Who's afraid of the keto diet?

In 1864, William Banting, director of London's retired funeral director, published a free booklet titled Letter on bodybuilding, addressed to the public, in which he wrote about how he managed the disabling effects of obesity. Banting lamented that he had to endure "sneers and cruel and misguided comments," struggled to climb the stairs or bend over to fasten his shoes. For three decades, he tried everything from "steam baths and shampoo" to Turkish baths. exercise, but "the evil increased again and, like the parasite of barnacles on a ship, if it did not destroy the structure, it prevented its fair and comfortable progression on the path of life".

And then Banting met William Harvey, whose prescribed diet lost 52 pounds. The former funeral director found himself on a diet rich in meat and fish – he abandoned "simple ailments" like bread, milk, butter, beer, sugar and potatoes, that he used to eat "more freely than his nature was aging". He began his day with a spoonful of syrup mixed with water in a wine glass ("a very grateful project"), then, with the exception of the French toast, the "fruit of a pudding and a shot of gin or whiskey, the diet eliminated almost entirely sugar and carbohydrates.

Banting writes: "At first glance, it seemed to me that I had little to live on …" But he decided to give a good shot to the plan, and his effectiveness was such that he published himself. even the booklet – the first two for free and the third at a price corresponding to its cost of printing.

In the early 1920s, somewhere in Minnesota, Russell Morse Wilder (no knowledge of Banting or his anti-carbohydrate propaganda) discovered for the first time the effects of ketogenic treatment, a slightly different diet, rich in fats and carbohydrates , in patients with epilepsy. He discovered that it reduces epileptic seizures until medications replace or supplement them.

It's been almost a century since. But today, any celebrity worthy of what they're worth with their bacon bread, their almond flour toast and their avocados will tell you that Banting's diet vaguely resembles the hugely connected ketogenic diet, and that Dr. Wilder's discoveries have gone from a crusade against convulsions to a type-2 counter-diabetes, possibly cancer, cholesterol, and clothing sizes.

Predominantly a high-fat, medium-protein diet, the keto provides plenty of nutrition such as butter, oils, meat, cheese and eggs – unlike its predecessor, Atkins, which also eliminates carbohydrates but favors foods rich in protein. Dieters on ceto can consume less than 5g of carbohydrates a day, usually in the form of low carbohydrate vegetables such as cauliflower and leafy greens. This combination sends the body into a state called ketosis, in which fat is used as fuel instead of glucose from carbohydrates, and since the protein can also be broken down into glucose, its intake is also measured and limited – the dissolution is Approximately 75% fat, 20% protein and 5% carbohydrates.

It sounds too good to be true, and for some people it has side effects, especially in the first few weeks when the body is in the process of ketosis. A condition called keto flu is common; usually presents with symptoms such as headache, nausea, bad breath and a recently discovered and widely refuted "keto-crotch", which results in a smell in the area of ​​the same name as people on the diet.

Nevertheless, the keto diet is exploding in popularity. In India, as in many other parts of the world, the group has cafes, coaches, department store counters, applications, distribution and Dabba and, perhaps more importantly, celebrity endorsements such as Alia Bhat and Rhea Kapoor on Instagram. But these diet champions are nothing compared to the quote from Banting's successful little culinary memoir, which seems to be the benchmark for the popularity of fashionable diets. It was previously considered the origin of Atkins when the regime was raging and was appropriated by the keto lobby.

In the United States, the ketogenic diet was the most-searched diet on Google in 2018 and, in India, curious weight watchers surfed the Internet and the regime's popularity culminated in tracking the search engine's trend between 10th and 16th of March. For a country where diabetes is spearheading the Banting boat, reducing carbohydrates and sugar has made the keto a huge success. And the worship is so great that people identify as "evangelists" keto. But where there are evangelists, can critics be far behind?

