Speaker A [00:00:00]:
So today’s episode is about my least favorite topic that I can’t stop talking about. Today’s episode is about keto, the ketogenic diet. Now, if you don’t know, the keto diet is an extremely, extremely restrictive, low carb diet that has gained popularity in the past few years. And anyone who follows any, you know, influencers or wellness pages or, you know, reads anything about health or nutrition these days has heard of keto. So why is it so popular? Why do I absolutely hate the keto diet for paralysis? Today I’m going to talk to you about it. Welcome to the paralysis nutrition podcast, where changing your eating habits is the key to losing weight, improving bowel health, and feeling your best. I’m your host, Fatima Fakouri. I’m a registered dietitian who’s married to a quadriplegic and specializes in nutrition for paralysis.
Speaker A [00:00:58]:
Get ready to be inspired, educated, and motivated so you can take control of your health using the power of food. Let’s get started. This is the paralysis nutrition podcast. So the keto diet has gained huge popularity in the last few years. And I have noticed that in the paralysis community, keto has become popular. And this really scares me because keto is probably, out of all the diets out there, the scariest one for paralysis. And first off, let’s just define what is the keto diet for anyone who doesn’t know, right, the ketogenic diet was designed for a medical purpose. Okay? All the research that says keto is great is about children who have epilepsy.
Speaker A [00:01:53]:
So the only health condition that keto is totally proven to help with is pediatric epilepsy. So children with epilepsy who go on the ketogenic diet under a doctor supervision, I might add, they have fewer seizures, they have reduced seizure activity. So keto is great. If you are a child with epilepsy and working with a doctor to reduce the, you know, number of seizures that you have, why is keto so popular? I think because people gravitate towards extremes, right? If you are of a certain age, you probably remember the Atkins diet. So keto is similar to Atkins. Keto is extremely low carb, but it’s not the same as a low carb diet because keto doesn’t want you to eat, like, any carbs. And if you’ve listened to any previous podcasts, you know, I am a big believer in eating carbs because when we eat carbs, we eat enough fiber and that helps with our bowels and it helps keep us safe, not to mention fruits and vegetables. And whole grains are very healthy foods, and they’re all carbs.
Speaker A [00:03:08]:
So with the keto diet, you are eating if you’re doing it right, which most people are not doing. Keto, I have argued with so many people on the Internet, wasted so much of my time discussing keto, because a lot of people who see positive results on keto are actually just following a low carb diet. They’re not actually following keto. So what exactly does the keto diet want you to do? The keto diet wants your body to run on ketones. The human body, though, is designed to run on glucose, and glucose comes from carbs, right? And so when your body doesn’t get any carbs, you can go into ketosis, right? So my concern is when you have paralysis and you eat no carbs, you’re going to be really, really constipated. And that in and of itself is a good enough reason for someone with paralysis to never do keto. But it’s also just really dangerous because your body is designed to run on glucose. Why in the world do you want your body to run on ketones? This is shenanigans.
Speaker A [00:04:15]:
And so ketosis, right, is when your body is going to be using fat instead of carbs for energy. So, honestly, this is shenanigans. And with the keto diet, you should be eating 60 to 70% of your calories from fat. I, like, can’t even say that without getting mad. No human being should be getting 60 to 70% of their calories from fat. You don’t have to be a nutritionist or a doctor or a dietitian to know that. That’s preposterous, right? That’s way too much fat. And so 60 to 70% fat, 20 to 25% of your calories are supposed to come from protein, and only 5 to 10% of your calories are supposed to come from carbs.
Speaker A [00:05:02]:
So the theory with keto is that your body goes into ketosis and it burns fat for energy. It’s also supposed to turn your fat into ketones, meaning in your liver, so that your brain gets fuel, because your brain runs on glucose. But if you don’t eat any carbs, your brain is going to have to use ketones. So if the human body is designed to run on glucose, why do we want it to run on ketones? Now, I’m sure a lot of people who are listening who have thought about doing keto or have done it, right? I’m sure you’re not happy hearing this because your argument is probably like well, why not run on ketones? Because it’s completely unnatural. Look around you. Look at the foods that are available to eat. All, you know, our whole foods, our fruits, our vegetables, our whole grains. These are all carbs.
