Ketogenic diets

Ketogenic diets have some benefits over others, particularly for the obese, as they address satiety where so many of the rest usually fail; you won't be constantly famished.

Those of you who follow this site with any regularity will know that I am dismissive of dieting in general; researchers evaluating the whole gamut found that a year later only five-percent of folk had lost a significant amount of weight, and around a half had actually added pounds.

Allow plenty of time to peruse this page on ketogenic diets; this is not one to be rushed. There is much to ponder; it could completely change your life. Rather come back to it later than try to skim it in five minutes.


"There is little support for the notion that diets lead to lasting weight-loss or health benefits.

We concluded most would have been better off not going on them at all."

- Prof Traci Mann, U of Minn, Health and Eating lab[1]


If it is not sustainable don't even bother starting; a complete waste of time and effort. Can you give up bread for ever, do you really need to, and is there an alternative? Yes, there is.

Stop counting calories; it's a complete waste of time.

Is there such a thing as a plan that does not restrict calories? Yes, there is.


There is one interesting proviso though. Most of this work was done on caloric-restriction diets. They leave us constantly famished, with hormonal signals to the brain chanting "eat, feed and snack."


Ketogenic

Those that push us towards ketosis by profoundly restricting all carbs, but increasing energy-dense foods do succeed. More fats and protein are what we need but where should they come from?

Then the body burns fat and protein for energy; gout is a potential side-effect if it all comes from meat.

This is profoundly good for diabetics as blood-glucose drops, often dramatically. Medication must be reduced immediately and so ketogenic diets should only be followed under the direction of your doctor, or you could go into a coma. Insulin is often halved within days.

This means restricting all starches, both whole-grains, legumes and refined carbohydrate; the good, the bad and the ugly.

And cutting out not only sugar, but legumes too because of their starch-content.

Yes but only for a season, whole grains and legumes must also be severely limited; they are both profoundly important in the bigger picture. Sugar and refined carbs must go for ever; they are what are literally killing us.

Fats are encouraged, particularly those of animal-origin; butter, cream, and that from meat. Blood cholesterol may rise, sometimes dramatically.

banting

Banting was first used by the celebrated medical doctor William Harvey when he treated a "morbidly obese" London undertaker.

His name was William Banting.

Carbohydrate was banned, and William Banting lost so much weight that Harvey reportedly did not recognise him when he returned for a follow-up consultation six months later.

There are three-levels of banting; less than 50g, 20g and 2g of carbohydrate per day. The latter is extremely difficult and only for epileptic children who respond to no medical treatment.

Eating less than 20g of carb is difficult for those used to enjoying bread, rice and legumes like green-peas; and colas and cookies too. It is for unstable diabetics who are not responding well to conventional medical treatment.

Less than 50g of starch per day is also difficult but a very effective way for the obese like William Banting to lose a lot of weight.

Billy Tosh lost an enormous amount of weight by banting. With thanks to the Nutrition Network.

Banting too is a high-fat meal plan; they have now acknowledged that they over-promoted cream and bacon dripping for example, looking currently rather to increased protein as in the Atkins diet.

Since the proponents of banting still gainsay legumes and whole grains, because of their carbohydrate content, both strongly associated with greater well-being, there are concerns whether this is a sensible way to lose weight.

Paleo

The Paleo diet recommends that we follow meal plans using foods from the era beginning about two and a half million years ago; before grains and legumes were readily available. Rather, it makes more sense proponents say genetically that we should be following the ways of the hunter-gatherers; meat, fish and vegetables. They would also have eaten nuts and seeds if and when they were available.

Paleo is an effective way of losing weight but scientists have the same concerns about the absence of whole-grains and legumes. Too much protein is being obtained from meat.

Whilst the WHO is recommending that we limit red meat, being probably a cause of neoplasms, Stone-Age man would not have eaten that from a feedlot or sty as we have to.

