Category Archives: q&a

Q&A: Keto diet

Q: Is the ketogenic diet safe? Does it work?

A: Thank you as always for the question. I always enjoy responding to reader questions.

The ketogenic is a popular low carb diet right now. Different from Atkins or South Beach diet, the keto diet focuses on high fat, moderate protein, and very low carbs. The diet has been used for years in neurological settings, helping with uncontrollable seizures.

The idea behind the diet is a bit complicated, but, similar to intermittent fasting, focuses on burning fat and lowering insulin. Our body wants carbs for energy. When we don’t consume them or have anymore stored, the body will break down fats into products called ketones (the source of the name ketogenic). The body then uses these ketones somewhat like carbohydrates. (This is an oversimplification, but works for our purposes). Since the body is burning fat (consumed and stored), insulin isn’t triggered.

There are some risks with this diet, like any.

-It could be lacking in vitamins and minerals. Over a very short term period, this isn’t as concerning as in the long term. Fruits and vegetables are often the most diverse sorts of micronutrients in our diets, so restricting these as strictly as many keto diets recommend could be dangerous.

-If you have liver or kidney problems, a diet very high in fat could exacerbate these problems and would not be recommended.

-This diet is low in fiber. The benefits of fullness seem to be covered by the full feeling provided by fatty foods. But you could become constipated.

-High ketones in the blood can alter neurological functions. This can be good in the case of epilepsy, and possibly Alzheimer’s and Parkinson’s (there is promising research here). But for normal, healthy adults, it could lead to difficulties in memory and fuzzy thinking.

-Risks for heart health and diabetes. The keto diet is often very high in saturated fat. Some studies have even shown increases in LDL or bad cholesterol with heart health. Experts have mixed thoughts on diabetes. Very low carb diets are not recommended for those with diabetes. And people with diabetes are at increased risk of heart disease, so our previous discussion on saturated fat applies. However, some carb restriction could lead to lowered insulin. Just likely not as low as keto diets recommend.

There are not enough long term studies yet to know if the keto diet is safe and effective in the long term. Short term studies do show it is very effective at weight loss.

Personally, I would not recommend this. I doubt it is sustainable in the long term, and question it would be healthy to do so. A more mild approach would likely be fine.

Hope that helps!

Do you have a question? Comment here, on Facebook, or email me at kimberlykmarsh(at)gmail(dot)com.

Sources: Harvard Health, US News, Cleveland Clinic

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Q&A: Intermittent fasting

Q: Many people I know are using “intermittent fasting” to lose weight. Is it effective? Are there health benefits? Should I try it?

A: Thank you for your questions as always. I actually have a few family members who follow an intermittent fasting “diet”, so I was very interested to research some more about this.

Intermittent fasting is followed in various forms by different people. The basics are that you limit your eating to a set number of hours per day. Most people it seems go with an 8-10 hour period, but I’ve heard of some restrict it down to only 2 hours per day.

What results are we seeing in scientific studies? Studies have shown that people have as good weight loss as just restricting their overall intake without a time restriction. But studies also indicate there may be benefits in relation to blood glucose and fat levels, which is good news for those at risk of diabetes and heart disease.

Why? This article from Harvard Health goes in much greater detail if you are interested. But in short, when we eat carbohydrates, one of two things can happen. First, those carbs are used for energy, which requires insulin (insulin levels are high). Second, they can be stored as fat. In between meals, when the body needs carbs but there aren’t any available (insulin is LOW), the body breaks down the fat for energy. This is good. We want the body to do this. But if we are CONSTANTLY eating, insulin levels stay high and we never break down that fat. Also, constantly overload of insulin can lead to our body not responding well to insulin, which can lead to diabetes.

But isn’t fasting hard? For some people, it can be. The Harvard article mentions some research that shows putting your eating period earlier in the day makes it easier rather than later (so 7 am-3 pm vs 12 pm – 8 pm). I think the timing of your fasting period is likely to be very individualized based on your preference and schedule. If you already aren’t a morning eater, don’t start just because of fasting.

Don’t want to fast? Me either. But there are some good take aways for EVERYONE, even if you aren’t intermittent fasting.

