Annabelle Marie Lat MD

”The mere mention of the word brings dread to many patients. Many ask “Doc, ano po ba ang bawal?” All their favorite foods flash before their eyes, and they brace themselves for what their doctors are about to say. The struggle is real. Obesity and diabetes are parallel epidemics that have been on the rise in the past decades. Diet, exercise, and medications are the essential pillars of management in these diseases. However, changing one’s lifestyle is easier said than done.

Ketogenic diet involves reducing carbohydrate intake to less than 50 grams per day or 10% of total calories per day with relatively higher consumption of fats and proteins (Figure 1). Carbohydrates are broken down into glucose, which typically serves as the body’s main fuel. Because of the decrease in carbohydrates eaten, the body is forced to utilize other compounds as fuel such as ketone bodies.

Figure 1: Comparison of low-carbohydrate, moderate-macronutrient and low-fat diets. An example of a diet with moderate macronutrients is the Mediterranean diet.

Another dietary approach called “Intermittent Fasting” requires fasting for varying periods of time. One form (time-restricted feeding) involves restriction of food intake to only 8 to 12 hours per day while another scheme (alternate-day fast) involves one full day of complete fasting alternating with one full day of unrestricted food intake (Figure 2).

Figure 2: Examples of “Intermittent Fasting”.

REFERENCES: Paolo A et al. European Journal of Clinical Nutrition, 2013; Anton SD et al. Obesity, 2017; Ajala O. et al. The American Journal of Clinical Nutrition, 2018; Schwingshackl L et al. European Journal of Epidemiology, 2018; Sacks FM et al. New England Journal of Medicine, 2009; Johnston BC et al. A Meta-Analysis. JAMA, 2014; Bravata DM et al. JAMA, 200; Wylie-Rosett J et al. Curr Diab Rep, 2013; Mansell K et al. Can J Diabetes, 2016; Trepanowski JF et al. JAMA, 2017; Antoni R et al. British Journal of Nutrition, 2018; Arnason TG et al. World Journal of Diabetes, 2017; American Diabetes Association. Diabetes Care, 2018


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What is PCEDM?

The PCEDM is a sub-specialty society of the Philippine College of Physicians, a founding member of the ASEAN Federation of Endocrine Societies, and a member of the International Society of Endocrinology.

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