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Different Diets Pros an Cons

Keto diet low carb concept top view

The Keto Diet

What exactly is the Keto Diet?

The Keto Diet is a very low or no carbs diet which induce ketosis, a metabolic state in which the body is forced to burns fat for energy instead of carbohydrates.

How doable is it?

The keto diet is not easy to manage and the rate of quick drop-off is very high due to his rigidity. Since the keto diet requires the body to remain in a state of ketosis, there is a very little margin for error.

What exactly can you eat on the Keto Diet?

The food allowed in a keto diet include meats, poultry, fish and other seafood, eggs, cheese and plain yogurt, nuts, low-carb vegetables and fats. Grains, beans, fruits and alcohol are eliminated.

What are the benefits?

Some studies shown that the keto diet is more effective in improving triglyceride level, reducing body weight, control type 2 diabetes, lowering the LDL cholesterol and lower the blood pressure when compared to a low fat diet. However in some other studies the results seen are sligthly similar, so the effect of both diets is pretty the same. Overall, ketogenic research is limited, and more studies are needed to fully understand the potential adverse effect and health benefit. What is well known is that the Keto diet can be helpful in treating epilepsy, but as a general weight loss plan is still controversial.

What are the drawbacks?

Ketogenic dieter can experience the keto flu which is the result of the body adapting to the low-carb condition. Usually the symptoms lasts for about a week, but for some people, the keto flu can last even longer. The most common symptoms are headache, weakness, irritability, constipation, nausea, and vomiting.

Other symptoms can include fatigue, irregular menstrual cycles, sleep issues and loss of electrolytes such as sodium, magnesium, and potassium through frequent and increased urination as a compensation mechanism of the body to remove ketones. This diet can lead also to yo-yo dieting becasue people cannot stay on a restrictive diet for long time. Lastly, the consequences in the long term of eating such a high intake of saturated fats are not yet clear.

How is it different than the Atkins Diet?

This two diet are quite similar because they tend to reduce as much as possible the carbohydrates intake but few differences are noted. The Atkins diet is divided in different phases where the amount of carbs is gradually reintroduced from 20g to 100g per day. While in the Keto diet the amount of carbs should be kept within 20 to 50g per day.

In both diet you don’t have to count your calories intake, but on Keto diet, you need to divide in the right percentages the calories coming from fat and protein.

The Paleo Diet

How realistic is the Paleo Diet?

For many people who follow the Paleo diet it is not easy to stay on track, especially if they have to eat out or travel. The variety of food you are allowed to eat is very limited and it is not easy to adhere to it to long term.

What are the benefits?

Differents studies were done in the past, but it is difficult to make any firm conclusion since those had some limitations. There was a small number of participats, the duration was very short, some studies couldn’t include the control group and in some the results were not always statistically significant. In the studies different health benefit were noted: weight and waist circumference loss, positive effect on cholesterol and tryglicerides, reduction of fatty liver, improvements in insulin sensitivity and glycemic control. However, other studies are needed to understand the long-term, overall health benefits and possible risks of this diet.

What are the drawbacks?

In the Paleo diet whole grains and legumes are completely excluded with a consequent reduction of good source of insoluber fiber, vitimin and minerals. This diet is also free of any source of milk and dairy which are good sources of protein and calcium. In the short term people may experience low energy level and bad breath, because the body has to adjust to the new fuel for the energy production. Moreover, change in bowel habits can be observed as a result of the low insoluble fiber intake. In addition to this, a diet high in animal protein may increase the production of insulin-like growth factor 1 (IGF-1), which has been linked to cancer and cardiovascular diseases.

The Mediterranean Diet

What exactly can you eat on the Mediterranean Diet?

On Mediterranean diet you can have a variety of foods: fresh fruit and vegetables, legumes, wholegrains, nuts, extravirgin olive oil, few lean sources of animal protein (chicken or turkey), fresh oily fish (salmon, tuna, sardine, herring, mackerel, anchovy, trout), a reduced amount of red meat and saturated fats, few processed foods or refined sugars.

What are the benefits?

Different studies shows that eating this diet can lower the risk of certain health condition.

The high amount of vitamin and antioxidant provided by fruit and vegetables, may help during the oxidation precesses in the body. Also, since they are loaded with fiber, they are helpful in reducing the LDL blood cholesterol and improve the blood sugar level, as demonstrated in different studies. Fiber plays also other important roles, for example it is beneficial to ease the constipation by regulating the intestinal transit; it helps to fill your stomach during meal, so you can control better your food intake and it can contribute to intestinal health, by selecting good and bad bacteria. Additionally, extravirgin olive oil, nuts, seeds and oily fish, contain good fats which have proven healt benefit in reducing inflammation, lowering high blood pressure, improving brain function and reducing the risk of cancer.