-Stop eating ALL the time. Allow insulin levels drop and you can burn some fat.

-“Hunger” in and of itself isn’t a horrible thing. Letting it get out of control so you eat out of control can be bad, but a little bit of hunger between meals is ok.

-Don’t eat late at night. This is likely to be just junk foods and shortens the periods of low insulin levels at night.

-Find what works for you. Fasters need to find the 8 hours that work best for them. Find what “schedule” of eating works best for you, be it 1, 2, or 3 meals a day. There is not a generic diet that will be perfect for everyone. You have to make it work for you!

Hope that helps!

Send questions to kimberlykmarsh(at)gmail(dot)com.

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Q&A: Ketogenic Diet

Q: Is the ketogenic diet helpful for brain health, remembering, clear thinking, etc?

A: Thank you as always for questions. I love hearing what nutrition topics are concerning everyone. With so much in the media, it is very hard to know what “real” people are focusing on.

The ketogenic diet is a high fat, low carbohydrate diet. Our body actually wants some level of carbohydrates for energy. Some organs, such as the brain, actually greatly prefer carbs to fats. If there are not enough carbohydrates, the body will burn fat and produce something called ketones. The brain can then use these ketones as a source for energy.

The ketogenic diet has been part of the treatment for epilepsy for many years. There are proven benefits for people whose epilepsy is not controlled well with medication alone. However, the diet needs to be closely monitored by a dietitian to ensure overall nutrient adequacy.

The ketogenic diet most people using it under generally “healthy” circumstances is really just another low carb diet like Atkins or South Beach. There are no proven benefits for weight loss or mental health or clarity. Many people do succeed with weight loss, but as with most diets, it is not sustainable when they go back to their traditional eating pattern.

Sorry this won’t give you the memory recall you hoped! Thanks again for the question.

Don’t forget you can always ask questions in the comments here or email me at kimberlykmarshgmail.com!

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What’s the deal with eggs?

Q: I just read this article about nutrition and eggs. While I don’t particularly like eating eggs, it was intriguing to me. What are your thoughts on the incredible, edible egg?

A: This was a very interesting article. Thanks for sharing it with me.

On the whole, I think there is enough research out there that shows one egg per day is safe for MOST people. There are hyper-responders, as mentioned in the article, who may need to be more cautious. Eggs are a great source of protein. And they are generally a “filling” breakfast, which can be helpful for those trying to limit calorie intake.

I think this article points out something critical about almost all nutrition recommendations/advice. Very little in nutrition is black and white. Consumers are always looking for “eat this, not that” advice. But it isn’t that simple. There are better choices, but it always depends on what you are comparing it too.

I really like the quote from Dr. Willett at the end. “In terms of health, they {eggs} seem to be in the middle somewhere.”

So, enjoy your eggs occasionally. But that doesn’t mean you need to eat only eggs for breakfast forever.

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Q&A: Sources of Omega-3’s

Q: Is it okay to take a flaxseed oil pill and a fish oil pill (omega 3 fatty acid) both at the same time? Or is one a better supplement than the other?

A: Great question!

We need to first talk about fats. There are 3 kinds of fats for our discussion: saturated, monounsaturated, and polyunsaturated.

Saturated fats: Generally bad for our health, we want to limit these kind. They are found generally in animal products and solid fats, like butter, whole milk, meat.

Monounsaturated fats: Generally good for our health. They are found in olive oil and avocados, among other foods.

Polyunsaturated fats: There are several kinds of polyunsaturated fats. These are generally good for our health as well, but we want to have the right “mix”. In our diets, we mainly talk about omega-6 and omega-3 fatty acids. As Americans, we eat too much omega-6 fats, which are found in vegetable oils. Omega-3 fatty acids also have several types, including ALA, DHA, and EPA. These are also found in some vegetable oils and fish.

Now, how much do we need to eat each day?

Saturated fat intake should be kept to less than 7-10% of calories. For an 1800-200 calorie diet, that would be 14-22 gm per day.

There aren’t specific recommendations for monounsaturated and polyunsaturated fat intake. However, total fat intake should be 25-35% of calories. If you account for saturated fat intake as above, that leaves 15-25% of calories for unsaturated fats.

