Meaningful Work And Joyful Play

“What do you do for fun?”

That may sound like a weird question for your doctor to ask you, but what can I say, I’m weird 😉 I’ve been doing some training on how to coach for nutrition and lifestyle change, and one thing I read this week really struck me.

Stress depends largely on a balance between meaningful work and joyful play.

So lately I’ve been asking my patients what they like to do for fun. If I’m seeing a patient for depression, chances are good they can’t tell me one single thing they do that they enjoy. One patient went so far as to tell me (tearfully) that she is not getting any fun out of life at all.

We’ll talk about Part Two in a minute, but I want to start by talking about meaningful work. Many of my patients, especially if they struggle with depression, have trouble with seeing their work as meaningful. They feel like they’re punching a clock, going through the motions.

I read once (probably connected with some small-business training or other) that all business boils down to making someone’s life better. Think about that. Why do you open your wallet and spend money? Because you believe that transaction will make your life better. Subscribing to Disney+, buying a new pair of shoes, sending your kids to private school, saving for retirement instead of taking an extra trip this year. Even paying taxes makes your life better (by averting the likelihood of prison for tax evasion)

There was a talk not long ago I attended about improving quality at a big hospital system. The speaker was talking about a time he visited an aircraft carrier. One of the airmen’s job was to clean up the deck. The speaker asked what his job was. He could have said “I’m the janitor,” or “I keep the deck clean.” But that’s not what he said.

When asked what his job was, the speaker said the airman stood up straight, looked him in the eye and said “Sir, I help planes take off and land safely to protect our pilots and further the mission of the United States Navy. Sir.” Wow! That’s a man with a clear idea of how his job makes people’s lives better!

When you go to work every day, your job will feel much more meaningful if you focus on how you are making someone’s life better. I challenge you in the comments to give me a job that DOESN’T make someone’s life better.

On the other side of the coin, no matter how meaningful your work is, you still need to make time for R&R, otherwise you’re courting burnout. My work is extremely meaningful, all of it, from doctoring to my Shaklee business to writing this blog. But if I don’t take time to play, I start to get irritable. I even have found myself feeling cynical.

For me, “play” means lots of things. I hang out with my kids and play video games sometimes. I practice martial arts with my family. I have a number of fiber crafts I love: spinning, crochet, knitting. I read novels. I practice my faith. I sing along with the radio and my music selection on my phone (not always well but with great enthusiasm, LOL). I do all these things to balance my incredibly meaningful but at times extremely stressful work.

In chasing the elusive “work-life balance,” it helps to focus on incorporating both meaningful work and joyful play in every day.

QUESTIONS: Two today! How do you play joyfully every day? And can you think of a job that would NOT make someone’s life better? Don’t pick politicians – that’s too easy 😉

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Measles Outbreaks In The Pacific

Fever, rash, cough and congestion. These are the hallmarks of measles. Before the beginning of the measles vaccination program in the 1960s, there were 3-4 million cases of measles annually in the United States, almost 40,000 people were hospitalized, over 1000 people developed permanent disability from measles encephalopathy, and almost 500 people died. Every year. Most of these cases happened in children.

Now with vaccination rates falling, we are again seeing outbreaks of measles. Right now, there are measles outbreaks occurring in the South Pacific. It’s estimated that only 30% of the population of Samoa, for instance, have been vaccinated against measles, and they are in the midst of a terrible outbreak right now. Other countries are sending medical supplies, doses of vaccine and health care personnel to help deal with this outbreak.

Samoa is a country with about 200,000 people. 3,149 cases of measles have been reported, 197 people are hospitalized and 42 have died. To give some idea of the magnitude of this outbreak, we can compare to the United States, which has a population of 327.2 million people. This size of an outbreak in the US would result in 5.2 million cases, 322,000 people hospitalized, and 68,712 deaths. Most of Samoa’s deaths have been in children under 4 years of age.

Think about that. Imagine a United States in which almost 70,000 infants, toddlers and preschoolers were killed within a month’s time. Bearing in mind that those deaths are preventable, this outbreak in Samoa is a heartbreaking tragedy.

The good news for the USA is that vaccine coverage overall is still above 90%. However, there are 11 states in which coverage is under 90% and there are pockets where vaccine coverage is much, much lower. Amish people reject most modern medical innovations (including vaccines). Many California communities have vaccine coverage rates at about 50%. This is much lower than what is required to prevent outbreaks of measles.

