I am not a fan of the keto diet, particularly as a registered dietitian specializing in sports and performance nutrition and plant based eating. In my opinion, a traditional keto plan is far too limited in carbs and fiber, and the emphasis on animal based foods, like red meat, has been linked to an increase in inflammation and health risks. And those are just a few of my concerns.

Now, a new version of keto, called keto 2.0, aims to resolve some of these limitations. It allows for more carbs, emphasizes healthier plant based fats, and as a result may be more sustainable long term and better for your health (note: the jury is out on the latter, as the diet hasn’t been studied). Here’s my take on it as a nutritionist, and my bottom line advice on how to determine the best diet for you, not just for weight loss, but for your overall health of mind, body, and spirit.

What is keto 2.0?

When keto began to bubble up, I hoped it would be a passing fad. But it has turned into quite the dietary juggernaut. In a traditional keto diet, 75-90% of the calories come from fat, about 5% from carbs, and the remaining percent from protein. (On a 1600-calorie diet, that’s just 80 calories from carbs, or 20 grams.)

Those strict macros wind up forcing people to forego many whole grains and healthy, higher-carb veggies, and instead load up on products that are carb- and fiber-free, like cheese and pepperoni. And even with weight loss, I have seen this eating pattern result in spikes in “bad” LDL cholesterol, in addition to other unpleasant side effects, including constipation, hemorrhoids, and irritability.

In keto 2.0, the proposed macros shift to 50% fat, 20% carb, and 30% protein. For that same 1600-calorie diet, that’s now 320 from carbs, or 80 grams worth. While still limiting overall, this modification makes room for more plant based foods, like fresh fruit, oats, and lentils.

As for fat, one of the reasons keto works so well for weight loss (healthfulness aside) is because fat is highly satiating. At 50%, keto 2.0 is still high enough in fat to promote fullness and delay the return of hunger, which helps prevent overeating.

Also important: Keto 2.0 emphasizes leaner protein sources, like fish in place of steak. Perhaps most importantly, a higher allowance of plant based foods and fiber better supports the growth of beneficial microbes in the gut tied to anti-inflammation, immunity, and positive mood.

So, is keto 2.0 healthy?

“Healthy” may be a stretch, but compared to the standard keto diet, keto 2.0 is better, and much closer to a traditional Mediterranean Diet, long considered a gold standard for weight loss and health. That said, I’m not convinced that this revamped keto plan is the most ideal diet.

First, keto 2.0 still doesn’t advocate for a entirely plant-based diet, which has been tied to lower BMI (body mass index), a reduced risk of chronic diseases, and improved longevity, in addition to being better for the planet.

This connects to the bigger issue, which is that healthful, sustainable weight loss is less about your exact macro ratio, and more about the quality and balance of what you eat. For example, while I don’t believe there is a one-size-fits-all approach to dieting, in my two decades of counseling clients, I’ve seen that long-term weight management and better health often results from nixing processed foods, eating plenty of non-starchy veggies and plant-based fats, opting for lean sources of protein, and eating whole-food carbs that match your body’s energy demands.

Noticed I mentioned carbs in that last paragraph—that’s because many people have come to believe that carbs are inherently fattening, and that’s not accurate. Carbs become problematic for weight management and health when they’re highly processed (stripped of nutrients and fiber, and combined with man made additives and/or sugar), and when the amount consumed exceeds your body’s ability to burn them—even healthy carbs. But, nixing carbs completely, or severely restricting them is also not the solution. Balance is key.

Should you try the keto 2.0 diet?

Overall, keto 2.0 is closer to a balanced diet that standard keto—it ticks some of the key nutritional boxes, like more fiber, the inclusion of plant based fats, and leaner proteins. But, it still may not be 100% right for you.

Ideally, we need to get away from these all-or-nothing extreme diets and focus on balance and food quality. For long term weight loss and optimal health, it’s also important to consider how any particular diet makes you feel. Evaluate your energy, mental focus, sleep, digestive health, workout quality and recovery, immune function, mood, and happiness. If you’re eating in a way that detracts from your mental and physical well being, or negatively impacts your quality of life, it’s not supporting your health, even if you are losing weight; and it probably won’t be sustainable.

