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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