ketosis (defined by an elevation of blood beta-hydroxybutyrate, the body’s primary ketone body). Thus, any style of eating can potentially be ketogenic, whether that is vegan, paleo, low FODMAP, etc.
When you are approaching the ketogenic diet from a plant-based perspective, look at what plant foods comply to the macronutrient ratios you are following and stick to those.
General guidelines for following a ketogenic diet:
Vegan ketogenic “food groups”:
Vegan food swaps
Tips & tricks
Submitted by the Metagenics Marketing Team
Wouldn’t it be nice to live in a world where the answers to all our health questions were black and white, (“Eat this, and you will feel good; don’t eat this, or you will not feel good”)? Unfortunately, health is not black and white, and often we have to navigate through the grey areas to find the truth.
MYTH #1: A ketogenic diet increases your risk for cardiovascular diseaseThis myth is centred around the misinformation that saturated fat and cholesterol are the main causes of heart disease. Despite being shown that dietary cholesterol does not raise blood cholesterol1 and saturated fat has little correlation to heart disease,2 there is still a stigma around both. Cardiovascular risk does not boil down to a single biomarker, but rather encompasses a host of factors such as age, sex, total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, smoking, blood pressure, glycemic control, and more. Several of these risk factors may be mitigated by lifestyle changes.
Low-density lipoprotein (LDL) cholesterol, as opposed to high-density lipoprotein (HDL) cholesterol, often gets a bad rap because the general understanding about cholesterol is that LDL cholesterol is the “bad” cholesterol, and HDL cholesterol is the “good” cholesterol. While this isn’t entirely misleading, what is misleading is referring to these as absolutes. LDL is usually misrepresented as the single factor that determines one’s risk for cardiovascular disease (CVD), when in fact there is more to the LDL and CVD risk story much of which is still uncovered. The danger lies with the small, dense LDL particles (as opposed to large, buoyant LDL particles),3 which have been shown to be associated with CVD.4 It is not uncommon to see a rise in total LDL levels when following a ketogenic diet. Recently published results of a one-year study of patients on a well-formulated ketogenic diet showed that the ketogenic diet did not change total LDL particle numbers but rather caused a shift toward an increase in large, buoyant LDL particles and decrease in small, dense LDL particles,5 which is a good thing! With all of this said, there is still a lot that is not fully understood about LDL cholesterol in the context of a ketogenic diet. As previously stated, LDL is not the only biomarker to consider when determining risk for CVD. Working with a keto-savvy physician is recommended when considering a ketogenic diet.
When part of a weight management program including exercise and lifestyle modifications, the ketogenic diet can actually improve other biomarkers of CVD risk, such as weight,6 HDL cholesterol,6 blood pressure,5 blood levels of saturated fat,7 HbA1c,5 inflammation,8 and more! In fact, research has shown that carbohydrate-rich diets pose more of a health risk than ketogenic diets. High-carbohydrate diets have been associated with increases in small, dense LDL particles and reductions in HDL cholesterol along with raised triacylglycerol levels, all of which contribute to increased CVD risk.9
MYTH #2: The human body requires carbohydrates to survive
This one may be hard to wrap your head around considering there are actually some cell types that do have an absolute requirement for glucose and cannot use fats or ketones for fuel, such as red blood cells which lack mitochondria, the organelle required for ketone utilization. Dr. George Cahill, former professor at Harvard Medical School, studied human body fuel metabolism under prolonged starvation, pioneering the understanding of ketones as an alternative fuel source to glucose. His research demonstrated that even after 40 days of fasting, glucose levels in the participants were maintained, despite consuming no food (Figure 1).10 So where does the glucose come from to fuel these cells when carbohydrates are restricted, such as with a ketogenic diet?
Once you are keto-adapted (i.e. in a state of sustained nutritional ketosis), there are two primary sources that contribute to glucose maintenance. The first is from amino acids via a process called gluconeogenesis, where certain gluconeogenic amino acids are broken down into glucose. These amino acids can come from the protein consumed or stored in muscles. However, when ketones are circulating in our blood and the brain begins preferentially using ketones for the fuel, glucose requirements are reduced, therefore the need to break down muscle is reduced. This is one way ketones are muscle-sparing. The second source of glucose is from the glycerol backbone of triglycerides. Triglycerides are the storage form of fat and contain one glycerol backbone attached to three fatty acids. When the body breaks down stored fat while in ketosis, the fatty acids are detached from this glycerol molecule to make ketones, and the glycerol molecule can be converted into glucose, accounting for most of the body’s glucose requirements when keto-adapted.
