Tag 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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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: 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: Diet during Cancer Treatment

Q:  What do you know about ketogenic and/or paleo diets? My sister is going that route during her cancer treatments. Any advice or recipes?

A:  Thanks for the great question.  I faced questions similar to this when I was working with cancer patients in the hospital.

First, ketogenic and paleo diets are two separate things, but they are related.  The simplest way to compare them is a ketogenic diet is an extreme form of the paleo diet.  But it goes a little deeper than that.

I previously reviewed the paleo diet for general health and weight loss here.  A paleo diet is a type of low-carb diet, focusing on meat, fish, fruits, vegetables, eggs, and plant-based oils.  You avoid grains, potatoes, legumes, salt, and refined or processed foods.

A ketogenic is more specific than just a low carbohydrate diet.  It is a very low carbohydrate diet that is high in fat and moderate in protein.  Compared to the typical paleo diet, it would be higher in fat and lower in carbohydrates and protein.  A truly ketogenic diet can have some beneficial effects in certain conditions, but can also have consequences on the body and should never be followed without consulting with a physician and dietitian first.

Why do people follow these diets during cancer therapy?  It is well documented that cancer cells LOVE glucose.  They rely on it for energy to divide and do all of their cancer damage.  So, people figure they can help fight the cancer by eating fewer carbs.

While this idea makes sense, it does have a slight problem.  ALL of the cells in your body rely on glucose to survive, especially your brain.  Your body isn’t going to know to only give the glucose you are eating to your brain and not give it to the cancer cells.  In fact, cancer cells can be hoarders and not share the glucose with the parts of your body you want to get it, like your brain, muscles, etc.  So it may not actually work to stop the cancer.

With that being said, there is some promising research into ketogenic diets as an additional therapy along with chemo or radiation for some people.  This research is in the very preliminary stages however.

I always recommend caution for cancer patients in following any diet, and even more so for a diet as extreme as a true ketogenic diet.  Part of this is just because of all the side effects of the treatments they are receiving.  Cancer patients feel sick, tired, have nausea/vomiting/diarrhea, can get severe sores in their mouth or throat, and the list just goes on.  Many of the foods people can tolerate at those times would not be allowed on a low carb diet:  mashed potatoes, jello, juice, yogurt, ice cream, and Ensure or similar supplements.

Nutrition is very important during cancer therapy, and you don’t want to box yourself into a corner that makes getting those nutrients harder.  Weight loss is a bad course to begin during cancer treatments, so you need to get those nutrients in somehow.  I recommend a general, healthy diet.  Focus on fruits, vegetables, lean proteins and dairy, and whole grains, all in moderation.  And when symptoms make that hard, you eat what sounds good to get you through.

If she wants to follow those diets, I would recommend she talk to a dietitian at her cancer center and her doctor.  And if it isn’t working for her, make sure she knows she isn’t failing herself if she has to stop.  Cancer treatment is hard.  Don’t make it too much harder with complicated diet regimens.

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: Holiday Eating

IMG_0942

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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Q&A: Single change

Pensive Pears

Pensive Pears

Q: What is the single thing you wish people would do differently about how they eat?

A: Wow, tough question.

All of us can change many things about our diets. No one is perfect. But I think one change can help bring about many of the other changes: mindfulness. I wish all of us would be more thoughtful and conscientious about what we are putting in our mouths. Even if it is a chocolate bar.

Why?

When we are mindful of our eating habits, we are in control of the situation. Control is the key for healthy eating. Whether it is stopping yourself from eating a snack when you aren’t hungry or realizing that a snack you thought was healthy actually has a lot of added salt or sugar. The knowledge we gain by thinking about each bite puts us in control.

That isn’t to say you can’t ever eat an “unhealthy” food. For example, I stopped myself from snacking on Halloween candy last Friday afternoon when I realized I was just bored. I thought through that I would really like to eat a treat while watching a movie with my husband that night. By being mindful of my eating, I was able to keep my sweet consumption in line but still enjoy my evening.

Stop and think the next time you eat. Think about how you feel before, during, and after eating. Ask why you are eating at all or that specific item. Read some labels. Measure a portion size. Even if it causes no diet change whatsoever, focusing on eating enhances the pleasure you derive from your food.

Thanks for the question. Happy eating and thinking!

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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