Semaglutide’s Surprisingly Unexamined Effects
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Semaglutide’s Surprisingly Big Research Gap
GLP-1 receptor agonists like Ozempic, Wegovy, and other semaglutide drugs. are fast becoming a health industry standard go-to tool in the weight loss toolbox. When it comes to recommending that patients lose weight, “Have you considered Ozempic?” is the common refrain.
Sometimes, this may be a mere case of kicking the can down the road with regard to some other treatment that it can be argued (sometimes even truthfully) would go better after some weight loss:
How weight bias in health care can harm patients with obesity: Research
…which we also covered in fewer words in the second-to-last item here:
But GLP-1 agonists work, right?
Yes, albeit there’s a litany of caveats, top of which are usually:
- there are often adverse gastrointestinal side effects
- if you stop taking them, weight regain generally ensues promptly
For more details on these and more, see:
…but now there’s another thing that’s come to light:
The dark side of semaglutide’s weight loss
In academia, “dark” is often used to describe “stuff we don’t have much (or in some cases, any) direct empirical evidence of, but for reasons of surrounding things, we know it’s there”.
Well-known examples include “dark matter” in physics and the Dark Ages in (European) history.
In the case of semaglutide and weight loss, a review by a team of researchers (Drs. Sandra Christenen, Katie Robinson, Sara Thomas, and Dominique Williams) has discovered how little research has been done into a certain aspect of GLP-1 agonist’s weight loss effects, namely…
Dietary changes!
There’s been a lot of popular talk about “people taking semaglutide eat less”, but it’s mostly anecdotal and/or presumed based on parts of the mechanism of action (increasing insulin production, reducing glucagon secretions, modulating dietary cravings).
Where studies have looked at dietary changes, it’s almost exclusively been a matter of looking at caloric intake (which has been found to be a 16–39% reduction), and observations-in-passing that patients reported reduction in cravings for fatty and sweet foods.
This reduction in caloric intake, by the way, is not significantly different to the reduction brought about by counselling alone (head-to-head studies have been done; these are also discussed in the research review).
However! It gets worse. Very few studies of good quality have been done, even fewer (two studies) actually had a registered dietitian nutritionist on the team, and only one of them used the “gold standard” of nutritional research, the 24-hour dietary recall test. Which, in case you’re curious, you can read about what that is here:
Dietary Assessment Methods: What Is A 24-Hour Recall?
Of the four studies that actually looked at the macros (unlike most studies), they found that on average, protein intake decreased by 17.1%. Which is a big deal!
It’s an especially big deal, because while protein’s obviously important for everyone, it’s especially important for anyone trying to lose weight, because muscle mass is a major factor in metabolic base rate—which in turn is much important for fat loss/maintenance than exercise, when it comes to how many calories we burn by simply existing.
A reasonable hypothesis, therefore, is that one of the numerous reasons people who quit GLP-1 agonists immediately put fat back on, is because they probably lost muscle mass in amongst their weight loss, meaning that their metabolic base rate will have decreased, meaning that they end up more disposed to put on fat than before.
And, that’s just a hypothesis and it’s a hypothesis based on very few studies, so it’s not something to necessarily take as any kind of definitive proof of anything, but it is to say—as the researchers of this review do loudly say—more research needs to be done into this, because this has been a major gap in research so far!
Any other bad news?
While we’re talking research gaps, guess how many studies looked into micronutrient intake changes in people taking GLP-1 agonists?
If you guessed zero, you guessed correctly.
You can find the paper itself here:
What’s the main take-away here?
On a broad, scoping level: we need more research!
On a “what this means for individuals who want to lose weight” level: maybe we should be more wary of this still relatively new (less than 10 years old) “wonder drug”. And for most of those 10 years it’s only been for diabetics, with weight loss use really being in just the past few years (2021 onwards).
In other words: not necessarily any need to panic, but caution is probably not a bad idea, and natural weight loss methods remain very reasonable options for most people.
See also: How To Lose Weight (Healthily!)
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Burned Out By Tuesday?
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Avoiding Burnout, The Active Way
This is Dr. Claudine Holt. She’s double board-certified, in Occupational & Environmental Medicine, and Lifestyle Medicine.
In short: preventative medicine in all parts of our life.
Hopefully, you are reading this bright-eyed and bushy-tailed and ready to take on another exciting day in this wonderful, beautiful world!
On the other hand, it’s possible that you’re reading this semi-focussed, looking for a crumb of dopamine as much as you are looking for information.
