The scientific review, conducted by Hematologic Oncologist Urvi Shah, MD, and Medical Oncologist Neil Iyengar, MD, of Memorial Sloan Kettering Cancer Center in New York City, explored the connection between food and cancer focusing on two popular dietary patterns: WFPB diet and ketogenic.

“There is currently no evidence to suggest that a particular diet on its own can treat cancer,” Iyengar explains. “However, growing evidence suggests that dietary interventions can reduce side effects from cancer treatments and could possibly help cancer treatments work better.”

Although the concepts behind a WFPB diet (which emphasizes whole, unrefined, or minimally refined plant foods and excludes or minimizes meat, dairy, and eggs) and a ketogenic diet (a low-carb, high-fat approach that tends to rely on animal foods) are diametrically opposite, Shah says examining the research to understand the differences is helpful.

In their review, Iyengar and Shah included 46 keto diet trials and eight plant-based diet trials. The studies included interventional studies—in which participants were assigned to a diet for a set period of time, with researchers measuring their biomarkers before and after each trial period—as well as epidemiological (population-based) studies. After reviewing the data collectively, they found that diets rich in whole plant foods were consistently associated with a reduced risk of developing and dying of cancer.

Clearing Up the Confusion

“Many of our patients ask about these two diets,” Shah says. “Patients sometimes question: ‘Are sugars bad? Do sugars cause the cancer to get worse?’ That’s why a keto diet may appeal to some patients. We also get many questions about a plant-based diet, as there is more awareness of the health benefits of plant foods, especially the importance of fiber, which is only derived from plants.”

Iyengar says there is a growing awareness of how lifestyle interventions, such as diet and exercise, can help fight diseases. “Most of the available data support a whole-food, plant-based diet over a ketogenic diet for reducing the risk of cancer,” he says. “The keto diet can be effective for weight loss. While weight loss is one important strategy for reducing cancer risk, there are many other variables that contribute to cancer risk—such as diet quality, fiber intake, and the bacterial composition in our gut. A plant-based diet is an effective strategy for addressing most of these variables in addition to weight loss.”

Following a cancer diagnosis, Iyengar says a WFPB diet still appears to be superior to keto. “Growing evidence suggests that dietary interventions can reduce side effects from cancer treatments and could possibly help cancer treatments work better,” he says. “There are ongoing clinical trials testing whether dietary interventions can help patients feel better while improving response to standard cancer treatments. In our paper, we call for more research in this area and we provide recommendations for designing successful trials.”

A Simple Rule

Hearing about different diets and food as medicine can be confusing and overwhelming. When in doubt, Shah recommends keeping a simple rule in mind: If a food is derived from plants and not processed, it will have beneficial effects on one’s overall health and risk of obesity, diabetes, and cancer.

“It is best to prioritize these foods, which include legumes, seeds, nuts, whole grains, fruits, and vegetables, and make them the bulk of your meals,” Shah says.

Want to try a plant-based diet but don’t know where to start? Visit our Beginner’s Guide.

The post New Study: Plant-Based Diet Beats Ketogenic Diets for Cutting Cancer Risk, Improving Outcomes appeared first on Forks Over Knives.

If you’re reading this story in the hope of seeing drastic before and after photos, I’m afraid you’re going to be disappointed. However, if I could wear my body inside-out, I think you’d find my transformation pretty damn impressive (if I say so myself)! My story is about how a drastic change in my nutritional approach—going from keto to plant-based—allowed me to regain control of my insulin and blood sugar levels and, ultimately, to thrive again.

Health-Conscious History
I’ll start by introducing myself. My name is Drew Harrisberg. I’m an exercise physiologist, diabetes educator, sport scientist, and most importantly, I’m a happy and healthy guy thriving with type 1 diabetes. I’ve not only accepted living with it; I’ve learned to love it and manage it so that it doesn’t manage me.