Speaker A [00:05:54]:
So eliminating perfectly healthy foods is a huge no, no. Why would we eliminate something that we enjoy that’s nutritious, that’s good for us? None of this makes sense, people. Ah, deep breaths. So super high fat, moderate protein. You can’t have too much protein on keto, otherwise you can turn that excess or that protein into glucose if you eat a lot of it. So I think that’s also a huge misconception, at least when I speak to people, like on social media or on discovery calls or even in my program. I think people think that keto is a super high protein diet. It’s not.
Speaker A [00:06:36]:
It’s a super high fat diet. And dietary fat is not something to fear. Okay? We want to eat our healthy fats, but if you are following the keto diet and you’re eating up to 70% of your calories from fat, that just makes no sense. Why would you eat so much fat? Right? And like I said, a lot of people who think that they’re doing keto aren’t actually doing keto. Sorry, you’re actually just following a low carb diet. Also, I have spoken to so many people, some of them who are current clients, who said, you know, I tried keto, and I say, okay, you know, tell me about that. And the truth was they just didn’t really eat carbs Monday through Thursday. Really, that’s what it was.
Speaker A [00:07:24]:
So they weren’t really doing keto, they were trying to eliminate carbs because they have this feeling or notion that eating carbs leads to weight gain or that eating carbs is not healthy. And I’m out here to shout from the rooftops that you absolutely need to eat carbohydrates if you are living with paralysis. And you know, honestly, if I had a dollar for everyone who thinks that they’re in ketosis, but they’re not, I would be a very rich woman. So I just wanted to kind of go over what is keto, because a lot of people don’t know what it is, right? And a lot of people, I think, equate it with a high protein diet, and that’s just not what it is. Keto is super high fat, moderate protein and super low carb. So one of the big reasons why I don’t like keto, other than the fact that your body is not meant to be in ketosis all the time. Is that the keto diet? And many, I should mention, other diets that are out there these days. It eliminates perfectly healthy foods like fruits, like beans, like whole grains.
Speaker A [00:08:32]:
And some people who do keto don’t eat dairy as well. So why are we eliminating all these foods? Why are we doing that? You need to eat fruit, right? Because it helps you poop. It has fiber in it. Also full of vitamins, minerals, antioxidants. Some of the things that are found in fruit can’t be found in other places, meaning other foods. So especially antioxidants. Why would we not eat beans? Why? Paleo is another diet that drives me nuts. And you’re not allowed to eat beans.
Speaker A [00:09:03]:
There’s nothing wrong with eating these wholesome real foods. There’s nothing wrong with it unless you’re allergic, obviously, right? If you’re allergic or you have a sensitivity to a food, you shouldn’t eat it. But any diet that tells you to cut out real foods, beware, right? Whole grains are a huge, huge part of getting enough fiber. It’s really hard. And it’s interesting because one of the hardest things to do is to get enough fiber. So in my group coaching program, we talk about macros, right? We talk about proteins, fats and carbs and the other kind of thing that we are tracking, not just macros, we’re tracking how much fiber and how much fluid that my clients are eating and drinking. So it’s really hard to get enough fiber. And I’ve mentioned this before on another episode, but for women, the general Recommendation is around 25 grams of dietary fiber per day.
Speaker A [00:09:59]:
And for men, it’s around 38 grams. It’s going to be really hard to get that if you don’t eat any grains. It’s going to be hard to get that if you don’t eat beans. It’s going to be really hard to get that if you don’t eat fruit. And yes, of course, you can eat vegetables on keto, but you can’t eat all vegetables on keto because some vegetables, like potatoes, for example, have carbs, right? So keto is even actually eliminating certain vegetables because if you eat more than like a couple of bites, you’re going to be over on your carbs again. Shenanigans, right? And so I’m a dietitian who only works with people who have paralysis. And every single person who comes through my program has neurogenic bowel. So they are constipated, they are spending a long time to go poop.