Figure 1: Circulating concentrations of βOHB, glucose, free fatty acids, and acetoacetate in obese but otherwise normal man fasting for 40 days. Adapted from Cahill GF et al. Ketoacids? Good medicine? Transactions of the American Clinical and Climatological Association. 2003;114:149-163.
MYTH #3: Nutritional ketosis puts you at risk for ketoacidosis
This is one of the most common myths, and despite being proven wrong time and again, people still want to believe that the ketogenic diet causes ketoacidosis. Ketoacidosis is a valid concern given that it can be a life-threatening event where ketone bodies cause a dangerous imbalance in blood pH. However, this condition occurs primarily in those with type-1 diabetes or insulin-dependent type-2 diabetes, and is uncommon in healthy individuals with a fully functioning pancreas. Blood ketone levels are regulated by insulin, just as blood glucose is. When ketones reach their upper limit (~7-8mmol/L), a small amount of insulin is released from the pancreas to help prevent any further elevation in blood ketones, this system is designed to help the body avoid what is considered ketoacidosis (~15-25mmol/L). Nutritional ketosis (i.e. ketosis achieved via a ketogenic diet) is highly unlikely to put a healthy person at risk of reaching dangerous ketone levels. There are rare exceptions to this where ketoacidosis can occur in those adhering to a ketogenic diet in instances such as dehydration, sickness, and possibly pregnancy. However, it is always advised to start a diet and/or weight management program under the supervision of a physician or healthcare provider.
MYTH #4: You can’t do keto as a vegan or vegetarian
The ketogenic diet is commonly associated with a diet primarily composed of animal fats. However, nowhere is it stated that to follow a ketogenic diet, solely animal fats are required. There are plenty of plant-based fat sources that are highly suitable for a ketogenic diet such as avocados, nuts and seeds, olives, etc., and their oil derivatives. For those people who are vegetarian (but not vegan), the options extend even further to include eggs and dairy, both excellent sources of fats. Incorporating oils will likely be necessary for those following a completely plant-based ketogenic diet, as it would be very difficult to fulfil the macronutrient ratios needed to enter ketosis by utilizing only whole foods. This recent post outlines different types of dietary fats that may be used on ketogenic diet, as many of the sources mentioned in the post are plant-based. There are many low-carbohydrate vegetables that should also be included in a ketogenic diet regardless of whether animal products are part of dietary intake. These primarily include leafy greens, cruciferous vegetables, lettuces, celery, cucumber, and zucchini. There are also many dairy-free alternatives to dairy fats such as nut milks, full-fat coconut milk, nut-based yogurts, and nut-based cheeses, all unsweetened of course!
MYTH #5: The ketogenic diet is the same as a low-carb diet
Many people begin their ketogenic diet by cutting out carbohydrates and replacing those calories with protein-based foods. Those who are used to restricting dietary fats may approach a ketogenic diet and foods with hesitation. A ketogenic diet is a high-fat, moderate-protein, very low-carbohydrate diet. So, while you may be under the allotted daily grams of carbohydrates, the amount of fats and proteins consumed must be considered as well. Fats contain ~9 calories per gram, while protein and carbohydrates contain ~4 calories per gram. Given this information, portion sizes will likely be reduced when following a ketogenic diet, and this may be more of a psychological barrier than a satiety one. Adding additional fats to meals in the form of oil, butter, ghee, or full-fat dairy can transform a low-carbohydrate meal into a ketogenic meal. Consider adding quality fats to protein sources to slow the digestion of protein and attenuate any glucose/insulin responses that could potentially prevent one from “entering” or “kicking out” out of ketosis. If you are not entering ketosis following what you believe to be a ketogenic diet, void of almost all carbohydrates, you may be over consuming protein. In this case, adjust your macro nutrients to include higher quantities of dietary fats and less low-fat protein sources.
This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues.