The World Health Organization has recommend some daily amounts of omega-3’s. They recommend 0.3-0.5 grams of EPA and DHA and 0.8-1.1 grams of ALA daily for general health. For specific conditions, you can read more information here.

With all that information, back to the original question.

First, it is probably fine to take both supplements at the same time. However, I don’t know that it is entirely necessary. I’d compare the amounts in each one with the above recommendations.

I might say the fish oil is better DEPENDING on the composition. Flaxseed oil is high in ALA, but not EPA and DHA. Fish oil should have EPA and DHA as well as ALA. To truly compare them, I’d look at the labels and see the total amount of omega-3’s and types in each one.

AND, I would feel remiss if I didn’t say you don’t HAVE to take a supplement. The American Heart Association recommends eating fatty fish at least twice weekly as well as other food sources of omega-3’s, such as tofu, walnuts, and canola oil.

Hope that helps!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Q&A: Leg Cramps

Q: I’m pregnant and have been waking up every night with horrible leg cramps. My researching online says I maybe need more magnesium. Do you have any suggestions how to work this into my diet?

A: Ouch! That is no fun. I had leg cramps with my second pregnancy, and I can remember how much those hurt.

The hard fact is that no one 100% knows why leg cramps happen, because there are lots of things that can lead up to them. Here are four common nutrients that are suggested or that I have seen be helpful. The good news is that many of these are found in the same foods (another reason it can be hard to identify exactly the cause/solution). Also good news, the same answers apply to pregnancy leg cramps or non-pregnancy related leg cramps.

1) Magnesium. As your researching suggests, magnesium is commonly recommended for leg cramps. In general, good sources are nuts, dark leafy greens (like spinach), and whole grains.

2) Potassium. Potassium rich foods are bananas, citrus fruits/juices, potatoes, tomatoes, yogurt, and dark leafy greens.

3) Calcium. Calcium rich foods are dairy products, dark leafy greens, and broccoli.

All three of these nutrients are part of normal muscle function. If one is depleted, it can cause cramps. Since all three work together, it can be hard to know exactly which one is missing, unless you are on a specific medication that we know depletes that nutrient.

4) Water. Water requirements in pregnancy can be hard to determine. You need a lot. Most say at least 8-10 cups a day, others will say up to 16 cups. I personally found that if I was better hydrated, my leg cramps went away. It’s hard, because we tend to not drink water late in the day so we aren’t up in the night using the bathroom. But I’d rather have to go to the bathroom than be up in pain.

Good luck! Hope this helps!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Q&A: Superfoods

Q: What is a superfood? I hear about them all the time. Is this a real thing or an advertising gimmick?

A: Thanks so much for the question. The idea of superfoods can be a bit confusing. Let me try to shed some light on the subject.

The term superfood is a marketing term, NOT a scientific term with a set definition. Health professionals generally will not advocate eating large quantities of any one superfood to help with a specific condition. So, to a certain extent, it is just an advertising gimmick.

HOWEVER, to my knowledge, no food with claims of being a superfood is bad for you. They are generally fruits, vegetables, or other items high in vitamins, antioxidants, or omega-3s. None of those things are bad, and in fact, I would generally recommend consuming these in greater quantities than we do now.

The catch is in focusing on one particular food. When claims are made of a “superfood” benefit, it is based on eating A LOT of that item (and may not have much science to back that up). When there is any evidence, these claims don’t always translate well into a normal diet.

The best advice – DO consume superfoods, but consume a variety in healthy quantities.

I hope that helps. Thanks for the question!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Q&A: Infertility and Nutrition

Q: I’m wondering if you have any nutrition tips for fertility/pregnancy. I’m struggling with infertility, and I’ve seen a lot of sites online with nutrition advice. Are there any fertility “super foods” I should consider adding to my diet? Or anything I should avoid, other than the usual culprits of sugary, fatty foods?

A: First, let me say I’m very sorry you are having this challenge in your life. I know it can be very taxing both physically and emotionally.

The general consensus I found on several nutrition and pregnancy expert sites don’t really suggest any super foods. A Mediterranean style diet – high in monounsaturated fats, fish, plant based proteins, whole grains, fruits, and vegetables – is the most commonly suggested diet. Avocado and olive oil would be two of the more common sources of monounsaturated fats. Beans and grains are good sources of plant proteins.

