5 posts tagged “dietary recommendations”

Keto + other diet trends: Healthy or hype?

Posted February 6th, 2019 by

Keto. Carnivore. Fasting. What should you know about these diet buzzwords and the potential benefits or risks, especially when you’re living with an existing or chronic health condition? Take a peek (and always talk with your doctor before making big dietary changes).

3 hot diet trends in 2019

According to Google Trends data (accessed in early 2019), some of the hottest topics people are searching for related to “diets” include:

  • Ketogenic diet
  • Carnivore diet
  • Intermittent fasting

What is the “keto” diet?

The ketogenic or “keto” diet is a very low-carb, high-fat diet that’s been around for decades and gained popularity thanks to books, blogs and celebrities/influencers touting it the past two years. Researchers developed the ketogenic diet in the 1920s as a treatment for epilepsy, and some people with epilepsy that doesn’t respond to medication still use the diet to help prevent seizures today.

Most people following the keto diet these days are using it for weight loss. By severely cutting carbs, the body enters ketosis — a metabolic state that burns fat for energy, essentially like starvation mode. The jury is still out on whether ketosis and the keto diet are safe, especially in the long term, because research is lacking.

And when it comes to weight loss, the keto diet doesn’t have a big edge over low-fat diets. “Ketogenic diets can help patients lose about 2 kg [4.4 pounds] more than low-fat diets do at 1 year, but higher-quality studies show no difference,” according to a Canadian Family Physician report published in December 2018. “Weight loss peaks at about 5 months but is often not sustained.”

Critics of the keto diet say it is a fad (like Atkins 2.0) and so extreme that it’s hard to stick with (thanks to the 80% fat, 15% protein, 5% carbohydrate breakdown). Just a slice or two of bread = all your carbs for the day.

But some researchers have been exploring the potential benefits of a ketogenic diet for people with some health conditions beyond epilepsy (such as type 2 diabetes, cancer and other conditions). And there’s a steady drip of studies on “going keto.” However, the studies are fairly limited in size and scope, ketosis is complicated, and nutrition experts say it can cause nutritional deficiencies and possible damage to the kidneys, liver, heart and muscles.

carnivore diet foods, meat and fish

What is the carnivore diet?

In a word: meat. Well, technically there’s no official definition, but this diet trend involves eating “only foods that either walked, swam or flew,” Everyday Health says. In addition to meat and eggs, some carnivore dieters also eat other animal products like milk, yogurt and cheese.

Why are some people rushing to the meat-heavy diet? Many people are using it for weight loss (especially if they’ve tried the keto diet but prefer eating more protein than fat). But some people have also turned to it to try to address inflammation, autoimmune conditions or food sensitivities.

“It’s important to note that this diet is so new that there’s no research on the health effects of an all-meat diet, if a carnivore diet can actually reduce symptoms of autoimmune conditions, or if it is a reliable method for uncovering food intolerances or aiding weight loss,” Everyday Health reports.

Besides being new and unproven, the nearly all-meat diet is controversial for a couple of reasons.

First off, the carnivore diet is even more restrictive than the ketogenic diet and carries some related risks. It calls for not eating any carbs (grains, legumes, bread), fruits or vegetables. Eliminating fruits, veggies and healthy carbs (all part of a healthy diet recommended by the World Health Organization) means people are missing out in important nutrients like fiber, antioxidants and a variety of vitamins. Eating too much protein can strain the kidneys, and a diet high in red and processed meats may increase the risk of stomach cancer, according to 2015 research published in The Lancet.

Secondly, one of the main proponents of the diet, Shawn Baker, who authored the 2018 book The Carnivore Diet, is a former physician whose medical license was revoked in 2017 “based on failure to report adverse action taken by a healthcare entity and incompetence to practice as a licensee.”

intermittent fasting diet, clock on plate

What is intermittent fasting?

Intermittent fasting is another topic covered in dozens of books and on countless blogs these days. This diet is less about what you eat and more about when you eat, and there are several variations and names, including the 5:2 diet, the 16/8 diet, “The 8 Hour Diet,” “The Fast Diet,” the “Warrior Diet,” “The Dubrow Diet,” and the “Eat Stop Eat” method.

These diets call for periods of fasting (or severely limiting your food intake), such as fasting two days in a row each week or only consuming food in an 8-hour window each day. See examples, like the 5:2 diet and 16/8 diet, explained here.

Somewhat similar to the keto diet, the aim of intermittent fasting is to send the body into a metabolic state that burns fat — but the “intermittent” part means this is balanced with periods of normal (ideally, healthy) food intake so that the body doesn’t enter extended “starvation mode.”

A 2013 article in the Canadian Medical Association Journal reported: “There is indeed a large body of research to support the health benefits of fasting, though most of it has been conducted on animals, not humans. Still, the results have been promising. Fasting has been shown to improve biomarkers of disease, reduce oxidative stress and preserve learning and memory functioning, according to Mark Mattson, senior investigator for the National Institute on Aging, part of the U.S. National Institutes of Health.”

A few of the human studies on intermittent fasting (IF) and alternate day fasting (ADF) have focused on overweight adults with asthma and people at risk for type 2 diabetes, with somewhat promising results but calls for additional research.

In general, paying attention to when we eat (over a shorter span of time each day) — but ideally not skipping breakfast or binge-eating on non-fasting days — could have some health benefits for some people, yet more large-scale and longterm studies are needed.