It is incredibly difficult to find the wholesome, pasture-fed red meat and whole grains that early man readily had access to.


"Eat less saturated fat: that has been the take-home message from the U.S. government for the past 30 years. But while Americans have dutifully reduced the percentage of daily calories from dripping, cream and eggs since 1970, the obesity rate during that time has more than doubled, diabetes has tripled, and heart disease is still the country’s biggest killer."

- Scientific American


Prevalence of diabetes in the U.S. showing the 20-year rule.

Notice the twenty-year rule; the onset of the massive diabetes spike two decades after changing from fat to a diet high in refined carbohydrate and sugar.

1977 was when the McGovern select-committee guidelines were promulgated.

Atkins diet

The much vilified Atkins, going back some 50-years, is another of the more successful ketogenic diets. The theme tune remains essentially the same; strictly limit carbs like potatoes and bread, enjoy plenty of protein and don't be anxious about saturated animal-fat.

Despite the contempt of the medical fraternity, researchers have now vindicated Dr Robert Atkins' belief that animal-fat does not raise blood cholesterol; it is the glucose from starches that the liver turns into triglycerides which are public enemy number-one.

Fats and protein provide the satiety, that feeling of fullness, that we all crave; no need to snack at 11 o'clock.


"Do not eat any refined-carbs, period."

Dr Atkins


Flexitarian diet

The Flexitarian diet is basically that of a vegetarian with occasional days when you might enjoy meat, fish or fowl. How often is not defined; it's up to you. Since whole grains and legumes are not restricted the carbohydrate content of meals would not be very low, and followers would probably not go into ketosis.

Nevertheless those following the Flexitarian way of eating are less likely to be enjoying refined carbohydrates, mitigating against obesity and type 2 diabetes. It is nutritionally-sound and effective way for the obese to consider. Weight loss is likely to be slow but sure, rather than dramatic.

How would a typical omnivore become a flexitarian? Simply by cutting out meat one or two days a week, and replacing it with legumes such as peas, beans and lentils.


"When we eat, we are literally constructing our bodies, so it is crucial to focus more on what you include in your diet to help build your body, rather than on what you restrict."

- Dr Casey Means


Lectin-free diet

Lectins are proteins found in legumes and whole grains especially but in all plant foods too; they link to carbohydrates and lessen the absorption of minerals. For this reason they are termed anti-nutrients.

Since a lectin-free diet would dramatically lower legumes and grains, they reduce carbohydrate consumption and increase animal-protein. Whilst the aim would be different it ends up being not dissimilar to the Atkins diet.

Lectin-free is effective but not considered a healthy way to lose weight since it limits vegetables, legumes and whole grains; nuts and seeds too. There is a mountain of research indicating these are all nutritious, good foods.

Popular guru of this way of eating, Dr Steven Gundry, describes the toxic-effect of lectins on our wellness, but then totally ruins his case by saying we can eat all these foods provided we purchase his supplement.

Cholesterol and carbs

No question of it, the obesity pandemic in the US began after Ancel Keys propounded his theory that cholesterol was the cause of heart-disease. Follow up studies have however found that he doctored the figures by selecting only those countries where this appeared to be the case, and striking out those that countered his thesis.

Banerjee et al have in fact proved quite the contrary; saturated-fat from our food is actually associated with lower overall mortality[2].

Following up on Keys' misplaced theory, the McGovern dietary guidelines then advised Americans to raise their carbohydrate consumption (in practice this turned out to be increased refined starch) and lower foods like eggs that are rich in cholesterol.

Within twenty-years Americans started becoming morbidly obese and diabetes spiked, and continues to do so.

Ketogenic diets go entirely counter to this, strictly lowering carbohydrates and again allowing foods rich in cholesterol.


"Although the subjects on the low-carb diet ate the most saturated fat, they ended up with the healthiest ratio of HDL to LDL cholesterol and lost twice as much weight as their low-fat-eating counterparts."

