Could ketosis be the answer to preventing deadly seizures during deep-diving missions?
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- The U.S. military has been funding research exploring how the keto diet might benefit soldiers during deep-diving missions.
- The technology that Navy SEALs use to stay hidden underwater can lead to seizures. Studies suggest ketosis might prevent these seizures.
- Still, ethical and legal questions remain, and researchers hope to continue learning more about how ketosis might yield advantages on the battlefield.
The keto diet could soon give Navy SEALs a tactical advantage in battle: The ability to spend more time underwater.
The keto diet — high in fat, moderate in protein, low in carbs — puts the body in a natural metabolic state called ketosis. In ketosis, brain cells burn ketones instead of glucose for fuel. Studies suggest that this state prevents people from having a seizure, which is a major risk for special-operations divers who use closed-circuit rebreathers on their oxygen supplies. These devices minimize the amount of bubbles that appear on the water's surface — crucial for stealth missions — but also increase the risk of seizure, convulsions and nausea, all of which can be deadly during a mission.
"One of the effects of truly being in ketosis is that it changes the way your body handles oxygen deprivation, so you can actually stay underwater at [deeper] depths for longer periods of time and not go into oxygen seizures," Lisa Sanders, director of science and technology at U.S. Special Operations Command, said at a high-level defense industry conference in Tampa in May, as the Washington Times reported.
For years, the U.S. military has funded research exploring how ketosis might benefit divers. The leading example is a 2015 study led by Dominic D'Agostino, a neuroscientist at the University of South Florida. D'Agostino and his team gave ketone supplements to rats and placed them in hyperbaric chambers that simulated deep-diving conditions. The results showed that, compared to a control group, rats on ketone supplements had fewer seizures. Also, these rats performed better on physical and cognitive tests.
But just because there's a clear link between ketosis and fewer seizures doesn't mean it's ethical or legal to command soldiers to stick to a particular diet — especially one as controversial (and potentially dangerous, if implemented incorrectly) as keto.
"... I don't have the authority to tell people — swimmers, submariners, etc. — that they're going to get themselves in ketosis so they can stay in the water longer," Sanders said at the defense industry event. "That's an authority question, not a technology question."
What's more, it's possible that radically changing soldiers' diets could have unpredictable consequences.
"For me, it smacks of the removal of free will from one of the most basic of biological functions: eating and consuming energy. It's also one that misunderstands and misrepresents how a biological organism works," E. Paul Zehr, a neuroscientist and biomedical research scholar at Canada's University of Victoria, told Business Insider. "Biological beings are not automatons or machines. You can't just attempt to optimize one thing and not have it alter something else. All systems … exist in a balance."
Ultimately, soldiers may simply decide for themselves whether the diet is right. Future research will hopefully help them make informed decisions.
"We are motivated to perform larger and more comprehensive studies aimed at elucidating therapeutic and health/performance benefits of ketosis for military members," Jeff Volek, a professor in the Department of Human Sciences at the Ohio State University who's conducted research on military personnel and keto, told Business Insider. "We have submitted several grants over the years and continue to do so to move this from hypothesis to the lab to the battlefield."
Can changing diet actually reverse the growth of cancer in the body?
- The keto diet is known to be an effective tool for weight loss, but in recent years some–including some doctors–have claimed the diet has cancer-reversing qualities.
- Although the theory might someday be proven correct, far more research is needed before scientists know whether the diet can be used as a safe and effective treatment for cancer.
- A 2018 study did show one promising use for the keto diet in treating cancer, though it was purely used a supplemental tool in conjunction with a conventional approach.
Like any trendy diet worth its balanced portion of salt, the keto diet is said to hold transformative powers. Proponents say it can help people lose weight, improve mood and experience fewer epileptic seizures. For the most part, the science seems to back these claims up — though, to be sure, it's not completely understood how exactly the keto diet affects mood (particularly depression), despite anecdotal evidence the diet might lead to clearer thinking and fewer symptoms of depression.
The boldest claim about the keto diet, however, is that entering a state of ketosis — which occurs when the body begins burning fat instead of glucose for fuel — can slow or even reverse cancer. It's an idea that stems from a century-old theory about the primary cause of cancer.
Cancer and metabolism
In the 1920s, a German biochemist named Otto Warburg observed that most cancers get their fuel differently than normal cells, a phenomenon dubbed the "Warburg effect". The difference, in simple terms, is that cancer cells consume a lot more glucose than healthy cells. So, because cancer relies heavily on glucose, the idea is that putting your body in a state of ketosis — which lowers blood sugar levels — might effectively "starve" cancer cells because there's less glucose to consume.