Everyone's cup of fat

During a busy day in her Khirki Extension apartment in Delhi, Roohan Singla, 34, bakes eight loaves of almond flour bread, prepares pizzas prepared with a similar base filled with cheese. mozzarella and pepperoni, adorable decadent cakes keto and rich cream – cheese-based cakes with erythritol, a sugar substitute allowed by keto, and a layer of almond flour crumble at instead of the usual Graham cookies. She runs KetoRoo Bakes, an experiment that started last year, while Singla herself was on a keto diet and wanted more than just stuffed chicken breast.

Finally, she left her position on the internal communication team of the insurance company Max Bupa, filled out the Zomato form and decided to get into keto cooking full time. "I thought I would be that elite baker who stays at home and does nothing, who gets an order a day, but that's not what happened," she says. sitting in his apartment. Her freezer is filled to the brim with cold meats and cream cheese, and Singla has had more than 120 orders just this month, and the numbers and incomes are only growing.

She swears by the regime. This helped her to go from 104 kg to 90.6 kg, her lowest level in five years, while eating the food that she likes. She started treatment after her hospitalization because of a form of gluten intolerance. Doctors described the problem as lifestyle, which she said was an insufficient prognosis. But then she found keto. "I was researching many low carb diets and seeing the word keto … as well as people's testimonials," she says. "And for an overweight person, she has to find something interesting, like cheese and meat, and being able to lose weight on bacon, that was amazing in itself. "She created an Instagram account and posted images before and after, accompanied by pictures of the food she ate throughout the day – which helped her to get on with it. stick to the scheme.

Lawyers Garima Mitra, 28, and Sahil Saini, 32, based in Mumbai, have a similar story. They started the keto together after their marriage. "You know how people say that when you're single, you look your best, you make efforts to keep yourself alive. Suddenly, in 2016, we were married, "says Saini. We had a lot of fun. We no longer care about our appearance or what we put in our body. The parents began complaining saying that we should look into the exercise and join a gym, "he adds.Finally, Mitra hired a physical trainer who recommended the keto diet and the couple the follows since 2016. During their first 12-week relay, Mitra has lost 12 kg and Saini, 13. The couple is part of an active WhatsApp group called Mumbai.Ketoers, which has nearly 150 members, exchange recipes, videos of Hasan Minhaj and Tiktok, photos of their keto meals, recommendations of restaurants and other memes and unrelated thoughts.

Mitra and Saini say that the keto has even brought them closer together. "We started spending a lot of time together for meals, otherwise we would both get tired, grab some food, turn on our laptop and look at something," says Mitra. Saini said: "It's a totally different process. We come home, she's already cooking something, I'm jumping in, the veneer and the photography of our Instagram account are happening. And then we sit together to eat. "

But the ketogenic diet, as inviting as it may seem, is not intended for people with weak will who like their carbohydrates (or their savings: they weigh heavily in fat and pocket).

Shawn Pereirra, 25, was a swimmer and was very fit during his teenage years. He went regularly to the gym and ensured that his body statistics were in a perfect range. But as all the privileged Delhi who had an appointment with the inevitable debauchery that accompanies the university life, it has changed quickly. He took more than 10 kg and in 2013 he decided to follow the keto diet recommended by a five-year-old doctor friend. "It was a mental torture. I started to be very depressed – negative thoughts all the time. I ran out of energy and stopped meeting people, "he says, citing what he thought was the psychological effects of a state of intense carbohydrate cravings in the body. Although he said he was losing weight, he had problems with digestion and constipation. the cravings were so strong that once a friend got married, her wedding card was accompanied by a K-kg cake. I finished it in 10 minutes. "

Others, like 24-year-old Diksha Singhi, managed to feed for only a few weeks, until her already chronic headache worsened. "I would have migraines and headaches because I was not eating enough," she says. The keto flu is manifested in different ways and to varying degrees depending on the practitioner: Singla herself suffers from phases of acute pain that flow with the tips of her fingers She manages to overcome this problem by increasing its consumption of water, its consumption salt or muscle relaxants, if necessary.