Measles is the most contagious illness we know. It is a serious illness and potentially fatal. The vaccine is safe, so safe that in 1.5 million people vaccinated in Finland from 1982-1992 no deaths or serious permanent adverse reactions were reported.

If you are not immune to measles and are exposed, you have a 90% chance of getting sick. This is in comparison to influenza, which has about a 50% transmission rate. Parents who choose not to vaccinate their children are making a choice to leave them unprotected against a serious, possibly fatal, horribly contagious illness that is still endemic in parts of the world.

No vaccine is perfectly effective, but the MMR vaccine is pretty close. It eradicated measles, mumps and rubella in Finland in the 1980s with a 12-year, 2-dose vaccination schedule.

Measles is still present in the world. The MMR vaccine is the most effective weapon we have against this illness. Please be sure to vaccinate your children.

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Taking A Break To Cultivate Faith

Hello everyone! I’m sending a short update because I’m taking a break this week from blogging. My son and I are attending the National Catholic Youth Conference in Indianapolis this weekend.

If you are Catholic and have young people in your life, PLEASE encourage them to get involved with their youth ministry at church. Encourage them to come to the next NCYC in November 2021. They will not regret it. This hasn’t been an incredible experience for me and for the teens.

I’ll be back to writing about health topics next week. In the meantime please pray for me – I am praying for you! If you have a specific intention you’d like me to pray for, please drop me an email ❤️

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Picky Eaters: Some Suggestions

“What should I do about my child, he is SUCH a picky eater!”

I hear this a lot in the office.  Parents are struggling to find foods that their child will eat.  Parents cooking several meals every night, one for their child(ren) and one for themselves.

Thanksgiving is a good time to reiterate:  this is a mistake.  Don’t go there.  Just don’t.

When I have a parent struggling with a picky eater, it is exactly that.  A struggle.  A battle.  A fight for control.  The parent trying to control what their child eats.  And the child fighting to control ANYTHING he or she can.

My absolute best suggestion for this situation is to take the fight out of it.  Give the child choices from the time the child can communicate.  Let your child control SOMETHING.  Do you want the red bowl or the blue bowl?  How about the Mickey Mouse plate or the Cars plate?  Do you want to try eating at the table like a big boy or do you want to stay in the high chair?  Straw cup or sippy cup?

As your child gets bigger let them take more control.  Ask for help with meal planning.  Should Daddy put the corn on the grill or should we cook it on the stove?  Do you think green peas or green beans sound better tonight?  Especially if it’s a special dinner like Thanksgiving, simple tasks give children a role to play and something to brag about over dinner (“Mommy let me stir the soup into the green beans AND I got to put the onions on top!”)  Let them say how much of each item they want on their plate.  Not WHETHER they want it, but how much:  a little or a lot.

Taking your children to a farmer’s market in the summer and exploring all the really cool and unusual foods is a way to trigger interest in food as well.  Ever had muskmelon?  I tried it for the first time at forty-two.  My six-year-old loved it.  We found it at the farmer’s market and it was love at first sample 🙂  Now both my kids (17 and 12 now) are pretty adventurous although my senior is still not a big fan of green things, LOL!

What do you do if you have a bigger picky eater?  Suppose your child is twelve and still has only five or six foods on the approved list?  That’s a tough one.  One of the best suggestions I’ve ever read is to have your child take charge of one meal per week.  From meal planning (within limits) to making a list to shopping to cooking (with help), making one meal per week is a great way to expose children to new foods and encourage them to be more adventurous with food.

There are lots of recipe sites and apps out there but my favorite is allrecipes.com. It’s easy to pick an ingredient and search for options.  Sure it’s a lot of work to help a tween plan, shop for and cook an entire meal, but they have to learn this skill sometime!  After a few weeks I think Mom and Dad will enjoy a dinner “off” once a week, and your child will have a new skill they can be very proud of.

PS – I highly recommend the book French Kids Eat Everything and Jim and Charles Fay’s Love and Logic series of parenting books, which have many very helpful suggestions for curing picky eater syndrome.

QUESTION:  Can you add more suggestions for helping parents with their picky eaters?

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Mental Health Professional Shortage

Tiffany came to see me as a new patient this week. She is a very nice young woman with a number of very big problems. She is a single mother to two daughters, one of whom is autistic. As a working mom, she has to juggle childcare and all the other household tasks. Her ex-husband is behind on child support and only rarely takes the girls for weekends. He has trouble managing their autistic child’s behaviors.

It probably won’t surprise you that Tiffany is REALLY stressed. She isn’t sleeping, and her anxiety is becoming harder to manage. She came in this week asking for a referral to a psychiatrist.