Still, if you want to give keto 2.0 a try, go for it. Just keep in mind that it’s always important to listen to your body and your gut instinct. And it’s OK to make tweaks to your eating plan that feel like a better fit, even if they aren’t in line with the newest trend.

Cynthia Sass, MPH, RD, is Health's contributing nutrition editor, a New York Times best-selling author, and a private practice performance nutritionist who has consulted for five professional sports teams.

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Keyyword Nutrition - Health.com , Health, Nutrition

Bananas are insanely good for you. Not only are they packed with 12% of your recommended daily dose of potassium and 20% of vitamins C and B6, but a single piece of the fruit also boasts 3 grams fiber. They are also a great source of resistant starch, a type that naturally suppresses your appetite, ultimately aiding in weight loss. Did we mention they are also super delicious, whether you are eating them straight from the peel or blended into a smoothie, added to baked goods, or sliced up in your oatmeal? But according to one nutritionist, if you want to really amplify the health benefits of bananas, you should be eating the peel as well.

“Specifically, you will increase your overall fiber content by at least 10 percent as a lot of dietary fiber can be found in the skin of the banana,” Australian nutritionist Susie Burrell wrote in a blog sponsored by Australian Bananas. “You will get almost 20 percent more vitamin B6 and almost 20 percent more vitamin C and you will boost both your potassium and magnesium intake.

She doesn’t suggest munching on the skins but cooking the skin to soften it first, which will “break down some of the cell walls within the skin helping to make the nutrients easily to absorb,” then blending it into recipes or smoothies.

She also maintains that the color of your banana skin makes a difference nutritionally. Green banana skins are both rich in the amino acid tryptophan (associated with good sleep quality) and also in resistant starch, which will benefit gut health. A ripened banana with yellow skin boasts a higher proportion of antioxidants associated with anti-cancer effects, she says.

But before you start boiling your banana skins, keep in mind that while banana peels are edible and do have some proven nutritional value, scientific evidence to back up Burrell’s weight loss claims is lacking.

“There is no published research on this, so we don’t know for certain how eating them may impact weight loss,” Health's contributing nutrition editor, Cynthia Sass, RD, explains. While theoretically nutrients like fiber, prebiotics, and antioxidants may help with weight loss, because the studies are lacking, there is no established form (green versus ripe), specific amount/dose, prep method, or frequency (daily, weekly, etc.) tied to a specific amount of weight lost over a given time frame. “I don’t think it’s absolutely necessary to try to incorporate them into your diet,” she says.

Adds New York City-based nutritionist Jackie Newgent, RDN, CDN: “There are so many more enjoyable ways to get fiber in general—and resistant starch in particular. I would much rather recommend someone enjoy a bowl of oatmeal or snack on some hummus, or add oats or beans to delicious recipes.

If you do decide to give them a try, Sass encourages you to choose USDA certified organic, and wash them well to avoid pesticide residues. “You can also start with a small amount and incorporate into dishes with ingredients that help counter the flavor, like a smoothie with sweet fruit and a touch of ginger root or vanilla,” she suggests.

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Keyyword Nutrition - Health.com , Health, Nutrition

Have all of your friends ever been obsessed with a TV show you've never seen? When you hang out, they laugh about the most recent episode, quote their favorite characters, and compare theories about the season finale—and you just sit there.

That's how I felt whenever my friends talked about Wellness Formula, a supplement made by a company called Source Naturals. It claims to "support the immune system when under physical stress" through a "powerful combination of herbs, antioxidants, vitamins and minerals formulated to boost your well-being." My friends (and I'm hoping I can still call them that after this article!), swear by it—and to me, it sounds like bullshit.

Nonetheless, about a week ago, I woke up on a Sunday morning with a sore throat, and my friends had that look in their eyes—the Wellness Formula look. "That stuff is just a placebo," I told them. They disagreed. "It's not approved by the FDA," I said. They were unfazed. "There's no research to say it works at all." Nothing.

After a day of protesting, I gave in. I'm not proud, but I did. What's the worst that could happen? I thought.