Submitted by the Metagenics Marketing Team
A ketogenic meal is comprised of approximately 10% of calories coming from healthy carbohydrates such as leafy greens, non-starchy vegetables, and limited amounts of legumes and berries; 20% of calories coming from proteins such as omega-3-rich fish and grass-fed animal protein; and ~70% of calories coming from high-quality fats such as avocado, unsaturated and medium-chain triglyceride oils, nuts and seeds, and coconut.
This 10/20/70 ratio is a guideline for the macro nutrient distribution for a given day, including meals, snacks, and beverages. You may recommend a slightly modified ratio based on your physical activity and personal health goals. The diagram below highlights how the calories provided from carbohydrate, protein, and fat differs between a standard American diet and a typical ketogenic diet.
Here are some healthy Keto options:
Tennis is a great game for staying in shape. The fitness you develop from a tennis game has an added bonus: It carries over into the rest of your life. By playing tennis, you also improve your functional fitness or your ability to do ordinary things, like carry a sack of groceries in from the car or climb a flight of stairs. The better your functional fitness, the better you can get through all the usual activities of your typical day with ease—and with energy left over for tennis.
Exercises to build functional fitness aim to mimic the activities of daily living by working several muscle groups at once. They’re designed to improve your strength, flexibility, endurance, range of motion, and balance, because you need all those abilities every time you do something like pick up a toddler, or reach for something on a high shelf, or carry a briefcase. Because they build overall fitness, they’re also great for your tennis game!
Exercises for functional fitness
Functional fitness exercises focus on building a strong core and then working several major muscles groups of the body at once. The five exercises I suggest here are a good basic workout that doesn’t require any special equipment—you’re going to use just your body weight. Plenty of other exercises also build functional fitness, so once you’ve mastered these, change up your routine by swapping some other exercises in and out.
This most fundamental of exercises is key to a strong core—it engages your abs, lower back, hips, and arms. This is the one functional fitness exercise that should always be part of your workout routine, because your core muscles are continually engaged when you play tennis.
Two-Legged SquatThis is a great functional fitness exercise for building up and coordinating your leg muscles, especially the quadriceps, hamstrings, and calves—the muscles that control your knees and hips. By doing this regularly, you improve your ability to get up and down from chairs, pick things up off the ground, and climb steps. For your tennis game, strong legs give you a strong foundation for your strokes and improve your ability to transfer your weight.
The plain old push-up is one of those basic exercises we tend to overlook, but it’s great for strengthening your core, your gluteus maximus and the chest, shoulder and arm muscles. You’ll notice the difference when you’re lifting or carrying something heavy or reaching up to get something in or out of a cabinet. You’ll also see a difference in your strokes—strong arms and shoulders are key to good control.
Bird dogs, also known as pointers, are great for the muscles of the lower back and thighs and the upper arms. If you do these, you’ll notice the difference in anything you do that requires lifting or bending. You’ll find that you’re more flexible on the tennis court.
About Robert SilvermanRobert G. Silverman, DC, DACBN, DCBCN, MS, CCN, CNS, CSCS, CIISN, CKTP, CES, HKC, FAKTR is a chiropractic doctor, clinical nutritionist and author of Inside-Out Health: A Revolutionary Approach to Your Body, an Amazon number-one bestseller in 2016. The ACA Sports Council named Dr. Silverman “Sports Chiropractor of the Year” in 2015. He also maintains a busy private practice as founder of Westchester Integrative Health Center, which specializes in the treatment of joint pain using functional nutrition along with cutting-edge, science-based, nonsurgical approaches. Dr. Silverman is a seasoned health and wellness expert on both the speaking circuits and within the media. He has appeared on FOX News Channel, FOX, NBC, CBS, CW affiliates as well as The Wall Street Journal and NewsMax, to name a few. He was invited as a guest speaker on “Talks at Google” to discuss his current book. As a frequent published author for Dynamic Chiropractic, JACA, ACA News, Chiropractic Economics, The Original Internist and Holistic Primary Care journals, Dr. Silverman is a thought leader in his field and practice.
View all posts by Robert Silverman →
If you’re trying to maintain a healthy weight, counting sheep may be as important as counting the carbs on your plate or weight repetitions at the gym. Because, while physical activity and a balanced diet are key factors, sleep may be the most overlooked aspect of your weight management plan.