Are there any drawbacks?

Following a Mediterranean diet doesn’t have any negative effect on health status, because the diet is packed with fresh and healthy foods which brings good nutrients into the body.

How doable is it?

The Mediterranean diet is very easy to follow because you can have everything in moderation choosing among a variety of foods.

How different is this diet than the Flexitarian diet? 

This diet can be considered quite similar to the flexitarian diet, because both are loaded with fruit, vegetables, wholegrain, nuts and extravirgin olive oil. The difference reside in the amount of animal protein consumed per day. In the Flexitarian diet it is just few times a week, while in the Mediterranean diet you can have lean poultry, fish, eggs, milk and dairy in moderation every day.

The DASH Diet

What exactly is the DASH diet?

The DASH Diet which mean Dietary Approaches to Stop Hypertension, is a diet created with the purpose to test the effect of a diet rich in plant-based foods on blood pressure.

Who should follow this diet?

The DASH Diet can be followed by people who want to prevent or treat hypertension, which is the high blood pressure, and reduce their risk of heart disease.

How doable is it?

The DASH Diet is a very feasible diet because you can eat almost everything in moderation choosing among a variety of foods. On this diet you are supposed to reduce your salt intake, but it is very easy when you have a variety of herbs and spices available to make your food tastier.

What can you eat and not eat while on this diet?

The DASH diet focuses on vegetables, fruits, whole grains and lean protein like chicken, fish and beans. The diet is low in red meat, salt, added sugars and fat. This diet encourage the consumption of not more than 1 teaspoon of salt and 2300 mg of sodium per day.

What are the health benefits?

Different health benefits are associated to the DASH Diet. Since this plan is rich in fruit and vegetables, the high fiber content may help in protect from various type of cancer, may help to ease the constipation and contribute to intestinal health and selection of god and bad bacteria. The role of fruit and vegetables is also important in reducing LDL blood cholesterol and improve the blood sugar level, as demonstrated in different studies. Additionally, extravirgin olive oil, nuts, seeds and oily fish, contain good fats which have proven healt benefit in reducing inflammation, lowering high blood pressure reducing the risk of heart disease and stroke.


The Keto Diet

  1. Reddel S, Putignani L, Del Chierico F. The Impact of Low-FODMAPs, Gluten-Free, and Ketogenic Diets on Gut Microbiota Modulation in Pathological Conditions. Nutrients. 2019 Feb 12;11(2). pii: E373. doi: 10.3390/nu11020373.
  2. Samaha FF et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med. 2003 May 22;348(21):2074-81.
  3. Brehm BJ et al. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab. 2003 Apr;88(4):1617-23.
  4. Yancy WS Jr et al. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia. Ann Intern Med. 2004 May 18;140(10):769-77.
  5. Daly ME et al. Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes. Diabet Med. 2006 Jan;23(1):15-20.
  6. McClernon FJ et al. The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms. Obesity (Silver Spring). 2007 Jan;15(1):182-7.
  7. Westman EC et al. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr Metab (Lond). 2008 Dec 19;5:36. doi: 10.1186/1743-7075-5-36.
  8. Wajeed Masood; Kalyan R. Uppaluri. Ketogenic Diet. StatPearls [Internet].NCBI Last Update: October 27, 2018.
  9. Eric Kossoff, MD. Danger in the Pipeline for the Ketogenic Diet? Epilepsy Curr. 2014 Nov-Dec; 14(6): 343–344. doi: 10.5698/1535-7597-14.6.343
  10. Sirikonda NS, Patten WD, Phillips JR, Mullett CJ. Ketogenic diet: Rapid onset of selenium deficiency-induced cardiac decompensation. Pediatr Cardiol. 2012;33:834–838.
  11. Bergqvist AG, Schall JI, Stallings VA, Zemel BS. Progressive bone mineral content loss in children with intractable epilepsy treated with the ketogenic diet. Am J Clin Nutr. 2008;88:1678–1684.
  12. Paoli A, Bianco A, Grimaldi KA, Lodi A, Bosco G. Long term successful weight loss with a combination biphasic ketogenic mediterranean diet and mediterranean diet maintenance protocol. Nutrients. 2013 Dec 18;5(12):5205-17.
  13. Hu T, Mills KT, Yao L, Demanelis K, Eloustaz M, Yancy Jr WS, Kelly TN, He J, Bazzano LA. Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trials. Am J Epidemiol. 2012 Oct 1;176(suppl_7):S44-54.
  14. Marcelo Campos, MD. Ketogenic diet: Is the ultimate low-carb diet good for you?
  15. Adam-Perrot A, Clifton P, Brouns F. Low-carbohydrate diets: nutritional and physiological aspects. Obes Rev. 2006 Feb;7(1):49-58.