If you’ve been following me for a while, you probably know part of me started to do a quiet little happy dance on the inside as I was listening to my new friend. She was in the absolute perfect place because I have so many tools to help her. The one that I DON’T use often (and just sits dusty on the shelf almost all the time) is a psychiatry referral. I don’t need it except in rare cases.

It’s a good thing, too, because psychiatrists aren’t exactly thick on the ground in northern Ohio. In fact, most of the country has a severe mental health professional shortage.

Researchers found that this shortage is impacting how people get care for mental health problems in a big way. They looked at claims for mental health vs. physical health problems. The researchers found that people chose to go out of network and pay a larger share of the cost of treatment for their mental health problems.

While the researchers didn’t speak to patients directly and didn’t ask why they went out of network, it’s pretty obvious to me. Those of us in primary care know it takes months to get an appointment with a psychiatrist. Insurance companies often have only a handful of choices for in-network care, and many psychiatrists don’t take insurance at all because reimbursement is very low. If someone is severely sick or a danger to themselves or others, they are directed to the ER where they may be hospitalized. Otherwise they wait.

Here is my prescription for fixing our mental health care shortage:

  • Every single person needs to have an established relationship with a primary care doctor. This means a family doctor, general internal medicine doctor (NOT A SPECIALIST) or pediatrician for little kids. If you are reading this and don’t have a primary doctor, GET ONE. See him or her annually for your physical at a minimum. If you don’t like your primary doctor, get a new one!
  • Be aware of your lifestyle and its impact on your mood. Sleep, exercise, your spiritual practice, diet, ALL will impact your mood. Take small steps to improve your lifestyle before your mood starts to suffer!
  • If you start to feel stress is getting to you, see your primary doctor before things get bad. Don’t wait until you’re so sick you can’t function at all!
  • Consider seeing a counselor. Cognitive behavior therapy (CBT) is as effective as medication for mild-to-moderate depression and anxiety symptoms. It’s hard work, and requires a special kind of courage to unpack what’s going on in your life, but so worth it!
  • Psychiatrists need to send patients with depression and anxiety who are improved and in remission BACK TO THEIR PRIMARY DOCTOR for management. There is no excuse for psychiatrists to continue seeing patients who don’t need them. This will free up space in their schedule for patients who are truly in need of specialty care.

So what did I do for Tiffany? First I asked her to make an appointment with a counselor. I also asked her to start some nutrition therapy with a good multivitamin, B complex and magnesium supplements. Because she was really struggling I started her also on a low dose of an antidepressant and a gentle non-habit-forming sleeping pill.

As food for thought, we discussed the recent research showing diet’s impact on depression and anxiety and I gave her some suggestions. We’ll continue to discuss this in the future. I’m sure when I see her back in a few weeks she will be feeling better and much more in control.

I can’t fix the things going on in Tiffany’s life that are difficult for her. Divorce, single motherhood, working motherhood, and a child with a chronic illness are real stressors. However, depression and anxiety make hard things just that much harder. Treatment is effective, and doesn’t require a visit to a psychiatrist.

QUESTION: Did you know there is a mental health professional shortage?

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Go Green: Greens Are Good For You!

How many servings of leafy green vegetables did you eat today?  There are so many to choose from, it’s easy to get some every day.  They are soooo good for you and tasty too!  At the end of the post I’ll share my favorite kale recipe 🙂

Why are green vegetables so good for you?  Pound for pound they have the most nutrition of any food on our planet.  They are low-carb, low-calorie and full of good stuff!

1.  Vitamins and minerals:  Vitamins K, E, C, and many of the B vitamins, as well as potassium, magnesium, calcium and iron.

2.  Powerful plant pigments that function as precursors to other vitamins and as antioxidants.  Beta-carotene, chlorophyll, zeaxanthin and lutein are some of the phytonutrients found in dark leafy green veggies.  The brightly-colored pigments in plants help fight cancer by acting as antioxidants.

3.  Green veggies don’t contain as much fiber as, say, beans or lentils or whole grains but they have SOME.  Kale, for instance, has 2.6 grams fiber per 1-cup serving.  They also have a small amount of omega-3 fatty acids.

Nutrition experts estimate that our ancestors ate five pounds of green leaves every day!  They were hunter-gatherers and hunting green leaves was a lot easier than hunting animals.  They didn’t get up and run away, after all!  When game was scarce they simply ate the plants all around them.