Can you sleep your way to your dream body? Perhaps not. But if you are sleep deprived, more sleep may help you reach your weight goals. Here’s what you need to know about the sleep-weight connection.
Are you sleep deprived? The National Sleep Foundation recommends seven to nine hours of sleep per night for adults 24-64, slightly more for younger adults and a bit less for those older.1 But due to electronic gadget lights, chronic stress, habitual caffeine, shift-work, and many other reasons, few folks get their target rack time. In fact, according to the Centers for Disease Control, insufficient sleep is a public health problem2 with serious concerns for our productivity, safety, and health—including your waistline.
It’s not just when you’re sleep deprived and find yourself battling the bulge, you’re in good company. Studies have found consistency in the sleep-weight connection; sleep deficiency is linked to weight gain. The largest study of its kind involved over 200 participants and simulated a sleep-restricted workweek. It compared the effects of restricting sleep to only four hours per night compared to unrestricted sleep, up to ten hours per night.3 After only five days, the sleep-restricted subjects had gained about 2 pounds. In contrast, the control group, allowed to sleep for up to 10 hours a night, gained virtually no weight.
If sleep restriction can cause you to gain two pounds in just five days, what can happen on the scale long-term?A lot, according to women tracked for 16 years in The Nurses’ Health Study. Women reporting six hours of sleep per night were 12% more likely to gain at least 30 pounds during the study compared to the women who slept seven hours per night. But those women who were even more sleep deprived, reporting no more than five hours per night, were 28% more likely to gain at least 30 pounds during that same period!4 Apparently, with the sleep-weight connection, every hour counts.
How does less sleep = less svelte? There are several underlying factors behind the sleep-weight connection. But a common thread is our own chemistry, which almost seems to revolt when restorative sleep is intentionally or unintentionally withheld. It’s you against them—and it’s not a fair fight.
Getting to know your hunger chemistry. There’s more than your sensation of fullness and stomach-brain communication involved. Rather, when it comes to hunger regulation and sleep, we have several chemical messengers at play. And when it gets complicated between you and the sandman, those messengers are not on your side. So get to know them:
As you can see, proper balance of ghrelin and leptin is very sleep-dependent. And for the caveman, perhaps these hormones were key to survival during the shorter, sleep-heavy but food-poor days of winter. They also played a part in the ability to capitalise on the longer, lighter sleep and more food-abundant days the rest of the year.
Today, our sleep-deprived bodies are prone to having too much ghrelin and not enough leptin. The result is that the body doesn’t feel satiated, thinks it’s hungry, and needs more calories—and squirrels away those calories for the long winter. In short, ghrelin and leptin kept the caveman alive, but they may be making you heavy.
What to do?
That depends. There are two main reasons behind sleep deprivation. Either you have a sleep hygiene issue (trouble falling asleep or staying asleep), or you have a scheduling issue, in that your lifestyle is interfering with adequate sleep.
For sleep hygiene issues, the typical recommendations always merit consideration: limiting caffeine, avoiding blue light before bed, creating a cool and dark environment, etc. But, when you have a scheduling challenge, getting adequate sleep requires some lifestyle restructuring. It’s worth the time to re-engineer your schedule to slowly go to bed earlier or rise later to increase your sleep time. But in the meantime, can you catch up on sleep on the weekends?
Weekend catch-up sleep: Is it a real thing?Of course, you can get extra sleep on the weekend. But can it potentially reverse your Monday-Friday sleep deprivation? Perhaps. In a study of over 2,000 people participants, those who slept longer on the weekends, nearly two hours longer on average, had a significantly lower body mass index (BMI) than those who didn’t. Further, it appears that the sleep:BMI relationship was dose-dependent in that every extra hour of weekend catch-up sleep was associated with a significantly lower body mass.8 So catch-up sleep can indeed be a good strategy. That is, if your overall average sleep for the week puts you out of the red and into the black, as in you’ve paid back your sleep debt.
Sleep more. Weigh less. Not convinced? Sleep on it…
When following a ketogenic diet, it is not uncommon for people to neglect eating quality sources of fiber in an effort to avoid any carbohydrate intake. There is a chance this can lead to constipation, poor digestion, and a lack of certain vitamins and minerals.