- New England Journal of Medicine


TG/HDL ratio

Lind et al found that those with the highest TG/HDL ratio were significantly more insulin-resistant and had an increased risk of coronary heart disease[3].

Glucose absorbed from the starches we eat, and especially those that are highly-refined, is processed by the liver and turned into triglycerides(TG).

Those on one of the ketogenic diets that restrict starches will lower the TG/HDL ratio lessening the risk of coronary heart disease.

Why exercise helps so little

Researchers have finally got it figured out why exercise contributes so little to weight loss in the obese; the basal energy expenditure drops by a massive half.

As we exercise all those those basal matters like digestion and even thinking drop so half the calories burned by our muscles are compensated for. Distressingly the more obese we are the less going walking or swimming contributes to weight loss.

Weight loss research explains some of these issues.


When browsing use right click and "Open Link in New Tab", or you may get a bad gateway signal.


  1. Dieting does not work
  2. The Diet-Heart Hypothesis: Changing Perspectives. Perspectives In Medical Research, 2018. 6(2): p. 4-11.
  3. Can the Plasma Concentration Ratio of Triglyceride/High-Density Lipoprotein Cholesterol Identify Individuals at High Risk of Cardiovascular Disease During 40-Year Follow-Up? Metabolic syndrome and related disorders, 2018. 16(8): p. 433-439.
  4. A Systematic Review of Supplements and Alternative Therapies for Weight Loss. Web: https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.23110
  5. Plant-based and pescatarian diets and COVID-19 severity
  6. Lignans and breast tumours
  7. Energy compensation and adiposity in human

Crazy about food? Bernie's no-diet plan.

Having meandered through this page you will know that Bernie (me) is dismissive of all diets; a dirty 4-letter word that never delivers on its promises. They simply don't work for the majority and leave us famished, depressed and angry.

There is no getting round it though; if you continue consuming foods high in refined carbs you will never win. You cannot drink colas and eat chocolate-cake and lose weight.

Refined carbs have to go for ever, or at least be kept for high and holy days only. This is where the ketogenic diets win. And don't ever start the shakes; just eat more protein, preferably from legumes. This authentic hummus recipe is our favourite; make it in only five minutes.

  1. Eat plenty of foods that satiate; give us that feeling of fullness.
  2. Enjoy your protein, but do emphasise the legumes like green beans, chickpeas and lentils despite their carbohydrate.
  3. Don't be afraid of fat but go light on the polyunsaturates; they are inflammatory and will give you pain in your joints and muscles. I love those from fruits, the olive and avocado, in particular, and am partial to butter and coconut-cream.
  4. Eat as many coloured-foods as you can; I aim for about ten a day, and even a sprig of parsley counts.
  5. Enjoy plenty of salads and fruit, but limit the load of those with a high glycemic-index; could you make a nutritious smoothie for two with just a quarter of banana and one teaspoon of natural honey?
  6. Don't be fearful of butternut and sweet-potatoes, but eat only sourdough bread and new spuds. Consider baking your own loaf.
  7. Take a short walk after a starchy-meal; it won't help much with the pounds and ounces but it does contribute greatly to lowering blood glucose and improving muscle tone.

More protein

Enjoy more protein, from meat unless you are a vegetarian, grean-beans of various kinds and eggs; we make and eat hummus daily too.

Butternut chicken curry with coconut cream.
Eggs Hilton poaching.
Mutton neck from lamb.
Authentic hummus recipe.
Grean beans and tomato salad.
Broad beans in their pods.

Fats

A moderate increase in fat helps to dispel hunger pangs, but get as much as possible from olive oil and avocados. Despite the cholesterol we are not anxious about butter and coconut-cream.

Butter is back and after all should never have been sent to Coventry.

Olives and the oil.
Fuerte and Hass avocados.
Butter makes you fat; or does it?

Salads

With a little imagination salads are delicious; and supply us with the many phytochemicals that are absolutely vital for our well-being.