Speaker A [00:10:52]:
They are relying on things like Miralax and Senna and softeners and things like that for years, and they’re still constipated. And what really works, honestly, what really works is dietary changes. So getting that fiber, that dietary fiber is huge for people with paralysis who want to spend less time pooping. And of course, this podcast is the paralysis nutrition podcast, right? So I’m only talking about people with paralysis. And so keto, while it may work short term for other populations, like if you are an, you know, an able bodied person who just kind of wants to lose weight, you might say, oh, I’m just going to cut out all my carbs and see how that works for you. Whether it works or not is none of my business. But if you’re a person with paralysis, it is my business because this is what I do, right all day. This is what I do.
Speaker A [00:11:49]:
So if you’re a person with paralysis, you shouldn’t do keto just based on the fact that it’s going to make you constipated. Vegetables do not have nearly as much fiber. I mean, okay, other than like artichokes, there is no, you know, group of vegetables or like, you know, fruitless, grainless diet that’s going to get you there in terms of your 25 grams or your 38 grams of fiber. So let’s not eliminate perfectly healthy foods. Fruit helps you poop. And the two main things that people join my program for are for weight loss and for regulating their bowels. They’re spending way too much time pooping. You cannot regulate your bowels if you don’t eat enough fiber.
Speaker A [00:12:34]:
And you will not get enough fiber in a sustainable way, in an enjoyable way. If you can’t eat fruit, if you can’t eat whole grains, if you can’t eat beans. So you need to eat your fiber. And keto eliminates all these perfectly good, delicious, natural, wholesome sources of dietary fiber. Also, some of the common side effects for keto are absolutely terrible, especially if you’re a person with paralysis and you’re trying to lose weight and you want to work on your bowels. So one of the biggest side effects is like gastrointestinal distress, right? That means like tummy trouble, diarrhea, constipation, that’s the last thing that any of my clients want. Also loss of muscle, because a lot of people on keto, they do eat too much fat and then they’re not eating adequate protein. So you could actually lose muscle on keto.
Speaker A [00:13:32]:
That is the worst. Because people with paralysis need to Maintain their muscle mass, you know, as much as possible. Also, because you’re not eating any carbs, you’re going to have low energy. How are you going to push your own wheelchair? How are you going to transfer? How are you going to do your PT or anything that you need to do in your day if you have low energy? Also, nutrient deficiencies. I will never forget, I had a client. I don’t have permission to say her name, so I’ll just say Jay. So, Jay, she went on keto, and I think she was pretty strict with it. And she lost 30 pounds in, like six months.
Speaker A [00:14:11]:
And then a few months later, she joined my program and she said, well, I tried keto, and it didn’t work for me. And I said, oh, it didn’t work for you? And she said, no, I mean, it worked. I lost 30 pounds, but now I’ve gained 45 pounds since I started keto. So she lost weight on keto, she regained the weight, plus more, and that’s when she joined my program. She also said that her hair was falling out in clumps, and her doctor had said that she was deficient in a bunch of nutrients. That’s perfectly logical because you eliminated perfectly healthy foods from your diet. You didn’t get all that goodness from fruit. You didn’t get all those minerals from the grains.
Speaker A [00:14:53]:
You didn’t get, you know, all these healthy foods into your diet. You were eating, I don’t know, butter and eggs and steak. I don’t know. But nutrient deficiencies are a side effect of keto. And another side effect is extra fat in your liver. So, yes, you can get a fatty liver. Just so, you know, once you. Once that happens, you have to go on medication.
Speaker A [00:15:14]:
You have to change your diet. It’s the last thing you need is extra fat in your liver. This is serious stuff. This is serious. And the last side effect is kidney stones. So, you know, if you follow me on social media, you know, my husband’s quadriplegic. I will tell you very honestly, he is, you know, healthy. He does his best.
Speaker A [00:15:37]:
But I do worry, you know, being quadriplegic for 18 years, having to do, you know, intermittent cathing and all of that for so many years. I do worry about his renal function. Renal function, meaning how well his kidneys are working. Okay? So the last thing that I would want is kidney stones or any type of extra stress on my husband’s kidneys. Right. And so a few years ago, actually, the leading cause of death among people with SCI was renal disease. It’s no Longer renal disease, I think it’s like respiratory illness or something, and then after that it’s cardiovascular and whatever. So.
