The Ketogenic Diet / Keto-Diet

I have been asked numerous questions about the Ketogenic Diet or Keto-Diet and whether it’s healthy or not, so we’re going to discuss it in a series of articles. Numerous studies findings have indicated that the Ketogenic Diet helps with Obesity management and weight loss, Epilepsy, Diabetes, Alzheimer’s disease, Cancer and overall improve health. 

  

So, what is a Ketogenic Diet?

The Keto Diet is a very low Carbohydrate, High Fat Diet. It involves drastically reducing carbohydrate intake and increasing fat intake, and basically using fats as the main energy source.

When you drastically reduce carbohydrate intake, which are basically the typical energy source for the body, this puts your body in a metabolic state known as Ketosis. In Ketosis, the body uses fat for energy.

The body breaks down fat into Fatty Acids and Ketones in the liver. The Ketones are used for energy.  The ketogenic diet actually originated as a tool for treating Epilepsy. The ketogenic diet was designed in 1924 by Dr. Russell Wilder at the Mayo Clinic. 

    

Types of Ketogenic Diets

       i.            The Standard Ketogenic Diet (SKD)

This is a very low-carb, moderate-protein and high-fat diet. It typically contains 75% fat, 20% protein and only 5% carbs.

     ii.             High Protein Ketogenic Diet

Similar to a standard ketogenic diet, but has more protein. The ratio is often 60% fat, 35% protein and 5% carbs.

  iii.            Cyclical Ketogenic Diet (CKD)

In this diet the person has higher-carb refeeds, for example, 5 ketogenic days followed by 2 high-carbs days

   iv.            Targeted Ketogenic Diet (TKD)  

This diet allows for higher carbs intake around work-out hours.

Of all the four diets however, only the Standard Ketogenic Diet is well researched. Therefore its benefits and side effects are more defined.   

The Role of Nutrition and Dietetics in Reduction of the County and National Curative Health Budget

Health is much more than the absence of disease. Optimum nutrition, providing all types of nutrients required by the body in the recommended daily amounts, is the cornerstone of good health and the cutting edge of disease prevention. 

Nutrition and Dietetics roles in healthcare include;

1.     Preventing onset of disease, therefore less admissions in healthcare facilities and a consequential reduction in the curative budget

2.     Faster cure and effective management of disease by boosting the body’s own defense against disease/Immunity System

3.     Shortening the length of hospital stay

4.     Reversing the effects of disease in the body

5.     Maintaining Optimal Health status, which assures more productive citizens, economic stability and overall increase in the country’s GDP.   

The foods we eat, and the nutrients they provide, are the most important continuing environmental factors influencing our growth, development, functional abilities, and optimal health.  

Nutrition plays a Crucial Role in Preventive, Promotive and Curative Healthcare Services. Nutritionists and Dietitians employment and active involvement in healthcare has tremendous unmatched benefits to County Governments and most importantly to Citizens across all age groups and throughout the lifespan.          

It is therefore crucial to ensure that ALL Health facilities; County Referral Hospitals, Sub-County Hospitals, Health Centres and Dispensaries, have the recommended number of nutritionists, in order to ease the burden of disease and the Curative budget on the County Government.  The most important level missing Nutrition and Dietetics Personnel is the Community level/Tier 1. The households and community level at large is the most crucial in influencing adoption of Nutrition and healthy behavior and choices that influence food security, disease prevention and overall optimal health.                     

It is important for County Governments and especially the leadership to understand Nutrition and Dietetics and its role in healthcare. That is the only way we will curb the rising Non-Communicable Diseases prevalence and decrease the curative budget. We need to be pro-active and focus more on disease prevention, and we won’t have to keep worrying about skyrocketing curative budgets, more so in Central Kenya and Coast, where NCDs seem to be drastically increasing.  

Duties and Responsibilities of Nutritionists/Dietitians

The duties and responsibilities of Nutritionists and Dietitians are well captured in the Revised Scheme of Service for Nutrition and Dietetics Personnel 2014.

