Is ketosis a ‘medical emergency’?
Health guru Jillian Michaels of “The Biggest Loser” fame has been appearing on videos all over the internet blowing up the popular keto diet. But are her concerns correct?
In the view of the former “Biggest Loser” trainer, the keto diet doesn’t provide proper nutritional balance.
On NBC’s Today Show she said:
“I don’t understand,” she said. “Like, why would anyone think this is a good idea?”
The ratio of fat to carbs and protein is 4:1 (or roughly 60-80% of daily calories coming in the form of healthy fats) in the keto diet, with a goal of burning fat for energy rather than carbohydrates in order to lose weight. Michaels, 44, is not buying it.
“You know what we need to do? All fat and animal protein!’” she said. “No! Bad plan. For a million reasons.”
“Your cells, your macro molecules, are literally made up of protein, fat, carbohydrates, nucleic acids,” she said. “When you do not eat one of the three macro nutrients — those three things I just mentioned — you’re starving yourselves.”
“Those macro nutrients serve a very important purpose for your overall health and wellbeing. Each and every one of them.”
On People TV she said:
“Don’t do keto,” she says. “Keto is a diet fad. The reason that keto has been getting so much attention is because it helps significantly to manage your insulin levels. Very high insulin, very bad thing.”
While those with conditions associated with high insulin levels like polycystic ovary syndrome, type 2 diabetes, and infertility may consider the diet, Michaels says it doesn’t make sense for most people.
On another site, she continued to rail against keto. She claimed the restrictive style of eating means people are missing out on a lot of nourishing foods. In Shape, she said, “You’ve got micronutrient deficiencies because you’re not getting all the phytonutrients, antioxidants, and the polyphenols you would be getting if you weren’t afraid of an apple or a banana or a papaya, which is absurd.”
She claims the diet calls for virtually eliminating an entire macronutrient group (carbs), which is an issue. “When you’re not eating all of the macronutrients, you’re literally starving your body. You’re starving your cells,” she says. “Those macronutrients have very specific jobs for your biochemistry, for your body to continue doing what it needs to do for you to continue living in the healthiest way possible.”
Let’s look at some of her claims followed by a refutation by medical science.
“Ketosis is a state of medical emergency.”
“Ketosis is a natural state for the body, when it is almost completely fueled by fat.” Dr. Andreas Eenfeldt MD
“Keto doesn’t advocate for calorie restriction.”
A common symptom of the ketogenic diet is appetite suppression. This feeling of fullness associated with the state of nutritional ketosis may be linked to a higher intake of protein and fat.
“High fat diets cannot help you lose weight.”
According to the National Institute of Health, a review of 13 randomized controlled trials (1,415 patients) found that people on the ketogenic diet lost significantly more weight than people on low-fat diets. They also kept the weight off for 12 months or more.
It should be noted that while Ms. Michaels is a well-known celebrity, she is not a doctor, nor does she even have a college degree. Her official bio lists the following:
“As a child, Jillian Michaels struggled with her weight until her mother enrolled her in a martial arts class. After high school, she briefly attended California State University at Northridge. Michaels worked as a bartender for a time before becoming a personal trainer. She went on to open her own gym.
Michaels is an experienced trainer in a variety of physical fitness disciplines. She holds two personal training certificates, one from the National Exercise & Sports Trainers Association (NESTA) and one from the American Fitness Association of America (AFAA). Jillian also has a certification in Kettlebell Concepts. She has a wellness and nutrition certification from American Fitness Professionals Associates (AFPA).
In 2004, Michaels made her television debut in the first season of The Biggest Loser. She has also released a verity of fitness and weight-loss products, including supplements, books, workout DVDs and video games.”
In other words, while Ms. Michaels is famous and a self-appointed diet guru, she does not have any formal training in medicine or nutrition.
The fitness guru’s argument is ‘calories are what count,’ but that presupposes that the body does not slow down when calories are restricted. And that is patently untrue.
Different foods have substantially different metabolic and hormonal effects on the body. So, what’s eaten (and how calories are expended) can change how much you eat and whether those calories are burned or stored.
But could it be that her animosity is really because no one is paying her?
If there is a better explanation, I am certainly open to hearing it.
But the most damning reason to ignore Ms. Michael’s opinion on keto may be her highest profile clients, the contestants on The Biggest Loser.