As we have now challenged seven dietary concepts, it is time to introduce orthorexia. From the above, it should be obvious that orthorcxia should involve the following:
- Limit carbohydrate consumption
- Consume food products rich in fiber
- Include food products with live bacteria
That’s it That is the basics. Now lets further examine the carbohydrate limitation.
At this point, I am going to have to return to the calorie counting concept. In general, I do not have my patients count calories. Recall from Chapter 3 that not all calories are metabolized equally. Calories from carbohydrate are metabolized much differently than calories from protein or fat. Nevertheless, no dietary plan will work if we consume calories in gross excess. In general, nutritionists claim that males require 2500 calories per day to maintain their weight. Females require about 2000 calories per day to maintain their weight. Therefore, no dietary plan can allow an excess of 2500 calories per day for males or 2000 calories per day for females. Having said that, you may wonder why I do not recommend calorie counting. What I have found is that once the carbohydrate count is significantly reduced typically, the total caloric intake is decreased. In my opinion, carbohydrates increase appetite and increase total calorie consumption. Once the carbohydrates are limited, appetite becomes suppressed and rarely does totally calorie consumption exceed maintenance needs. The only time that I would recommend calorie counting is when I have not succeeded with simple carbohydrate counting. To date, I have not resorted to total carbohydrate counting in any of my patients.
How many calories are Americans consuming per day? As with a lot of things in nutrition research, it depends on whom you ask. According to the Center for Disease Control and Prevention, from 1999 to 2000, American males consumed on average 2475 calories per day, where females consumed 1833 calories per day. If that were the case, how could we possibly be in an epidemic of obesity? The CDC also states that
Americans consume about 50% of their calories from carbohydrates. Contrast this with what British researchers concluded about American calorie consumption. According to the British, Americans lead all countries in calories consumed per day at 3770 calories per day (Evoke.ie). In my opinion, this excessive calorie consumption is more consistent with what I have experienced with my patients.
Based on these estimations of average calorie consumption per day, lets get an understanding of how much carbohydrate Americans are consuming per day. If the CDC values are correct, then American males are consuming 312 grams of carbohydrate per day and females are consuming 225 grams of carbohydrate per day. If the British calorie estimations arc more accurate plan, then Americans are consuming 471.25 grams of carbohydrate per day.
So, how many grams of carbohydrate should we take in each day? Again, it often depends on whom you ask. Some nutrition experts define a low carbohydrate diet at 100 grams per day (Ludwig, DS, BMJ 2018). Others define a low carbohydrate diet with much lower carbohydrate totals. To better manage this issue, I have arbitrarily defined three different diet plans based on total daily carbohydrate consumption. The first of these plans I call the Anti-Metabolic-Syndrome. Please see the chart below. This diet is designed to avoid developing the dreaded Metabolic Syndrome. The daily carbohydrate load for this diet should be at 100 grams or less. I have named the second dietary plan the Ideal-Bodyweight plan. What do I mean by ideal bodyweight? In general terms, men are fully grown at their college graduation, and women are fully grown at their high school graduation. With this plan, the goal is to retwn to the weight when we first become fully developed. In this plan, the total carbohydrate consumption per day should be less than 60 grams. As the charts below will indicate, the protein consumption for the Ideal-Bodyweight plan is the same as that for the Anti-Metabolic plan. Please note how the daily fat consumption increases from the Anti-Metabolic plan to the Ideal Bodyweight plan. Finally, I recognize the traditional Ketogenic Diet. This diet was created in the early 1900s as a treatment plan for refractory pediatric epilepsy. In general, I do not recommend a traditional Ketogenic Diet to my patients, unless they have epilepsy or they have a history of cancer. Please understand that cancer cells can only metabolize carbohydrates for energy. In a sense, a traditional Ketogenic Diet deprives cancer cells of their only energy source. Please sec the graph below.
Ideal Body Weight
Male & Female
There are significant medical benefits with dietary ketosis. These benefits can be achieved to some degree with the Ideal-Bodyweight plan and to a more significant degree with the traditional Ketogenic Diet. The goal is to create a Dietary Ketosis. That means that fat becomes a primary fuel by way of Ketone Bodies. These Ketone Bodies, also called Ketones, are produced by the liver from fatty acids. These Ketones can create energy within the cells mitochondria. These Ketones can cross the blood brain barrier and nourish the brain. The following advantages have been described with Dietary Ketosis:
- Decreased Body Fat
- Decreased Insulin Resistance.
- Decreased Blood Pressure
- Decreased Lipidemia
- Increased High Density Lipoprotein-Cholesterol.
- Decreased Inflammation
- Increased Saturated Fat
- Decreased Lipogenesis
- Increased Diuresis (urinary output).
Some foods help in facilitating Dietary Ketosis:
- Butter or Ghee
- Coconut Oil/Butter.
- Full Fat Cheese
- Full Fat Yogurt
- Meats and Fish
- Olives and Olive Oil
- Nuts (especially Macadamia Nuts, Walnuts, and Brazil Nuts).
- Cottage Cheese
- Heavy Whipping Cream.
As the above charts indicate, Dietary Ketosis requires consumption of most calories from fat. There are many desirable fats to choose from. Monounsaturated fatty acids can be found in nuts, avocados, and olive oil. Saturated fats can be consumed with cream, cheese, butter and meats. Omega-9 fatty acids are in olives and macadamia nuts.
Recently, health benefits have been attributed to medium-chain triglycerides (MCTs).
Medium-chain triglycerides include coconut oil and its extract known as caprylic acid (C8). Omega –6 polyunsaturated fats should be avoided: Com oil, soybean oil, sunflower oil and cottonseed oil.
At the moment, I have no more to say about Orthorexia.