If you’ve ever had the “What a week!” / “It’s only Tuesday” moment, this one’s for you.
What does Dr. Holt want us to know?
You can recover from burnout without guilt
Sometimes, we overreach ourselves. Sometimes, life overreaches us! Sometimes it’s not that we overcommitted—it’s just that we were taking each day as it comes, but sometimes several days gang up on us at once.
Sometimes, even, we can feel exhausted when it seems like we haven’t done anything.
Note: if you feel exhausted and it seems like you haven’t done anything, then be aware: you are exhausted for a reason!
What that reason might be may vary, but contrary to popular belief, energy does not just vanish. It went somewhere.
This goes double if you have any chronic illness(es), even if you’re not aware of having had a flare-up, chances are you were just exceptionally busy (on a cellular level).
And it’s easy to think that “mere” cellular activity shouldn’t be exhausting, but that is 100% of where our energy transactions happen—whether or not we are consciously aware of them!
See also: Eat To Beat Chronic Fatigue ← yes, this also covers when you are too exhausted to shop and cook like a TV chef
Dr. Holt specializes in working with burned out medical professionals (and also specifically specializes in working with women), but there are lessons for everyone in her advice. For example:
Fiction: ”Medicine is my calling–it’s who I am.”
Fact: You are more than medicine! Remember that your career is just one aspect of your life. Don’t forget to create your big-picture vision and tend the garden of the other areas of your life too.
Read more: Dr. Claudine Holt | Burnout: Fact vs Fiction
This same thing can go for whatever part of your identity frequently follows “I’m a…”, and is somewhere that you put a lot of your energy; it could equally be a non-professional job like “homemaker”, or a relational status like “husband”, or a cultural identifier like “Christian”, or a hobby like “gardener” (assuming that is not also your profession, in which case, same item, different category).
Indeed, a lot of women especially get hit by “the triple burden” of professional work, housework, and childcare. And it’s not even necessarily that we resent any of those things or feel like they’re a burden; we (hopefully) love our professions, homes, children. But, here’s the thing:
No amount of love will add extra hours to the day.
So what does she recommend doing about it, when sometimes we’re juggling things that can’t be dropped?
Start simple, but start!
Dr. Holt recommends to start with a smile (yes even if, and sometimes especially when, the circumstances do not feel like they merit it), and deploy some CBT tools:
Two Hacks to Quickly Rise Above Burnout (Or Any Circumstance)
We’ve expanded on this topic here:
With a more level head on, it becomes easier to take on the next step, which creating healthy boundaries—and that doesn’t just mean with other people!
It also means slaying our own perfectionism and imposter syndrome—both things that will have us chasing our tails 36 hours per day if we let them.
See also:
- Perfectionism, And How To Make Yours Work For You
- Imposter Syndrome (And Why Almost Everyone Has It)
❝Burnout is the culture of our times. A culture that expects us to do more and think our way out of everything. A culture that asks for more than the body can bear. Unfortunately, even though the situation might not be of our creation, burnout culture is our inheritance.
An inheritance we can either perpetuate—or change—depending on what we embody.❞
Source: The Embodied MD on Burnout with Dr Claudine Holt
That “embodiment” is partly our choices and actions that we bring and own just as we bring and own our body—and it’s partly our relationship with our body itself, and learning to love it, and work with it to achieve wonderful things, instead of just getting through the day.
Which yes, does also mean making space for good diet, exercise, sleep and so forth, per:
These Top Five Things Make The Biggest Difference To Health
Want to know more?
You might like to check out Dr. Holt’s website:
The Embodied M.D. | Burnout Coach
…where she also offers resources such as a blog and a podcast.
Enjoy!
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100,000 People, 30 Years, One Clear Winner vs Aging
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Generally speaking, the scientific community most highly lauds the Mediterranean diet as being best for general health:
The Mediterranean Diet: What Is It Good For? ← what isn’t it good for?!
However, even this can be tweaked with specific health considerations in mind, for example:
Four Ways To Upgrade The Mediterranean Diet ← these tweaks offer adjusted versions of the Mediterranean diet, optimized for anti-inflammation, gut health, heart health, or brain health
And today we present to you some very good research into…
The best diet for aging well
Let’s be clear on terms first: by “aging well”, this means reaching age 70 without chronic diseases and maintaining good cognitive, physical, and mental health.
105,015 participants (of whom, 66% women, average age 53 at the start of the study) were followed for up to 30 years. Not in the stalkery way, but in the longitudinal study way. We say “up to”, because as with any sizeable longitudinal study, some died before the end of the study.