Bottom line? Talk with your doctor and/or a registered dietitian who knows about your health condition(s) and treatments and can help you come up with a healthy eating plan that you’re most likely to stick with. Even if they’re not getting as much attention as the latest diet trends, some less restrictive and more balanced eating plans are still highly regarded (for example, the Mediterranean diet tops the list of U.S. News & World Report’s Best Diets Overall in 2019).

How has your diet or way of eating affected your condition (pro or con)? Join PatientsLikeMe or log in to connect with others on this topic in our forum. Also, complete your PatientsLikeMe profile with the latest treatments or lifestyle adjustments you’ve tried and how they’re working for you. For example, you can add diet types (such as Mediterranean or low-carb/high-protein) to your profile (once you’re logged in, click the “My Health” tab). Together, we can learn more.

MS constipation blues? See 12+ treatment options

Posted August 15th, 2018 by

Feeling “irregular” on the regular? Constipation is a common issue for people living with multiple sclerosis (MS), affecting as many as 40% of patients. Over 15,000 MS members on PatientsLikeMe report experiencing bowel problems and of those, about 47% have reported it as “moderate” or “severe” – take a look here. With help from our team of in-house health professionals, we took a closer look at this taboo topic, as well as available treatments.

What’s going on with constipation?

Typically, constipation is defined as having fewer than three bowel movements a week. But only you know what’s “regular” for you — constipation isn’t just about bowel movement frequency and averages. It can also mean going #2 less often than what’s normal for you – or having stools that are hard, dry or difficult to pass.

Other symptoms that can come with constipation include incomplete evacuation of stool, abdominal bloating, cramping and straining. When constipation becomes chronic or interferes with your daily life, it may be time to seek treatment.

What’s the constipation/MS connection?

MS and some medications used to treat it may cause constipation. MS damages the nerve cells of the intestines and can slow down and impair the muscles that usually push food along. Constipation can also lead to bowel incontinence.

Constipation, the most common bowel complaint in MS, can be caused by poor diet or physical inactivity which can disrupt the digestive system. Symptoms like difficulty in walking, fatigue, spasticity and dehydration can also contribute to constipation. Medications used to treat MS – like antidepressants or bladder-control medications – can also cause constipation. These drugs block the chemicals in the brain that are responsible for involuntary muscle movement or contractions.

Decreased physical activity, poor diet, dehydration, genetics and other health conditions can also cause constipation.

What lifestyle changes can help?

Talk with your healthcare provider to decide whether and how to treat your constipation, keeping in mind all your medications and other condition(s). Also, ask about nutrition counseling and exercise ideas.

Here are some lifestyle tweaks to consider:

  • Establish a regular time of the day for bowel movements. Having a consistent time to go each day trains the body to regulate bowel movements.
  • Eat regular meals that include fruits and vegetables, whole grains and other high-fiber foods.
  • Avoid low-fiber, starchy foods like white bread. These can “plug up” your system.
  • Try drinking six to eight 8-ounce glasses of hydrating fluids (ideally water) per day.
  • Steer clear of alcohol or coffee – they can worsen constipation. Maintain an exercise routine, if possible. Regular physical activity can also help move things along.
  • Try keeping a diary to track symptoms, diet, medications and bowel movement (or lack thereof). See if there are any patterns that may give clues about the cause of your constipation.

How about OTC options?

If you think you need more than just lifestyle modifications to alleviate your constipation, talk to your health care provider about which (if any) over-the-counter (OTC) or prescription treatment options might be best for you – and how often to use them. You’ll find several treatments at the drug store, but they work differently, and some should be used sparingly. Your provider can help you decide which treatment would be best considering your symptoms, medical history and other medications you’re taking. Here are some OTC examples:

  • Emollient laxatives (also known as “stool-softeners”): These allow more water to mix with stool making it softer and easier to pass. Example: Colace (docusate)
  • Bulk-forming laxatives: These are mixed with an 8-ounce glass of water or juice. They contain fiber that will “bulk-up” the stool, which helps it move along. They also soften the stool by allowing more water to remain in it. This means softer, larger stool that is easier to pass. Examples: Benefiber (guar gum), Citrucel (methycellulose), Fibercon (polycarbophil), and Metamucil (psyllium)
  • Lubricant laxatives: These lubricate the intestines to help soften the stool and make it easier to pass. They should only be used for a short time because they can absorb vitamins, preventing absorption into the body. Example: mineral oil
  • Osmotic laxatives: These help draw water into the intestines to soften the stool. They may cause gas when first used. Example: Miralax (polyethylene glycol 3350)
  • Saline laxatives: These often have magnesium sulfate, magnesium phosphate or magnesium citrate in them. By retaining water in the colon, these drugs soften the stool, similar to osmotic laxatives. Examples: Milk of magnesia (magnesium hydroxide), magnesium citrate
  • Stimulant laxatives: These should be used sparingly because they can cause diarrhea/cramping and – if used long term – colon damage. They help stimulate the muscles of the intestines to move things along. Examples: Doculax (bisacodyl), senna, senna tea
  • Enema products: These stimulate the colon using a stream of fluid introduced via the rectum. The fluid also softens the stool, making it easier to pass. Some enemas include laxative ingredients, such as docusate sodium and mineral oil. Example: Fleet enema (saline enema)
  • Suppositories: These medications are inserted into the rectum. There are two types: Glycerin suppositories lubricate the rectum; bisacodyl suppositories stimulate movement. (Doculax suppositories)

Several combination products and prescription products are also available.

Some people with MS have noted that the Squatty Potty – an ergonomic footstool that helps position your body better for using the toilet – can help relieve constipation.

What treatments/lifestyle changes have you tried for constipation? Join PatientsLikeMe to chime in and help others in the community.

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