So what is the best way to eat your greens?  The same way our ancestors did!  Raw 🙂  You can also lightly steam or saute them.  DON’T boil them (it leaches away the cancer-fighting phytonutrients) and don’t overcook them because that begins to destroy the nutrition.

Try adding a big salad of leafy greens every day.  Mix up your leaves or combine them to take advantage of different flavors.  Use just a little dressing and it’s best to make your own dressings fresh.  If you have a food processor it’s easy to whip up a small amount of fresh dressing for your salad.  Combining different oils (like olive, sesame or walnut) with different vinegars (such as balsamic, red wine, rice wine, or apple cider) and different spices is much healthier than using mass-produced bottled dressings.

One of the most nutritious leafy green vegetables is kale.  Kale is bitter and many people don’t like eating it raw (including me).  I much prefer it sauteed.  Here’s my recipe!

Dr. Jen’s Sauteed Kale

Ingredients

  • 1 tablespoon extra-virgin olive oil or sesame oil
  • 1/2 onion, peeled and chopped
  • 2 cloves garlic, minced
  • 1 large bunch kale, washed, stems removed, and coarsely chopped
  • golden raisins soaked in hot water to plump them
  • Handful of pecans, chopped

Directions

  1. Drizzle a large shallow pan with oil and heat over medium heat. Add the onion and garlic and saute about 5 minutes, until starting to soften.
  2. Add a little water to the pan (for steam) then add the kale.  Cover and steam for about 5 minutes, then drain the oily water out.  Transfer the kale to a bowl and top with plumped golden raisins and pecans.  Enjoy!

Please feel free to play with this recipe.  There are so many fruits that you could use to add a little sweet to balance the bitter kale.  Toasted almonds, walnuts or sesame seeds could also be used for variety.

Want another easy way to get your greens?  Shaklee’s Organic Greens Booster has kale, spinach and broccoli in a form that’s easy to add to soups and smoothies.

For more information, check out 13 easy ways to eat more greens and Fitness Magazine’s guide to leafy greens.

QUESTION:  What is your favorite leafy green vegetable, and how do you like to eat it?

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Direct To Consumer Genetic Tests

Sharon is a patient of mine who has a problem with debilitating migraines. She also has osteoporosis in spite of a healthy diet and a ridiculously high level of physical activity. When she read about a genetic test she could purchase online without a prescription, she ordered it. Then she brought the results to me to review.

Many patients order these direct to consumer genetic tests. Are they a good investment? Are the results accurate?

Researchers in the UK recently reviewed the risks and benefits of direct to consumer (DTC) genetic tests. They found that positive results are not always accurate and usually need follow up testing. Sometimes negative results are not accurate either, because they don’t test for more uncommon disease-causing genes.

Suppose a man gets a DTC genetic test and finds he has a gene that increases his risk for Parkinson’s disease. He’s upset because there’s no family history and he knows that’s an awful disease. Worse, he did not realize DTC genetics testing results are not covered by the HIPAA privacy regulation so they can be disclosed to life insurance and health insurance companies. He may wind up paying much higher insurance premiums for the rest of his life for a test result that may not be accurate. Worse, he would likely have anxiety and spend the rest of his life waiting for tremors, memory loss and other PD symptoms to start.

Suppose a woman has a strong family history of breast cancer. Should she get a direct to consumer genetic test to check for the BRCA breast cancer genes? That’s a tough question to answer without knowing the specifics. Did her family members with breast cancer get tested? Were they positive or negative? What would the woman in question do with that information? Would she have her breasts and ovaries removed if she were positive? Would she neglect to have annual mammograms if she were negative?

The best place to have these discussions about genetic testing is with your doctor, and likely with a medical geneticist. A pedigree (chart of family members and their medical history) can be done which can help spot patterns and identify which tests will be most helpful, and most cost effective. You may pay more for the targeted tests you choose to have done, but the results will be more accurate and applicable to your specific situation.

What happened with my friend Sharon? Her test was positive for a genetic variant which makes her body not process folic acid well, which increases the risk of migraines. She needs to take higher supplemental doses of folic acid which help reduce her risk of cardiovascular disease and also help keep her migraines in check. That was really the only useful finding. I usually have my patients with migraine take B vitamin supplements (including folic acid), so did she really get anything from her genetic test?

If you’re considering having a direct to consumer genetic test done, there are 3 things to think about:

  • What are you looking for?
  • What will you do with the information?
  • Are you prepared to have your health and life insurance companies in the future aware of increased genetic risks?