9,771 of them were deemed, at the end of the study, to have achieved “healthy aging”.
So, how did those participants achieve that, in terms of diet?
The dietary patterns that had the strongest positive impact were:
- AHEI (Alternative Healthy Eating Index): best for mental and physical function, overall healthy aging.
- PHDI (Planetary Health Diet Index): best for cognitive health and survival to age 70.
- DASH (Dietary Approaches to Stop Hypertension): strongest general impact.
- MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay): best for brain health.
- rEDIH (Reversed Empirical Dietary Index for Hyperinsulinemia): most effective for chronic disease prevention.
In contrast:
- EIDP (Empirically Inflammatory Dietary Pattern): shocking nobody, performed least well in all areas
You are probably wondering what those dietary patterns actually consist of, so click here to see a chart of what’s included or excluded in each dietary pattern.
As you can see, the AHEI diet that was “best for mental and physical function, overall healthy aging” is essentially the Mediterranean diet with three small tweaks:
- no seafood, but long-chain omega-3 fatty acids include to compensate
- no sugar-sweetened beverages or fruit juices
- “no” sodium (in other words, minimal sodium, since almost everything contains trace amounts)
The PHDI diet, which was “best for cognitive health and survival to age 70” is essentially a whole-foods plant-based diet. Which in turn is very consistent with the Mediterranean, except that it excludes animal products, of which the Mediterranean diet uses small amounts.
You can read the paper in its entirety here:
Optimal dietary patterns for healthy aging
Want to know more?
A panel of 69 doctors and nutritionists examined the evidence for 38 diets (including Mediterranean, MIND, DASH, Vegan, Keto, Slimfast, WeightWatchers, Nutrisystem, and more) and scored them in 21 categories (e.g. best for general health, best for weight loss, best for heart, best against diabetes, etc):
Which Diet? Top Diets Ranked By Experts
Enjoy!
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F*ck You Chaos – by Dominika Choroszko
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We’ve all read decluttering books. Some may even have decluttering books cluttering bookshelves. This one’s a little different, though:
Dominika Choroszko looks at assessing, decluttering, and subsequently organizing:
- Your home
- Your mind
- Your finances
In other words
- she starts off like Marie Kondo, and…
- phases through doing the jobs of Queer Eye’s “Fab Five”, before…
- sitting us down with some CBT worksheets, and…
- finally going through finances à la Martin Lewis.
By the time we’ve read the book, it’s as though Mary Poppins has breezed through our house, head, and bank account, leaving everything “practically perfect in every way”.
Of course, it’s on us to actually do the work, but as many of us struggle with “how” and the ever-dreaded “but where to begin”, Choroszko’s whirlwind impetus and precision guidance (many very direct practical steps to take) really grease the wheels of progress.
In short, this could be the book that kickstarts your next big “getting everything into better order” drive, with a clear step-by-step this-then-this-then-this linear process.
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He Fell Ill on a Cruise. Before He Boarded the Rescue Boat, They Handed Him the Bill.
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Vincent Wasney and his fiancée, Sarah Eberlein, had never visited the ocean. They’d never even been on a plane. But when they bought their first home in Saginaw, Michigan, in 2018, their real estate agent gifted them tickets for a Royal Caribbean cruise.
After two years of delays due to the coronavirus pandemic, they set sail in December 2022.
The couple chose a cruise destined for the Bahamas in part because it included a trip to CocoCay, a private island accessible to Royal Caribbean passengers that featured a water park, balloon rides, and an excursion swimming with pigs.
It was on that day on CocoCay when Wasney, 31, started feeling off, he said.
The next morning, as the couple made plans in their cabin for the last full day of the trip, Wasney made a pained noise. Eberlein saw him having a seizure in bed, with blood coming out of his mouth from biting his tongue. She opened their door to find help and happened upon another guest, who roused his wife, an emergency room physician.
Wasney was able to climb into a wheelchair brought by the ship’s medical crew to take him down to the medical facility, where he was given anticonvulsants and fluids and monitored before being released.
Wasney had had seizures in the past, starting about 10 years ago, but it had been a while since his last one. Imaging back then showed no tumors, and doctors concluded he was likely epileptic, he said. He took medicine initially, but after two years without another seizure, he said, his doctors took him off the medicine to avoid liver damage.
Wasney had a second seizure on the ship a few hours later, back in his cabin. This time he stopped breathing, and Eberlein remembered his lips being so purple, they almost looked black. Again, she ran to find help but, in her haste, locked herself out. By the time the ship’s medical team got into the cabin, Wasney was breathing again but had broken blood vessels along his chest and neck that he later said resembled tiger stripes.