This 'cancer thrives on sugar' theory can be summed up like this, as Dietarytherapies.com outlined:
- Over half of the calories in standard diets come from carbohydrates.
- Carbohydrate digestion produces spikes in blood glucose which in turn causes a spike in insulin.
- Insulin's job is to move glucose from the blood into cells.
- Cancer cells typically have many more insulin receptors than normal cells.
- Limiting carbs restricts the movement of glucose into cancer cells.
- When glucose is in short supply, the body will increase its use of fats as fuel.
- The liver converts some of this fat to energy molecules called ketones.
- Most normal cells (including brain tissue) readily adapt to using ketones.
- Tumor cells suffer because they are not as fuel flexible as normal cells.
A 'blueprint for the destruction of cancer'?
One of the most vocal proponents of the keto-diet-as-cancer-treatment theory has been Dr. Thomas Seyfried, a cancer researcher and professor at Boston College. Several years ago, Seyfried said that the keto diet actually beats chemotherapy for some types of cancer, a claim founded in his rather controversial belief that cancer is primarily a mitochondrial metabolic disease. In a recent paper, Seyfried outlined a cancer-treatment approach that he thinks could be the "blueprint for the destruction of cancer," as he told U.S. News & World Report:
"It's called ketogenic metabolic therapy," and he says in this context, "the ketogenic diet shouldn't be considered a diet like green salads or other such stuff. It's essentially medicine, and the process primarily tries to remove one of the driving fuels for the disease, which is glucose, and transition the whole body over to ketones, which the tumor cells can't use as a fuel."
"It's a cocktail of drugs and procedures and foods and they all work synergistically to gradually eliminate the tumor while maintaining the health and vitality of our normal organs. The whole goal of this metabolic therapy, which involves the ketogenic diet, is to gradually degrade and eliminate tumor cells without toxicity so the patient emerges from the therapy healthier than when they started."
Some have argued that Seyfried has "put the cart in front of the horse" in his past claims, and it should be noted that some prior studies which ostensibly show the keto diet's cancer-reversing properties fail to demonstrate conclusively that it was ketosis, and not another factor, that helped beat cancer.
Ultimately, more research on the keto diet and cancer is required before doctors can responsibly recommend it as a standalone treatment.
"Most of the work in this field is still pre-clinical, meaning it's been conducted in animal models," Angela Poff, a research associate in the Department of Molecular Pharmacology and Physiology at the University of South Florida, told U.S. News & World Report. "It's been done in various cancer types, but most of the work has been done in brain cancer specifically. But there's very little clinical data all around. There's some case reports and very small preliminary clinical studies in small groups of patients, usually very late-stage patients with various types of cancers. So in the clinical realm, which is the most important in telling us whether this is going to be useful, we have a long way to go."
Another use for the keto diet in cancer treatment
In July 2018, a study published in the journal Nature described how researchers used the keto diet to help a cancer-treating drug become more effective.
Recently, scientists have been experimenting with a new class of cancer drugs that target a cell signaling pathway called phosphatidylinositol-3 kinase. Studies have found mutations in this kinase as cancer develops, so the aim of the new drugs is to block the pathway with the hopes of stopping tumor growth.
But researchers found that taking these drugs seems to cause spikes in blood sugar, which reactives the pathway and effectively kills the purpose of the drugs. In the 2018 study, researchers decided to use the keto diet as a way to control glucose levels in the body.
"The ketogenic diet turned out to be the perfect approach," study author Benjamin D. Hopkins, a postdoctoral associate at Weill Cornell Medicine in New York City, NY, Hopkins, told Medical News Today. "It reduced glycogen stores, so the mice couldn't release glucose in response to PI3K inhibition."
"This suggests that if you can block spikes in glucose and the subsequent insulin feedback, you can make the drugs much more effective at controlling cancer growth."
The study authors noted that the promising results don't suggest that the keto diet on its own has any cancer-reversing effects. What's more, they noted that a group of mice in the study that was placed on the keto diet but didn't receive any cancer drugs actually developed cancer at faster rates than the other mice.
Folios cheese wraps can be a surprisingly healthy substitute for traditional tortillas. Of course, there's a catch.
- To help keto dieters stay the course, Lotito Foods has developed the Folios cheese wrap, a tortilla made entirely of cheese.
- These cheese wraps can be part of a healthy diet, but only if eaten in extreme moderation and alongside low-fat, low-salt foods.
- Research shows that replacing grains and fiber with fat and salts in the long term can be dangerous.