Summer salads have plenty of vitamin C.
A divine green salad with hummus.
Cauliflower salad lunch plate.

Fruit

Enjoy as many different whole fruits as you can, especially berries and lemons. Limit the load of those with a high glycemic-index; like grapes for example. We have smoothies several times a week. 

Absolutely eschew fruit juices like OJ from a carton. It's a very high-carb junk food.

Lemons and limes.
Purple power of mulberries.
Nutritious green smoothie.

Starches

Commercial loaves all use refined flour. It takes only five-minutes to prepare the sourdough for your own artisan bread every day.

New potatoes have far less starch than those from cold-storage but are very difficult to locate. So we grow our own.

Growing butternut squash is very easy if you have a large garden; we had an astonishing harvest of 150 this year.

Bread machine loaf.
New potatoes.
Butternut grown in compost.

Carbs

There were only two things that were difficult and required some real will-power. Giving up sugar for ever and finding a source of natural honey. That meant for us keeping our own bees.

And giving up all refined flour; that meant kissing commercial bread, cookies and cakes goodbye and, instead, buying a mill, grinding our own flour and baking sourdough. Understanding net carbs was a big step forwards.

For five-minutes work you can bake a loaf of the best-tasting bread in the world for less than half a dollar; rich in fibre, lignans and vitamin E. Prior to the milling of flour heart disease was almost unknown.

Lignans help prevent breast tumours[6]; a must for every woman.

True wholemeal from a Hawo mill.
First fruits of honey.
Creaming honey.

No shortcuts

Various supplement are purported from "clinical trials" to be effective in reducing weight. Researchers reporting in the journal Obesity[4],  state that there was very little high-quality evidence supporting any of these claims. The industry is valued at over 6 billion dollars in 2020 in the US alone. Only 16 studies out of hundreds demonstrated significant results.

Exercise for weight loss

Exercise is beneficial in every way, bar one. It simply does not help significantly with weight loss. Researchers reporting in Current Biology[7] reporting on data from 360 studies collected over three decades found that increasing daily physical activity just does not translate into more calories burned.

Energy expenditure they found comes in two types.

  1. That which relates to activity (AEE).
  2. That which they called basal energy expenditure (BEE).

What they found is that the body compensates for increased energy expenditure from activity by decreasing BEE up to 28% for an average person. In other words, only 72pc of the extra calories burned actually translate into weight loss.

But here's the stickler; for the obese this compensation increases to 50%; only half the calories burned by exercise translates into weight loss. The body reduces its basal metabolic rate making it very difficult for those with a BMI of over 30 to lose adipose tissue by increasing their physical activity.

Professor Dugas cautions though that we should not write off the benefits of more exercise; it correlates strongly with better cardiovascular health and quality of life, but it does not contribute nearly as much as expected to weight loss.

In short the battle with obesity is won primarily at the dining-room table and not from pounding down the streets. Once again two factors stand out clearly in this struggle.

  1. Strongly cut out refined carbohydrates.
  2. Enjoy plenty of those foods that contribute to satiety as promoted by the ketogenic diets.

Then, and only then will exercise for weight loss become meaningful.



"Changing your lifestyle is the only way to manage your weight."

- Sharon Zarabi, director at Katz Institute for Women's Well-being.


Ketogenic diets

Ketogenic diets are in the main about restricting carbs; it's a massive lifestyle change. Add to that a short walk after any starchy meal and you are home and dry.

Covid-19 severity

Throwing a cat amongst the pigeons is new research published in BMJ Nutrition[5] who followed a large group of healthcare workers from six countries; it showed that those following a plant-based diet had a 73% lower odds of moderate to severe Covid-19 severity.

And those on a low carbohydrate, high-protein diet had greater odds of moderate to severe Covid-19.

Only the Flexitarian diet which is low in animal protein would qualify amongst the Ketogenic diets as promoting a lower likelihood of succumbing to Covid-19.


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