Wasney was in the ship’s medical center when he had a third seizure — a grand mal, which typically causes a loss of consciousness and violent muscle contractions. By then, the ship was close enough to port that Wasney could be evacuated by rescue boat. He was put on a stretcher to be lowered by ropes off the side of the ship, with Eberlein climbing down a rope ladder to join him.
But before they disembarked, the bill came.
The Patient: Vincent Wasney, 31, who was uninsured at the time.
Medical Services: General and enhanced observation, a blood test, anticonvulsant medicine, and a fee for services performed outside the medical facility.
Service Provider: Independence of the Seas Medical Center, the on-ship medical facility on the cruise ship operated by Royal Caribbean International.
Total Bill: $2,500.22.
What Gives: As part of Royal Caribbean’s guest terms, cruise passengers “agree to pay in full” all expenses incurred on board by the end of the cruise, including those related to medical care. In addition, Royal Caribbean does not accept “land-based” health insurance plans.
Wasney said he was surprised to learn that, along with other charges like wireless internet, Royal Caribbean required he pay his medical bills before exiting the ship — even though he was being evacuated urgently.
“Are we being held hostage at this point?” Eberlein remembered asking. “Because, obviously, if he’s had three seizures in 10 hours, it’s an issue.”
Wasney said he has little memory of being on the ship after his first seizure — seizures often leave victims groggy and disoriented for a few hours afterward.
But he certainly remembers being shown a bill, the bulk of which was the $2,500.22 in medical charges, while waiting for the rescue boat.
Still groggy, Wasney recalled saying he couldn’t afford that and a cruise employee responding: “How much can you pay?”
They drained their bank accounts, including money saved for their next house payment, and maxed out Wasney’s credit card but were still about $1,000 short, he said.
Ultimately, they were allowed to leave the ship. He later learned his card was overdrafted to cover the shortfall, he said.
Royal Caribbean International did not respond to multiple inquiries from KFF Health News.
Once on land, in Florida, Wasney was taken by ambulance to the emergency room at Broward Health Medical Center in Fort Lauderdale, where he incurred thousands of dollars more in medical expenses.
He still isn’t entirely sure what caused the seizures.
On the ship he was told it could have been extreme dehydration — and he said he does remember being extra thirsty on CocoCay. He also has mused whether trying escargot for the first time the night before could have played a role. Eberlein’s mother is convinced the episode was connected to swimming with pigs, he said. And not to be discounted, Eberlein accidentally broke a pocket mirror three days before their trip.
Wasney, who works in a stone shop, was uninsured when they set sail. He said that one month before they embarked on their voyage, he finally felt he could afford the health plan offered through his employer and signed up, but the plan didn’t start until January 2023, after their return.
They also lacked travel insurance. As inexperienced travelers, Wasney said, they thought it was for lost luggage and canceled trips, not unexpected medical expenses. And because the cruise was a gift, they were never prompted to buy coverage, which often happens when tickets are purchased.
The Resolution: Wasney said the couple returned to Saginaw with essentially no money in their bank account, several thousand dollars of medical debt, and no idea how they would cover their mortgage payment. Because he was uninsured at the time of the cruise, Wasney did not try to collect reimbursement for the cruise bill from his new health plan when his coverage began weeks later.
The couple set up payment plans to cover the medical bills for Wasney’s care after leaving the ship: one each with two doctors he saw at Broward Health, who billed separately from the hospital, and one with the ambulance company. He also made payments on a bill with Broward Health itself. Those plans do not charge interest.
But Broward Health said Wasney missed two payments to the hospital, and that bill was ultimately sent to collections.
In a statement, Broward Health spokesperson Nina Levine said Wasney’s bill was reduced by 73% because he was uninsured.
“We do everything in our power to provide the best care with the least financial impact, but also cannot stress enough the importance of taking advantage of private and Affordable Care Act health insurance plans, as well as travel insurance, to lower risks associated with unplanned medical issues,” she said.
The couple was able to make their house payment with $2,690 they raised through a GoFundMe campaign that Wasney set up. Wasney said a lot of that help came from family as well as friends he met playing disc golf, a sport he picked up during the pandemic.
“A bunch of people came through for us,” Wasney said, still moved to tears by the generosity. “But there’s still the hospital bill.”
