Bangkok hospital Khonkaen- Annual check- Ditch the KETO diet!

[Scouse123]

Guys,

 

I went for my annual check up yesterday to the Bangkok hospital in Khonkaen as they had a special deal on for the absolute package for over 50s at 14,900 Baht.

 

Last year I used the Ratchaphreuk hospital for my annual check, but I moved, as the deal this year was better and offering more, at Bangkok hospital.

I definitely got more for my money this year. The checks were more thorough and detailed as was the patient/doctor meeting with their findings.

 

However,the doctor said I need to watch my cholesterol and sugar intake. I am not at the threshold yet, but it needs to be kept in balance to ensure future good health. No diabetes and no gout.

 

They found a small gallstone, a small kidney stone, and I have a stomach hernia. None has given me any problems but the doctor has recommended I be referred to a specialist in the said hospital and with a view to an operation.

 

Last year, the doctor recommended nothing. I had these abnormalities of course last year, as well.

 

My heart,  lungs, prostate, kidneys, all normal and unremarkable. She commented they were in good order. I did have, what she described as fibrosis or scarring on the lungs, but this was caused by a major operation back in 2005. She asked and I confirmed, I had previously had pneumonia due to the operation years ago.

 

One startling piece of information she gave was to tell me to quit the Keto diet! This diet has successfully helped me shed 13 kilos and I am keeping it off. She said there were ' mild ' fatty build up in some tissue and she was definitely against Keto diets in men who are approaching sixty years old.

 

She said in your forties with no side health issues, then OK. But not at my age. She recommended a diet high in Vegetables and certain fruits as well as lean meat as opposed to fatty meat and reduce the dairy intake.

 

I now have the full report and I am now going to check on whether or not I need an operation and should be concerned or whether this is for the benefit of the hospital revenue stream.

 

I consider this annual check up at just short of 400 GBP well worth doing and value for money.

 

 

 

 

 

Edited April 21, 2022 by Scouse123

[scubascuba3]

Sounds mostly good advice about the diet, as for suggesting ops, she isn't exactly impartial

[Scouse123]

2 hours ago, scubascuba3 said:

Sounds mostly good advice about the diet, as for suggesting ops, she isn't exactly impartial

Definitely agree with you on that.

[HauptmannUK]

The Keto diet has long been recognised as unhealthy. It places an emphasis on consumption of saturated fats and restricts fruit and veg.   The doctor's advice is pretty much standard - i.e. eat a diet high in fiber, fruit and veg.

As regards your other issues, well my daughter is a doctor back in the UK. She is rather wary of some of these 'comprehensive' annual check ups from private hospitals. Many times these are fishing expeditions to generate income. Worth having some basic bloods done - but keep in mind that a large proportion of older people with have minor issues such as small stones etc that cause no problems and are best left alone. 

 

[internationalism]

So it looks like you had usg of abdomen.

for hernia talk to a physiotherapist what exercises you should and can't do. Maybe wearing support belt at some lifting. If no symptoms and not palpable probably you should wait another year.

For kidney stone read about coconut juice - used in traditional medicine in Philippines. As I remember 2 coconuts daily for a week would help even in acute stages. Some other foods might also help to brake it or prevent further growth. You need to increase water, probably low calcium, to prevent build up. In europe doctors would tell what mineral content should be, but in thailand bottled water doesn't have this info on packaging.

[Scouse123]

23 minutes ago, HauptmannUK said:

The Keto diet has long been recognised as unhealthy. It places an emphasis on consumption of saturated fats and restricts fruit and veg.   The doctor's advice is pretty much standard - i.e. eat a diet high in fiber, fruit and veg.

As regards your other issues, well my daughter is a doctor back in the UK. She is rather wary of some of these 'comprehensive' annual check ups from private hospitals. Many times these are fishing expeditions to generate income. Worth having some basic bloods done - but keep in mind that a large proportion of older people with have minor issues such as small stones etc that cause no problems and are best left alone. 

 

Thanks,

 

I was thinking similar thoughts and my other half stated after the report that I was just a potential " revenue stream" 

[BigStar]

8 hours ago, Scouse123 said:

However,the doctor said I need to watch my cholesterol and sugar intake.

I assume you mean she told you to watch your cholesterol levels, not cholesterol intake. Sugar intake, of course, but then she advised eating more fruits. You don't say what guidance exactly she gave about that.

 

Her take on cholesterol is surely outdated. You might take a look at a recent very readable book by Malcolm Kendrick,

 

 

 

a Brit, and therefore totally credible. He speaks at length in a podcast here. The triglyceride/HDL ratio is one of the best indicators, and low carb diets are particularly effective in keeping it low--far as diets go.

 

8 hours ago, Scouse123 said:

One startling piece of information she gave was to tell me to quit the Keto diet! This diet has successfully helped me shed 13 kilos and I am keeping it off.

You'll get the same standard advice from any doc untrained in the subject. Losing 13 kilos was all very much to the good.

 

8 hours ago, Scouse123 said:

She said there were ' mild ' fatty build up in some tissue and she was definitely against Keto diets in men who are approaching sixty years old.

