NR 305 Discussion Exploring Popular Diet Trends

According to Ramsey & Makris (2019), “The ketogenic diet is typically used in the context of epilepsy treatment and is 70% to 90% fat and low (<10%) but adequate protein. Keto, however, is a popular term that refers to a diet that is typically 60% to 70% fat and approximately 20% protein and is used for weight loss and metabolic improvement” (pp. 1734-1735).
I would start by doing a health assessment with her. Referencing Weber & Kelley (2018), I would start by asking her what her typical food intake is throughout the day, how often she eats sweets/how much, and what she usually drinks throughout the day and how much. I would then assess her exercise regimen and how active she is throughout the day.
My advice to her would be to make sure she is mentally ready for this strict of a diet, maintain necessary caloric intake, and continue with the diet because if she were to go back to old eating habits after completing the diet, she would gain weight back. I would also advise her to not be too hard on herself if she strays from her diet a small amount, since mental health and a positive attitude is very important as well.

References:

Ramsey, D.J. & Makris, K.I. (2019). Letters. JAMA Internal Medicine, 179(12), 1734-1736.
Weber, J. R., & Kelley, J. H. (2018). Health assessment in nursing (6th ed.). Wolters Kluwer.

I have celiac disease. I must eat gluten free and with no cross contamination or I have terrible reactions including heart palpitations, bloating to a degree of false pregnancy, swelling, nausea/vomiting/diarrhea, worsening migraines, and even neuropathy. There are more symptoms, but these stick out most. The trendy gluten free eaters truthfully hurt my feelings. If I want something substituted for gluten grains, I find that the breads/pastas, etc. are higher in carbohydrates and yet much smaller portions. The trendy gluten free should really read their labels and I find myself constantly with an opportunity to educate patients and friends/family.

NR 305 Discussion Exploring Popular Diet Trends

Some people with celiac disease opt for a paleo diet as it is inherently gluten free. Therefore, for the purposes of this assignment, my cousin has celiac disease and has an elevated A1C. She wants to try the paleo diet.

The paleo diet is the “hunter-gatherer” diet and “consists of literally meats that can be hunted and fruits/vegetables along with nuts, but avoids diary, processed grains, and legumes” (Masharani, et al, 2015). Diabetics need to count carbohydrates and lower carbohydrate diets improve blood sugar (Weber & Kelley, 2018). Therefore, I would encourage my cousin to take a journal and count carbohydrates in even fruits and vegetables (Weber & Kelley, 2018). I would be on board with my cousin trying a paleo diet while ensuring her diabetes is managed and her celiac disease. There is evidence that in the “short-term” at least that there is better “blood glucose control” with this diet (Masharani, et al, 2015).

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Further questions I would ask include:

Are you making sure you still balance your meals with protein and carbohydrates?

Is your endocrinologist on board with your diet change?

Is this sustainable?

Did you make an appointment with a dietitian to see if you can cover all the nutrients you need from your diet?

Do you have a glucometer to make sure your sugars do not run too high or drop too low with this diet change?

References

Masharani, U. Sherchan, P, Schloetter, M, Stratford, S., Xiao, A., Sebastian, A., Nolte Kennedy,

M, and Frasset, L. (2015). Metabolic and physiologic effects from consuming a hunter-

gatherer (Paleolithic)-type diet in type 2 diabetes. European Journal of Clinical Nutrition 69, pp. 944-

948.

Weber, J.R. & Kelley, J.H. (2018). Health assessment in nursing (6th ed.). Wolters Kluwer.

An anti-inflammatory diet is a diet based on eliminating foods that can contribute to inflammation. The idea is that eliminating these foods will decrease or eliminate inflammatory conditions. (Janet R. Weber Rn Edd & Kelley, 2018) Inflammatory conditions are diseases such as Rheumatoid Arthritis and Lupus. Inflammatory foods are foods such as processed sugars, processed flours and bread, and most dairy products. This also includes nightshade vegetables, including tomatoes, white potatoes, and eggplant. (Bustamante et al., 2020) Red meat is discouraged on this diet, and it is recommended that one eat two servings of fatty fish per week to, “Lower the omega6 /3 ratio 2:1” (Bustamante et al., 2020, Table 1) There is also a push toward increasing probiotic intake, which includes supplements, yogurt and kefir. The diet I follow also includes soaking all nuts, grains, and beans overnight before eating to remove phytic acid enzyme inhibitors. Phytic acid enzyme inhibitors prevent the absorption of nutrients in these foods. (Gupta et al., 2013) Anti-inflammatory diets are very restrictive, and can be expensive. Most of the ingredients in cooking are fresh, not frozen or canned. It is recommended that you use olive oil, sesame oil or coconut oil, which are also expensive. Sweeteners are pure maple syrup and local honey. Supplements include Turmeric, ginger and cinnamon. It is important to know that these may also increase bleeding risk. That being said, it is possible to get all of the food categories and all of the nutrients you need in a day with adaptation and planning.