The diagnosis came unexpectedly when I was 22 years old. It was a moment that changed my life forever. I remember making a conscious decision that I would become an expert in managing my disease and that I would share everything I discovered with the world. So the journey began. I went back to university and completed my second degree to add to my exercise physiology title, this time in diabetes education and management.

Since being diagnosed with diabetes, my life has been one big self-experiment. The cool thing is, I’ve been the subject and the lead scientist. I’ve made countless mistakes and discovered just as many solutions.

My first nutritional triumph came very soon after my diagnosis, when I transitioned from the conventional food pyramid to a mostly plant-based, low carb (50-150 grams per day), Paleo approach. About 70 percent of my diet consisted of low-carb, non-starchy vegetables; nuts; and seeds. Animal foods (meat, fish, eggs, and dairy) made up only about 30 percent of my diet, but I had some animal products with every meal. I ate very minimal fruit (just berries) and almost no grains, legumes, or nightshades. I followed this way of eating for the first seven years of my diabetes journey, and it did help me to achieve some great results: My insulin requirements dropped significantly, my blood sugar levels were tightly controlled, and some physical ailments, such as chronic sinusitis and shin splints, disappeared and never came back. My overall health improved.

Recently, my desire for personal development led me down an entirely different road. All the buzz about the ketogenic diet had me interested, so I decided to try it out in the hope that I could further reduce my insulin requirements and achieve even better blood sugar control.

One Step Forward, 10 Steps Back
Initially, that’s exactly what happened. After two months on a ketogenic diet, I was lean, fit, had great focus and concentration, could go long hours without eating, had stable blood sugar levels, and had lower insulin requirements. At this point, it seemed like keto was a magic bullet, and I was a huge proponent of this way of eating. But after two months, everything took a horrible turn for the worse. I became the most insulin resistant I have ever been. I lost all metabolic flexibility. Sure, I was a very efficient fat- and ketone-burner, but it was at the expense of the ability to tolerate any glucose whatsoever. Not only could I no longer eat the smallest amount of carbs without a massive blood sugar spike but also I was resistant to the insulin that was meant to bring my levels back into the normal range. It would have been easy to blame my high blood sugar levels on the tiny amounts of carbs I was eating, but that would have been a mistake. Here’s why: Even if I didn’t eat anything and my liver dumped glucose into my bloodstream, I couldn’t fix my high blood sugar levels, because I was resistant to the insulin that I was injecting. It felt like I was on my way to developing type 2 diabetes (type 1 is more than enough, thank you). It was a very frightening reality and a huge wake-up call.

I came to an eye-opening realization: The ketogenic diet is a short-term, Band-Aid solution. By removing carbs from the diet, you’re simply removing a trigger that leads to symptoms (hyperglycemia) without addressing the actual cause. Then when you add carbs back in, your body can’t tolerate them, which makes it seem like carbs are “bad” for you, but really they’re the victim of something else. After spending hours and hours down a rabbit hole of research, it turns out that high amounts of intramyocellular fat accumulation cause the cell to become dysfunctional, leading to insulin resistance and impaired glucose tolerance. I’ve seen numerous keto advocates demonizing carbs because they personally can’t tolerate them. Once again, it may seem like the banana caused your blood sugar to go up, but what it really did was trigger a symptom that was caused by a much deeper problem. After becoming aware that the large amounts of saturated fat I was eating (from eggs, chicken, meat, and full-fat dairy, and coconut oil) was making me insulin resistant, I knew I had to make a change.

Getting to the Root of the Problem
Having made the connection between poor health outcomes and saturated fats, I was hesitant to return to a Paleo diet. I realized that perhaps when I’d previously done well on Paleo, I was just “getting away with it” because of the healthy plant foods that I was eating. Were my positive results on Paleo due to the 30 percent of my diet that was animal products or the 70 percent that was plants? I suspected it was the latter. The only way to truly find out was to start a strictly plant-based approach and track the changes.