The Takeaway: Billing practices differ by cruise line, but Joe Scott, chair of the cruise ship medicine section of the American College of Emergency Physicians, said medical charges are typically added to a cruise passenger’s onboard account, which must be paid before leaving the ship. Individuals can then submit receipts to their insurers for possible reimbursement.
More from Bill of the Month
- Sign Here? Financial Agreements May Leave Doctors in the Driver’s Seat Apr 30, 2024
- A Mom’s $97,000 Question: How Was Her Baby’s Air-Ambulance Ride Not Medically Necessary? Mar 25, 2024
- Without Medicare Part B’s Shield, Patient’s Family Owes $81,000 for a Single Air-Ambulance Flight Feb 27, 2024
He recommended that those planning to take a cruise purchase travel insurance that specifically covers their trips. “This will facilitate reimbursement if they do incur charges and potentially cover a costly medical evacuation if needed,” Scott said.
Royal Caribbean suggests that passengers who receive onboard care submit their paid bills to their health insurer for possible reimbursement. Many health plans do not cover medical services received on cruise ships, however. Medicare will sometimes cover medically necessary health care services on cruise ships, but not if the ship is more than six hours away from a U.S. port.
Travel insurance can be designed to address lots of out-of-town mishaps, like lost baggage or even transportation and lodging for a loved one to visit if a traveler is hospitalized.
Travel medical insurance, as well as plans that offer “emergency evacuation and repatriation,” are two types that can specifically assist with medical emergencies. Such plans can be purchased individually. Credit cards may offer travel medical insurance among their benefits, as well.
But travel insurance plans come with limitations. For instance, they may not cover care associated with preexisting conditions or what the plans consider “risky” activities, such as rock climbing. Some plans also require that travelers file first with their primary health insurance before seeking reimbursement from travel insurance.
As with other insurance, be sure to read the fine print and understand how reimbursement works.
Wasney said that’s what they plan to do before their next Royal Caribbean cruise. They’d like to go back to the Bahamas on basically the same trip, he said — there’s a lot about CocoCay they didn’t get to explore.
Bill of the Month is a crowdsourced investigation by KFF Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Black Beans vs Fava Beans – Which is Healthier?
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Our Verdict
When comparing black beans to fava beans, we picked the black beans.
Why?
In terms of macros, black beans have more protein, carbs, and notably more fiber, the ratio of the latter two also being such that black beans enjoy the lower glycemic index (but both are still good). All in all, a clear win for black beans in this category.
In the category of vitamins, black beans have more of vitamins B1, B5, B6, E, K, and choline, while fava beans have more of vitamins A, B2, B3, B9, and C. That’s a marginal 6:5 win for black beans, before we take into account that they also have 43x as much vitamin E, which is quite a margin, while fava beans doesn’t have any similarly stand-out nutrient. So, another clear win for black beans.
When it comes to minerals, black beans have more calcium, copper, iron, magnesium, phosphorus, and potassium, while fava beans have more manganese, selenium, and zinc. Superficially this is a 6:3 win for black beans; it’s worth noting however that the margins aren’t high on either side in the case of any mineral, so this one’s closer than it looks. Still a win for black beans, though.
Adding up the sections makes for an easy overall win for black beans, but by all means, enjoy either or both—diversity is good!
Want to learn more?
You might like to read:
Eat More (Of This) For Lower Blood Pressure
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Ketogenic Diet: Burning Fat Or Burning Out?
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In Wednesday’s newsletter, we asked you for your opinion of the keto diet, and got the above-depicted, below-described set of responses:
- About 45% said “It has its benefits, but they don’t outweigh the risks”
- About 31% said “It is a good, evidence-based way to lose weight, be energized, and live healthily”
- About 24% said “It is a woeful fad diet and a fast-track to ruining one’s overall health”
So what does the science say?
First, what is the ketogenic diet?
There are two different stories here:
- Per science, it’s a medical diet designed to help treat refractory epilepsy in children.
- Per popular lore, it’s an energizing weight loss diet for Instagrammers and YouTubers.
Can it be both? The answer is: yes, but with some serious caveats, which we’ll cover over the course of today’s feature.
The ketogenic diet works by forcing the body to burn fat for energy: True or False?
True! This is why it helps for children with refractory epilepsy. By starving the body (including the brain) of glucose, the liver must convert fat into fatty acids and ketones, which latter the brain (and indeed the rest of the body) can now use for energy instead of glucose, thus avoiding one of the the main triggers of refractory epilepsy in children.