Questions I would ask my cousin:

* Do you have an inflammatory condition?

* What do you hope to achieve with this diet?

* Are you prepared to adapt this as a lifestyle vs. a “fad diet”?

* Are you prepared to permanently eliminate certain foods from your diet, like bread, tomatoes and alcohol?

* Do you do most of your own cooking?

* Are you aware that this is an expensive diet?

* Do you take blood thinners? Are you at an increased risk for bleeding?

* Do you like tuna, sardines, and other fatty fish?

* How do you tolerate yogurt and probiotics?

References

Bustamante, M. F., Agustín-Perez, M., Cedola, F., Coras, R., Narasimhan, R., Golshan, S., & Guma, M. (2020). Design of an anti-inflammatory diet (itis diet) for patients with rheumatoid arthritis. Contemporary Clinical Trials Communications, 17, 100524. https://doi.org/10.1016/j.conctc.2020.100524Links to an external site.

Gupta, R., Gangoliya, S., & Singh, N. (2013). Reduction of phytic acid and enhancement of bioavailable micronutrients in food grains. Journal of Food Science and Technology, 52(2), 676–684. https://doi.org/10.1007/s13197-013-0978-yLinks to an external site.

Janet R. Weber Rn Edd & Kelley, J. H. (2018). Health assessment in nursing (6th ed.). Lww.

Diet Chosen for discussion: Ketogenic Diet

Ketogenic Diet: The Ketogenic diet usually consists of high-fats, moderate proteins and very low carbohydrates. It was originally introduced back in 1921 by a man named Russel Wilder as a therapeutic diet to treat pediatric epilepsy. (Masood et al., 2020) Decreasing the total carbohydrate intake significantly reduces the secretion of insulin and causes the body to enter a catabolic state. Stored Glycogen is depleted which then forces the body to go through metabolic changes. The metabolic processes that initiate when there is a low consumption of carbs is gluconeogenesis and ketogenesis. The way the Ketogenic diet is successful for most people is it causes a rapid weight loss of up to ten pounds in roughly two weeks or less. It has a diuretic effect so initially it is water weight lost, then followed by fat loss. With this diet lean body muscle is spared then as the nutritional ketosis state is sustained, hunger pangs subside, people then have a reduced amount of caloric intake which then helps to further weight loss. (Masood et al., 2020) Unfortunately most people who attempt this diet maintain it short term. This diet also has been found to be associated with increased trips to the emergency room with admissions to the hospital for dehydration, electrolyte disturbances and hypoglycemia. (Masood et al., 2020)

Important information to obtain from my cousin would be:

What makes you interested in possibly beginning this diet?

(This will give background information as to body image feelings, whether they believe their health is poor/lacking/in need of adjustment.)

Have you spoken to your primary care physician regarding beginning a diet regime?

(This gives information to know whether they will be followed closely by a licensed professional, monitored with testing, etc.)

Have you completed your own research after speaking to your doctor to find the best diet/exercise regime that is right for you?

What have you already tried for weight loss prior to looking into this specific diet? Did any of it work? What has worked and not worked for you in the past?

Do you have any medical problems (diagnoses) that could be detrimental to starting this particular diet? What medications do you currently take, including OTC meds/supplements?

Current height and weight to calculate BMI to know where they are as to being normal/overweight/obese/morbidly obese.