I took six capsules after dinner. (Yes, you must take six capsules. Six capsules every three hours.) Everything was fine for the next hour or so, but around 9 o'clock, when I was ready to get into bed, my heart started racing. I was lying in bed, exhausted but unable to sleep. I was sweating. My stomach was in knots. This is it, I thought, my tragic end is going to be a Monday morning headline on the very website that employs me: "Girl, 23, Dies Alone in Bed From...Vitamins"

Then, I got up, rushed to the bathroom, and vomited. Ah yes, my preferred way to spend a Sunday evening. Also, as if I hadn't already felt enough of Wellness Formula's wrath, the vomit was acidic. So much so that it burned my throat, making it painful to swallow for the next 24 hours—and giving me an even worse sore throat than the one I was trying to get rid of. After I threw up, I felt 90% better. Wellness Formula couldn't give me the other 10%. She's ruthless.

The next morning, I did what anyone would do: I bitched to my coworkers about what happened, and, because we're health editors, here we are, in the middle of this article on what's really in these supplements—and if they're dangerous at all.

See, as a health journalist, I'm skeptical of pretty much anything, especially vitamins and supplements. Why? Because I know the Food and Drug Administration only inspects a small percentage of the supplements sold in the US every year. That lack of regulation opens the door for many supplements to falsely claim specific health benefits, since their claims don’t have to be backed up by research.

I wasn't able to find any clinical trials to prove Wellness Formula's specific claims, and Source Naturals didn't respond to a request for comment. There's even a disclaimer on the company's website that says, "The statements made in this website have not been evaluated by the Food and Drug Administration," which aligns with the FDA's stance that it is "not authorized to review dietary supplement products for safety and effectiveness before they are marketed."

Still, my friends worship Wellness Formula. When one sneezes or coughs or gets a paper cut (OK fine, I'm being dramatic with that last one), another will suddenly whip around, their palm extended flat holding six capsules of Wellness Formula. They truly believe that if you take the supplement when you first feel sick, you can dodge a full-blown illness.

So, what I needed to know (and why I wanted to write this article): Can these supplements actually help you avoid getting sick? Or is my experience common, and can they actually make you feel sick?

It turns out, these 'Wellness' supplements have way too much...wellness

At first, I thought there was no way something billed as "natural" and "healthy" could make me ill, but Beth Kitchin, PhD, assistant professor of nutrition studies at the University of Alabama at Birmingham, tells me it's entirely possible. "You got crazy high amounts of vitamin C," she says. "Which can cause stomach cramping, diarrhea, and nausea." Interesting.

About Wellness Formula's vitamin C content: Six capsules contain 1,275 mg of vitamin C. Meanwhile, the recommended daily allowance for vitamin C for adults is 75 to 90 mg per day, and the tolerable upper intake level, or the "maximum daily intake unlikely to cause adverse health effects," is 2,000 mg a day, according to the National Institutes of Health (NIH).

While one dose puts you well above the recommended daily allowance, it keeps you just under the maximum of 2,000 mg a day. A second dose, however, puts you at 2,550 mg—or 128% of the upper intake level. Three doses puts you at 191%, and, well, you get the idea.

But wait, there's more. The amount of zinc can also exceed the upper limit, Kitchin says, which may have contributed to the nausea and vomiting. (Oh right, the vomiting. How could I forget?) The recommended dietary allowance for zinc is 8 to 11 mg per day, and the tolerable upper intake level is 40 mg, according to NIH. Just one dose of Wellness Formula has 23 mg of zinc, meaning after two doses, you're at 115% of the upper intake level.

Cynthia Sass, RD, Health contributing nutrition editor, also points out that some of the ingredients "can interact with certain medications, or existing medical conditions." For example, echinacea, an herb, has been known to exacerbate autoimmune diseases, such as lupus, she says.

