Days later, Hefford was pronounced dead. Only after her death did her family learn that Hefford, the mother of a 7-year-old girl and a 5-year-old boy, had a rare genetic disorder that prevented her body from properly metabolizing her high-protein diet.

Normally, the body can remove nitrogen, a waste product of protein metabolism, from the blood. However, a urea cycle disorder would prohibit this.

Therefore, nitrogen, in the form of toxic ammonia, would accumulate in the blood and eventually reach the brain, where it can cause irreversible damage, coma and death.

"The enzyme deficiency can be mild enough so that the person is able to detoxify ammonia adequately -- until there's a trigger," said Cynthia Le Mons, executive director of the foundation. The trigger could be a viral illness, stress or a high-protein diet, she added.

"There was just no way of knowing she had it because they don't routinely test for it," said Michelle White, Hefford's mother and a resident of Perth. "She started to feel unwell, and she collapsed."

White blames protein shakes for her daughter's death.

'Nuanced symptoms'

Since 2014, Hefford, who worked at Princess Margaret Hospital for Children and studied paramedicine, had been competing as a bodybuilder.

It was only after Hefford's death that White discovered containers of protein supplements in her daughter's kitchen, along with a strict food plan. White understood then that her daughter, who had been preparing for another bodybuilding competition, had also been consuming an unbalanced diet.

Hefford's diet included protein-rich foods, such as lean meat and egg white, in addition to protein shakes and supplements, her mother said.

"There's medical advice on the back of all the supplements to seek out a doctor, but how many young people actually do?" White asked.

Le Mons said, "typically, there are nuanced symptoms that just go unrecognized" with mild cases of urea cycle disorder. Symptoms include episodes of a lack of concentration, being very tired and vomiting.

"Sometimes, people think it's the flu and might even go to the ER thinking they have a really bad flu," Le Mons said, adding that a simple serum ammonia level test, which can detect the condition, is not routinely done in ERs.

It's unclear whether Hefford suffered symptoms of her condition. White, who hopes her daughter's story will serve as a warning to help save lives, believes protein supplements need more regulation.

The Australian Medical Association says there's no real health benefit to such supplements. And, while they may not be necessary for most people, they're not dangerous to most, either.

Treatment

The estimated incidence of urea cycle disorders is 1 in 8,500 births. Since many cases remain undiagnosed, the exact incidence is unknown and believed to be underestimated.

"There's a myth that this disorder only affects children," Le Mons said, noting that one patient reached age 85 before diagnosis.

Regarding Hefford, Le Mons said that "this is not the first time this has happened." Other athletes, who like Hefford were unaware of their condition, have died when a high-protein diet triggered their condition.

Treatment may include supplementation with special amino acid formulas, while in some more severe cases, one of two forms of an FDA-approved drug may be prescribed. When these therapies fail, liver transplant may become necessary.

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Australian bodybuilder with rare disorder dies eating high-protein diet - CNN

Kasen Williams credits some changes to his off-season diet and conditioning regimen for his impressive showing in Sunday's pre-season opener.

The Seattle Seahawks under Pete Carroll have thrived on devising ways to best use a players most defining and unique talent.

And when it comes to receiver Kasen Williams, that singular talent has been evident for years.

Kasen has shown us the ability to get off the ground, Carroll said Tuesday. He has been a leaper all the way back to when he was in high school.

Sunday, Williams put that talent to use in a way that might also prove to be a true jumping off point in his NFL career.

Williams has mostly been a practice squad player during his two-plus years with the Seahawks, though when injuries hit the receiving corps late in the season he has found himself on the 53-man roster at the end of each of the last two years, officially playing in three regular season games and all four in the playoffs.

But a new season also means a new challenge to make the roster, especially with the Seahawks adding the likes of third-round pick Amara Darboh to the receiving group as well as bringing back basically everyone who was on the team at the end of 2016.

Its a really good group, Carroll said Tuesday. Well just see what happens.

Sunday, though, it was Williams who made something happen, using the leaping ability that allowed him to win 4A state titles in the long, high and triple jumps as a senior at Skyline High to make four highlight-reel catches, each one seemingly more spectacular than the next good for 119 yards as the Seahawks beat the Chargers 48-17.

Thrilling to see him make those plays, Carroll said. Thats not surprising because we see him do it (in practice). What was great is that he got a chance to do it in the game and show that he can do that.

Williams had little chance to show that last preseason when he was bothered by a nagging hamstring injury that limited him to one game and no catches and led to his release at the final cutdown time before he was later brought back to the practice squad and ultimately onto the active roster for the final game of the regular season.