So, I decided to embark on a journey to see if removing those foods altogether and eating more carb-rich plant foods would reverse the metabolic damage I had caused. I immediately embarked on a strictly whole-food-plant-based journey.

I dropped my fat intake from 75 percent of daily energy to less than 20 percent. I removed all animal foods and oils. Rather, I focused on getting healthy fats from avocados, nuts, and seeds. I also added whole grains and legumes back into my diet (both of which I hadn’t eaten in nearly seven years since following a paleo approach) and an abundance of all types of fruit. Within 48 hours my insulin sensitivity started to return to normal. Within 1 week my carbohydrate intake was the highest it had been since being diagnosed with diabetes, and my insulin intake was reducing day by day.

As I write this story, I’ve been strictly plant-based for 30 days and the results have been astonishing. I’ve achieved my best ever insulin-to-carb ratio, and it feels like I’ve regained control of my health. What started as a plant-based journey toward personal development and health has turned into something so much bigger. The positive impact I’m having on myself, the people around me, the environment, and animals gives me so much fulfillment and joy. I cannot wait to see where this journey takes me over the long-term.

Ready to get started? Check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path. To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer.

The post Why I Quit The Keto Diet appeared first on Forks Over Knives.

Carbs: A Brief History

Some hundreds of millions of years ago, plants developed the ability to take energy from the sun (along with carbon dioxide and water) and make carbohydrates. The process, called photosynthesis, allowed plants to store energy in the form of carbohydrates.

This evolutionary step completely transformed the planet because it allowed the flourishing of organisms that lacked the ability for photosynthesis, since they were now able to obtain energy by eating carbohydrates in plants.

The human body, which does not have the ability to make food from the sun, also happens to use carbohydrates as its main energy source. For example, our brain and red blood cells depend specifically on glucose (a carbohydrate) for normal functioning and energy.

Carbs also serve as an important energy reserve in the form of glycogen in our muscles and liver, allowing us to maintain steady energy levels and also to have energy for sudden strenuous activities (such as sprinting). Thus, carbohydrates enable the body to adapt to a diverse range of situations.

How, then, did we come to vilify carbs? Most plant foods are naturally high in carbohydrates, so if we shun carbs, we’re shunning some of the healthiest foods that exist. We’re also shunning our bodies’ main source of energy. So how did this all come about?

Throwing the Baby Out with the Bath Water

There’s a world of difference between eating fruits, vegetables, and whole grains, and eating doughnuts, candy, and other processed foods.

In this vein, there’s a kernel of truth in the low-carb message: Refined sugars, white bread, and other processed foods high in carbs are unhealthy. Indeed, they are. But it’s not because they are high in carbs; it’s because they are processed foods that have had all of their nutrients stripped out.

However, fruits and other plant foods that are naturally high in carbs (such as vegetables, whole grains, and legumes) contain fiber, phytonutrients, antioxidants, minerals, and vitamins that are critical for good health—from protecting our eyesight by helping prevent macular degeneration to helping fight infections and cancer. Yet in the minds of many, these immensely healthy foods have been grouped with white bread and table sugar.

By telling people to avoid or significantly limit carbs in general, the low-carb movement has erased the crucial distinction between unprocessed and processed foods—creating an entirely new paradigm that goes against everything we know about nutrition and health.

Long-Term vs. Short-Term

If you eliminate carbohydrates from your diet and put your body into a state of ketosis, whereby it’s forced to burn fat to make ketones for energy, it can lead to short-term weight loss. But keeping your body in a state of ketosis is neither sustainable nor healthful, and it does not fulfill the long-term promise of effective weight loss. Indeed, observational population studies show that high-protein, high-fat diets are associated not only with more health problems but also obesity.

When looking at long-term and sustained weight loss without mandated exercise or calorie restriction, the most effective eating pattern has been shown to be a whole-food, plant-based diet (low in fat and high in unprocessed carbohydrates).

