Dr. Sanjeev Balakrishnan - 'Busting Low Carb Myths'

[Music] good morning everyone uh yeah so so uh just a general disclaimer that none of this is a um uh professional medical advice and um conflicts of interest I have none I used to be a low carber these days I'm on a Carnival diet that's me so these are some of the things that we're going to cover this morning so these are all the um common myth uh my patients um come to me and asking for clarification so let's go to myth one I'm afraid my cholesterol levels will go up if I eat saturated fats but uh the more important important question is why do we need cholesterol right so cholesterol is very important because uh without cholesterol our cells won't have a shape and uh we need cholesterol to uh help digest the fat we consume it's also found in large amounts in the brain where it's needed for normal brain function and um cholesterol is also required in the skin where it's um you know it's vital for good skin health and infants need a lot of cholesterol for proper brain development and it's found in large amounts in breast milk without cholesterol we won't be able to produce very important hormones like estrogen testosterone cortisols uh and um it's all our nerves in our the nerves in our body are all lined by a thin layer of sheets which are made up of um cholesterol and um again without cholesterol we cannot synthesize vitamin D so I don't understand how something this important can be bad for us um yeah so uh the Japanese have done a lot of work in this field and um this is a very interesting um article which um uh where they looked at about 90,000 people uh age between 40 and 79 who had no history of any cardiovascular disease and they followed these people for about 10 years and uh what they found is that the people who had the lowest LDL levels had the highest risk of dying from something all cause mortality so for them it was not just important preventing heart disease uh it was important to prevent dying from all reasons or all possible reasons so the higher your LD levels were the lower your risk of um all cause mortality and uh they also saw this in the elderly population which was uh replicated in studies that were done in Norway and also in Holland right so elderly people with high cholesteral levels lived longer irrespective of where they lived so because the intake of saturated fats are closely linked with um heart disease this paper from Canada uh so the team decided to look uh at U all the previous studies that linked the consumption of saturated fats to heart disease and what they found was that saturated fats were not associated with all cause mortalities cardiovascular diseases coronary heart disease ishemic Strokes or type two diabetes what was associated with all those conditions were the consumption of trans fats so this paper uh that was published in the uh Journal of American College of Cardiology in 2020 decided to look at that advice you know the advice that tells us to um reduce our intake of saturated FS so they decided to look at all the papers that came up with that conclusion and they found that the evidence for such advice uh lacked any Merit so this used to be the previous advice asking us to reduce our intake of saturated fatty acids uh to reduce our risk of heart disease but when they looked at all the data they found consuming food like that had no increased risk of cardiovascular diseases or type two diabetes this is a very interesting paper that uh concluded that almost 50% of people who get admitted in hospitals in America have either normal or low cholesterol levels almost half of people admitted to the hospital with coronary artery disease had cholesterol levels less than 100 mg or um less than 2.6 uh 2.6 milles that's the one we use in Australia here so in summary is cholesterol bad for you answer is no so this is uh another common myth my neighbor said too much proteins is bad for my kidneys so um not much studies is done in this area however this um review paper from the US published in 2005 showed that um consuming a large amount of proteins is not bad if you have good healthy functioning kidneys right but let's look at what we need to do to keep our kidneys healthy basically you need to keep your blood pressure under control you've got to have good blood sugar levels healthy weight not smoke or quit smoking and um avoid medications that damage the kidneys like your anti-inflammatories and your proton pump inhibitors right so you can see three out of five things that relate to our diet now but what if you do have kidney disease there there have been some observational datas that show a data that shows slight Improvement but the results are quite mixed all right it's always good to talk to your doctor first before you adopt a diet low in carbohydrates if you've got existing kidney disease um what I see in my clinical practice is uh patients who have mild kidney disease tend to have Improvement in their kidney function when they um adopt a diet low in carbohydrates um but um there's not much data done in patients who have advanced kidney disease when I tell my patients to have more fat in their diet they tend to some of them would say that they've had their gallbladder removed and um someone told them they can't have a high fat diet so when you have your gallbladder removed only the gall blad is removed the liver continues