See: The Ketogenic Diet: One Decade Later | Pediatrics
Even the pediatric epilepsy studies, however, conclude it does have unwanted side effects, such as kidney stones, constipation, high cholesterol, and acidosis:
Source: Dietary Therapies for Epilepsy
The ketogenic diet is good for weight loss: True or False?
True! Insofar as it does cause weight loss, often rapidly. Of course, so do diarrhea and vomiting, but these are not usually held to be healthy methods of weight loss. As for keto, a team of researchers recently concluded:
❝As obesity rates in the populace keep rising, dietary fads such as the ketogenic diet are gaining traction.
Although they could help with weight loss, this study had a notable observation of severe hypercholesterolemia and increased risk of atherosclerotic cardiovascular disease among the ketogenic diet participants.❞
~ Dr. Shadan Khdher et al.
On which note…
The ketogenic diet is bad for the heart: True or False?
True! As Dr. Joanna Popiolek-Kalisz concluded recently:
❝In terms of cardiovascular mortality, the low-carb pattern is more beneficial than very low-carbohydrate (including the ketogenic diet). There is still scarce evidence comparing ketogenic to the Mediterranean diet.
Other safety concerns in cardiovascular patients such as adverse events related to ketosis, fat-free mass loss, or potential pharmacological interactions should be also taken into consideration in future research.❞
~ Dr. Joanna Popiolek-Kalisz
Read in full: Ketogenic diet and cardiovascular risk: state of the art review
The ketogenic diet is good for short-term weight loss, but not long-term maintenance: True or False?
True! Again, insofar as it works in the short term. It’s not the healthiest way to lose weight and we don’t recommend it, but it did does indeed precipitate short-term weight loss. Those benefits are not typically observed for longer than a short time, though, as the above-linked paper mentions:
❝The ketogenic diet does not fulfill the criteria of a healthy diet. It presents the potential for rapid short-term reduction of body mass, triglycerides level, Hb1Ac, and blood pressure.
Its efficacy for weight loss and the above-mentioned metabolic changes is not significant in long-term observations.❞
~ Ibid.
The ketogenic diet is a good, evidence-based way to lose weight, be energized, and live healthily: True or False?
False, simply, as you may have gathered from the above, but we’ve barely scratched the surface in terms of the risks.
That said, as mentioned, it will induce short-term weight loss, and as for being energized, typically there is a slump-spike-slump in energy:
- At first, the body is running out of glucose, and so naturally feels weak and tired.
- Next, the body enters ketosis, and so feels energized and enlivened ← this is the part where the popular enthusiastic reviews come from
- Then, the body starts experiencing all the longer-term problems associated with lacking carbohydrates and having an overabundance of fat, so becomes gradually more sick and tired.
Because of this, the signs of symptoms of being in ketosis (aside from: measurably increased ketones in blood, breath, and urine) are listed as:
- Bad breath
- Weight loss
- Appetite loss
- Increased focus and energy
- Increased fatigue and irritability
- Digestive issues
- Insomnia
The slump-spike-slump we mentioned is the reason for the seemingly contradictory symptoms of increased energy and increased fatigue—you get one and then the other.
Here’s a small but illustrative study, made clearer by its participants being a demographic whose energy levels are most strongly affected by dietary factors:
The ketogenic diet is a woeful fad diet and a fast-track to ruining one’s overall health: True or False?
True, subjectively in the first part, as it’s a little harsher than we usually go for in tone, though it has been called a fad diet in scientific literature. The latter part (ruining one’s overall health) is observably true.
One major problem is incidental-but-serious, which is that a low-carb diet is typically a de facto low-fiber diet, which is naturally bad for the gut and heart.
Other things are more specific to the keto diet, such as the problems with the kidneys:
However, kidney stones aren’t the worst of the problems:
Is Losing Weight Worth Losing Your Kidney: Keto Diet Resulting in Renal Failure
We’re running out of space and the risks associated with the keto diet are many, but for example even in the short term, it already increases osteoporosis risk:
❝Markers of bone modeling/remodeling were impaired after short-term low-carbohydrate high-fat diet, and only one marker of resorption recovered after acute carbohydrate restoration❞
~ Dr. Ida Heikura et al.
A Short-Term Ketogenic Diet Impairs Markers of Bone Health in Response to Exercise
Want a healthier diet?
We recommend the Mediterranean diet.
See also: Four Ways To Upgrade The Mediterranean
(the above is about keeping to the Mediterranean diet, while tweaking one’s choices within it for a specific extra health focus such as an anti-inflammatory upgrade, a heart-healthy upgrade, a gut-healthy upgrade, and a brain-healthy upgrade)
Enjoy!
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