The keto puzzle

In September, the Indian Journal of Medical Research (IJMR) published an editorial entitled "Ketogenic diets: boon or bane?", which begins by highlighting the prevalence and rapid rise of obesity in recent decades, in the world and in India – and the problems that result, such as "type 2 diabetes, hypertension and cardiovascular disease, apart from osteoarthritis, sleep apnea and even some forms of cancer." The use of ketogenic diets for weight management has gained tremendous popularity, but it has also generated a lot of controversy, "he said.

The article quotes a study published in the Lancet Public Health diary, which showed that there was a U-shaped relationship between carbohydrate intake and mortality. "Mortality rates were higher (60% and higher) and low in carbohydrates (<30% carbohydrate). The risk of death was lowest when carbohydrate intake was between 50 and 55%, "the study says.

"Mortality is the main thing. You may be thin, but if you die, what is it for? ", Explains Shilpa Joshi, clinical nutritionist in Mumbai, one of the authors of the editorial. You can have any shape or size, you can look any way, but you must be alive! She says on the phone, although she does not deny the effects of the diet on weight loss and diabetes, she points out that these benefits are only revealed by short-term studies. term, the first enzyme in cholesterol synthesis was HDL reductase, which is regulated by results, "she says.

But diabetics have found its effectiveness. Keto helped Jyotsna Pattabiraman to control pre-diabetes. Upon returning from Silicon Valley to Bengaluru, she went on a diet and explained that it brought her hemoglobin A1C. "My HbA1C was at 6.7, which is really high, and after three months of keto it dropped to 5.4, which is a semi-normal range," she said. In 2016, she launched Grow Fit, an app and a website. , which provides low-carbohydrate and ketone dishes, as well as products such as almond flour, coconut flake keratene and Keto almond dark chocolate bars, among others.

But a number of nutritionists and doctors warn against diet, encouraging people to regulate their meals and their consumption in a more sustainable way. "Indian diets are very rich in carbohydrates. A STARCH study showed that Indians with and without diabetes consume at least 65% of calories from carbohydrates. The Rural Rural Epidemiological Study of Chennai (CURES) also showed that carbohydrates were the main source of calories in southern India, "reads Joshi's editorial. IJMR. So giving up carbohydrates completely, especially for Indians, is a difficult lifestyle change and can be a huge shock to the body.

Ishi Khosla, a nutritionist in Delhi, said: "The only consequence of the keto diet is to tell you that fat is not bad for us, good fat is good for us. But I think that any fad diet that eliminates a normal diet – two food groups (carbohydrates and fiber) – is radically suspect, "she says." It eliminates the good vegetables, very important fruits of our diet. and the health of being an individual, which is not acceptable. "

Faced with this potentially harmful deficit, keto producers are now turning to alternative sources of fiber: expensive and perhaps less palatable flax and chia seeds are often the main substitute.

And they change because they see results. Singla discovers that her cholesterol level is failing, she feels lighter and holds less water when she follows her diet, aside from the added benefit of losing nearly 14 kg in four month.

However, doctors remain skeptical about the repercussions that would have occurred between an Indian diet traditionally rich in carbohydrates and a low-carbohydrate ketogenic routine. V. Mohan, based in Hyderabad, who co-authored the book IJMR written with Joshi, finds that although many of his patients have tried the diet, the issue of sustainability makes him ineffective and potentially dangerous. Mohan is a diabetologist, chair and head of the Diabetes Department at the Diabetes Center of Dr Mohan, a WHO Collaborating Center for the Prevention and Control of Noncommunicable Diseases.

"As soon as you start consuming carbohydrates, the reversal begins. Soon, you'll get 70% more carbs and get your weight back, "he says," this yo-yo effect and this sudden change is not good for the body. " Instead, he recommends a diet consisting of 40% carbohydrates, 20% protein and the rest in polyunsaturated fatty acids, such as peanut oil, mustard oil and nuts. . "It lowers bad LDL cholesterol and raises good HDL cholesterol," he adds.