The Paleo Diet

  1. Lindeberg S, et al. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia, 2007.
  2. Osterdahl M, et al. Effects of a short-term intervention with a paleolithic diet in healthy volunteers. European Journal of Clinical Nutrition, 2008.
  3. Jonsson T, et al. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovascular Diabetology, 2009.
  4. Frassetto, et al. Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. European Journal of Clinical Nutrition, 2009.
  5. Ryberg, et al. A Palaeolithic-type diet causes strong tissue-specific effects on ectopic fat deposition in obese postmenopausal women. Journal of Internal Medicine, 2013.

The Mediterranean Diet

  1. Martinez-Lacoba, R; Pardo-Garcia, I; Amo-Saus, E; Escribano-Sotos, F (2018). “Mediterranean diet and health outcomes: a systematic meta-review”. European Journal of Public Health. Advance articles (5): 955–961.doi:1093/eurpub/cky113PMID29992229.
  2. Joanne Slavin. Fiber and Prebiotics: Mechanisms and Health Benefits. Nutrients 2013 Apr; 5(4): 1417–1435. doi: 3390/nu5041417
  4. Andreson JW et al. Health benefits of dietary fiber. Nutr Rev.2009 Apr;67(4):188-205. doi: 10.1111/j.1753-4887.2009.00189.x.
  5. Basu A et al. Dietary factors that promote or retard inflammation. Arterioscler Thromb Vasc Biol.2006 May;26(5):995-1001. Epub 2006 Feb 16.
  6. Ferrara LA et al. Olive oil and reduced need for antihypertensive medications. Arch Intern Med.2000 Mar 27;160(6):837-42.
  7. Psaltopoulou T et al. Olive oil, the Mediterranean diet, and arterial blood pressure: the Greek European Prospective Investigation into Cancer and Nutrition (EPIC) study. Am J Clin Nutr.2004 Oct;80(4):1012-8.
  8. Kastorini CM. Dietary patterns and prevention of type 2 diabetes: from research to clinical practice; a systematic review. Curr Diabetes Rev.2009 Nov;5(4):221-7.

The DASH Diet

  1. Sacks FM et al. A dietary approach to prevent hypertension: a review of the Dietary Approaches to Stop Hypertension (DASH) Study. Clin Cardiol.1999 Jul;22(7 Suppl):III6-10.
  2. Sung Kyu Ha, M.D. Dietary salt intake and hypertension. Electrolyte Blood Press. 2014 Jun; 12(1): 7–18. doi: 10.5049/EBP.2014.12.1.7
  3. Shokouh Onvani, Fahimeh Haghighatdoost, and Leila Azadbakht, PhD. Dietary approach to stop hypertension (DASH): diet components may be related to lower prevalence of different kinds of cancer: A review on the related documents. J Res Med Sci. 2015 Jul; 20(7): 707–713. doi: 10.4103/1735-1995.166233
  4. Saneei P et al. Adherence to the DASH diet and prevalence of the metabolic syndrome among Iranian women. Eur J Nutr. 2015 Apr;54(3):421-8. doi: 10.1007/s00394-014-0723-y. Epub 2014 Jun 7.
  5. Hinderliter AL et al. The DASH diet and insulin sensitivity. Curr Hypertens Rep. 2011 Feb;13(1):67-73. doi: 10.1007/s11906-010-0168-5.
  6. Shirani F1, Salehi-Abargouei A, Azadbakht L. Effects of Dietary Approaches to Stop Hypertension (DASH) diet on some risk for developing type 2 diabetes: a systematic review and meta-analysis on controlled clinical trials. Nutrition. 2013 Jul-Aug;29(7-8):939-47. doi: 10.1016/j.nut.2012.12.021. Epub 2013 Mar 6.
  7. Salehi-Abargouei A, Maghsoudi Z, Shirani F, Azadbakht L. Effects of Dietary Approaches to Stop Hypertension (DASH)-style diet on fatal or nonfatal cardiovascular diseases–incidence: a systematic review and meta-analysis on observational prospective studies. Nutrition. 2013 Apr;29(4):611-8. doi: 10.1016/j.nut.2012.12.018.

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