Just to mention a few, they include;    

Preventive and Promotive Healthcare Services - Summary

1.     Educating community members and encouraging adoption of a healthy lifestyle 

2.     Initiating and ensuring nutrition and health behavior change communication (BCC)

3.     Initiating health awareness campaigns e.g. 6 months Exclusive Breastfeeding and continued breastfeeding up to at least 2 years, prevention of malnutrition and stunting in children, Non-Communicable Diseases (NCDs e.g. Cancer, Diabetes, Hypertension, Obesity)prevention

4.     Prevention of maternal and child health complications by correcting nutrient deficiencies which research has proven to cause diseases and premature deaths.

5.     Demonstrating cooking methods to preserve nutrients and gain maximum nutrition from different foods.

6.     Health education and communication on healthy food choices and specific ingredients in manufactured foods that predispose them to diseases e.g. Salt – Hypertension, Sodium Benzoate – Cancer, Monosodium Glutamate (MSG), Simple Carbohydrates-Diabetes, High Fructose Corn Starch (HFCS) – Obesity among many others.    

7.     Collaborating with Stakeholders e.g. NGOs, Ministry of Education and Ministry of Agriculture to ensure food availability, accessibility, affordability and safety, kitchen gardening, among others

Curative Healthcare Services – Summary

1.     Providing outpatient and inpatient nutrition care

2.     Providing therapeutic nutrition support for effective disease management in health facilities and shortening length of patients stay in the hospital

3.     Providing nutrition care for Pre-term and Low Birth Weight babies and preventing newborn mortalities

4.     Nutrition management in specialized clinics including HIV/AIDS, Diabetes, Tuberculosis, Renal clinics, ICU, Burns, Prenatal and Antenatal, Cancer Management, Cardiovascular and ALL other specialized clinics (Specialized Medical Nutrition Therapy)    

5.     Management of Malnutrition (Undernutrition/wasting and Obesity)

6.     Calculating dietary requirements for each patient and developing  meal plans

7.     Supervising administration of inpatient feeds ; Enteral and Parenteral

8.     Admitting patients to Supplementary Feeds e.g. Flours, Micro-Nutrient Powders (MNPs), RUTF among others   

9.     Implementation of baby friendly hospital and community initiatives

10.                        Assessing and reviewing nutrition referral cases  

11.                        Facilitating nutrition in health and inter-sectoral teams, among other roles

Nutritionists/Dietitians play a crucial role in Preventive, Promotive and Curative Healthcare. So, how can Nutrition and Nutritionists’ reduce the Curative Healthcare budget? Let’s discuss that in the next article.

HOW MANY NUTRITIONISTS/DIETITIANS ARE IN YOUR COUNTY?

Kenya has some of the most hardworking, warm-hearted people I’ve come across. Non-Communicable Diseases (NCDs) are however one big threat we must deal with, if we’re to keep our people alive and healthy enough to build a better Kenya for us all. 

 

The Kenyan population is ailing. Most of us can attest to being affected in some way by lifestyle diseases.  So what is the problem? Why the drastic increase in NCDs prevalence?  How can we solve this problem before it becomes too expensive for us to manage? Which is where we are heading.   

A recent staff establishment analysis conducted by Nutrition Association of Kenya indicates that on average Counties have 20 Nutritionists/Dietitians including the management teams in the County and Sub-Counties, serving a population of over 1 Million people. This means one Nutritionist in Kenya serves approximately 50,000 people. Ridiculous right?  

According to the Kenya Health Strategic and Investment Plan 2014-2018, the ‘Human Resources for Health Norms and Standards Guidelines for the Health Sector’ direct that every Community Unit should have 2 Nutritionists, a Dispensary should ideally have 3 Nutritionists, a Health Centre should have 8 Nutritionists, a County Referral Hospital should ideally have 22 Nutritionists and a Level 5 and National Referral Hospital should have 36 Nutritionists. There are many variables that could influence these numbers, but these are at least the bare minimum to work with.  

Somebody once said that Kenya has excellent policies and strategies, on paper, but never implements them. In fact, numerous delegates from other countries borrow many strategies from Kenya, implement them, and end up creating rigid, practical systems, while we stuck-up the policy documents away in shelves, and continue doing things the same old way that created the problems in the first place.