Studies on the long-term effects of the ketogenic diet are still ongoing – Siddhartha Mukherjee, Pulitzer Prize-winning oncologist and oncologist, is studying the effects of the diet on patients with lymphoma and endometrial cancer at Columbia University Medical Center of New York. But he also warned on Twitter: "… people, do NOT go to the keto diet alone without the PI3 kinase inhibitor, nor without supervision or medical evidence. In our article, leukemia accelerates only with the keto diet, "referring to an article published in July Nature International Journal Of Science. Inhibitors of PI3 kinase are essentially drugs that inhibit the enzyme PI3 kinase, which regulates the growth of tumor cells.

It produces an effect similar to that of famine on the tumor, but also acts on the liver – "which detects the same signal similar to that of famine and, in reflexive response, sends glucose into the blood. Glucose, in turn, has most likely prompted the release of insulin into the pancreas, "wrote Mukherjee in The New York Times. It turned out that the drug itself created the side effect of diabetes, forming a vicious circle in which it negated the effect of what the drug was trying to achieve, namely, starve the cancer. Enter keto, famous for its bright effects by controlling type 2 diabetes and insulin levels.

As Mukherjee and Lewis Cantley, director of the Sandra and Meyer Cancer Center at Weill Cornell Medicine, discovered at a restaurant on the Upper East Side during dinner, the drug could be associated with the diet – "And if we cut off any additional insulin released, by subjecting patients to a low carbohydrate ketogenic diet during treatment? This would be a new type of test – a diet in which the diet itself becomes a drug, or a co-drug, associated with PI3 kinase inhibitors, "wrote Mukherjee.

While Mukherjee's study is ongoing, the responses to his tweet have made a definite conclusion. He calls them "quick, vicious, angry, suspicious and sometimes funny". One person responded by asking, "Who is supporting you? Big Kale? and others have accused "of having undermined the effectiveness of the ketogenic cancer diet."

There is no debate that people in the regime are passionate, sometimes to the point of militating, keto. They read the researches, the researches that refute the counter-argument and did their homework.

Sahil Makhija, or Demonstealer, as he has been calling for almost 20 years, is the leader of Mumbai's oldest death metal band, Demonic Resurrection, and runs a YouTube kitcho channel, Headbanger's Kitchen, which counts currently over 350,000 subscribers. He does not identify himself as an evangelist but has faced criticism of the regime. Just like Singla, who said that "the worst thing about the keto industry is dealing with idiots," referring to customers who hope for an overnight miracle by ordering their treats.

"If someone says, oh, the keto can give you a heart attack, I'll at best show them a science to counter it, give them anecdotal evidence, and if they still believe it, I do not can not impose on them, "says Makhija. It's like making someone understand that our country needs a party other than the BJP (Bharatiya Janata Party) to govern, but if you discuss this with a Bhakt… it's like that. That's how I like to treat it, "he adds.

The fierce (and very public) struggle between pro-keto and anti-keto activists may only be resolved when new studies show how the keto diet affects vital signs and disease indicators over time. For now, the popularity and the business of the keto are going well.

Low in carbohydrates, in high recipes?

A diet that often complains about the diet is that it tends to be expensive – "do it if you are rich," advises Singhi. Homemade iterations can be tedious for those who do not have the time. So when doctors wonder if keto is a boon, entrepreneurs and restaurateurs have benefited from its popularity and price.

It is booming in the food industry and the growing demand for keto products is satisfied with a constant supply. Trendy restaurants and cafes such as Bastian, Farmer's Cafe and The 15 Café in Mumbai, Pan-Indian Outposts of Smoke House Deli, among others, have introduced keto-friendly meals. Entrepreneurs also benefit from the creation of delivery services such as Food Darzee and Grow Fit from Pattabiraman. And there is an increase in the number of coaches and keto bakers.

Priya Dogra Aurora, a keto trainer based in Shimla, has entrusted more than 2,000 people who have solicited from around the world the opportunity to customize Indian meals. Gourmet Foodhall has recently launched keto-friendly options: cakes, brownies and breads. They also have bowls of keto in their cafes.