The Rise of Atkins

The low-carb idea first became well known in 1972 after Dr. Robert Atkins began publishing his Diet Revolution books, which sold more than 15 million copies and established the Atkins brand and marketing empire.

Atkins is considered the “father” of the low-carb movement. He pushed the remarkable idea that if people ate fat and protein and eliminated (or significantly minimized) carbs, they would be more slender and healthy. Calories were deemed unimportant, allowing people to embrace some of the unhealthiest foods while still following a “diet.”

It’s not hard to see the appeal of this movement, which persists to this day. Gluttony is permitted and encouraged, and people think they are sticking to a diet while loading up on fried chicken, butter, bacon, eggs, steak, and cheese.

The chair of Harvard’s Department of Nutrition said that the Atkins diet was “nonsense” and “dangerous.” The prestigious Medical Letter on Drugs and Therapeutics called the diet “unbalanced, unsound, and unsafe.” But no amount of criticism stopped the diet’s popularity and the newfound fear of carbs it perpetuated.

The Zone and Other Atkins Spin-Offs

Seeing how Atkins hit the financial jackpot, it didn’t take long for a slew of other “low-carb” spin-offs to follow suit.

In the 1990s, we saw the rise of the Zone Diet, which claimed to achieve both weight loss and “hormonal balance” with a so-called “40-30-30” approach, whereby you obtain a relatively low 40 percent of calories from carbs (so still low-carb), 30 percent from protein, and 30 percent from fat. The Protein Power diet was a high-protein/low-carb approach, with significant vitamin and mineral supplementation (perhaps to compensate for the deficiencies of avoiding high-carb fruits and vegetables).

The blood type diet was an even more unusual idea, where people with different blood types would follow dramatically different diets (which is akin to someone recommending different diets based on different eye or hair colors—sounds curious enough, but has no real science behind it). Interestingly, it recommended a meat-free diet for those with blood type A but a meat-heavy low-carb diet for those with blood type O, which is the most common blood type in the U.S.

The 2000s produced even more low-carb variations. The South Beach Diet emphasized “leaner” meats, but still limited carbs to no more than 28 percent of daily calories. The Paleo diet, popularized by an exercise physiologist, is another “high-protein/high-fat/low-carb” diet, but with an emphasis on avoiding processed foods and dairy. It’s based on very subjective assumptions about hunter-gatherer life in Paleolithic times, with provocative and sweeping claims that animal foods comprised up to 75 percent of the human diet (despite evidence to the contrary), and that these questionable estimates should dictate what we eat today (despite being at odds with mainstream medicine).

These diets and their promoters have enjoyed immense commercial success. The author of The South Beach Diet, for example, has sold more than 17 million books and generated large revenues from online services and major licensing deals. The founder of the Paleo diet gained a huge share of the weight-loss market, with cookbooks, Paleo-themed magazines, “Paleo-approved” protein bars, and other products.

These low-carb entrepreneurs tapped into something very powerful: people’s desperation to lose weight. But they have done so by introducing serious confusion about basic nutrition, to the detriment of people’s health.

The Real Skinny on Weight Loss

In short, low-carb/high-fat diets are not good strategies for sustainable or healthy weight management.

One reason is that it’s metabolically a lot easier for our bodies to use carbs for energy, and to store fat as fat. Certainly, if you’re eating too many calories in general, then carbs can and do get metabolized into fat. But it costs our bodies a large percentage of calories to do so: About 28 percent of energy content of carbs is needed to convert them into fat.

In addition, it’s much harder to overeat whole plant foods that are naturally high in carbohydrates (such as fruits and vegetables) because they are typically less calorically dense than high-fat foods and come packaged with lots of fiber, which provides satiety (i.e., you feel full before you eat too much). By contrast, high-fat/low-carb foods can easily trick our brains into overeating because they are more calorically dense and lack fiber.

A Lesson from History?

Low-carb advocates sometimes claim that we’ve tried limiting fat before and it didn’t work—that it actually made Americans fatter. Specifically, they point to a U.S. Senate report published in 1977 that recommended increasing plant foods while cutting back on high-fat meat and dairy.

