DEAR DR. ROACH: What is your opinion of the keto diet? I have been doing it for a few weeks now and lost a few pounds, but it goes against everything I usually eat — high quantities of red meat, lots of full-fat foods and dairy. Since I am losing some weight and actually feel better and am sleeping better, I like the short-term results, but I cannot see this as a long-term way of life. I am concerned about all that fat going into my body and clogging my arteries. I exercise every day with Zumba, jogging, etc. — J.P.
ANSWER: The ketosis diet favors very large amounts of fat — 60% to 80% of calories, with 15% to 20% of calories from protein and 5% or less from carbohydrates. The theory is to cause ketosis, a physiological condition of ketones in the blood as a result of high fat intake. It has been used since the 1920s as a treatment for seizures, but now is used for weight loss.
Like every diet, it has both good and bad aspects. On the good side, it is effective at short-term weight loss. However, much of the apparent early weight loss is due to water weight, which is a universal finding on a high-fat diet. Weight gain is likely when stopping the diet.
It is highly restrictive. Further, many of the foods that you can't eat on this diet are those that have been shown to be associated with improved health, especially vegetables and most fruits. Most people will have a substantial increase in cholesterol levels (by as much as 50%). The red meat and saturated fat probably present an independent risk of heart disease and cancer (even apart from its effect on cholesterol), although this remains somewhat controversial.
I do not recommend the keto diet for long-term use, at all. It may have some benefit in helping with short-term weight loss, but I think there are much healthier alternatives for most people.
DEAR DR. ROACH: Your column about the 58-year-old woman who felt like she had oil in her eye reminded me of having a very similar situation.
I described it to my optometrist, and he also diagnosed ocular migraine. I wanted another opinion, because the only symptom I had was the oil, no headache or visual disturbances. The ophthalmologist diagnosed blepharitis, or clogged oil glands at the base of my eyelashes. She recommended placing a warm pack of rice in a sock over my eye and then washing the eye area with baby shampoo on a washcloth. I did this for a week or two, and on my visit with her to recheck the eyes, the problem was gone. — J.P.
ANSWER: Thank you for writing. Blepharitis is caused by changes in the meibomian glands, oil glands that are present in both eyelids, often associated with changes in bacteria. I usually see people with this condition noticing red eyes and a gritty sensation. However, you are quite right that it includes blurry vision, and the eye-care professional sometimes can see an oily or foamy film over the eye.
The treatment the ophthalmologist recommended works for most people. Gentle lid massage may help get additional oily material out of the glands. However, antibiotics or other treatments are sometimes necessary.