"We're launching a new cupcake menu in April and adding a new keto cupcake to the menu," said Pooja Dhingra, pastry chef and owner, Le 15 Patisserie and Café. "We did a blind tasting for 12 cupcakes So those who ate it did not know it was a keto cupcake, they thought it was just a chocolate and hazelnut cupcake and it was giving such good results – it was the top 3 that people liked. . "Dhingra says that the high-fat allowance guarantees the decadence of pastries, and that the use of almond flour and sugar substitutes is the only variant of the recipe.

The trend is so widespread that the Raasta Lounge Channel has also introduced a keto menu. A Keto Burger (two pork loin fillets with lamb and cheddar pancake) and a cake without flour are among the options. While it's hard to imagine that it's possible to push back calm spirits without the absorbing superpowers of carbohydrates, the owner, Goumtesh Singh, considers the selection a success and receives between 15 and 20 keto orders a week.

"It was the need of the hour because people were turning to the keto, but still wanted to go out. This is not a 100% cheat for them, but there is a satisfying value that you eat healthy, "says Singh." People who order via the keto menu order more simple alcohol than cocktails and the majority do not order beer. "

Gautam Krishnakutty of The Smoke Co. in Bengaluru is not so convinced. Although he offers keto meals on Café Thulp, his online restaurant business, he says his business is stable but that there is nothing exceptional. "I would not say that he grew up a lot, he grew up a bit," he says. "The keto menu is a very expensive menu, so I do not earn much money on it.I can not afford it myself.Keto meals are somewhere between ₹350-400, but it does not work on the same cost as the rest of my menu, which would cost 25-30%, and the keto, 40-45%.

Yet entrepreneurs like Singla and Pattabiraman are putting all their eggs in the keto basket. As Singla left KetoRoo Bakes and Pattabiraman, who was starting to grow up at Silicon Valley, started to grow up, Makhija resigned as artistic director of the famous Furtados music retailer in Mumbai to head Headbanger's Kitchen full time. What started out as an ancillary promotional project for the group – he would interview other metal musicians and cook recipes inspired by their band's name or their music – and pass on his love for cooking and food, suddenly became a started diet in 2016 and switched to keto recipes. "Before keto, I had 5,000 subscribers. The last year alone has been a jump of 180,000 people, "he says, an easy installation: using his camera phone to film videos of himself keto, vlogs on his course and other information related to the scheme.

Contradictory opinions on keto shape both passions and professions. But Singla, who claims to have benefited from the diet both in terms of health and weight, sums up perfectly the meteoric rise of the keto (and this is perhaps the only source of thought where all beliefs, nutritionists, adepts and critics, intersect cardiologists and diabetologists). "I want to lose weight so I can look good in pictures. And there is nothing superficial about it, "she says. I lose weight comfortably with this diet, and the food I eat … you would binge if you see my plates. "

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KETO IN YOUR KITCHEN

How to prepare Indian meals everyday

Priya Dogra Aurora, a Keto coach, helps Indians around the world create keto-friendly meals at home. From everyday vegetables to non-vegetarian options and desserts, the diet, contrary to popular belief, can be adapted to local cuisines without staples such as roti and rice, taking into account macros (carbohydrates, protein , fat) eaten by dieters one day. She warns against the use of tomatoes and onions, or at the very least, not to apportion the use to ensure that the percentage of carbohydrates allowed is achieved but not exceeded. Here are six recommended dishes, easy to prepare and easy to put in the pocket.

– Palak paneer: cottage cheese with spinach puree

-Tandoori gobi: Grilled or roasted cauliflower

-Chicken tikka: Grilled chicken skewers with spicy mint chutney

-Paneer bhurji: cottage cheese crumbled with peppers

-Kheera raita: curdled curd with grated cucumber

-Shrikhand: Traditional dessert made from sour milk and sweetened with stevia or erythritol