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June 2012
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What's in a name?

By DAVID ZOELLER dzoeller@paducahsun.com

igh-fat, low-carb diets promoting weight loss have been around for years, with names like Atkins and South Beach.

Joining the low-carb craze more recently is the ketogenic diet, although its origins date back further.

"The ketogenic diet actually has been around since the 1920s," according to Renee Waggoner, clinical dietician at Lourdes. "They used it (and still do) a lot of times for kids with epilepsy. They found that instead of your brain using sugar (carbohydrate glucose), they use ketones (fat) and it changes the way their brain works. They tend not to have either as many seizures, or not as bad."

According to WebMD, the idea is to get more calories from protein and fat and fewer from carbohydrates, particularly the ones easy to digest like sugar, soda, pastries and white bread. By reducing the number of carbohydrates, the body is forced to burn fat for energy, a process called ketosis.

"You do lose weight very quickly because it takes more energy to burn fat than it does carbohydrates," Waggoner said. "So even though fat has more calories, you're expending more energy ... it makes a difference that way."

A strict ketogenic diet can be hard to follow.

"A true ketogenic diet calls for eating four times as much fat as you do carbohydrates," Waggoner said. "Could you imagine giving kids balls of butter rolled in unsweetened Koolaid for flavor? Or drinking whipping cream? That's kind of what a true ketogenic diet is."

While today's versions of the high-fat, low-carb diets have been modified so as not to be so strict, sustaining them over a period of time remains a challenge.

"You know most of the time, even with Atkins, South Beach or ketogenic, after a while people get tired of it," Waggoner said. "It gets pretty boring eating meat and the right kind of fat. It sounds wonderful -- 'oh, I can have all the fat that I want' -- but it has to be the right kind of fat. You can't eat a pound of bacon even though you want to. That's not the right kind of fat.

"And, for some people it's hard to give up bread, it's hard to give up potatoes."

The "right kind" is eating more polyunsaturated or monounsaturated fats, which are more nutritious and also offer protective benefits that might reduce the risk of certain illnesses and diseases.

"You're doing more of your polyunsaturated and monounsaturated, so olive oil, peanut oil, canola oil, sunflower oil, those type of things," she said.

"With a true weight-loss, ketogenic diet, you're doing about 30 grams of carbohydrates, and one gram per kilogram of body weight of protein. So, if you're about 150 pounds that would make you about 70 kilos. That tells you get about 70 grams of protein per day," Waggoner said.

"That sounds like a lot, but that's only about 10 ounces of protein. If you go to Doe's, you're going to get a bigger than 10-ounce steak just for one meal. So that's showing you it's not as high protein as a lot of people think," she said.

"And then you're doing 80 percent of your fat from poly-or monounsaturated fat, then 20 percent from saturated which you would get from your protein, your lean meats, things like that. If you have eggs or cheese ... you get saturated fat in that."

What you're not eating, according to Waggoner, is a lot of butter or a lot of steaks with fat on them.

"You're eating your leaner meats, eating T-bones and porterhouses, chicken and a fatty fish like salmon, said Waggoner.

"If you stop and think about it, all those things like fatty fish and lean meats ... those are healthy anyway."

A ketogenic diet could be beneficial, for instance, for someone with a body mass index of 35 or over, to get their weight-loss "jump-started," Waggoner said, "if they don't have any other health issues like diabetes. Anyone with Type 1 diabetes needs to stay away from this diet."

Waggoner urges people considering the ketogenic diet to discuss the matter with their doctor. And, regardless of which diet you choose, remember to follow some simple rules.

"You need to learn good habits, watch portions, eat more fruits and vegetables, less starches and get moderate exercise," she said.

"Just be smart."

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