The health struggles of last preseason led to an off-season revelation for Williams.

You hear a lot of people in the NFL say the best ability is availability, Williams said.

Williams, of course, is all too familiar with the training room having seen his UW career derailed by a devastating broken leg and displaced foot injury in 2013.

Williams says any lingering effects of that stopped being an issue as soon as I had the Seahawks logo on my chest. My rookie year (in 2015) I was ready.

The kind of injury he suffered at UW is an unfortunate reality of football, the kind of thing he couldnt do anything about.

But after what happened last preseason after Williams had earned raves for his work in the offseason and seemed in position to make a legitimate run at a roster spot Williams decided to do whatever it took to get his body in the best possible position to make it through camp healthy.

Even if Im not hurting Im spending time in the rehab room just to make sure everything is in line, Williams said.

Williams also changed his eating habits saying he switched to a diet heavier in fruits in vegetables including frequent stops at Pressed Juicery in Bellevue.

Vegetables, fruit, all that asparagus, Williams said of the juices he drinks. It was just the biggest improvement I made. I lost 5-6-7 pounds off just eating right.

He missed a couple of days early on with a slight foot injury but otherwise has made it through camp this year healthy.

And Sunday, when the likes of Doug Baldwin, Tyler Lockett and Darboh all sat out with injuries, Williams was ready when his number was called not once but four times.

All four catches came on fade routes thrown by backup QB Trevone Boykin, with Williams each time winning battles with Chargers rookie cornerback Michael Davis for the ball.

I seen the ball in the air, Im locked in, said Williams, who said he also caught an additional 100 passes during workouts this offseason compared to past years. Nothing else matters at the time. Nothing else is important. The DB is not even there. Im just focusing on the ball.

Watching from home, Baldwin marveled at what he saw.

Extremely happy for Kasen Williams and all his efforts, all his work, Baldwin said. Hes worked tirelessly to come back from injuries to get his opportunities and he got to display that. I couldnt be happier for him just because the man he is. Hes had an uphill climb and hes done it with grace. Hes just been patient and waited for his opportunity and I was so excited for him to be able to see him get his opportunity finally and do extremely well with it.

Given the depth at receiver, Williams may need to show it was not just a one-time thing if hes going to make the regular season roster.

Williams says its not something he worries about, that if he does what hes supposed to that will take care of itself.

But then he also makes a statement that sounds like he feels pretty good about where its headed.

I do feel like Im in my prime even though Ive gone through some injuries and whatever, he said. Those are all in the past and I feel like Ive got a great handle on what I need to do to get my body 100 percent ready and I feel like the sky is the limit.

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New diet, improved health have Seahawks receiver Kasen Williams flying higher than ever - The Seattle Times

Hanna_photo/TLpixs/Moving Moment/bigacis/ShutterstockHad the runs or feeling queasy? You might have tried home remedies for diarrhea or morning sickness, but youre still not feeling up to scratch. Maybe youve heard that plain foods, like the BRAT diet, might help? Heres what you need to know.

The BRAT consists of eating only B-R-A-Tbananas, rice, applesauce, and toast. The BRAT diet originated in the 20s, explains Pat Salber, MD, founder of The Doctor Weighs In. There was this idea that when you have gastroenteritis or nausea, vomiting, and diarrhea, you needed to have something bland to eat. And what could be more bland than bananas, rice, applesauce and toast? So the BRAT diet was recommended, especially for children, as a good way to nurture the body back to full health.

The BRAT diet has fallen out of favor in recent years. While theres nothing inherently wrong with the foods, the diet is low in protein, fiber, and fat, which means even though its easy to digest (and thats kind of the main idea), it doesnt contain enough good nutrition to help your body recover from illness. In fact, studies showed that people who followed the diet for long periods actually became malnourished. Because of this, the American Academy of Pediatrics no longer recommends the BRAT diet for children, advising instead that they should get back to eating normal foods as soon as possible.

The first line of defense against stomach flu is to avoid contracting it in the first place. Practicing good hygiene will go a long way towards preventing the spread of the illness. Dr. Salber also strongly recommends getting your baby vaccinated against rotavirus. Its a common cause of diarrhea and its preventable with a vaccine, she advises. Its a really safe and very effective vaccine.