Speaker A [00:16:22]:
But renal disease was and is still one of the things to really watch out for, to be careful with. So if you really want to know, yes, there are a million reasons why people with paralysis shouldn’t do keto, but I think the number one would be save those kidneys. Because the last thing that you want is to have compromised kidney function, right? It’s not reversible. The best thing that we can do is so say you have, like, stage three kidney disease. The best thing you can do is keep it at stage three. You’re not going to go to stage two. You’re going to be at stage three, and if you’re lucky, you’ll stay there, but most more likely you will go to stage four, and, you know, that’s no good. So I hate keto, and these are the many reasons why.
Speaker A [00:17:13]:
Let’s see what else. I did mention that so many people gain the weight back, and I’ll tell you, that’s depressing. So my client Jay, who, you know, lost that 30 pounds and then gained it back, how do you think that she felt when she regained the weight? She felt terrible. How do you think that she felt when she gained extra weight? And I said, you know, Jay almost said her name by accident. Why do you think you gained the weight back and more in such a short period of time? And she said, well, as soon as I got off the diet, I just ate everything and anything and I drank a bottle of wine and I just went completely off the charts. That’s right. That makes perfect sense, because any diet that’s too restrictive is not going to last. Anytime I have a new client in the group program, I have to give my.
Speaker A [00:18:00]:
What do you call it? Speech. I guess it’s a speech about how paralysis. Nutrition is not a diet. I hate diets. Diets mean that you are cutting things out. Keto is cutting out fruits, cutting out beans, cutting out grains and beans, and sometimes cutting out even, you know, healthy vegetables. Cutting out all sugars. Hello.
Speaker A [00:18:22]:
All sugar. Really? So if it’s your mom’s birthday, you don’t want to have a piece of cake. This is not healthy. Meaning mentally and socially, this is not healthy. Right. And so you will gain the weight back because you’re not going to stay on this really restrictive diet forever. Right? You’re not eating fruit. So good luck pooping.
Speaker A [00:18:45]:
Now your hair is falling out because you don’t. You have mineral, you know, and Nutrient deficiencies. And I might mention this too. We don’t know. Well, I have my, my predictions, but we don’t know if this is safe long term. You know what I mean? Like, there are no long term studies on keto because it’s relatively kind of, you know, new. So let’s use our brains and trust ourselves. Is skipping wholesome real foods such as fruit, whole grains.
Speaker A [00:19:19]:
Is that good for you? Is that good for you mentally? Is that sustainable? Right. The answer is no. And I was, you know, in, in preparation for this episode, I was kind of looking at some of the research and there’s a study that came out of Harvard that says the keto diet, not surprisingly, is associated with an increase in your bad cholesterol. So, you know, they say there’s good cholesterol and bad cholesterol. So ldl, the low density lipoprotein, that is the bad cholesterol. So one of the top causes I just mentioned of death with sci is heart disease. Okay, why? And I might mention it’s not even just for sci. One of the leading causes of death of, you know, any human ever is that something went wrong with your heart.
Speaker A [00:20:06]:
Okay? Why would you go on the keto diet and eat 60 to 70% of your calories from fat? That goes back to the using your brain thing. That’s just way too much fat. And so it is no surprise that this study from Harvard says that the keto diet is going to. It is associated with an increase in your bad cholesterol. And as your ldl, your bad cholesterol goes up, your risk of heart disease goes up. Hi. That’s just, you know, that’s like, scary to me because, you know, right now I’m, I’m in my office and I’m looking at the list of all my clients. You know, right now I have three different groups going and I’m just looking at all these names and I’m like, heart disease.