 

. . . She recommended a diet high in Vegetables and certain fruits as well as lean meat as opposed to fatty meat and reduce the dairy intake.

But that mild fatty buildup in some tissue, whatever that means, had around 60 years to build up and very few have managed to avoid any by that age. Before you lost the 13 kilos, might that have been strong fatty buildup in more than some tissues?

 

I dunno where she got that age limit, haven't seen that urged by all the usual enemies. Surely some of the many docs supporting Low Carb Down Under are over 60 themselves. I'm well over that and been following low carb for a couple of decades, been great, kept me healthy and off all meds.

 

And I dunno, nor did she, probably, exactly what you were eating.

 

Now I'm not going to get drawn into a useless discussion here with the mighty TVF Starve 'n' Sweat Chorus.  Only a very few here know anything about low carb/keto; most have a lot of misconceptions.

 

But, to focus, all fruits and veggies aren't the same. Low carb/keto merely restricts you to low carb fruits and veggies.

 

 

I mostly stick with berries, have some daily.???? Frozen, from Makro, are cheap.

 

It'll be argued that blood glucose spikes aren't an issue in healthy people. But everyone started off in life pretty healthy. Now, in the USA, 88% aren't in optimal metabolic health and 50% have prediabetes or diabetes. You've enjoyed lots & lots of spikes already. And you've been significantly overweight, suggesting some degree of insulin resistance. Better to stick w/ low glycemic foods, which happen to be low carb as well. But only if you're serious. I'd hate to diminish anyone's love of just being themselves. And if you're serious and consistent, fats are quite OK. Me, I'm having fine pork chop tonight, with veggies of course.

 

And low carb has always recommended "whole foods," long before formal whole food diets and the Whole Grains Council recommended whole foods--which no one dares call fad diets.????

 

Fiber is another non-issue arising in recent attacks. Add in a few tablespoons of ground flaxseed if that worries you for some reason.

 

I've never followed keto or had any reason to. Seems like too much work anyway. But I can highly recommend low carb as part of a healthy lifestyle.

 

Edited April 21, 2022 by BigStar

[Sheryl]

kidney stone and small gallstone, I take it both asymptomatic - whether to operate depends on just how small.

 

<5mm asymptomatic kidney stone can be managed expectantly and may well pass on its own (does so in about 80% of cases).

 

Even a bit above 5mm, majority will not need surgery.

 

Would be wise to up your fluid intake on an ongoing basis both to help the stone pass and prevent new ones.

 

Gallstones:  standard of care for small asymptomatic stones, is expectant management and surgery only if they start to cause symptoms, which they do not ever do in most cases.

 

I doubt they really said you needed surgery but rather that you should see a specialist to determine IF surgery was indicated - a very different thing.  The doctors who work in the health screening departments are non-specialist and are under standing instruction to refer all positive findings to the relevant specialist for evaluation.

 

All properly conducted studies confirm the value of a diet high in fresh fruits and vegetables (unless diabetic in which case most fruit may be unwise), whole grains, fish and lean meats, and healthy oils. And in general; the value of plant-based diets as opposed to diets mostly or wholly based on animal food sources.

 

Sustained keto diets do increase the risks of some chronic diseases, a concern especially as one ages. See https://www.frontiersin.org/articles/10.3389/fnut.2021.702802/full

 

 

[BigStar]

30 minutes ago, Sheryl said:

Sustained keto diets do increase the risks of some chronic diseases, a concern especially as one ages. See https://www.frontiersin.org/articles/10.3389/fnut.2021.702802/full

Anyone reading that article should also read the comments, such as

 

Funded by an organization with an aggressive agenda for plant based food coupled with an aggressive agenda against consumption of animals, written by a member of that same organization, and actually just an agenda driven review of literature hand picked and then written/crafted to support the same agenda.

 

One of the authors and researchers whom the article references even weighs in with

 

Please note that these authors have never conducted research on low carbohydrate, ketogenic diets, and in my view have done a very poor job in giving a balanced review. The work Dr. Yancy and I have done on low carb diets is presented in an unfair, biased manner.

 

[86Tiger]

 

 

Congrats on the good report.  And kudos on the weight loss.

 

 

[BritTim]

Over the last 15 years, or so, I have tried hard to understand he pros and cons of different dietary strategies. The only absolute conclusions I have come to are

• Extreme diets may be appropriate for limited periods, especially if weight loss cannot be achieved in other ways. However, a more balanced diet should be employed most of the time.
• Weight control is key in most people, and especially as we age. Being underweight is worse than being overweight. Being slightly overweight may not be harmful for some people, especially if they exercise regularly.
• The most important nutrient to avoid consuming to excess is fructose which is associated with many long term health issues. This should guide us, especially, in which fruits we consume often.
• Optimum sustained glucose levels is really hard to assess, and probably very much dependant on the individual. Low glucose levels seem to be correlated with long term mental deterioration. The risks of high glucose are well known.