The most important thing is to stay hydrated. The body loses fluids quickly through diarrhea and vomiting, so drinking water, oral rehydration solutions, or sports drinks can help replenish your stores. Mild diarrhea wont require medication (and you should never give it to children), but in some cases, OTC medication may help. Try these home remedies for an upset stomach. If your symptoms are very severe, see your doctor. The really serious diarrheas, like cholera or some of the bacterial diarrheas you can get, may need antibiotics, says Dr. Salber. Once the worst symptoms have passed, Dr. Salbers advice is also clear: Go back onto your normal diet as soon as you can tolerate it.

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Here's What You Need to Know About the BRAT Diet - Reader's Digest

In the 1980s, health and nutrition experts waged a war against dietary fats.

Food companies began to cash in by creating "fat-free" versions of popular foods.

That trend continued into the 1990s and even into the new millennium.

Now, a growing number of health experts, including some doctors and nutritionists, are finding that fat may not be the enemy after all, rather shifting the focus on reducing the consumption of too many carbohydrates.

The shift in philosophy has caused a rise in popularity of a diet called the ketogenic diet, or keto, for short.

The ketogenic diet is a variation of a low-carbohydrate diet, which encourages the process of ketosis. That, in turn, utilizes fat as the body's fuel rather than carbohydrates.

"The level of carbohydrates that are consumed for a ketogenic diet are super-low," said Dr. John Thomas, owner and physician at On Point Primary Care. "Usually carb intake is at 5 percent, versus the normal diet of 45 to 65 percent in the makeup of macronutrients of proteins, carbohydrates and fats."

Thomas explained that carbohydrate consumption has been what he believes to be a leading cause of many health problems.

"All in all, we just consume, as Americans, way more carbohydrates than we need," he said.

A ketogenic diet often is a more extreme reduction of carbs. Thomas said that this isn't always necessary to help.

He recommends a less drastic approach.

"The benefits for most people are just reducing their consumption to maybe moderate levels of carbohydrates and not the extreme," he said.

Unlike other low-carb diets, the ketogenic diet focuses more on consuming a larger portion of fats, a moderate amount of protein and a very low amount of carbohydrates.

"Often times the ketogenic diet has between 70 and 80 percent fat consumption, and proteins are between 25 and 30 percent," Thomas said.

The key for a ketogenic diet to work is to trigger ketosis.

Carbohydrates are used as energy in the body.

From simple sugars to complex carbs, the body relies on the macronutrient as fuel.

However, eating too many carbs causes the body to store fat at a greater rate.

"Our bodies have a tendency to burn carbohydrates pretty rapidly, before we're going to burn protein and fat," Thomas said. "Carbs aren't bad, they serve a purpose. Too much might be a problem and that's where I say we eat too much."

In a ketogenic diet, the low amount of carbs causes the body to adapt to a new fuel utilization.

"You're not really going to break down your muscle tissue unless you're in a starvation mode," Thomas said. "But, we have plenty of fat stores, most all of us do. By lowering carbs drastically, we begin a survival process called nutritional ketosis where we start to liberate fat, typically from the liver, and we'll break that up and utilize it as fuel."

The process produces ketones in the liver, which in turn act like carbs in many ways. Ketones are transported throughout the body, providing fuel.

"The ketones will allow all these cells that normally use glucose to run on ketones," Thomas said. "This allows you to push whatever glucose you do have to the brain."

Chiefly, people use the keto diet to lose weight.

By using body fat as the energy source, the body's insulin (the hormone responsible for fat storage) levels drop greatly.

"If you're burning fat in that way, there's a tendency to lose weight," Thomas said. "Weight loss is probably the major reason people are getting into this."

The ketogenic diet has also been shown to help control blood sugar levels.

Though there are not long-term studies, research has shown several significant benefits to ketogenic, and other low-carb diets.

"We have studies that show that this diet improves blood sugar and lowers insulin levels," Thomas said. "It can lower high blood pressure, decrease weight and improve cholesterol, decrease triglycerides and can reverse fatty-liver diseases."

Keto could help treat diseases like cardiovascular disease and diabetes; however, there are no studies that show long-term lasting effects.

Though the diet is high in fat, it is recommended that a majority of that which is consumed should be from natural sources.

Peanut butter, avocado, some nuts, fish and grass-fed meat such as beef, lamb, goat and venison are recommended staples of the diet.

"The one thing I think is important, and what I try to emphasize when a patient is consuming a little bit more fat, is that those fats are healthy fats instead of high fats," Thomas said. "I like to emphasize the healthy benefits of omega-3 acids."

Oils, too, can be a source of such healthy fats.

"Coconut oils, olive oils ... those should be emphasized as fats to obtain," Thomas said.

High-fat foods, like bacon, can be eaten, but in moderation.