Then discussing and offering my advice I would start by making sure my cousin understands that to have adequate nutrition your body requires essential nutrients which include: carbohydrates, proteins, fats, vitamins, minerals and water. (Weber, Kelley, 2018) I would stress/educate the importance that when beginning any exercise/diet regime that you should be monitored by a licensed practitioner because they are skilled to assist you to make sure you are completing weight loss safely as well as assisting with keeping the weight off long-term unlike most “fad” diets we hear about today. I would tell my cousin that is is great that their friend is having success with the Ketogenic diet, but due to the fact that I do not know their friend, their friends health history, background or situation, that I professionally could not endorse them starting any change without having that discussion with their doctor because I want them to be safe and healthy. Considering there is “no scientific recommendation formulated to guide evidence-based or rational use of ketogenic diet in obesity and diabetes management” (Kalra et al., 2018) it would further back my stance of wanting my cousin to be safe when attempting to manage weight loss.

References:

Weber, J., Kelley, J., (2018). Assessing nutritional status. Health Assessment in Nursing 6th ed., 13, 217.

Masood W., Annamaraju, P., Uppaluri, K., (2020). Ketogenic diet. StatPearls, NCBI. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK499830/Links to an external site.

Kalra, S., Singla, R., Rosha, R., Dhawan, M., (2018). Ketogenic diet: situational analysis of current nutrition guidelines. The Journal of the Pakistan Medical Association, 68 (12). 1836-1839. Retrieved from: https://eds-a-ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=4&sid=ddadb5aa-e909-4763-8769-a0e0510c2d78%40sessionmgr4007Links to an external site.

A vegan diet is one where absolutely no animal products are consumed or used in the process of making food, not even honey. While there are many benefits to this diet, there are also downsides to it. Aside from the fact that a vegan diet does not harm animal, other benefits include decreased risk of heart disease, lower body mass index, lower cholesterol levels, and lower blood glucose levels. (McEwen & Bingham, 2019). The downsides to this diet are that it is very strict in terms of what you can eat so you must be prepared to give up a lot of common foods. Eating out will also be very difficult because not many places have vegan options, not to mention most convenient food are not vegan friendly. Another problem with vegan diet is that if it is not done correctly it can result in nutrient deficiencies such as protein, vitamin B12, calcium, and omega 3 (McEwen & Bingham, 2019). Protein is necessary to the body as it provides energy, promoted growth and development, and structure to cells (Weber & Kelley, 2018).

Questions I would ask?

What is your reason for adopting this diet?
1. Do you have any health conditions that might be affected from a vegan diet such as osteoporosis or anemia?
1. Are you prepared to do research to ensure you get adequate nutrition?
1. Are you prepared to invest more time and money in preparing your meals?

I would advise my cousin to make sure she does extensive research before adopting this diet. This diet, more than any other diet, is life changing. While there are many vegan options out there, they are not always easy to find, expensive, and some are highly processed. Due to these limitations she will need to be creative and invest more time into preparing her meals to ensure she is getting a well-balanced, nutritious meal.

Referneces

Weber, J. R., & Kelley, J. H. (2018). Health assessment in nursing (6th ed.). Wolters Kluwer.

McEwen, B., & Bingham, M. (2019). Vegan diet and chronic disease: A brief report. Journal of the Australian Traditional-Medicine Society, 25(2), 77–79.

I really enjoyed reading your post about the vegan diet. I personally tried a vegan diet for almost three months. I do recall something that you mentioned which was the cost of produce and vegan products being awfully expensive. I took a liking to tofu meat alternatives, and I realized early on these products were highly processed and stopped eating them. Overall, during my short time as a vegan, I felt very energetic, and I noticed a positive change in the appearance of my skin, hair, and nails. I would like to mention, there are many health benefits to being a vegan if an individual can adhere to this lifestyle. I recently read about a study on the benefits of plant-based diets, and how they can help type 2 diabetics. I would like to share a line from the article, “Based on the evidence of the research analysis by this systematic review, it can be concluded that plant-based diets accompanied by educational interventions can significantly improve psychological health, quality of life, HbA1c levels and weight and therefore the management of diabetes”(Toumpanakis, 2018, p. 8). I found it very hopeful to learn that a vegan diet can have such positive health benefits for diabetics. Especially the psychological benefit of decreasing depression in diabetic patients. In my opinion small inconveniences like taking vitamins and spending more on food, does not outweigh the benefits of a vegan diet.

Resource:

Toumpanakis, A., Turnbull, T., & Alba-Barba, I. (2018). Effectiveness of plant-based diets in promoting well-being in the management of type 2 diabetes: a systematic review. BMJ open diabetes research & care, 6(1). 1-10. Retrieved on July 23, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6235058/Links to an external site.

NR 305 Discussion Exploring Popular Diet Trends