Now they've gone and done it. Keto diet enthusiasts have concocted all manner of unsettling dishes to kick the carbs: coffee with butter instead of cream, cauliflower pizza crust, and "cheesecake bites" made from cream cheese rolled in sugar-free Jell-O dust. Now they've come for that most saintly of all carb-loaded foods. The tortilla.
Lotito Foods, an Italian specialty foods manufacturer, has devised a tortilla made entirely of cheese. Called Folios, they contain no starch, wheat, flour, or additives and come in three flavors: Parmesan, Jarlsberg, and cheddar.
The cheese wraps are currently available in Northwest grocery stores, and they've garnered a lot of hype. They've been featured on the Today Show and in Women's Health, and keto followers are starting to take notice on social media.
But is a tortilla made of cheese truly the healthier option? As with any dietary inquiry the answer is yes, no, but also maybe.
Keto vs. carbs
Can Lotito Foods' Folios cheese wrap stack up to the comfortable goodness of a traditional tortilla. For ketogenic dieters, the answer is obvious.
To find out, we'll need to compare the nutritional information of Folios cheese wrap to a traditional tortilla. We'll stack the Folios' cheddar flavor against an organic Mission whole wheat tortilla—for the incredibly scientific reason of that's what I had in the fridge.
A Folios cheddar wrap has a serving size of one tortilla (42g) that nets you 180 calories. The tortilla's serving size is also one tortilla (49g) with 150 calories. Neither are very high in sugar (0 vs. 2g) or iron (0 vs. 6 percent), and both contain roughly one-sixth of your daily recommended sodium.
Where the two differ, no surprise, is carbs and fat content.
The cheddar wraps contain 13 grams of total fat, eight of which are saturated fat. That means one wrap is worth 20 percent of your daily recommended fat and 40 percent of your saturated fat (per a 2,000-calorie diet). It also has 45 milligrams of cholesterol. On the more salutary side, the wraps contain a whopping 11 grams of protein and no carbs.
The tortilla has far more carbs, but at 24 grams, it's only one-tenth your daily total. It also has far less fat (5g), no cholesterol or saturated fat, and some fiber and potassium (7 and 2 percent respectively).
It's worth noting that Folios cheese wraps' ingredients are pasteurized milk, salt, enzymes, and annatto coloring. That's it. There's something incredibly pleasing about an ingredients list so simple.
It's not easy going cheesy
Trying to stay low carb and don’t wanna taco ‘bout how much you miss #TacoTuesday? Folios™ to the rescue! https://t.co/2RgEfGWJUQ— Cheese Folios (@Cheese Folios)1514303991.0
For the average, non-keto consumer, Folios cheese wraps can be a healthy dietary choice, as are most cheeses. As we've seen, cheeses provide a delicious source of protein, and they also sport calcium, vitamin B12, and healthy gut bacteria. Eating cheese regularly has even been linked to increased longevity.
A meta-analysis published in the Journal of the American Heart Association (JAHA) found that milk and cheese consumption were associated with lower risk of stroke. Another meta-analysis—this one published in the European Journal of Nutrition—supported that long-term cheese consumption lowered one's risk of stroke in addition to cardiovascular disease.
But there's a catch. These health benefits required one to limit the amount of cheese they consume. The JAHA analysis found risk reductions were maximal at around 25 grams of cheese per day. The European Journal of Nutrition found the largest risk reductions in those who ate roughly 40 grams of cheese per day.
Based on these studies, a healthy diet would make room for exactly one Folios cheese wrap per day, and no more cheese after that.
Then there's that fat. The 2015-2020 Dietary Guidelines for Americans, put out by the U.S. Departments of Health and Human Services and of Agriculture, recommends that all Americans curb their sugar, sodium, and saturated fat intake. The report suggests Americans consume less than 10 percent of their daily calories as saturated fats—allotting you two cheddar cheese wraps per day.
If you're not into keto but like the idea of a cheesy blanket for your tuna fillet, you can still enjoy a cheese wrap or two. You just have to be conscientious about the foods you eat in and alongside it. Nutritionist and author Bonnie Taub-Dix recommends not filling the cheese wraps with high-sodium or high-fat ingredients, such deli meats.
"Healthy types of tortilla wraps can provide whole grains and fiber, both missing from [Folios] wraps. The majority of us don't get enough whole grains or fiber, but we get plenty of fat and protein," Taub-Dix told Today. Most nutritionists, she notes, encourage a balanced diet with fresh produce, whole grains, and lean proteins.