Speaker A [00:20:51]:
You know, like all these people in this program, they have their unique situations, right? And I know them all personally. And, and yes, sometimes people have high cholesterol here and there, but I can’t imagine telling these people that they should go on a diet like this. Like, I would never in my wildest dreams tell anyone living with paralysis or without that the keto diet is a good idea, right? And I had mentioned not just heart disease, but also liver problems because it’s so much fat. It’s so much fat. How are you going to break down all that fat? You know, you’re not that’s why you’re going to end up with a fatty liver. And the kidney issues, you know, those are, those are probably the worst. And kidney disease, it cannot be reversed. Exactly.
Speaker A [00:21:37]:
Right. So it’s the last thing that you want. So I think I’ve, I’ve. I rest my case. Right. Keto is the worst for paralysis. I’m sure I’m going to get a lot of feedback, let’s call it feedback, right, on this episode. But I’ll tell you honestly, you do not have to go on a restrictive diet such as keto.
Speaker A [00:21:58]:
You don’t. You need to learn to balance your macros. So proteins, fats, carbs, those are the three main macros. Alcohol is also a macro, water is also a macro. But in terms of diet, you know, we really talk about the three. The proteins, fats and carbs. Adequate protein and, you know, balancing your carbs. That’s what we want.
Speaker A [00:22:21]:
And we want to eat healthy fats. We want to eat our monounsaturated fats, our omega 3 fats. And keto doesn’t exactly tell you which fats to eat. You know, it’s just like 60 to 70% of your calories should be coming from fat, which is obscene. It’s just obscenely high. So if you are, you know, we’re considering to go on keto, if you’re currently trying to do keto, whatever it is. I hope that this episode has kind of shed some light on why, in my professional opinion, as a dietitian who specializes in weight loss and bowel health for people with paralysis, I hope that this kind of sheds some light on why. Right.
Speaker A [00:23:03]:
On why I’m really against the keto diet. And also I hope that you will kind of do your due diligence to learn the right way to eat for paralysis. You’ll balance your macros, you will be eating whole foods, you will be eating some fun foods. Right. Like I mentioned, if it’s somebody’s birthday, I want you to have a piece of cake. I just don’t want you to eat cake every day alone in your kitchen at 10pm Right. There’s a big difference between that. So having a good relationship with food is a huge, huge part of sustainability.
Speaker A [00:23:41]:
Sustainable success with weight loss and with keeping your diet consistent so that you can keep your bowels consistent and any restrictive diet. Right. Today’s episode was about keto. But any diet that tells you that you shouldn’t be eating things that you like, like, ever, you should never be eating those things. Why? You, you deserve to eat Foods that you enjoy, right? You deserve to enjoy your meals. You and you deserve to have that fun food that you’re really craving, but you deserve to feel good about your food choices, right? And so the purpose of my episode today was to inform you guys about keto and tell you why it’s not a good choice for paralysis. But I do want to just leave you with a couple of quick tips. So if you are a person with paralysis and you are wanting to lose weight and you are wanting to improve your bowel health, you should start tracking your meals in an app just so that you learn about what nutrition you’re getting every day.
Speaker A [00:24:43]:
Maybe you’re not eating as many calories as you thought. Maybe you’re eating way more than you thought, right? So all of this is data, right? So I encourage you to educate yourselves a bit about your current diet. Where are you at? You know, how many calories you’re eating? How much protein are you getting? How much fiber are you getting? Right? How much water are you drinking? So if you want to lose weight with paralysis and you want to spend less time in the bathroom, focus on adequacy. Getting enough protein, getting enough fiber, right? Drinking enough water and being smart about your carbs, being smart about your dietary fats and being smart about how often you drink alcohol and have desserts and things like that. So that’s it, people. Keto is shenanigans. And I hope that this was informative and helpful. And until next time, that’s our episode for today.
Speaker A [00:25:44]:
Thanks for listening. I hope you enjoyed it and that you learned something new. Remember, if you want to lose weight with paralysis, improve your bowel health and feel your best you can. It’s possible you just have to change your eating habits. If you need inspiration on how to get started, check out the paralysis Nutrition Cookbook 101 Recipes to Help you lose weight and improve bowel health. The cookbook comes with a bonus 30 day meal plan and is the perfect way to start eating healthier. You can find it online@paralysisnutrition.com cookbook. I’ll talk to you again soon.