A majority of Kenyans have no idea who a Nutritionist/Dietitian is, and those with a clue, including medics and paramedics, think all a Nutritionist does is tell people what to eat and what not to eat. This could be the reason why other medical/health professionals, herbalists, fitness professionals among many others, feel a Nutritionist is not necessary, and or worse still take up the role of a Nutritionist, then we end up with a misinformed, confused, sick population. Wanjiku has been receiving Nutrition advice from people, who are neither adequately trained, nor registered or licensed to practice Nutrition and Dietetics. 

I remember a medical representative (med-rep) from a reputable company that sells Nutrition Supplements recently asking me why he should bother contacting or working with Nutritionists, when he can make more sales by having his products directly prescribed by other medics and paramedics and sold over the counter. I was not surprised by his business argument, but I was astounded by his level of ignorance and sheer greed to increase sales at the cost of ailing uninformed Kenyans, some of who are so desperate that they will take anything that promises good health. 

But let’s face it, as long as the number of Nutritionists and Dietitians continue to be ridiculously low and literally out of reach to a majority of the population; Cancer, Hypertension, Diabetes, Cardiovascular Diseases and Obesity among other Non-Communicable Diseases, which are rapidly on the rise are here to stay.  We will also continue having a people ready to take any ‘Nutrition’ and Herbal concoctions, as long as they promise to ‘save’ them from pre-mature death due to disease; because the Professionals who actually understand the science of Nutrition, Nutrients and the bio-chemical processes that come with it are literally out of reach!   

Our People are Ailing, Over-spending and very unfortunately complicating from medical conditions that can very effectively be prevented and where already present, they can be effectively managed through Nutrition and many lives saved. 

Ironically, over 1,000 highly qualified and Registered Nutritionists/Dietitians, who can provide Kenyans with Behavior Change Communication to curb the increase of diseases, help take Kenyans back to optimal health, provide effective Nutrition Management to those who are sick and prevent disease relapse, are unemployed.   

This is an unfortunate reality, and we can only hope that the Council of Governors and ALL Governors in Kenya listen to our pleas and close the ridiculous gap in Nutritionists/Dietitians staffing establishment in ALL Counties. 

NUTRITION IS A BASIC HUMAN RIGHT and it does not end with having food on Your Plate. NO! That is actually where it begins. NUTRITION IS THE FOUNDATION OF OPTIMAL HEALTH! The more we put Nutrition on the back burner, the sicker we will become.   

We will discuss Nutritionists/Dietitians’ role, duties and responsibilities in healthcare in the follow-up article.

Until then, remember that Your Health is Your Responsibility. Get a check-up today, if you haven’t, workout and eat healthy!   

CANCER-FREE THEN DEAD?

The story of Janet Kanini Ikua is not only a heart-breaking story, but also leaves many unanswered questions about the medical field. Why should a doctor declare a patient Cancer-Free, then they are declared dead soon after? Should we even trust doctors’ results? Is there something we are missing and or overlooking as medics and paramedics?

Cancer is one of the most ruthless, devastating, agonizing and aggressive medical conditions I’ve seen so far in my line of work. Most Cancers’ symptoms mimic those of other common diseases, therefore more often than not, doctors either misdiagnose or end up managing the symptoms for too long, and by the time they get the right diagnosis it’s by far too late. This was the unfortunate reality for Janet and my Mum’s friend’s Mum, who was treated for Cellulitis for so long, only for the doctors to realize she actually had Leukemia (Blood Cancer). She died less than a week after diagnosis. 

But why would a person be declared Cancer-Free then they end up succumbing soon after?  The answer to this is in the fact that we keep constantly over-looking the basic Foundation of the Human body. The human frame and all structures in it run 100% on Nutrition.

The human body is an intricate network of well-coordinated systems that are programmed to carry out various functions, which together directly influence optimal health. This complex system is Fueled and run Fully on Nutrients. The body needs energy for cells and all systems in general to function; energy comes majorly from Carbohydrates and Fats as a secondary source.