What is fiber?Dietary fiber is the indigestible plant material that passes through our digestive system either completely undigested, or broken down via microbial fermentation, in the large intestine.1 Fiber aids in the removal of waste via the colon and is important for maintaining healthy digestion. Fiber is categorized as either soluble or insoluble, and each is digested differently.
Soluble fiber: Soluble fiber dissolves in liquids and becomes gel-like in the digestive tract.1 It slows digestion, increases satiety, and when consumed with carbohydrates can slow intestinal absorption and can help minimize increases in postprandial blood glucose.2
Soluble fiber is predominantly found in fruits and legumes, which are not advised on a ketogenic diet, and small amounts are found in vegetables.3 Soluble fiber ingredients are also commonly found in low-carb packaged foods, such as isomalto-olidosaccharides (IMOs) and soluble corn fiber.
Insoluble fiber: Insoluble fiber does not dissolve like soluble fiber does. This type of fiber stays intact and is responsible for what people refer to as “roughage” when speaking of fiber. This type of fiber aids in digestion and promotes elimination of waste by the colon.4
Insoluble fiber is the predominant type of fiber found in vegetables, especially the low-carb, non-starchy options that are fitting for a ketogenic diet.
Taking in fiber on a ketogenic dietFollowing a ketogenic diet is easy when you stick to fatty meats, eggs, oils, and full-fat dairy. However, by a strict intake of these foods, there is very little consumption of whole-food fiber in addition to a lack of micro nutrient intake. Moreover, low-carb, “keto-friendly” packaged foods, although providing ease of entry into a ketogenic lifestyle, are typically filled with soluble fibers. These soluble fibers contribute toward the majority of the daily carbohydrate count and lead to a lack of insoluble fiber in the diet. Consequently, due to the attempt to meet daily macronutrient ratios, there is a tendency to neglect all vegetables, even low-carb options, and thus losing out on insoluble fiber intake. A well-formulated ketogenic diet should not be void of fiber; some may even argue it provides more fiber than other diets. This is because a well-formulated ketogenic diet includes regular amounts of low-carb vegetables on a daily basis, along with quality sources of fats and protein.
Intriguingly, the fermentation process of insoluble fiber during digestion can also contribute to ketogenesis (i.e. the production of ketones). Fiber is broken down by the gut microbiome into short-chain fatty acids, such as butyrate,5 a molecule that is very structurally similar to the ketone body, beta-hydroxybutyrate. Subsequently, butyrate can be converted to beta-hydroxybutyrate and has been shown to increase blood ketone levels in humans.6
Fiber sources on a well-formulated ketogenic dietLow-carbohydrate fibrous whole foods, such as those listed below, are recommended as part of a well-formulated ketogenic diet to allow for entering and/or sustaining nutritional ketosis (defined as an elevation of beta-hydroxybutyrate (BHB) above 0.5 mmol/L). Consider adding these examples to your diet:†
Tips for consuming more fiber on a ketogenic diet:SaladsThis may be an obvious solution to a lack of insoluble fiber in the diet, and you may even be experiencing flashbacks from traumatic dieting memories you just can’t shake. However, a ketogenic salad should be an exception to this bias. If you have ever had a good salad, you know salads are underrated; they only become boring when you take away the fat—not an issue on a ketogenic diet. Gone are the days when you ask for “dressing on the side.” When you find a high-fat dressing you enjoy, you will begin to enjoy your salads!
Recommended ingredients: leafy greens (all types), avocado, hemp seeds, boiled eggs, fatty cuts of beef, chicken thighs, fatty fish, olives, nuts & seeds, artichoke hearts, high-quality oils, high-fat dressings (see below)
Sautéed & roasted vegetablesWhile from a glycemic standpoint there is an advantage to eating vegetables raw (due harder access to carbohydrates stored inside plant cells), sometimes eating cooked vegetables can bring a sense of comfort, and could translate to better compliance to a ketogenic diet. The best oils for cooking that can handle heat contain saturated and monounsaturated fats such as butter, ghee, avocado oil, extra-virgin olive oil, MCT oil, and coconut oil. Use of fresh or dried herbs and spices such as garlic, parsley, cumin, chili, oregano, paprika, rosemary, coriander, etc. will add additional flavors.
