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Jillian Michaels Doesn’t Advocate for Keto…Is She Right?

Last April, fitness expert Jillian Michaels authored a blog post called “The Truth About Keto.” In it, she makes several points that I would like to address. She does note that she will infuriate the “Keto community,” is willing to incur their wrath and outrage. I am neither infuriated or a part of the “Keto community,” but I do find it necessary to counter some medical inaccuracies.

Jillian says:

There is some logic to the benefits of ketones or brief periodic ketosis, but those benefits have been manipulated and commercialized making this diet downright dangerous.

I do agree that the idea of the Keto diet has been commercialized. At it’s basis, however, it refers to the process of breaking down fats in your body through the process of lipolysis, and forming ketone bodies which are an alternative form of energy for your body (the other being sugars). There is a dangerous situation that can occur in uncontrolled diabetics called ketoacidosis, which can lead to coma or death, but the necessary component that leads to this state is pathologic insulin deficiency or insulin resistance. For the healthy person, ketosis is not a dangerous state.

Jillian says:

Ketosis is considered a state of medical emergency.

This is an old idea, which was never backed by any scientific evidence, but was assumed. When you are in a fasted state, your body will first use your glycogen (sugar stores) for energy. But when glycogen is depleted, it then uses a combination of protein breakdown and fat stores for energy. Ketosis is an alternative mechanism for energy production that can result either from starvation, or from dietary modification – the second of which is by no means a medical emergency when done with adequate caloric intake. Jillian mentions vitamins and minerals as a deficiency in a Keto diet, but ignores that there are vegetables, fruits, and legumes that can provide all the vitamins you need, but still have a low sugar index, and be appropriate to consume on a Keto diet.

Jillian says:

Keto doesn’t advocate for calorie restriction.

There is no one Keto diet in terms of calories recommended, or exact macronutrient ratios. It is defined by the ketogenic state that the body achieves. The word diet also refers to the types of food you consume, and does not assume caloric restriction. However, in common vernacular, if you are dieting for weight loss, that requires a calorie deficit.  Keto does not advocate for calorie restriction inherently, but if anyone is suggesting you can consume everything in the diet without a calorie deficit, and still lose significant weight, then that is incorrect.

Jillian says:

The Keto diet does not address what types of proteins and fats are ideal . . . and when we aren’t eating macronutrients in a balanced way, we are literally starving our cells.

This is literally incorrect. Essential macromolecules for cellular functions have pathways of production that can be achieved through adequate protein, fats, and some carbohydrates. If there is a carbohydrate deficit, there are biochemical mechanisms for obtaining simple sugars from protein, if needed. There is no valid scientific evidence that the Keto diet accelerates aging or damages our bodies in any way.

Jillian ends with stating medical problems that can develop from over-consumption of proteins and fats. It is important to note that a Keto diet relies on only adequate, maintenance protein, and fat as an energy source – not an over-consumption of either. I agree that excessive macronutrients of any kind can have untoward long-term effects. However, besides protein, there is much leeway between what ratios of fats to carbohydrates you can consume to acquire necessary energy.

Any diet that you are attempting should be done without extremes in any one direction. Especially if you have pre-existing medical problems, you should clear everything with your physician. The Keto diet is one type of diet that if done in a reasonable manner, can reduce your weight, body fat composition and serum levels of cholesterol and triglycerides. Like any diet, however, it also requires commitment.

I will agree with Jillian Michaels on this point: if you are seeking to improve your overall health and you are currently obese or overweight, the best thing you can do is to achieve a calorie deficit based on your basal metabolic rate (BMR) and to exercise.

Published on Jun 26, 2019 by Dr. Shawn Tsuda, FACS

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