Sorry, but anecdotal evidence just doesn't cut it

In all fairness, Sass says that many of the ingredients in Wellness Formula, like vitamin A, vitamin C, and vitamin D, are known to support immunity (again, in amounts that don't exceed the upper intake level). But both Sass and Kitchin point out that it's simply impossible to know how the supplement will affect the immune system without clinical trails. "This is how we know, for example, that supplemental vitamin C can’t cure a cold, but that zinc lozenges may reduce the duration of cold," Sass says.

Despite this lack of scientific evidence, my friends have been unswayed: "Well, I can give you anecdotal evidence that it works for me," one said—to which I say, Hello, placebo effect. Kitchin agrees: "Someone can tell you that it made them feel better, but how do they know that they wouldn’t have felt better without the supplement? They don’t. That’s why we do research."

Overall, neither Kitchin nor Sass say they'd recommend this supplement to their clients. Sass even went a step further about supplements and vitamins in general, saying she wouldn't blindly prescribe anyone any specific supplement without assessing "a client’s personal medical history, medications, and any other supplements they’re taking" first. Huh.

That, I realized, is where I went wrong. If you take anything away from this article, it should be to always consult a professional before taking something—even a supplement. Not your friends who are entranced by a supplement's too-good-to-be-true benefits; a g'damn professional, like Sass. "Meet with a registered dietitian who can sit down with you and go over each supplement to determine if it’s appropriate, and if so, the proper dose, form, and how long you should take it," she advises.

Another tip: Kitchin says to look for a supplement with US Pharmacopeia (USP) or NSF International (NSF) logos, to be sure that it's free of contaminants and actually has in it what it says it does. Keep in mind, though, these logos do not mean that the product is effective—just that the ingredients list isn't falsified. (FYI: Wellness Formula does not have USP or NSF logos.)

As for my friends, they're not going to stop taking Wellness Formula, and they've told me as such. They're in too deep—if there's even the slightest chance they won't have to deal with the common cold this winter like the rest of us, they're down to take anything. Me? I'll stick to washing my hands and steering clear of anyone not covering their mouth during a sneeze, thankyouverymuch.

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Keyyword Nutrition - Health.com , Health, Nutrition

For years, public health officials have urged Americans to cut back on eating red meat and processed meats due to cardiovascular health, cancer risk, and other health concerns. But now, a new report from a panel of researchers is saying otherwise—and it’s causing confusion.

The new guidelines, released Monday in the Annals of Internal Medicine, say that there’s no need to cut back on red and processed meats.

This advice comes from fourteen researchers from seven countries, who looked at previously published studies to assess the links between red and processed meats and the risks of heart disease, diabetes, and cancer. From that information, they concluded that the quality of the evidence connecting red meat to disease was low to very low.

The researchers also looked at consumers’ attitudes toward eating red and processed meats. They found that people enjoy it, and are reluctant to reduce their consumption. Based on their analysis they say that most adults should continue to eat their current levels of red and processed meat. It should also be noted that researchers say their report was not funded by any external sources.

FYI: Many other experts disagree with the new recommendations.

The guidelines have triggered a bit of an uproar amongst other researchers and health organizations who disagree with not only the group’s conclusions, but also the methods used to reach them. Dr. Frank Hu, chair of the nutrition department at the Harvard T.H. Chan School of Public Health, deemed the report irresponsible. Harvard has even devoted a page on their website to refuting the new recommendations.

They point out that the group’s meat-friendly conclusions contradict evidence found within their own meta-analysis. Hu also says that the methodology the group used to scrutinize the previously published data is inappropriate for nutrition research.

The Harvard page goes as far as to say that the guidelines are inconsistent with the principle of “first do no harm.” They deem the conclusions at odds with the large body of research which indicates that a higher intake of red meat—especially processed red meat—is in fact associated with higher risk of type 2 diabetes, heart disease, certain cancers, and premature death.

Those health risks associated with red and processed meat consumption are actually a big deal.

In a 2019 study published in The BMJ, Harvard scientists calculated that an increase in total red meat consumption of at least half a serving a day (about 1.5 ounces) was associated with a 10% higher death risk. They conclude that even a modest reduction in red meat intake could result in approximately 200,000 fewer deaths a year in the US. Red meat has also been shown to increase “bad” LDL cholesterol, and negatively impact blood pressure and artery stiffening, per a 2016 study in the Journal of Internal Medicine.