Discuss your reasons for considering a DTC genetic test with your doctor. Your doctor may be able to order a more specific, targeted, accurate test which WILL be HIPAA protected. If you have deeper concerns or a family history of an unusual problem, a medical genetics referral is the best option.

QUESTION: Have you or someone you know done direct to consumer genetic tests? What was your experience?

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Soy and Breast Cancer

I have a lovely patient who suffers terribly with menopausal hot flushes.  It’s been years and they show no signs of stopping.  The problem is, she also has a condition that increases her risk of breast cancer.  Hormone replacement with estrogen, while it would help her hot flushes, would be dangerous for her.  Some time ago her oncologist told her she also should avoid soy because it has estrogen effects and may increase her breast cancer risk as well.

You probably know I hate to see anyone suffer.  I hate it even more when the reason for the suffering is based on faulty or outdated logic.  I know newer research has shown that soy foods and soy isoflavone supplements do not increase the risk of breast cancer, but I didn’t have the research to back that claim up.  Off to the research database!

First, some background info.  The reason so many doctors and scientists assumed soy was dangerous for breast cancer patients is because soy contains substances, called isoflavones, that are structured like estrogens.  There’s evidence they can bind to estrogen receptors in cells.

It was assumed that, since most breast cancer tumors are responsive to estrogen, that any estrogen activity would stimulate the cells to grow.  In fact, highly successful treatments for breast cancer like Tamoxifen and Arimidex act by blocking ALL estrogen activity.  As you can imagine, these medications cause a lot of side effects like hot flushes, vaginal dryness and other symptoms that mimic menopause.

You know what happens when we assume, right?  More recently, scientists have decided to question that assumption and look to see if soy intake (both soy foods and soy supplements) actually does increase the risk of breast cancer.

What did they find?  LOTS of studies are out there, but I just want to mention a few.  There was a review article published in late 2013 that looked at 131 different studies on soy foods and soy and red clover isoflavones.  There was evidence that eating soy foods was protective against breast cancer.  Even stronger evidence is that breast cancer patients taking Tamoxifen had no increased risk of recurrence when they used soy.

Another study published in February of 2014 analyzed 35 studies looking at associations between breast cancer risk and soy intake.  The study concluded that in Asia, soy intake reduced the risk of breast cancer in women both before and after menopause.  However, there was no change in breast cancer risk demonstrated in women in Western countries with soy intake.  There was certainly no evidence of an INCREASED risk of breast cancer in women using soy.

A very large study published in 2013 asked over 3800 women about their dietary patterns, including soy intake, when they enrolled in the study.  Over 14 years the authors tracked several variables in study participants, particularly breast cancer diagnosis, breast cancer mortality and all-cause mortality.  There was no difference in breast cancer risk or mortality (from breast cancer or other causes) in women with the highest soy intake vs. those with the lowest soy intake.

A review article published in Germany in 2016 also concluded that soy did not increase the risk of breast cancer and increases survival after breast cancer diagnosis.

It is pretty clear that soy intake does not increase the risk of breast cancer and may actually be protective in some populations.  Why is this?  There is a theory that soy isoflavones, while mimicking estrogens in structure, do not actually behave like estrogens.  Therefore, when they bind to estrogen receptors in cells, they block the actions of the person’s own estrogen molecules.  This theory could explain why soy isoflavones do not increase breast cancer recurrence in patients taking Tamoxifen for estrogen-sensitive breast cancer.  The soy actually behaves a bit LIKE Tamoxifen without the side effects.

If you have considered trying soy isoflavones to reduce hot flashes or using soy as a good source of complete dietary protein, there is plenty of good evidence that it won’t hurt you.  Even if you have a higher-than-normal risk of breast cancer, or have actually developed breast cancer, there’s no evidence that soy is harmful.  As always, you should always discuss supplementation with your doctor to make sure any supplements won’t interfere with your treatment plan.

QUESTION:  Do you have menopausal hot flashes?  Have you considered trying soy?  Have you been told it could be harmful?

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Diet Change And Depression

Depression and anxiety are incredibly common symptoms that we see in primary care. It is estimated that 75-90% of visits to doctors are related to problems caused or made worse by stress. I was so excited to see a new study published showing a link between diet change and depression symptoms!

We all have to eat. Most people recognize that our diet has a huge impact on our health. Heart attacks, strokes, cancers, obesity and many other illnesses are impacted by what we eat. Doctors spend a lot of time advising people to eat less sugar, less saturated fat, and more fresh fruits and vegetables.

Many people don’t realize what you eat affects your mood, too! I’ve had great success with nutritional supplements in helping people with depression and anxiety feel better. A new research study has shown a very clear association between diet change and depression as well.

