Doctor Explains the Latest Vegan vs Keto Head to Head Study

[Music] as regular viewers know whilst i'm very interested in diet i don't really cover it very often on the channel for two reasons first there's already so much on youtube about diet i try not to go over previously covered territory and second i just can't be bothered with all the tribalism and arguments even when i post an entirely innocent neutral question without any commentary on twitter people feel mandated to reply about why their camp is better why i know absolutely nothing and it gets pretty boring a few weeks ago i tucked a paper into my bookmarks to read later and when i finally got time last weekend on nights and read it i actually thought it was quite a good trial and worth sharing with you which is why i'm making this video and why i've escaped to this beautiful scenic location to get away from my kids so here is a deliberately short little discussion of what can be summarized for this trial as basically keto versus plant-based and it was published in nature medicine a good journal last month my name is rohin i'm a cardiologist in the uk and i have no diet books or diet plans to sell you now i've said before that nutrition research is sullied by a lot of garbage untested theories retrospective questionnaire-based studies that are pointless and inaccurate and that's because it's profoundly impractical to lock people and lock people up in a room and monitor everything they eat and do well that's exactly what they did over at the nih the national institutes for health in the u.s they convinced 21 people to spend a month locked up with all their food provided now this was done pre-lockdown but you know they should probably start recruiting for their next trial now because that doesn't really sound any different to the life most people have been living for the last 12 years except with free food and actually pretty nice food so um you know i think they'd probably get a lot more volunteers now the participants were not told what the trial was about they were just instructed to do their normal things not try to lose weight or do anything special they were actually given loose fitting sort of scrubs to wear and just eat as much as they want and that's ad libidum that you see in the title it's a fancy way of saying basically eat as much as you like the catch was that half received a keto-style low-carb animal-based diet and half received a plant-based high-carb low-fat diet and then after two weeks they switched now the first thing that i'm sure you'll say is that this is a month in total it's too short and of course this is a short trial but this comes down to study design they're not looking for prevention of stroke or heart attack risk this wasn't designed to do that it wasn't powered to do that uh you need thousands of people over many years to establish that kind of thing and you obviously can't lock people in a room to do that for a long period of time the prime outcome for this study was to measure energy and macronutrient intake with a bunch of secondary endpoints like measuring insulin and blood glucose and things like that so what was the thinking behind this well the central ethos to low carb diets which is the carbohydrate insulin model of obesity was was kind of the the inspiration for this we know that um insulin we've known this for decades has a very important role in how fat is laid down and how it's used up and we know that insulin levels go up when you eat more carbohydrates so carbohydrates cause insulin release and the thinking is that insulin causes fat storage so the level of circulating fuels in your blood decreases and this tells your body to eat more and to deposit fat and you use less energy and this is the idea behind low carb diets which remember haven't we have been around for a long time since the 70s or so with atkins and um also it's important to remember that this theory was counterintuitive to the the commonly beheld uh hell theory which still a lot of people believe now that it is just purely about total calories in and calories out and it doesn't really matter what the constituents are so the carbohydrate insulin model challenged that simplistic belief i do apologize for the wind the study in hand randomized participants to either 14 days low carb or 14 days low fat and then switched them over and they were all non-diabetic participants they had an average age of around 30 and an average bmi of about 28 so they were overweight the low-carb food was consistent with keto meals it was animal based with non-starchy vegetables i.e things like greens and the low-fat one was consistent with a plant-based vegan healthy diet again with non-starchy vegetables alongside things like sweet potato and so forth as expected the insulin and blood glucose levels were significantly higher in the plant-based group versus the keto group and blood ketones were higher in the keto group so far nothing new nothing that surprising so why am i telling you about this trial because people ate significantly less on the plant-based diet right from the beginning and even with the documented high insulin levels which should we would think would tell them to eat more that's the belief uh they ended up eating less and they actually consumed about 700 calories less per day and quite strikingly this was seen in every single participant there was no noise that it was every single participant from from day one and this is simply because plant-based diets plant-based foods are just lower in calories per gram so you feel full and you've eaten less calories and there were no differences in hunger fullness satisfaction eating capacity and interestingly things like familiarity and enjoyment were also the same as well which is part of the selection criteria they didn't choose fussy eaters and they chose people who would be familiar with most of the food that they were presented with so with the low lower caloric intake of the plant-based diet people lost more body fat not on the keto one they lost more water weight on the keto diet which is a recognized phenomenon that occurs early on and this is to do with glycolysis activation mobilizing water but body fat was not significantly reduced with the keto diet overall in spite of the keto group eating 700 more calories per day they lost more weight overall but i reiterate this was not body fat weight loss so should we chuck out the carbohydrate insulin model like a tub of e-number enriched margarine well a lot of people think we should and is the effects on insulin and glucose in the keto diet and the lower levels of particular interest and importance to metabolic health and diabetics probably yes is a healthy plant-based diet a good starting place for good weight loss i think it probably is as i said at the start the most tiresome thing to people who aren't staunchly in one of the different camps is the endless arguments that assume that life is binary and you can only do one diet or the other and you can't possibly be flexible in your choices but can't we all just get along because there is actually some common ground here if you look at the foods that they served in this trial there are some pictures on the nih website both groups had meals that look actually really nice lots of non-starchy veg and a distinct lack of ultra-processed food keto and plant-based diets might seem world apart but are they really they both emphasize moving away from the standard american diet which we all know is awful that's the overwhelming message that emerges from a multitude of trials including work by this the same group that we can argue to the vegan cows come home about all the different macros and ketones and so on but the ultra processed foods like ready meals and cookies and crisps and frankly most things i see in american supermarkets and i'm not having a good americans here uk is not far behind we're both significantly worse than in mainland europe but foods with long lists of additives refined carbs salt and so on they're the real problem i i read somewhere don't quote me on this i probably shouldn't put it in a video but something like two-thirds of the american diet comes from ultra processed foods compared to about five percent in portugal and eight percent in france i think uk was somewhere in the middle around 30 so this trial is an important extra data point by all means criticize the duration but people complaining about the sample size are missing the point here both groups lost weight so instead of fighting between belligerent camps or more importantly instead of berating yourself for not sticking to a certain diet and messing up your ketosis or you know being unable to stick to a diet that your friend karen promises you is the best one just try one intervention first and that's cutting your intake from highly processed foods down to as close to zero as you can and i appreciate that the the term highly processed is also confusing and that needs a bit of clarification as well but whenever people talk about that healthiest populations in the world um in italy or japan none of them are doing extreme restrictive diet and there's little in common between a lot of these places in terms of what they're actually putting in their food except there's one thing that is in common they are mostly natural good unprocessed foods well i haven't really thought of a way to end this video so i'll sign off from sunny east london once again apologies for the wind noise but i thought you'd prefer that to screaming kids

Channel: Medlife Crisis

Views: 646,064

Keywords: Medlife Crisis, Medicine, Science, Education, Comedy, Doctor, Cardiology, Medical School, Biology, Diet, Keto, Nutrition, VEgan, Plant based, Carnivore, Low carb, Low fat, Weight loss

Id: SsSHzTsG4wY

Length: 10min 6sec (606 seconds)

Published: Wed Feb 17 2021