Cooked red meat and processed meats are also sources of cancer-causing substances. In fact, the World Health Organization declared that processed red meat is a carcinogen, with a strong link to colon cancer. Their data revealed that every daily 50-gram portion of processed meat–that is, meat that's been cured, salted, smoked, or preserved, including ham, bacon, and sausages–ups the risk of colorectal cancer by 18%. A 50-gram portion is a little under two ounces, or about two breakfast sausage links. The WHO says it's as certain that these foods cause cancer as they are certain that cigarettes cause cancer.

As for type 2 diabetes, as many as one in three US adults will have the disease by 2050 if current trends continue, according to the Centers for Disease Control and Prevention. A study based on Harvard data, published in JAMA Internal Medicine, found that men and women who increased their red-meat consumption by more than half a serving per day increased their risk of developing diabetes over the subsequent four years by 48%. By contrast, those who reduced their red meat consumption by more than a half-serving per day lowered their risk of developing diabetes by 14%.

Red and processed meats also have a big effect on the environment.

A major factor not addressed in the new seemingly pro-meat report is the impact of red meat on the planet. The researchers stated that this was outside the scope of their guidelines, but it shouldn’t be. Climate change is a major public health emergency, per the CDC. In addition to extreme weather, the climate crisis impacts food security, water safety, air pollution, and diseases carried by insects.

Research published in Proceedings of the National Academy of Sciences concludes that the environmental impact of beef production is significantly greater than that of dairy, poultry, pork and eggs. Beef production requires more land and water, and produces more greenhouse emissions.

The EAT-Lancet Commission, a comprehensive report put together by over 30 world-leading scientists, is devoted to assessing the impact of what we eat on human health, and the health of the planet. Their recommendations, referred to as the Planetary Diet, advise minimizing meat, and increasing intakes of produce, legumes, and nuts. For example, the recommended limit for red meat is no more than about three ounces per week, roughly the size of a deck of cards.

So, what should you, as consumers do about your red meat consumption based on these new findings?

Basically, ignore them—it’s still wise to cut down as much as you can on your red and processed meat consumption.

That said, you don’t have to completely give up red meat if you don’t want to, but for your own personal health and the health of the planet you should be minimizing it. This is particularly true for processed red meats like bacon, pepperoni, sausage, and the like. Dozens of studies consistently support this, and one flawed analysis doesn’t negate that.

In my practice I see dramatic improvements in health outcomes among my clients who reduce or eliminate red meat, including better cholesterol and blood pressure, weight and fat loss, and enhanced digestive health. However, what you replace red meat with is important. Trading a steak for a bowl of mac and cheese isn’t an upgrade; and it’s the overall eating pattern, rather than just one food, that truly impacts human and planetary health. Build in more produce, pulses, whole grains, nuts, and seeds, opt for water over sugary drinks, and nix highly processed foods.

If you really love red meat eat think of it as a treat and eat it occasionally. Or try to satisfy your meat cravings with a pea protein based meat substitute, like Beyond Meat. Even if the calorie and saturated fat contents parallel meat, it’s still a better choice for the planet, and you don’t expose your body to the heme iron and nitrates found in processed red meats, which are the compounds linked to cancer risk.

Bottom line: disregard the new report. Contrary thinking is great for generating headlines, raising questions, and opening up a dialogue. But in this case it does not merit a change in direction.

Cynthia Sass, MPH, RD, is Health's contributing nutrition editor, a New York Times best-selling author, and a nutrition consultant for the New York Yankees.

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Keyyword Nutrition - Health.com , Health, Nutrition

What is keto 2.0?

So, is keto 2.0 healthy?

Should you try the keto 2.0 diet?

It turns out, these 'Wellness' supplements have way too much...wellness

Sorry, but anecdotal evidence just doesn't cut it

FYI: Many other experts disagree with the new recommendations.

Those health risks associated with red and processed meat consumption are actually a big deal.

Red and processed meats also have a big effect on the environment.

So, what should you, as consumers do about your red meat consumption based on these new findings?

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