The biggest departure from normal nutrition advice is that one Harvard study found women who consumed high fat dairy had decreased risk of infertility. So, if you wanted to swap your skim milk for some 2% or even whole, it might help. The best results were seen for women with ovulatory infertility, although some benefit was seen for all sources.

I hope this was helpful and wish you the best!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Q&A: Food Dyes

Question:  What’s the big deal about food dyes?  Are food dyes really bad for you?  What is the harm in eating them?

Answer:  Thanks for the question.  Food dyes have been a hot topic in recent years, and it can be hard to sort fact from fiction.  As I mentioned recently, General Mills is removing food dyes from their cereal products (read more here).

I think it is important to remember that any food dyes used in our food products have been approved for use by the FDA.  There are regulations for how to use these additives as well.

However, some suggest that food dyes pose risks for increasing hyperactivity in children, cancer, and allergies.  Are these concerns based in science?  Let’s look at each risk individually.

There is some research that shows that consumption of artificial food colors can increase behavioral problems in sensitive children.  It was originally thought children with ADHD would be sensitive, but other children may also show a sensitivity.  The responses seem to be very individual however, so general conclusions cannot be made for any large popluation group.

Artificial food dyes have been linked with cancer in animal studies only.  If there was strong evidence of a link, these ingredients would not be approved for use in our food supply.

A few people do exhibit allergic reactions to food dyes.  This is why it is mandated that these ingredients are labeled on all food products.  An ingredient being an allergen is not a reason to eliminate it from the food supply.  Much larger groups of people are allergic to gluten, milk, or peanuts, for example.  However, there are still food products containing these ingredients; the labels clearly indicate the contents to help those people.

There are strong movements in Europe and Great Britain to remove artificial food colors and replace them with natural based dyes.  There are petitions to the FDA and food companies about food dyes that you can join, should you desire.  Here is a link to one trying to remove them from M&M’s:  https://www.change.org/p/m-m-s-candies-stop-using-artificial-dyes-linked-to-hyperactivity

Personally, I don’t see any evidence that they need to be removed from the food supply entirely.  As I said in my previous post about the cereals, if you are focusing on a diet of whole foods, you won’t be consuming excess amounts of these ingredients.  If you do feel that you or your child has adverse reactions, try an eliminating them from your diet.  If you see improvements, great.  If not, you don’t need to stress about it.  But I don’t think the evidence is strong enough or effecting a large enough group at this point that they need to be eliminated entirely.

Hope that helps and thanks for the question!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Q&A: Holiday Eating

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Q: During the holidays, I eat at other people’s homes frequently. How do I eat healthy and control my weight when I am not planning the menu?

A: Great question! The holidays are often a difficult time for making healthy choices. Treats are everywhere, and big meals become the norm. Here are a few tips for eating healthy when you are eating at someone else’s home.

-Make sure your other meals are very healthy. If you know you are eating at a party for dinner, make sure you eat extra fruits and veggies at breakfast and lunch. Then your daily total will still be adequate.

-Eat light at other meals to balance overall intake. However, make sure you aren’t making yourself go hungry. Excessive hunger will just lead to overeating.

-Try and focus on any healthy dishes that are available.

-If you can, stick to one plateful. If this will leave a bad impression with your hostess, take a second helping before you finish your first. I know that seems strange. But, if you add just a little bit of a second helping to what remains of your first, your plate will look more full and you will eat less food.

-Spread food out on your plate. Avoid tall mounds of potatoes. By making food a thinner layer, it looks like your plate is full when you have less food on it.

-If the event is potluck, bring something healthy yourself.

-If you are hosting a holiday event, try to focus on health when planning your menu. Make it easier for others to keep their goals. If we all try to help each other out, everyone’s holiday eating will be healthier.

I hope that helps. The most important thing to remember is that a little splurging here and there in the holidays isn’t horrible. But being conscious of your choices and trying to minimize the splurges will make for healthier and happier holiday season.

Happy holidays and holiday eating!

Also, I just found a new online resource for healthy recipes. Check it out: https://aloha.com/shop/recipes/

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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