But the basis for this argument is simply not true.

First of all, the 1977 recommendations specified that no more than 30 percent of calories should come from fat—which is not “low-fat” by any measure. Second, even that modest recommendation was not followed by most Americans; instead, fat and calorie consumption continued to increase.

A Better Lesson From History

It’s no big surprise that Americans are not the healthiest population: We weren’t in the 1970s and we still aren’t today. So, who are the healthiest populations and how do they eat?

The healthiest populations in the world have thrived on carbohydrate-centric diets with corn, wheat, rice, or barley as the main staple, plus lots of vegetables and fruits. These populations are sometimes referred to as “Blue Zones.”

One example is the Okinawans of Japan. Their traditional diet derived close to 85 percent of calories from carbohydrates, with about 60 percent of calories specifically coming from sweet potatoes.

This emphasis on whole unprocessed foods high in carbs served the Okinawans very well. They were not obese, had much lower rates of diseases that plague the West, and were the longest-living people on the planet until they changed their diets. Older Okinawans who continue their traditional way of eating are still among the oldest living people on the planet.

Increased Cardiovascular Risk

Those who follow a low-carb diet have been found to be 50 percent more likely to die of cardiovascular disease and 51 percent more likely to die from cerebrovascular disease.

Cardiovascular disease involves the hardening of the arteries and formation of cholesterol plaques in our vessels, which can cause blockages, blood clots, or tears in our vessels. The disease can manifest in the heart, as it often does; in the brain, where it causes strokes; or in other parts of the body. It’s the world’s leading cause of death, and the only diet that’s been found to stop and reverse it is a whole-food, plant-based vegan diet.

There are numerous factors that help explain the strong association between animal food consumption and cardiovascular risk. For example, eating animal foods in general (including poultry, eggs, dairy, and fish) results in our bodies’ producing higher amounts of a substance called trimethylamine N-oxide (TMAO). TMAO directly injures the lining of our blood vessels and makes them prone to develop atherosclerosis.

That may be why cardiologist Dr. Kim Williams vigorously promoted a plant-based vegan diet during his tenure as president of the American College of Cardiology, and once famously said, “There are two kinds of cardiologists, those who are vegan and those who have not read the evidence.”

Dr. Robert Atkins himself sadly had a history of congestive heart failure and a heart attack, according to a medical report that was accidentally leaked from the New York medical examiner’s office following his death. His widow and the Atkins organization have always denied it.

It’s worth noting that those following a low-carb diet were also found to be 35 percent more likely to die of cancer.

Takeaways

It is extremely important to eat a varied and large amount of whole plant foods every day, something that is exceedingly difficult (if not impossible) to do if you’re displacing plant foods with animal foods in a misplaced effort to avoid carbs.

Yes, refined and processed foods (including processed carbs) are to be avoided. But don’t replace them with meat, eggs, and cheese. Replace them with foods that actually promote good health, such as vegetables, fruits, legumes, whole grains, and, yes (gasp!), potatoes, sweet potatoes, and bananas, too.

It’s easy to get the right proportions of nutrients (plus lots of antioxidants and phytonutrients that promote health and prevent disease) simply by eating a well-balanced and varied diet of whole plant foods. And, as no small added benefit, eating a plant-based vegan diet is also an effective and sustainable way to manage your weight.

Ready to get started? Check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

The post How Carbs Became a Dietary Supervillain appeared first on Forks Over Knives.

For those who are unaware, the keto, or ketogenic, diet excludes all carbohydrates to the point that the body derives energy from another macronutrient: fats. Followers of the keto diet do not eat whole grains, legumes, or fruit because of the carbohydrate content of these foods: Even some vegetables contain too much starch to be allowed in the diet. As a result, the body extracts energy from fats consumed in the diet, which creates ketone bodies as a byproduct of metabolizing fats, hence the name.

