Long-term effects of a ketogenic diet in obese patients

so am I to understand a ketogenic diet is like adkins or is it different somehow. interested in understanding a bit more let me know if you have any information. thanks for sharing this.

Yess Bevin, like Atkins

I lost a significant amount of weight on this type of diet, and my cholesterol plummeted, but I couldn't maintain it. I wanted more fruits and veg. I want to know how/if people transition to more fruits and vegetables and still maintain their weight loss.

Yes Melissa, I would be very wary of going there again. Maybe if I had very clear instructions for reintroducing the carbs, and a lot of support at home, maybe. But it was truly discouraging to have it all zoom back on (and then some).

I do think ketogenic diets can be very effective for weight loss. I'm just not sure if they will make cancer less likely. On the one hand obesity increases risk of BC by about 20%, so just lowering your weight if you are obese is lowering your risk of cancer. I just wonder if you can get enough fiber on a keto diet to promote an "anticancer" gut environment, and whether you can maintain weight loss, as reflect mentions.

I second what Wallycat said about meat (and not because I'm a mostly vegetarian!) There have been a few studies that showed increased risk of breast cancer with high meat intake, although not all. This study found higher risks of BC associated with high vs. low consumption of red and processed meat: http://www.ncbi.nlm.nih.gov/pubmed/26505173, and this meta-analysis also found an increased BC risk, although smaller, associated with red and processed meat consumption. http://www.ncbi.nlm.nih.gov/pubmed/25893586

And higher meat intake also seems associated with a higher risk of diabetes: http://www.sciencedaily.com/releases/2013/06/13061...

Wallycat, I'm not pushing vegetarianism (I was one for 35 years before I got cancer, and well, it didn't stop me from getting cancer), but I do think that meat is associated with some negative health effects, so that should be considered when looking at ketogenic diets. I know you can do paleo as a vegan, but I've never heard of any vegan or vegetarian keto diets. But maybe it is possible.

Fallleaves, agreed! I too enjoyed being a vegetarian when I was one. Vegan is harder to accomplish (and as a dietitian, I have some issues with vegan diets in terms of health) but vegetarians should be able to do it, especially if they include eggs. Since the higher calories should come from fat, it makes it easier to accomplish.

Solfeo-Would you mind sharing an average day of what you eat?  I am very impressed by your weight loss and would love to hear more of what you ate exactly.  Thank you.

Hi vettegirl - I've written about my modified ketogenic diet elsewhere so I will copy and paste (with some editing for clarity)

You can read more about ketogenic diets online, and I suggest you do your own research because it would be impossible for me to explain everything here. The basics are that it is a high fat, moderate protein and low carbohydrate diet, to the point that you want to stay in a state of ketosis. It was originally used to control epilepsy in children and there is a long history of it working for that purpose. It was recommended to me by my naturopath for the cancer. Like everything related to breast cancer there is some controversy about whether it helps cancer or not, but all I can do is share my personal experience, which is that I've lost a ton of weight, my blood pressure, blood work and energy levels are great, and I'm healthier now than I have ever been.

There are a lot of misconceptions out there, such as that a ketogenic diet is high protein. It is not. You eat moderate, adequate levels of protein for bodily functions and tissue repair, and no more, because too much protein will raise insulin levels (not everyone knows this but it is true). That's what we're trying to avoid. That's going to be a different amount of protein for different people. There are various calculators available online based on body weight, but you want to calculate based on your lean body mass only. I eat in the neighborhood of 50-60 grams of protein per day. I do moderate amounts of exercise. Athletes need more protein.

My modifications for ER+ cancer are that I do not eat dairy except for a very small amount (more like condiment-size) of sheep and goat cheese, and only occasionally. I do not limit healthy fat, such as olive oil, coconut oil, avocados, etc., but I don't eat extra fat on purpose just to reach the suggested 70-80% of fat recommended on keto. Whatever amount of healthy fat I need to make what I'm eating without skimping works out well. I only eat hormone-free meat (organic and grass fed when I can get it), and I do limit the amount of animal fat I get, but I don't eliminate it completely. I eat one egg per day as a rule, but sometimes I'll have more. No added sugar. No wheat, gluten or grains (every once in awhile I'll have a very small amount of rice). A small amount of fruit, usually berries, and not every day. I do not limit the amount of most vegetables I eat, except for high-glycemic and starchy veggies, which I don't eat much at all. I will have a little sweet potato every once in awhile, but no white potatoes, corn, etc. I don't usually eat full servings of beans and legumes, but I do enjoy them in small amounts added to soups and stews.

Besides staying in ketosis, what I want is to keep my blood sugar steady to the point that it doesn't vary even before and after meals (mine usually stays around 75 at all times). That takes a different amount of effort by different people, but for me I've got the process down after testing my blood sugar before and after meals for a month to see what my body reacts to. I've also figured out how to eat some healthy high-glycemic vegetables I don't want to have to give up (like beets), by tweaking the amount I eat and the amount of healthy fat and fiber I eat with them. It's like your own personal lab experiment because everyone is different. But it can be done, and it's not really that hard once you get past the withdrawal/detox. There really is a physical withdrawal from sugar and grains (I recommend a book called Wheat Belly Total Health for more info about this) but it usually doesn't last longer than a week or two. Then you will never feel deprived or crave carbs or sugar unless you re-awaken the physical "addiction." I don't have to count calories, or even carbs now that I know what I can eat.

If there is a recipe I want to eat and it's not on my diet, I just figure out how to adapt it. I did that with my Thanksgiving meal, and not only did my family not notice the difference, but I lost a pound Thanksgiving day.