A Keto Case Study, Part One

What I’m going to do in this post and at least a second one is what is called a “case study.” I’ll divide up the material because I want my readers to be willing to consume all of it. Sometimes I read others’ posts that are pages long, and if it’s a subject in which I’m interested I’ll probably at least skim it all. But I think it’s far better to write material that can be read in 5-10 minutes and then follow up with later posts. You don’t read blog posts the way you read a book, coming back to the place you left off. Instead, you usually just go on to the next post when it comes up. I want you to get the whole enchilada here and so always try to limit my individual posts to 1,000 words or less.

Let me first of all be clear about what a “case study” is. An online dictionary says that it is:

“a particular instance of something used or analyzed in order to illustrate a thesis or principle.”

Notice the neutral terms: “used,” “analyzed,” “illustrate.” There’s no idea here that a case study has to involve some sort of negative criticism, although it certainly may do so. So, since the very definition says that I should be illustrating some kind of main idea, here it is:

All diets, no matter how extreme, work in the short term, but they are doomed to fail in the long term.

I use the word “diet” not in its classical sense that simply means “a way of eating or the content of what you eat” (as in “my diet includes lots of green vegetables”) but in the sense of “an unnatural, extreme, forced way of eating” (as in “I’m following the keto diet.”) Let me start, then, by introducing you to the subjects of the case study: a blogger named Kristi who runs a site called “Addicted2Decorating” and her husband Matt. Two points before I dive in:

1. I’m drawing this material from a public website. I do plan to let Kristi know via her comments section that I’ve published these posts.

2. I love this website and totally appreciate and respect Kristi, who is positive, productive, funny, honest . . . etc. I would strongly recommend that you subscribe to her blog even if you have zero interest in home decorating and DIY projects, as she’ll give you a shot of energy no matter what. (You can skip over her detailed descriptions of various building projects if you’d prefer.) I’m always pleased to see a new post from her.

Her husband Matt has MS and is confined to a wheelchair and bed. She never, ever displays the slightest hint of self-pity about her husband’s health; indeed, he usually comes up only in the context of some type of remodeling project—a ramp for his wheelchair, for instance, or the fact that he doesn’t care what color she uses as long as it’s not pink. He’s included some in the keto posts, though, because they both went on the diet and she wants to give a total picture of their experience.

Okay. Everybody got that? I’m not bashing this woman and her husband; I’m simply using their publicly-posted story as an example of this diet and taking what she says herself to illustrate the problems with jumping on a food-related bandwagon (or any other kind, for that matter).

Here’s a good selection from Kristi’s initial post on their new diet to start us off (and I will limit myself to quoting 200 words or less in this post in order not to violate the “fair use” principle):

The ketogenic diet is all the rage right now, but we decided to do it not because it’s a fad diet, but because it makes sense to us. Low carb eating has made sense to us for years now, but for two carb/sugar addicts, it can be a challenge to get over the emotional hurdle and get started on low carb.

We’ve done the Atkins diet in the past, generally with great success, but we always seem to fall off the wagon at some point and return to our unhealthy way of eating with lots of sugar, flour, etc. That’s what addicts do.

Let’s take the above quotation apart, looking carefully at its content, as it’s a perfect example of why people go on fad diets. First of all, notice the issue of being a carb and/or sugar “addict,” as this idea crops up all the time in diet discussions. I believe that the use of this term is incorrect in this context. A true addiction creates an actual physical dependence on the addictive substance, caused by changes in brain circuitry. We are often told that sugar lights up the same “pleasure centers” in the brain as heroin or cocaine, but this statement is profoundly misleading. (The otherwise excellent film “Fed Up” makes this mistake.) The fact is, those areas in our brains “light up” in the same way to any pleasure; that’s why they’re called “pleasure centers.”

(I’m going to add a note here and say that Dr. Robert Lustig, a true authority on the obesity epidemic as he’s a pediatric endocrinologist, does say that sugar is addictive. I’ve been posting his video series on my author Facebook page, and on the whole I think they’re very helpful. He says, and this is almost certainly true, that an obese person’s metabolism has been permanently harmed. On the one hand, he’s pushing for the same type of thing happening with sugar that happened with tobacco–warning labels, restricted advertising, etc. But while we’re waiting for all that to happen, guess what? His advice is basically the same as mine: cut out extraneous sugars, watch portions, and incorporate physical activity into your life.)

Okay. In spite of the note above, I do think it’s fair to say that in general, people who label our desire for sugar as an addiction are confusing several terms:

Habit

Craving

Addiction

These three mechanisms can work together and strengthen each other, but they are not the same things. Habits are actions that we take repeatedly and that have formed a feedback loop in our brains so that we find it easy to keep doing them. As Charles Duhigg has outlined in his book on habits, they consist of three parts: a cue, a routine, and a reward. We may, for instance, have formed a habit of always getting the cookie with the sandwich at a favorite lunch place. We see the cookie and are reminded of how good it tastes (the cue), so we reach for it and put it on the tray (the routine) and then eat and enjoy it once again (the reward). After awhile the action of taking the cookie becomes automatic; we have formed a strong habit.

Can you believe it? I’ve more than used up my word limit for this post. Be sure to come back and read more in later articles! I’ll get at least one more out this weekend.