No Human Population Has Survived in Ketosis

Don’t let keto evangelists tell you the Inuit survived and thrived on a nightly fare of seal blubber, whale sirloins, and caribou jerky while being in the purportedly nirvana-like state of ketosis. (“Keto flu,” the common phrase for the symptoms of malaise, nausea, and fatigue that keto dieters regularly experience, is more indicative of the unpleasant truth.) The Inuit certainly ate those things; farmers markets are scarce in the Arctic because, well, there aren’t vegetable farms in the tundra. But they also evolved to avoid ketosis altogether: A mutation occurred several thousand years ago to prevent ketosis in this population. The mutation is now found in more than 80 percent of Greenland and Canadian Inuit. Because the keto diet increases acid levels in the blood, it is hypothesized that ketosis reduced the ability to tolerate further acidosis during times of illness, injury, or complete starvation, thereby increasing the chance of death. That so many Inuit have the mutation strongly suggests that ketosis was perilous for the aboriginal inhabitants of the Arctic—and likely is perilous for anyone else on the diet as well.

Deficiencies in Vitamins A to Z

It should come as no surprise to anyone that the ketogenic diet causes vitamin and mineral deficiencies. After all, there are large food groups that followers simply cannot eat, such as whole grains and most fruits. The rules for maintaining ketosis are so strict that an extra helping of broccoli might push you over the carbohydrate limit.

The only people who should be on a ketogenic diet are children who have refractory epilepsy, for which the diet has been used as therapy to reduce seizures for nearly a century. Researchers have been studying the side effects of the diet in this population, including vitamin and mineral deficiencies. In one study, researchers found deficiencies in every vitamin and mineral analyzed except for vitamin B12, which is commonly found in fatty foods of animal origin. The severity increased with increasing ketosis. In some cases, deficiencies in selenium were so severe that children died.

Until Death Do Us Part

Study after study has shown an increased risk of death with low-carb diets, and the keto diet maintains utmost supremacy in carbohydrate restriction. In a recent study published in The Lancet, those eating low-carb diets and relying primarily on animal-based foods, such as lamb, beef, pork, and chicken, were associated with a higher mortality. We already know that eating animal-based foods, such as dairy and meat, increases the risk of dying. The keto diet, in particular, also worsens levels of both good and bad cholesterol, which puts one at risk of dying from heart disease. The foods that the keto diet excludes—fruits, vegetables, legumes, and whole grains—are some of the healthiest foods around. It’s no wonder the risk of dying goes up when you leave these foods off the plate.

Does Keto Keep Its Promises?

Keto’s claim to fame is its almost mythical ability to treat diabetes and obesity. However, long-term studies show no benefit for diabetes. Although studies of short-term duration (less than a year) frequently show a benefit in the treatment of diabetes, a meta-analysis of studies lasting more than a year showed no difference in glucose levels of those on the ketogenic diet compared with controls. And for weight loss? A paltry two-pound advantage over a low-fat strategy, after one year of counting carbs. Two pounds of weight loss is not enough to make you look that much more svelte. There are saner—and safer—ways of losing two pounds over the course of a year, like eating a whole-food, plant-based diet.

I’ve Got 99 Problems, but Carbs Ain’t One

Even if you believe the keto diet works for weight loss, there are plenty of other reasons to avoid it. In reviewing the literature of the documented side effects in epileptic children on the diet, I found that patients suffered from no shortage of side effects, including kidney stones, restricted growth, fatal cardiac arrhythmias, pancreatitis, higher cholesterol levels, and many more. The diet seems to be worth utilizing only if one happens to be a child with refractory epilepsy—and even then, children discontinue the diet because of its numerous side effects.

The ketogenic diet has swept the country up with the hope of a miracle diet, but, in the end, it may only bring us down with disappointment. Let food be thy medicine, but not if you need actual medicine to support thy food.

The post Why You Should Say No to the Keto Diet appeared first on Forks Over Knives.