"Bacon would be considered an edible item in the ketogenic diet," Thomas said. "But, it'd have to be mixed with the healthy fats."

While eating low-carbs, it is suggested that the carbs that are consumed come from leafy, green vegetables such as spinach, lettuce, chives, kale, celery, stalk, asparagus, cucumber and summer squash.

A drawback to the diet is what is often called the keto flu.

"It can be presented with headache, fatigue and muscle cramping," Thomas said. "Those are potential side effects with ketogenic diets, or any of the lower carbohydrate diets."

Keto can cause a significant drop in water retention, and without proper hydration, can cause dehydration.

"We encourage water intake, as these symptoms could be secondary to dehydration," Thomas said. "Some will also recommend additional sodium in their diet during that period, or as needed if you're having these symptoms. Again, I caution that sodium introduction may interact with people who have high blood pressure."

These symptoms typically last for only a couple of weeks.

Thomas said the symptoms are similar to having a withdrawal.

"They're similar effects to when people take too much caffeine," he said. "People have severe migraines because of the withdrawal of caffeine."

To combat cravings and symptoms, Thomas said to remain consistent and try salt water.

He also recommends consistent medical supervision.

"Always seek advice from your doctor and nutritionist," Thomas said. "That's super important."

If ketosis becomes too great, it can lead to ketoacidosis.

Ketoacidosis is a pathological response which can be life-threatening.

"Even with your typical American diet, we still form ketone bodies, but the amount we make is super small," Thomas said. "We generally see nutritional ketosis occur when the levels rise about 10 times the normal amount, all the way up to 70 times. When blood-ketone body concentration exceeds 250 times normal, that makes our blood become acidotic, and that's where it becomes life-threatening."

Thomas said this does not occur often, and is usually caused by a pre-existing condition.

"It would generally be rare unless there are some issues, like diabetes," he said. "You'd have to be careful, even Type-II diabetics have that possibility of going into acidosis."

Thomas again recommends working closely with a licensed medical technician when attempting to go on a keto diet.

"Any diet, and something like this, you should be monitored by a doctor or nutritionist and followed closely," he said.

Thomas himself is not necessarily a proponent of a keto diet.

He is, however, an advocate of lowering carbohydrates and tailoring one's nutrition to impact long-lasting change.

"What's important is, and what we try to do at our clinic because we can monitor our patients pretty regularly is, we identify and overcome barriers as they happen," he said. "This is typically on a month-to-month basis. I ask every one of my patience if this is something they can do for the rest of their life."

Thomas explains that diets are only truly effective if they can be sustainable. He suggests implementing a complete lifestyle change rather than creating a temporary solution.

Thus, it is important to tailor these diets to the individual.

"We begin to make this diet that is individualized for that person," he said. "It's no longer a low-carb, ketogenic diet. It's your diet within this (low-carb) spectrum that we've worked with by going back and forth and find out what you can live with for the rest of your life."

llyons@chieftain.com

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Ketogenic diet becoming popular weight-loss plan - Pueblo Chieftain

Jean Anthelme Brillat-Savarin's aphorism "Tell me what you eat and I shall tell you what you are" is one of the most overused cliches in food culture, appearing everywhere from the opening sequence of Iron Chef to T-shirts and coffee mugs. But to the culinary historian Laura Shapiro, learning what someone ate is just the beginning of unlocking his or her identity.

"Tell me what you eat," Shapiro imagines herself asking her subjects, "and then tell me whether you like to eat alone, and if you really taste the flavors of food or ignore them, or forget all about them a minute later. . . . Please, keep talking . . . and pretty soon, unlike Brillat-Savarin, I won't have to tell you what you are. You'll be telling me."

In short, you can't tell a life story without telling a food story, though it's astonishingto Shapiro, anywayhow many biographers try. Food provides a new way to consider people's lives, not just their activities, but also their needs and how they care for others. This is especially true of women, who have, historically, been called upon to feed others. Shapiro's three earlier books, Perfection Salad, Something From the Oven, and Julia Child: A Life, all considered the lives and work of women who changed the way Americans ate during the 20th century. Her latest, What She Ate: Six Remarkable Women and the Food That Tells Their Stories, is an experiment in straight-up biography: the food stories of six famous women, only one of whom cooked professionally. Some never cooked at allor ate, for that matter. But not eating is part of a food story too.