to produce bile so you still can consume a diet rich in fat the other concern is always oh I have gall stones can I have um a diet high in fat yes you can and that's probably the reason why they developed G stones in the first place because if you're on a low lowfat diet you are not using a lot of your bile that leads to bile stasis which increases your chances of having gallstones so there's a very small study here looking at 51 obese people and um they put them on a very very low fat diet which was just less than one gram of fat a day and what they found that after a month four of them had developed gall stones and after 2 months about 25% of them had already developed gall stones and that's just on a lowfat diet this Pap looked at the incidents of uh gston a symptomatic gallstone disease in men what they found was that uh men on a um lowfat diet and high intake of carbohydrates had a higher risk of De developing G stones and they this this this was done in 50,000 this observation was in 50,000 uh health professionals in the US over 12 years showing that you know um a diet high in carbohydrates increases your chances of Goldstone disease this is another one my patient told me that um they told their Pharm that they were doing the keto diet and they said that ketosis is dangerous so um often comes up and um let's let's see what is ketosis ketosis is a metabolic state that occurs when our body burns fat for energy instead of glucose and this is purely physiological keto acidosis is also a metabolic state but it's associated with high serum and urine concentrations of Ketone bodies and this is ological this is a medical emergency keto acidosis happens when you've got very high blood sugar levels very high Ketone uh blood Ketone levels and the blood is our blood is acidic so this is keto acidosis and this does not happen when we on ketosis so in summary is ketosis bad no ketosis is never bad ketosis is physiological after I've had a discussion with my patient about improving their diet to lose weight they would ask me don't I need to exercise to burn fat um it depends because you have to do the right exercise to burn fat most of the time when we say exercise people imagine cardio you know running jogging in the rain or something like that this study here looked at aerobic exercises right so aerobic exercises are all cardio exercises it was a review paper looking at 14 trials that involved about almost 2,000 patients and um what they found is that the weight loss achieved from cardio exercises are quite modest and that's usually not sustainable because uh I mean you can do intense cardio and lose weight but you cannot maintain that sort of exercise as you get older and uh you can also damage your joints so what works what sort of Exercise Works High interval intensity training or high inter high intensity intermittent exercise this study is quite interesting but again a very small study involving 45 ladies what they did was they put onethird of them in an anerobic regime uh another one3 aerobic regime and 15 of them another one3 as um the control group and what they found was the 15 ladies who were in the anerobic group um after about just 15 weeks they had uh the most significant reductions in their total body fat and insulin resistance resistance training and weight training that's uh what we call anerobic exercises and I think this is very very important you don't have to do a lot of this uh to achieve uh huge outcomes and um just doing resistance training or weight training just two or three times a week for 20 30 minutes to prevent sarcopenia as Nicole had discussed yesterday sarcopenia is associated with very very poor health outcomes if we can preserve our muscle mass uh our Health improves we become more insulin sensitive and uh we live longer so what is the right exercise to reduce body fat increase muscle mass and uh improve health outcomes it's high interval intensity training with resistance training or weight training uh I get this from a lot of my male patients I have gout ion eat meat uh not true right I feel uh this is just my opinion gout is over diagnosed not every pain in your foot is gout right and just because your uric acid levels are high does not mean you have gout so what causes gout okay um so so what is gout actually the the the pain that we get when we have gout so it's actually a very quick pain hits you with a bang really intense and it tends to get better by day two or day three even without medications that's gout right the skin is warm it's red and it's very sensitive to touch so we we've all been told that gout happens when we consume a diet high in purine right and purine gets converted into uric acid in our body but the purine that we consume from our diet is just a small amount right so most people people with gout are actually producing a lot of uric acid right and that uric acid crystallizes in the in our joints especially the big toe and that's gout however we tend to forget that fructose is also converted into uric acid in the body and we are consuming a lot of fructose in processed foods so this is how fructose is converted into uric acid so the reasons for high uric acid levels in our body uh so most of it is from our own metabolism some of it is from our diet but most of it is from the fructose that we are consuming and as we know fructose is uh found in large quantities in a lot