Recommended ingredients for sautéing: spinach, onion, mushrooms, kale, zucchini, cabbage, Bok choy
Recommended ingredients for roasting: Brussels sprouts, broccoli, cauliflower, onion, mushrooms, celery (don’t knock it ’til you try it!)
Chia puddingYes, pudding! Ketogenic chia puddings are extremely easy, cheap, and convenient to make and, most importantly, are full of fiber. The carbohydrate content of chia seeds is primarily fiber, 86% to be exact, and most of it is insoluble fiber! When chia seeds are soaked overnight, they absorb the liquid and take on a pudding-like consistency. Spruce up the chia puddings with some of the recommended ingredients below to avoid a flavorless gel and make sure to include healthy fats!
Recommended ingredients: chia seeds, flax seeds, hemp seeds, low-carb nuts/nut butters, sugar-free chocolate chips, cocoa powder, cinnamon, vanilla extract, MCT oil/powder, full-fat coconut cream, coconut butter, shredded coconut, unsweetened nut-milks, coconut oil, sea salt, sugar-free/low-carb protein powders
Dressings & dips Dressings and dips are like smoothies in that you can easily sneak ingredients into them. Adding fiber into dressings and dips makes food taste better, as well as being an easy way to get in those healthy fats! Use a blender to make these, and include dressings and dips with any savory snack or meal!
Recommended ingredients: spinach, kale, steamed cauliflower, raw or steamed zucchini, high-quality oils, tahini, herbs & spices, garlic, lemon juice, apple cider vinegar, full-fat yogurt (or dairy-free alternative), MCT oil/powder, avocado oil- or olive oil-based mayonnaise
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If you have ever walked down a grocery or health food store aisle containing protein powders, you’ve likely found that the sheer volume and varieties of protein supplements can be overwhelming and confusing. How do you choose the right supplement? How much should you consume? Will you be able to absorb and tolerate it properly?
Let’s take a closer look at the importance and requirements of protein and best available sources of protein supplements.
How Much Do You Need?
Proteins are the building blocks of life. They are a class of molecules that are a key structural component of all cells in the body. Protein is needed for growth and repair of the body and maintenance of good health. Additionally, protein is required for energy metabolism, muscle synthesis, cell signalling, immune responses, and enzymatic reactions.
The amount of protein we need is varied and changes throughout our lifetime. The Recommended Dietary Allowance (RDA) for protein is 0.8g/kg of body weight per day for healthy individuals aged 19 and older.1,2 This equates to approximately 55g of protein per day for a person weighing 150 pounds. This is the minimum amount needed to maintain nitrogen balance and prevent protein deficiency.1,2 But recent research indicates that the RDA requirements are not adequate to maintain optimal health, and in fact more protein is needed for women who are pregnant or lactating, older individuals, active people, and athletes.3-5
Animal vs. Plant-Derived Protein is available in a variety of dietary sources. These include foods of both animal and plant origin. Both animal and plant-derived proteins are made up of 20 amino acids.1 Nine of these are not synthesised by humans and are considered essential.1 Therefore, these essential amino acids have to be obtained from the diet.
Proteins from animal sources (eggs, dairy, meat, and poultry) are considered high biological value protein because they contain all nine essential amino acids. Plant-derived proteins (from legumes, nuts, seeds, etc.), on the other hand, typically lack one or more of the essential amino acids and are considered a lower biological value protein.
But when these proteins are combined (e.g.: rice and beans), not only do they provide a complete source of protein, but they also offer a protein profile that is lower in saturated fats and cholesterol.
What Is a PDCASS Score?