Her subjects are Eleanor Roosevelt, Eva Braun, diarist Dorothy Wordsworth, Cosmopolitan editor Helen Gurley Brown, novelist Barbara Pym, and Rosa Lewis, the Cockney scullery maid who became one of the most celebrated caterers and hoteliers of Edwardian London. Each woman left a lengthy paper trail, which Shapiro followed faithfully to the very end, through archives and libraries on two continents. The amount of research that must have gone into this book is staggering: Wordworth's barely legible early 19th-century diaries through Gurley Brown's chatty, heavily italicized editor's letters, with detours through endless menus, memoirs, correspondence, cookbooks, newspaper clippings, histories, and much, much more. Though each chapter is fewer than 50 pages, these aren't biographical sketches: they are complete portraits.

Naturally, after spending so much time with people, even people who are dead, you tend to feel close to them (as Shapiro, a former alt-weekly journalist, points out, dead people never hang up on you). You want to refer to them informally, by their first names, as Shapiro does. Some, it's obvious, were more congenial companions than others. Shapiro appears to feel the strongest kinship with Pym, who took notes at restaurants on what other people ate and filled her novels with meticulously described meals. "Tea plays so many symbolic roles," Shapiro writes, "that another writer would have had to create a whole slew of walk-on characters to say what Barbara says with a cup."

She also feels a deep appreciation for Wordsworth, who for years selflessly took care of her brother, William, and his family, during which she was determined to find joy and blessedness in every aspect of her life, even a disgusting black pudding. Dorothy discovered the upside of invalidism in late middle agenow everyone had to care for her for a change and, especially, cater to her incessant demands for food to satisfy her feelings of "faintness and hollowness" as she slid deeper into dementia.

This is far more understandable and less reprehensible than how Eva Braun, who became enamored of Hitler when she was just 17 (her first words to him, incidentally, were "Guten Appetit" as she served him Leberkse, a Bavarian sausage), spent the second half of her life willfully creating her own glamorous reality, in which Hitler didn't call her because he was a neglectful boyfriend, not because he was busy invading most of Europe and killing millions of people. "For Eva," Shapiro writes, "who was looking forward to starring in a movie about herself when the war was overHitler had promisedlife itself was tantamount to a glass of champagne."

Braun drank champagne because she was on a perpetual diet. So was Gurley Brown, who discovered dieting in the summer of 1959 at the ripe old age of 37. She was a successful ad copywriter, able to pay cash for a Mercedes-Benz 190 SL, but she was a failure as a woman because David Brown, whom she had targeted as the ideal husband, refused to set a wedding date. The Serenity Cocktail ("pineapple chunks, soybean oil, calcium lactate, vanilla, fresh milk, powdered milk, and brewer's yeast") did its magic, thoughthey finally made it to city hall that Septemberand after that, her greatest joy in eating came from the discipline of counting calories. Her favorite comfort food was sugar-free Jell-O prepared with one cup instead of four so, Shapiro writes, "the dense, rubbery results would deliver the strongest possible hint of chemical sweetening."

Shapiro is bewildered, but also amused, by Gurley Brown's refusal to reconcile her girlish self-image with the powerful editor and businesswoman she truly was. (Her chapter is, at certain points, laugh-out-loud funny.) Gloria Steinem once begged Helen "to say something strong and positive about herselfnot coy, not flirtatious, but something that reflected the serious, complicated person who was in there, under the wig and makeup." Helen tried, Shapiro reports, she really did, but the best she could do was "I'm skinny!"

The most poignant food story belongs to Roosevelt. At times it's also nearly as funny as Gurley Brown's. This is largely because of Henrietta Nesbitt, the inexperienced and, as it turned out, inept Hyde Park neighbor Roosevelt hired to be the White House housekeeper and who tortured FDR and various guests for a dozen years with overcooked meat and watery prune pudding. Other biographers, such as Blanche Wiesen Cook, have proposed that Roosevelt herself was indifferent to food and that Mrs. Nesbitt was her ongoing revenge against FDR, for both his 1918 affair that destroyed her entire sense of identity and, later, for forcing her to assume the role of First Lady. Shapiro sees it an entirely different way.

"Yes, asceticism was a strong aspect of her personality," she writes, "but what's striking about her culinary asceticism is that she practiced it chiefly in context of being wife to FDR. Inside the White House, she was apathetic about what was on her plate. Outside, we get glimpses of a very different Eleanor. . . . It was Eleanor, away from FDR and ensconced with the people she cherished, who discovered the delights of appetite." Those were the meals, Shapiro writes, that Eleanor associated with love. It's a devastating commentary on the Roosevelts' marriage. But it also shows the power of a food story. v

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The stories of six famous women, as told through their diets - Chicago Reader