of processed foods so a diet high in protein will not give you gout and um consuming rate m in large amounts will not give you gout as long as you're not consuming fructose yes so a few years ago this this myth was published in the papers newspapers that um low cup diets were associated with increased risk of mortality and every few every few years a paper like this will come up reminding you that you should not do the low cup diet otherwise you're going to die early yeah right but um these are all observational papers and um they are they are always um done B uh using questionnaires right questionnaires this paper here which was widely quoted showed that if we consumed a low carbohydrate diet which was high in animal proteins you had a higher risk of dying but if you replace that animal protein with plant based proteins you live longer so um again it was just an observational um uh paper where they did not investigate the low car diet as a specific intervention low carb has many meanings for many people what is low carb is less than 30 gram low carb is less than 150 g low carb some studies use 150 g as low carb which doesn't make sense to many of us right studies like that rely on uh food frequency questioners and just like dea said you know I can't remember what I ate last week and you're asking me to recall what I ate in the last two years right and um and and data is collected like you know very sparingly like in these papers this paper data was collected twice per patient in a six-year interval right and and um and in in this group uh a lot of them were also consuming uh high amounts of uh vegetable oils and unsaturated fats so um it's just like what zo hakum says right don't blame don't blame the steak for what the fries did right so it's very easy to to have a nice big juicy Big Mac and and and and then blame the the the the red meat there not the buns and not the fries and the the coke that came with it I hear this so often and it really uh frustrates me um low cup high fat diet is not sustainable it's just not the diet right people are telling you that uh your attempts to stay healthy is not sustainable right people keep telling us that uh in my clinical experience that's not true it is very sustainable in individuals who um who have specific goals you must know why you want to improve your health right you must have a goal so my patients adopt this diet or this way of living to reduce their risk to reduce their dependence on medications that's that's usually the reason I've had patients do this to come off their insulin I've had patients do this to come off their medications and um so it is sustainable provided you have a specific goal of course it is sustainable for people who are committed right is what I tell my patients is uh you cannot quit smoking if others are asking you to quit smoking you have to quit smoking because you want to quit smoking similarly if your doctor is telling you to lose weight others are telling you to lose weight it's not going to work you you need to have that desire to lose weight or improve your health right it's not easy okay no one say it's going to be easy it is hard but guess what the more you do it the easier it gets right and you've got to always remind yourself why you're doing it you need to have good support all right so I always tell my patients um get their family members involved so you can't have one person eating healthy and everybody else not doing that in the family right it's just like smoking again you can't quit smoking if everybody else in your family is smoking so with my female patients who are doing most of the cooking or meal preparations at home I tell them to just start changing the diet grad ually slowly without telling anyone in the family so they don't realize what's going on right so if you tell them hey today we're going to eat really healthy we're not going to have this and that uh you know you will get a lot of resistance but if you just do it gradually no one realizes what's happening and and you know and they wake up one day and realize that everyone's eating healthy right and it's also important for you to have a uh good GP a GP who understands what you are doing right and I I I often get a lot of new patients like that um because they always looking for a GP who understands what they are doing who has read the same literature as as they have and they need some support so um find a GP that can help you and have regular followup with them because um studies show that you know when we have regular followup and when we accountable to someone uh we get good results so uh in summary my take home message is now just reduce eliminate consuming processed foods saturated fats are not bad but please avoid seed oils and trans fats do the right exercise and uh do not do not Outsource your health to anyone always question your doctor if you're not sure of something ask them to explain it to you don't take what we say uh as the gospel truth and um even for everything I've put up there you know I invite you to go and look it up and do your own research thank [Applause] [Music] you

Channel: Low Carb Down Under

Views: 34,247

Keywords: Low Carb Down Under, LCDU, www.lowcarbdownunder.com.au, Low Carb Sydney 2023, Sanjeev Balakrishnan, LCHF, Ketogenic, Carnivore, Low Carb Myths

Id: Xe4t2hN5oSk

Length: 21min 50sec (1310 seconds)

Published: Sat Jan 27 2024