Powder supplements offer an easy, convenient, and reliable source of high-quality protein. The most common sources of protein supplements include whey and casein (animal-derived) and soy and pea/rice blend (plant-derived). Depending on the source and purification methods used to manufacture the supplements, a consumer may or may not obtain a high-quality product. The quality and digestibility of a protein is vital considering the nutritional benefits it can provide. It is very important to determine this since the quality of the protein refers to the availability of amino acids that it supplies, whereas the digestibility considers how the protein is best utilised in the body. Therefore, in 1989, the Food and Agriculture Organisation (FAO) along with the World Health Organisation (WHO) in a joint statement recommended utilising the protein digestibility corrected amino acid score (PDCAAS) to determine the quality and digestibility of a protein.6
Anti nutritional factors such as trypsin inhibitors, lectins, and tannins may be present in some protein sources, such as soybean meal, peas, etc., and may cause reduced protein hydrolysis and amino acid absorption.⁶ These factors may be compounded by age, since the ability of the gut to adapt to environmental and dietary insults reduces as we age.6
The PDCAAS score for whey protein is the highest at 1.0 compared to other common protein sources, due to their high content of essential and branched chain amino acids.7 Soy protein isolate is also considered a high-quality protein source (containing all nine essential amino acids) and contains a PDCAAS score of 1.0.7 Pea protein concentrate has a PDCAAS score of 0.89 because it contains lower levels of the sulfur-containing amino acids cysteine and methionine.7
Whey proteins one of the most widely used protein sources for supplementation. Whey protein contains a high amount of the amino acid cysteine. Cysteine has been shown to enhance glutathione levels and has strong antioxidant properties that are capable of helping to prevent damage to important cellular components in the body.6 It also contains a high concentration of branched chain amino acids (BCAA). BCAAs are important for their role in the prevention of muscle breakdown during exercise and tissue maintenance.6
There are different forms of whey protein: Whey Protein Concentrate (WPC) and Whey Protein Isolate (WPI).
WPC is about 80% protein and is created by removing water, lactose, and some minerals. WPI on the other hand contain protein concentrations of 90% or higher since there is significant removal of fat and lactose making it the purest form of protein.6 Unfortunately, the manufacturing process often leads to some proteins breaking down and becoming denatured, reducing the effectiveness of the protein.6 Therefore, even though WPI contains higher protein concentrations than WPC, whey protein concentrate contains more biologically active components. People who are lactose intolerant are able to utilise WPI more readily without experiencing many negative side effects.
Both WPC and WPI can be further hydrolysed. Protein hydrolysates contain di- and tripeptides and therefore can be easily absorbed.
Soy protein contains beneficial phytonutrients such as phytosterols, saponins, and isoflavones. These nutrients have been associated with positive cardiovascular benefits, menopausal symptoms, and osteoporosis.6
Soy protein can also be found in various forms: soy protein concentrate and soy protein isolate. Concentrates have some fat and carbohydrate removed, providing about 70% protein content.6 They have a high digestibility and are usually found in nutrition bars, cereals, and yogurts. Isolates are further refined, lacking dietary fibre but provide 90% protein content.6 They are easily digestible and can be found in protein supplements and infant formulas.
Pea/rice protein blend is recommended if you have a milk protein allergy/sensitivity, are avoiding soy products, or consume a vegetarian diet. Including a pea/rice blend protein powder is an alternative to whey protein, has a high PDCAAS score, and provides all nine essential amino acids.
Pea protein also contains a variety of phytonutrients such as polyphenolics, which may have antioxidant activity; saponins; and galactose oligosaccharides, which may demonstrate beneficial prebiotic effects in the large intestine.8
Whether you are using these supplements as a meal enhancer, snack, or a post workout drink, adding a high-quality protein supplement will help meet your daily protein needs. Metagenics provides a variety of protein options; work with your healthcare provider to figure out the amount and type of protein you need for optimal health.
About Nilima Desai
MPH, RD, Metagenics Manager, & Medical Marketing Nilima Desai is a Registered Dietitian who received her undergraduate degree from California State University Long Beach in Nutrition and Dietetics and her Master’s in Public Health Nutrition from Loma Linda University. She has over 14 years of experience providing medical nutrition therapy in diabetes, renal disease, weight management, and vegetarian nutrition. She also served on the board of the Renal Practice Group of the Academy of Nutrition and Dietetics from 2012-2016 as the Membership Chair. Her passion about living and teaching a healthy lifestyle led her to collaborate with a nephrologist on creating the Pocket Dietitian app, which offers the user personalized, easy-to-use dietary prescription on conditions such as diabetes, hypertension, renal disease, weight management, etc. In her free time she runs half marathons and shuttles her two kids to their activities.