The body has a way of destroying all worn-out cells and tissues and creates new ones to replace them. The body triggers a self-destruction process in any cells that develop abnormally or have any defects in a process known as apoptosis, or simply cell death. The Nutrients in-charge of this rejuvenation and rebuilding process is Amino Acids, which are the building blocks of Proteins.

No pathogens; Viruses, Fungi, Bacteria, Worms etc. can survive in the body under optimal health status. This is because the body was created with a defense system to destroy any pathogens before they can cause any harm in the body. Why then, do diseases and more so chronic illnesses like Cancer develop, in-spite of the defense system being present? Also, why would Auto-immune conditions develop?

Vitamins and Minerals are the ammunition in the body’s defense system. The wide range of Vitamins and Minerals not only strengthen the immune system, they also stop various destructive processes. For example, Vitamin C, Vitamin E and the Mineral Selenium stop the Oxidation process, which plays a huge role in Cancer development. Vitamin A and Omega 3 also play a huge role in strengthening the body’s immunity.

Several questions then arise;

1. Why do we develop diseases?
2. Do we take enough Nutrients to prevent us from developing diseases?
3. If a person develops Cancer, do they require the same amount of Nutrients as a ‘healthy’ person?
4. Does a person under the various Cancer treatment methods; Chemotherapy, Radiotherapy and Surgery require the same amount of Nutrients?                                                                        NB: I put the word ‘Healthy’ in quotes because it’s very under-rated. How do we define optimal health in regard to Nutrients intake?
5. Do persons with Cancer, need the normal levels of Required/Recommended Daily Intake Amounts of Nutrients or much more than the Required Daily Intake amounts based on;

·         The specific disease

·         The stage at which the disease is at

·         The Disease treatment modalities

·         The specific individual’s Nutrient status and Nutrient stores

·         The Individual’s Gastro-Intestinal System’s (Digestive System) ability to effectively digest and absorb the Nutrients, but most importantly, the specific cells ability to adequately and efficiently assimilate the Nutrients, or simply put to use the Nutrients to support optimal function.

·         Most importantly, how do we determine or gauge the individual’s Digestive System’s ability to effectively utilize Nutrients from food ingested? Moreover, do we consider the food’s bio-availability levels if ingested cooked or raw?   

These are pertinent questions we MUST get right in order to stop the unfortunate reality of people being declared Cancer Free, then Dead soon after.  

Cancer is an extremely aggressive, ruthless disease. When you introduce even more aggressive Conventional Cancer treatment methods like Chemotherapy and Radiotherapy, then we end up with a battered, mistreated,   completely drained body, whose systems have not only been completely weakened by the disease itself, but the cells are completely destroyed by the non-selective treatment methods, which tend to destroy both cancer cells and healthy cells.

Once the doctors declare that the individual is Cancer Free, assuming they are clear of both Cancer Stem Cells (CSCs) and Cancer Tumor Cells (CTCs); we then as a care team need to work towards restoring the body back to optimal health, and trust me, Vegetable juices only won’t do. Instead, the juices might cause renal failure, due to high concentration levels. By the way, do we consider the amount of minerals and vitamins in vegetable juices? Remember even too much of a good thing is poisonous. You can’t compare eating half a beetroot in salad to drinking 4 beetroots in juice mixed with other vegetables, with no water. That concoction will kaput your Kidneys.

What a recuperating Cancer warrior needs is a balanced blend of all Nutrients the body requires, according to the individual’s weight. Medical Nutrition Therapy is the best and only way we can be sure that we’re providing Nutrients in the right amounts and high bioavailability. Many people become skeptical the moment the word ‘Nutrition Supplementation’ or ‘Nutrition Supplements’ are mentioned, and understandably so. Many scrupulous businesspersons have taken advantage of the sense of desperation in many patients, and sold them useless concoctions and capsules with a promise of full recovery.

Let me make it clear that there’s a difference between herbal concoctions and Nutrition Supplements. Nutrition supplements should ONLY be administered and prescribed by a qualified, registered Nutritionist/Dietitian. They are not ‘Miracle drugs’ either. The body does not get destroyed in a day; therefore one requires a period of time to fully get the body back to optimal function and health, even with Medical Nutrition Therapy (MNT).

