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Pronokal diet slowly?

Hello, I am 54 yo with BMI 34. My nutritionist suggested to start Pronokal diet, I need to lose ~25 kg. From the descriptions of the diet I see that people lose this amount of weight in 2 months, on average.
Why do not slow down the process and lose the weight more slowly? Are there any problems with getting in and out of deep ketosis compared to staying in it for a long time? Is the reason more commercial or there is some objective physiological justification for such a schedule in Pronokal?
I have high blood pressure (controlled), thyroid goiter (Armour Thyroid) and had an episode of kidney stones. Are any of these conditions interfering with ketosis?
Thank you!
4 Responses
649848 tn?1534633700
I'm not familiar with the diet with which you refer, so I did a quick search... The first thing I find is that it restricts calories to about 600/day, which puts up a red flag immediately for me.  

Of course, you can probably lose weight on any diet that only allows 600 calories/day, but can you stick with it? And is it healthy?  My little bit of research shows that ketogenic diets are a bit controversial as to how healthy they are.  That seems to be one of the drawbacks - most people can't stick with it because of the restrictiveness. It's certainly not something I would try even if it is suggested by a nutritionist because I don't like anything that seems too radical and of course, I'm sure it's not inexpensive.  

All of that said, let's look at your health issues.  I'm going to zero in on the thyroid/goiter first because there's a good chance that might have something to do with your weight since the thyroid controls metabolism.  

Are you sure you're on a high enough dose of medication to get/keep your thyroid levels (Free T4/Free T3) where they should be in order to help promote weight loss?  If you've had recent thyroid tests done, I'd be interested in knowing what your levels are.  Just having levels "in range" isn't good enough; most of us find that we feel best with Free T4  about the middle of its range and Free T3 in the upper half to upper third of its range.

Another issue I might worry about in your case is whether or not you could have insulin resistance/pre-diabetes.  Entering a state of ketosis if one has impaired glucose tolerance can cause glucose levels to drop too low.  

Both thyroid and insulin resistance/pre-diabetes can affect blood pressure.

So then we move on to your current diet and exercise...do you eat a healthy diet, to begin with?  Your body needs all the food groups in order to get adequate nutrients and some of them, such as A, D, E, K are fat soluble, so you even need fat in order to absorb/use them.  This means that cutting out fat and going with a very high protein diet is not necessarily the way to go... My doctor put me on a high protein diet and I gained MORE weight  :-(

That said, some of us have food sensitivities we aren't aware of, so we do have to eliminate certain foods, but that's another issue.  

I've been told that the Mediterranean Diet is one of the best there is... It incorporates plenty of fresh fruits, veggies, fish, chicken and other meats, nuts, seeds, and all the other things that are most healthful.  Eating the freshest, unprocessed food we can is always the best.   Anything you buy in box/package is not as good as what you buy in the produce or meat section.

And then there's exercise. Even a short walk around the living room, the yard, the block a couple of times/day is better than no exercise.   Exercise can also help your blood pressure.
Avatar universal
The first thing to find out, if you can, is how much money the nutritionist is getting paid by Pronokal.  It may be nothing, but I doubt it.  Doing a quick check on the website of the company, they are selling their products.  Anyone can go on a high protein diet, anyone can then add in more of their regular foods later on, and anyone can then go back to eating whatever they want in a third stage.  What these programs do, though, is some people just won't do it themselves and for those people a program can substitute for the discipline they lack.  This particular diet seems a bit better than others in the sense that it isn't requiring an unhealthful high protein diet forever, just until you lose your first batch of weight, then it changes by opening up what you can eat.  Now, there's no way to know if it works or not, because the data on the website is extremely short-term, a failing of pretty much all high protein diets -- the issue isn't whether they work, they do, the problem has always been that the weight loss doesn't last because eating higher than healthful amounts of protein has to stop at some point and then you go back to where you started.  So your thought that losing slower is better is generally thought to be correct because it implies a permanent change of diet and exercise that will hopefully keep working, though even with this people do plateau and have to make further changes to lose more weight.  Judging from the program, if it's true, and I never trust proprietary websites, because this one does guide you back to a more normal way of eating -- unfortunately they don't describe what that is -- you're not staying permanently on a diet too high in protein and too low in essential fats.  You're obviously going to have to choose, but I do find it odd that a nutritionist doesn't just recommend a diet for you and instead recommends one you have to buy -- again, my suspicions are raised that this person is making money doing that, which might skew your trust in this person.  But as the above has already said, the longest-term ongoing studies of human health show that eating a balanced diet of complex carbs, lots of veggies, and limited animal fat with most of it in the form of fish (which, you should know, the fattier the better, fat isn't the enemy, it's the kind of fat that's the problem, just as carbs aren't the enemy, it's the kind of carbs) leads to communities with the lowest levels of obesity and the longest healthiest lives.  These diets are grouped under the term Mediterranean Diet, but it's not just one diet, it's a way of eating.  But again, if you have to lose weight quickly, high protein diets do work in the beginning better than this longer-term approach, and if you are doing any resistance training as your preferred form of exercise, higher protein is necessary to see results in increased muscle.  This is a long way of saying, who knows?  You're going to have to make a choice but discipline and lifestyle changes are probably going to be the key unless, as also stated above, your health problems are a cause and aren't being properly treated at the moment.  You know, nobody's ever topped eat less, move more!
649848 tn?1534633700
"You know, nobody's ever topped eat less, move more!"  LOL  We've kind of been down this road and I'll skip down it briefly one more time - not as an argument, just as a reminder - unless that thyroid issue is treated optimally, the O.P. can eat less all she wants and although she will probably, eventually, lose some weight at only 600 calories/day, she will also get much sicker than she already is.  I've, personally, gained weight on fewer calories, more exercise.