A keto revolution?
But are the Folios cheese wraps a healthy choice for keto enthusiasts, who are, after all, the target market? That answer depends on whether the keto diet itself proves healthy, and the scientific consensus is currently TBD.
The ketogenic diet has seen some preliminary successes in studies and lab experiments. It's been shown to produce weight loss faster than traditional low-fat diets. Lab studies using mice have suggested that the keto diet may improve neurovascular function to prevent cognitive decline and improve longevity. The diet also has a history of success as an effective treatment option for epilepsy and cancer.
"Keto diets should only be used under clinical supervision and only for brief periods," Francine Blinten, a clinical nutritionist and public health consultant, told Healthline. "They have worked successfully on some cancer patients in conjunction with chemotherapy to shrink tumors and to reduce seizures among people suffering from epilepsy."
Although noting its efficacious uses, Blinten added that it has the potential to damage the heart. "People are using this for cosmetic reasons, but it's so extreme that it's dangerous."
Other experts agree that the short-term benefits can be outweighed by long-term harm. One study found that participants on the ketogenic diet did not perform as well at anaerobic exercises, which are known to strengthen bones, burn fat, and build muscle. While at the Harvard Health Blog, Marcelo Campos, MD, concluded:
But [the keto diet] is hard to follow and it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects, probably because it's so hard to stick with that people can't eat this way for a long time. It is also important to remember that "yo-yo diets" that lead to rapid weight loss fluctuation are associated with increased mortality.
We may not know much about keto's long-term effects, but we do have good data on low-carb diets in general. A 2018 study from the European Society of Cardiology explored a sample of 24,825 participants and found that the lowest intake of carbs had a 32 percent higher risk of all-cause death, while "risks of death from coronary heart disease, cerebrovascular disease, and cancer were increased by 51%, 50%, and 35%, respectively." The researchers confirmed their results alongside a meta-analysis of seven prospective studies with a combined 447,506 participants.
Study author Professor Maciej Banach, Medical University of Lodz, said in a statement: "Low carbohydrate diets might be useful in the short term to lose weight, lower blood pressure, and improve blood glucose control, but our study suggests that in the long-term they are linked with an increased risk of death from any cause, and deaths due to cardiovascular disease, cerebrovascular disease, and cancer."
If you're on keto as part of a clinical treatment, feel free to ask your doctor or nutritionist if you can incorporate cheese wraps into your diet. They could potentially help your treatment while adding culinary benefits, like reintroducing taco bowls to your life. If you're on the keto diet outside of medical recommendation, then cheese wrap at your own risk.
The exploding popularity of the keto diet puts a less used veggie into the spotlight.
- The cauliflower is a vegetable of choice if you're on the keto diet.
- The plant is low in carbs and can replace potatoes, rice and pasta.
- It can be eaten both raw and cooked for different benefits.
Of all the ubiquitous diet trends, the keto diet is probably the one with the most current buzz. While the long-term health benefits of this low-carb approach are debatable, keto has thrust one vegetable into the spotlight. Welcome to the age of the cauliflower.
What's made the cauliflower, the bane of kids everywhere, experience such a burst in popularity? The keto (or ketogenic) diet calls for getting rid of high-carb foods in favor of fatty foods rich in protein. The goal is to get your body into a state of ketosis, where it will burn fat for fuel instead of sugar. The short-term weight loss that ensues has been the reason for the diet's growing amount of followers.
The biggest reason for cauliflower's resurgence? It is very versatile and has only 3 grams of net carbs (from 5 grams of carbs) per a 100-gram cup. That makes it an excellent low-carb vegetable substitute in many recipes that call for things like potatoes, rice or pasta.
What's also great about this under-utilized veggie is that a cup of cauliflower would have only 25 calories while giving you 77% of the daily allowance of vitamin C and high levels of vitamin K and B6. It also contains omega-3 fatty acids, fiber, choline, biotin, phosphorus, magnesium, manganese, niacin, pantothenic acid, vitamin B1, B2 and protein. You can search its full nutritional values in this expansive USDA report. Suffice to say, the cauliflower is chock-full of nutritional goodies.
This plant, which has its origins in Cyprus and the Asia Minor region, with first historical mentions going to back to around 600 B.C., has also been found to have anti-carcinogenic properties.
This is what a cauliflower mac 'n cheese looks like. The recipe can be found at MinceRepublic.com.