Researchers in Australia studied 76 young adults with depression and anxiety symptoms. They were randomly assigned to two groups – one group got no intervention, and one group got instructions to improve their diet via a 13-minute video they could re-watch whenever they wanted to.

They were instructed to increase their intake of

  • vegetables to 5 servings per day
  • fruits to 2-3 servings per day
  • whole grains to 3 servings per day
  • lean protein (lean meat, poultry, eggs, tofu, legumes) to 3 servings per day (Remember, plant sources are healthier than animal)
  • unsweetened dairy to 3 servings per day
  • fish to 3 servings per week
  • nuts and seeds to 3 tablespoons per day
  • olive oil to 2 tablespoons per day

They were also instructed to take 1 teaspoon of turmeric and 1 teaspoon of cinnamon most days. They were to DECREASE their intake of refined carbohydrates, sugar, fatty or processed meats and soft drinks. They were given sample menus and handouts answering common questions as well.

After 3 weeks the average depression questionnaire scores had not changed in the control group, not surprisingly. However, in the diet-change group the scores had returned to normal! And the improvement was maintained when they were rechecked after 3 months.

This study supports what I’ve said for a long time. Depression and anxiety are not just related to stress or genetics. Our nutrition strongly impacts our brains’ ability to manage and cope with stress. A crappy diet predisposes us to depression and anxiety, and we can improve our mood by improving our diet.

If you struggle with stress, depression and/or anxiety, improving your diet is something you can do TODAY. Improving your diet is as effective as medication, and works just as quickly. It also has no side effects! What are you waiting for?!

QUESTION: Do you see a link between how you eat and how you feel?

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Low Carbohydrate Diets And Health

Confession time. I tried Atkins in the ’90s to try to lose that stubborn 10 pounds that clung to me like stink on a skunk. I dutifully checked my urine every day to see if the magical ketones were present. Unfortunately I found that unless I ate nothing but meat and cheese those ketones kept disappearing. Unable to exercise due to profound fatigue, I eventually gave it up. The few pounds that I did manage to lose came right back, and brought along friends. My experiment with low-carbohydrate diets was a miserable failure.

Many of my patients proudly tell me that they are eating “low carb” to lose weight. A research study was recently published that looks at the evidence regarding the health effects of low-carbohydrate diets.

Credit: GreatLakesLedger.com

It doesn’t matter if it is called “keto,” Atkins, South Beach, or Paleo. Proponents of low-carbohydrate diets all insist that carbohydrates are the cause of overweight and obesity and must be avoided. The original ketogenic diet was developed to treat intractable seizures in children and did have some success. However, low-carbohydrate diets today are almost exclusively used for weight loss. A survey of over 1000 adults conducted in 2018 found that 16% reported eating some sort of low-carb diet in the previous year.

Are low-carbohydrate diets better than diets (low-fat, calorie-controlled, DASH, Mediterranean, etc) that don’t restrict carbohydrate intake? It seems that, in the short term, they do promote more weight loss while suppressing appetite. They also do increase insulin sensitivity and decrease blood sugar levels in diabetics.

However, low-carb diets are notoriously difficult to maintain. It is just really hard to avoid fruits, root vegetables and whole grains for long periods of time. Once a person starts adding back carbohydrates, it is a slippery slope and the weight typically starts coming back, with interest.

Scientists have not done long-term studies on those who eat a low-carb diet. We don’t know if they are less likely to have a heart attack, cancer, diabetes or other lifestyle-related illness. Low-carb diets are associated with higher levels of LDL (“bad”) cholesterol. And after a year or more, those who eat low-carb haven’t lost more weight than those who use other diets.

A healthy diet is pretty simple, but it isn’t easy. Plenty of whole fresh fruits and veggies. Green leafy vegetables, nuts, seeds and beans. Small amounts of lean meats and lowfat dairy, if any. Fatty fish several times per week. Water, water, water. Avoid processed foods and artificial food ingredients when possible. Carbohydrates-good fat-protein macros in a 50-30-20 ratio for most people. If you’re not sure what your macro ratios are, you can track for a few days at MyFitnessPal.com (not an affiliate, just a happy user of the app).

Low carbohydrate diets sound like an attractive way to lose weight rapidly. But they are hard to maintain and result in yo-yo dieting. They are not more effective for long-term weight loss than other diets. And they haven’t been shown to create long-term health.

QUESTION: Have you tried a low-carbohydrate diet? What was your experience?

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