I agree (and should have said) that the Mediterranean diet is not a single diet, but a way of eating.  There are a number of books/articles one can read about it, but Paxiled explained it quite well.

Safe weight loss is generally considered to be 1-2 pounds/week.  Anything more than that is, often, difficult to impossible to maintain because it's likely accomplished by impractical or unsustainable means.   Most of us didn't gain all our weight overnight and it's not practical to think we should be able to lose and keep it off in a short time.
Hey, Barb, I did say at the very end unless your health problems are the cause -- I've been listening.
That didn't go unnoticed and I'll certainly give you that - thank you; it's just that the "eat less, move more" concept always seems to come in at the end and appears to be trying to trump everything else when in cases like this, eating less and moving more might not be all that helpful until the thyroid hormones are adequately balanced.  

Of course, I do have to qualify that, as well, because we both know that a balanced diet of fresh, whole food is good for us, as is plenty of exercise; just not always the less/more concept.

It's a fine point and maybe I'm being too much a stickler for it, but having lived and dealt with the unbalanced hormones (both thyroid and adrenal) for 10+ yrs, it tends to be kind of a sore spot with me.  My apologies.
I posted a comment here and it didn't show up... I'll wait and see if it does; if not, I'll repost as I don't want to double post...
Avatar universal
Hello, and thank you very much for your detailed answer, I really appreciate it. I will try to comment on your points in order.

Thyroid: I have thyroid goiter diagnosed about 20 years ago, it is considered asymptomatic for the last 10 years, with all nodules being "cold". All my thyroid results have been normal all the time, even at the time of diagnosis, for one year I was off any medication, but did not feel well and my TSH went up to 2.6, currently it is 1.18. Free T4: 15.76 out of range 10.90-22.20, free T3 : 4.63 out of range 3.1-6.8. While I do feel that thyroid could contribute to my problems with weight, the clinical picture always has been quite normal.
Glucose 5.5 (out of 4.2-6.2), cholesterol 4.66 (0-5.2), HDL 1.8 (0.9-2), LDL 2.4 (0-4).
Taking supplements : Omega 3 & DHA, Evening primrose, D3/k2, Taurine, Benfotiamine and Alpha Lipoic Acid.
Diet: almost no processed food, I am a good cook and cook at home 95% of the time. When eating outside - no fast food. No sodas, no cookies. Eating quite a lot of fruits, not that much of vegetables, but always having some with the meal. I am 5'11", and gaining almost steadily around 10 lbs (~5 kg) every two years in the last 6-7 years.
Exercise: walking 3-4 times a week about 3 miles for about an hour. Will be swimming in the lake regularly once the lake we live next to is warm enough. Occasionally go to gym, but should do it more regularly.

Overall I have a relatively sedentary but not horribly unhealthy lifestyle.