So what can you do with cauliflower ? You can cook it in a variety of ways: sautéing, roasting, steaming, you name it. Interestingly, a case can be made both for eating it raw and cooked. For one, the organic compound indole, which helps kill precancerous cells, is formed when the cauliflower is cooked. Another reason why cooking may be the way with this veggie, besides making it taste better, is that it's more likely to cause gas, bloating and other gastrointestinal distress in its raw form. On the other hand, fresh cauliflower has up to 30% more nutrients and antioxidants, says Dr. Marlynn Wei.
Check out this plethora of cauliflower recipes for those on the keto diet. Keep in mind, research shows that it's not a diet that is beneficial over the long term. No more than three months of ketogenic dieting is about the length to aim for.
While short-term results are positive, there is mounting evidence against staying in ketosis for too long.
- Recent studies showed volunteers lost equal or more weight on high-carb, calorie-restricted diets than low-carb, calorie restricted diets.
- There might be positive benefits to short-term usage of a ketogenic diet.
- One dietician warns that the ketogenic diet could put diabetics at risk for diabetic ketoacidosis.
A few weeks ago I stopped by the Korean stand at my local farmer's market. I was picking up fermented daikon and tempeh when the seller tells me about a woman that had just stopped by to ask if tempeh has protein. The look on my face answered his non-question. He continues to tell me that she's on a "no protein" diet because, well, at this point, I just give up.
Humans can be absurd in our dietary beliefs. Every other animal eats due to necessity and availability. Our relative luxury has afforded us the opportunity to partake in eating plans that thwart basic biological needs. Some plans seem to make sense until science steps in.
For a minute it appeared the keto diet had traction. Advocates were seeing drastic weight loss. By their telling, "Big Food" is waging a longtime conspiracy to inject as many big carbs into our bodies as possible. (Not that excess carbohydrates, especially in the form of sugar, isn't a problem.) My personal experience with keto, which lasted roughly three months, was successful in certain regards. Weight loss wasn't the intended goal, though that did happen; I did it to address chronic GI issues.
As it turns out, I might have inadvertently nailed the timing, at least according to one doctor that never puts his clients into ketosis for more than three months. Let's face it: our ancestors never purposefully restricted carbohydrate intake. They just didn't have a Whole Foods to shop at. Macronutrients weren't on their minds as they had no awareness of the building blocks of calories to begin with. The question was never "What's my meal plan this week?" but rather, "What can I catch today? What plant is ripe to forage?"
Now that more research is emerging, the news on keto isn't good. Scientists leading one 2016 study, led by National Institutes of Health obesity researcher Kevin Hall, confined 17 volunteers to a hospital for a two-month stay. This is important, as self-reported studies are always at risk of being invalidated by faulty data. In this study, volunteers ate plenty of sugary carbs for the first month; during the second they received the same caloric load, replacing the bulk of those carbs with fats.
At the end of the two months, Hall was unimpressed.
In this case, we saw daily insulin secretion drop substantially within the first week and stay at a low level. But we only saw a small transient increase in energy expenditure during the first couple of weeks of the [low-carb] diet, and that essentially vanished by the end of the study.
Despite what some expected, it took the volunteers on the high-fat diet 28 days to lose as much weight as those on the baseline diet lost in 15 days. (All volunteers were overweight; the mechanism for their weight loss was lower daily caloric intake.) To be fair, there was no control group and calorie restriction generally has a bigger impact during the first month on any diet. That said, this study provided a serious blow to low-carb advocates.
As dietician Bonnie Taub-Dix told Well + Good, there should be an emphasis on eating the right carbs, such as whole grains. She's also not a fan of diabetics getting into ketosis, even though this community is specifically targeted by advocates. "It can cause DKA, diabetic ketoacidosis," she said. "This happens when your body is producing a lot of ketones and can lead to vomiting, diarrhea, feeling faint, and being [excessively] thirsty."
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The Internet is filled with anecdotal tales of triumph thanks to ketosis. The diet should not be completely written off, as other studies — on mice — have shown positive benefits, such as weight loss and memory improvement. Again, these are short-term fixes, not longitudinal proof.
Besides, a 2018 study, published in JAMA, found that low-carb and low-fat diets were equally effective for weight loss. This isn't the only evidence of this fact. A 2015 meta-analysis found that low-carb diets barely outperformed low-fat diets.
As Taub-Dix notes, balanced dieting is "boring." People always want the next great thing, be it a shamanically-blessed Amazonian berry or a supercharged Pacific Northwestern mushroom. I recently had dinner with a fellow who talked about his nootropics regimen, which greatly increases his focus, yet he checked his cell phone every five minutes during our two-hour meal. The distance between our brain and our gut remains too long to traverse.