Other than the above, I continue to read the latest research with interest. I am especially interested (as I am now in my seventies) on how dietary decisions can facilitate delaying the diseases of aging. Occasionally inducing ketosis, it seems, might be part of the puzzle, but this is controversial.

[whereyougo]

Many doctors have totally wiped cholesterol as outdated and no longer relevant except to bring on massive profits for big pharma. 

They are all over you tube 

 

Remember when eggs were supposed to kill you with cholesterol over load and now debunked. 

 

Stay true to your keto diet because the weight gain when you go back to the SAD diet will bring you heart problems and diabetes! 

Edited April 27, 2022 by whereyougo

[Sheryl]

2 hours ago, whereyougo said:

Many doctors have totally wiped cholesterol as outdated and no longer relevant except to bring on massive profits for big pharma. 

They are all over you tube 

 

 

 

it is not "many" doctors and the doctors who appear in you tube are far from representative of current medical thinking.

 

Expert doctors publish in peer reviewed medical journals, and do not usually go on Youtube.

 

It is not that "cholesterol is outdated" but that medical knowledge about it has greatly increased along with an understanding of the role of different types and subtypes of cholesterol. And the role of triglycerides, which are also very important.

 

It is true that total cholesterol level alone is no longer used as an index of anything (though some Thai doctors still make this mistake). But LDL cholesterol, HDL cholesteril and triglyceride levels, and the cholesterol ratio are quite important and very much used by up to date, state of the art cardiologists.

 

A keto diet does not have to have a negative impact on lipid profile (negative  meaning: higher cholesterol ratio, elevated triglycerides). But it often does. It really depends on what type of fat/oils  are consumed and what protein sources are used.

 

A keto diet that involves a lot of fish and lean meats, for example, will do much better than one heavy in fatty meats.

 

Totally aside from lipid concerns, it should be noted that high consumption of red meats has been shown to be a risk factor for several cancers.

 

And there is also the issue of fiber as keto diets tend to be low in fiber which can lead to constipation and is also linked to increased risk of some cancers. It does nto have to be so (i.e. one could go Keto and still get enough fiber) but it is the case for many.

 

A diet free of processed carbs (which are unquestionably bad for you) is a far better idea, healthwise, than a keto diet unless there is a really compelling need for more rapid weight loss. In that instance, I would advise:

 

1. A moderate, rather than extreme keto diet (specifically: do not entirely eliminate vegetables  and fruit, and in fact, include a lot of fresh vegetables);and go easy on red meat in favor of more fish or non-animal protein sources,  be careful about oil type, and ensure enough fiber (if necessary can take psylliuym).

 

2.   Follow this only until significant weight loss has occurred, then gradually transition to a diet free of processed carbs but allowing whole grains and unlimited fresh fruits and veggies. You can phase in the whole grains and more fruit gradually and keep an eye on its effect on weight.

 

And at all stages,  be mindful of type of oils used.  In Thailand in particular one has to eb careful because almost all fried/sauted foods you get here were made using very unhealthy palm oil. They also tend to re-use oils, which builds up carcinogens.

 

 

 

[connda]

On 4/21/2022 at 7:56 AM, Scouse123 said:

One startling piece of information she gave was to tell me to quit the Keto diet! This diet has successfully helped me shed 13 kilos and I am keeping it off. She said there were ' mild ' fatty build up in some tissue and she was definitely against Keto diets in men who are approaching sixty years old.

You will eventually develop 'mild' arteriosclerosis as you age.  Genetics, age, oxidation - it just is what it is.

She is giving you - an opinion.  Do you believe that the average doctor is 100% accurate.  <laugh>  Then by all means.  Don't do Keto.  I've also have read that intermittent fasting is worthless.  According to one study. 
Do I buy that as absolute fact?  No.

Here's what you do.  You obtain information from a multitude of studies and aggregate the data and view it though the lens as metadata.  Then you make a decision for yourself.

I eat keto but for set periods of time.  I intermittent fast as well.  I do three day fasts a few times a year.  At 70 years old your going to be hard pressed to convince me that the "mild arteriosclerosis" I have at my age isn't age related simply because over time you body breaks down.  Some faster than others.
They say "you have mild arteriosclerosis", but then they never tell you we're you stand on a Bell Curve of those of your own age and sex.  Mild arteriosclerosis may well put my two or three standard deviations from the norm to the "good side."  Most doctors don't have a clue. 

Personally?  I'll continue intermittent keto, intermittent fasting, and periodic fasting.  I feel good.

Then you doctor tell you:  "You'll die for sure!!!"
Yep - you're right.  Everyone is gonna "die for sure."  I gauge my life via quality of life.  I'll live however long I live.
Now that I'm past 70 - I'm pretty Ok with the shape I'm in and I'm well aware that I'm now in the range where people die of "old age related conditions."   Right now - mild arteriosclerosis isn't at the top of the list of things that may kill me.  Cardiovascularly - I'm doing pretty good for a guy may age.

So - do what make you feel good.  Your BMI is better than it was?  You probably feel better.  Exercise.  Eat reasonably.  Don't sweat the small stuff.  Enjoy the time you have left.