Nutritionist: obviously she is paid and gets some commission from Pronokal, I have no big problem about it. If it works, if the nutritionist gives me more or less objective information for me to make the choice, I would consider it relatively fair game. As usual, there is very little info on Pronokal website, I know Spanish a bit, googling in Spanish provides many websites with sad stories from people who did Pronokal. But I have not found anything really drastic - as I said, many people rebound, especially the ones who eat a lot of fast food and were missing it during the diet, quite many people had some complications and had to stop the diet earlier. No stories about heart attacks or similar grave consequences, but it could be just a selection bias. I will continue searching and reading. Some people manage to keep the weight off for a few years at least.

Pronokal -- very intense original phase with 600-800 Kkal per day, almost all coming from proteins in liquid form. It seems to work, meaning that people do lose a lot of weight if they manage to stick to the diet for 2 months.
I am considering the diet because I ran out of the alternatives -- I cannot exactly trace why I keep getting on weight. While I do not adhere to any diet, I think I do eat relatively healthily, the problem should come from very slow metabolism. I've tried to kick it incot action (intermittent fasting or the opposite, eating every 3 hours), did not seem to work.

I know that the healthy loss of weight is 1-2 pounds/week. With Pronokal it is much more dramatic, with major losses coming in the first 2 weeks of the diet (4-5 pounds of which I think would be water). But the speed of the weight loss with Pronokal is too fast, seems to be too unhealthy, and doing it for 2 months seems to be too drastic. Pronokal puts you in a deep ketosis, and keep you there for 2 months. My question is: why not to do this type of diet for 2 weeks, then let your body to adjust (and perhaps to get used to) your new state, perhaps to gain a bit of water and weight back, and then repeat this operation 4-6-8 times, as needed. My reasoning is that it could be milder on the body, less taxing for the kidneys. Perhaps it would cost more, but right now I am not considering this side of the diet.

Also, my cardiologist thinks that if I lose the additional weight I carry, my blood pressure can normalize on its own. I hope he's right. So is it worth the risk (including cardiovascular) to try and go through the Pronokal diet to get to the optimal weight where supposedly I will have better heart conditions?

Thank you very very much for your comments!
Hello - thank you for responding to our comments.

One thing I notice is that although your thyroid hormone levels are within the ranges, they aren't optimal.  Most of us find that we feel best with Free T4 at mid-range; your Free T4 is only at 43% of its range.  In addition, most of us feel best with Free T3 in the upper half to upper third of its range; your Free T3 is only at 41% of its range.  Free T3 should be higher in its range than Free T4 in its range.  It's important to know that Free T3 is the hormone that's used by nearly every cell in the body, while Free T4 is considered a "storage hormone" and must be converted to Free T3 prior to being used.  

Under-treated hypothyroidism can cause cardiovascular problems, just as it can cause weight issues.  I have both, and I also have hypothyroidism; I've also lost a good bit of weight that did not resolve my cardiac issues, but that's not saying it wouldn't help yours.  If your hypothyroidism is caused by Hashimoto's, you might need adjustment in medication periodically.

MedHelp does have a Thyroid Disorders forum from which you can get further information if you choose.   That forum can be accessed via the following link:  https://www.medhelp.org/forums/Thyroid-Disorders/show/73

Another thing I might point out is that fruit has a lot of sugar, even though it's natural sugar.  Excess sugar that's not used immediately for energy/exercise is stored in fat cells for later use.  It's, typically, recommended that we consume more vegetables than fruit because of the higher sugar content of fruit.  

Of course, I can't/won't tell you what to do and I don't know enough about the Pronokal diet to be able to advise whether or not it's safe to try it differently than it's meant to be done; however, I believe that if one doesn't stay in the state of ketosis (using one's body fat for energy) long enough, one might not lose weight as anticipated.  That is a subject for more research.

Good luck.
Just want to second Barb here -- fruit, at least those fruits people usually think about when they think of fruit (keeping in mind that tomatoes are a fruit, though they are pro-inflammatory, squash are fruits, nuts and seeds are fruits, meaning, a lot of fruits aren't the high sugar variety) should be eaten in moderation, although some in Chinese medicine believe this depends on the climate in which you live -- in tropical climates, more fruit is okay, but most of us live in temperate climates.  Veggies in abundance.  
That's a very good point, Paxiled... several things that we consider vegetables are actually fruits, including the tomatoes you mentioned, along with avocados and others...
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