Medical Nutrition Therapy’s goal is to provide the body with the required Nutrients during treatment, restore the body back to optimal function, and replenish the body’s Nutrient stores. Depending on the Nutritionist’s assessment of the individual, he/she could be put on aggressive Nutrition therapy for a certain amount of time, then an immune complex, for the long-term, with periodic review of the individual. The reason for having long-term Nutrition Supplementation for most individuals is the fact that a majority of us do not meet the Required Daily Intake of Nutrients. For Cancer warriors unfortunately, the disease could relapse. And more so, if the immune system is not strengthened and the body’s nutrient needs constantly provided on a daily basis. Therefore a long-term supplementation plan is crucial in ensuring that the body is provided with the vital Nutrients it requires for optimal function.

What makes the real difference between a person being declared Cancer-Free and not only surviving but actually thriving and being declared Cancer-Free and dying is how their Nutrition Status is managed before commencement of Cancer treatment, during Cancer treatment and after the cancer treatment.

 It is about time we woke up to the reality that without the appropriate Nutrition management in terms of Medical Nutrition Therapy and fully integrating a Clinical Nutritionist in Cancer management, we will keep losing Patients and missing the mark over and over again, while the writing is clearly on the wall and by now we are all cognizant to the fact that Cancer Management without appropriate Nutrition Management equals disaster.  

INTERNATIONAL CHILDHOOD CANCER DAY, 2017

Do You Care?

Childhood Cancer prevalence is on the rise in Kenya, but most of us may not be aware due to the numerous challenges facing our Nation. I won't be surprised if today goes unnoticed by media houses, due to other issues that seem to be overshadowing the one thing we can't afford to forget.

In-spite of all the challenges, today is one day, WE MUST CARE about.

A day more important than any other day.

A day we must put our challenges on the back burner, even just for a few hours,
A day we must all get online and in solidarity commemorate,
A Day we must get our armor, and go to battle,

Children CANNOT Battle Cancer alone!
With the doctors strike today at Day 76 and clear uncertainty of ending, Our little warriors are literally staring at death.
You see,
Even One day without a doctor, for a child with Cancer, is one more day, towards an uncertain future! A step closer to the end of a life that has just began

Join Hope for Cancer Kids in commemorating this day. Let's raise awareness on the unfortunately increasing prevalence of Childhood Cancer, and Fundraising to pay for NHIF for every child with Cancer, in order to ensure that ALL children diagnosed with Cancer access the best possible treatment.
Cancer IS NOT a death sentence, but it becomes one, without quality comprehensive healthcare.

LET US ALL JOIN THE CHILDHOOD CANCER FIGHT!

#ICanWeCan
#FightChildhoodCancer
#Kenyans4KidsWithCancer
www.hope4cancerkids.org

Inflammation Diet

Those of us who have sought advice on the most effective Arthritis, joint pain or inflammation diet, have most probably come across the Mediterranean diet.

Multiple studies recommend various dietary regimes to prevent and effectively manage inflammation. There is however key elements all these studies agree on; a meal plan low in saturated fat, low in processed foods and high/rich in vegetables, fruits, beans and legumes, fish, seeds and nuts is excellent not just for inflammation prevention and management, but also optimal health and wellness. These are all traits of the Mediterranean diet.

The Mediterranean diet has over the years been proven to;

• Lower Blood Pressure
• Slow the aging process
• Prevent chronic conditions e.g. Cancer, Cardiovascular Diseases e.g. Hypertension, Kidney Failure, Diabetes
• Control Arthritis by curbing inflammation
• Benefit the joints
• It has also been proven over and over again to be excellent for heart health
• Best for weight management and fat loss. Weight management has been proven to manage joint pain.

Based on the evidence above, it’s crystal clear that the Mediterranean diet is not like any other diet plan people obsess about. It is not only excellent in disease prevention and boosting immunity, it is also an anti-inflammatory diet or simply an arthritis diet.

What we eat directly affects our health and overall wellness. It is therefore our responsibility to choose the best possible diet, in order to boost our immunity, prevent and effectively manage medical conditions.