Gun Violence & Physician Puppets

Today is gun violence awareness day.  Physicians around the country are hitting social media about terror of guns, of gun ownership, and how “guns are killing our children.”  In fact, there is a whole movement to “wear orange today.”  I truly appreciate the importance addressing violence in our homes, families and neighborhoods.  Violence in any form is terrible and tragic.  Yet, I am disturbed that very intelligent people are swayed into relinquishing rights of freedom and liberty based upon emotions and fear.  I’m sure my comments will strike up the ire of a number of my colleges and a few patients (Not that that is anything new – I’ve been beating the ketogenic drum for 15 years telling people to ignore the AHA and have some bacon).  Yet, I cannot, and I will not remain silent.

Evidence Doesn’t Support the Media’s Claims

In medicine, we are taught to practice and act based upon evidence.  Wearing orange to support removing my right to own a firearm fly’s in the face of evidences.  Over the 20 years of my medical practice, I have witnessed progressive socialists, liberal media and those that don’t know better, in an attempt to legislate greater control over the population, very successfully use our emotions to slowly remove our inalienable rights of freedom.  One of those is our second amendment right to own firearms.  The media, with many well meaning physicians and physician groups around the country, are using days like today to try to convince you that homes are more dangerous because there are more guns in homes, and more violence due to the presence of those guns.  But is that true?

According to recent research, gun homicide has actually decreased 49% since 1993.

And, according to a 2017 Journal of Pediatrics article, “Nearly 1300 children die and 5790 are treated for gunshot wounds each year. Boys, older children, and minorities are disproportionately affected.” Yet, this number is down from 1993.

And interestingly, “. . .unintentional firearm deaths among children declined from 2002 to 2014, firearm homicides declined from 2007 to 2014, and firearm suicides decreased between 2002 and 2007.”

The research does, however, show an upward trend in suicide from 2007 to 2014. But, according to the article, this appears to be “. . . precipitated by situational and relationship problems. The shooter playing with a gun was the most common circumstance surrounding unintentional firearm deaths of both younger and older children.”  However, overall the numbers are down by almost 50%.  Yet, that’s not the message being shared today.

Fewer People’s Homes Have Guns

Today, fewer homes have guns in them.  Fewer people hunt and use the firearms regularly.  And, because we live in bigger cities, opportunities to educate our youth about proper use and storage of firearms occurs less often.  Fewer families teach their children gun safety and unintentional injury and death can occur when our children are not correctly taught about the use and safety of firearms.

The progressive left and media will tout that according to the Congressional Research Service, as of 2015 there actually are almost twice as many guns per capita in the United States as there were in 1968: more than 300 million guns in all. And, gun sales actually have increased in recent years. You will hear that according to the Bureau of Alcohol, Tobacco, Firearms and Explosives, U.S. gun-makers produced nearly 11 million guns in 2013, the year after the Sandy Hook elementary school massacre. That’s twice as many as they made in 2010.

You even hear the words of Dr. Deborah Azrael parroted that, “There’s a gun for every man, woman, and child, more or less.”

But does every man, woman and child in the U.S. have a gun?  The number of armed households has actually declined to about 1 in 3. So an ever larger number of guns is concentrated in a shrinking number of homes:

Listen for just a short time today and you’ll hear the media and the progressive left claim that we need to make it harder to obtain a gun.  Well, we’ve done that already!
According to FBI records, background checks have more than doubled, making it harder to obtain a firearm in the U.S.

Involve the Pillars of Safety to Move the Agenda Forward.

I will paraphrase the comments of Jonathon Schuldt, a professor of communications at Cornell University. He stated that  in a nation where freedom is among the deepest ideals, control is almost a dirty word, and it is much easier to justify why one is against [gun] control that it is to justify why one is against [gun] safety.
Making the case for safety is easy, just involve the doctors.  Use the emotions and fear of violent injury and the treatment of horrible gunshot wounds.  If the doctors, especially our beloved pediatricians, are for “Gun Safety” [implying gun control], then we must support it. Right?!
Progressives have subtly changed our minds by changing the words and adding emotion.  Change the word “control” to “safety” & sprinkle with some doctors in white coats while wearing orange. Then, change the headlines that show up in today’s Google search of the news (for example):
  • ABC News: Virginia Gov. Northam on gun safety: Summons lawmakers to special session.
  • MSNBC News: Virginia democrats pressure for gun safety
  • CBS News: Senator Cory Booker: Unveils new gun safety plan
Yet, in the news today people like Virginia’s Governor, Ralph Northam, are following the gun control playbook to the letter by exploiting a tragedy to push political agendas.  None of Governor Northam’s gun control proposals would have prevented the horrible tragedy at Virginia Beach.  If he is genuinely interested in pursuing policies that will save lives, he and states around this great nation should focus on the following:
  • Prosecuting violent criminals
  • Fixing our broken mental health system
  • Identifying the real cause of suicide in our school systems
Instead, Gov. Northam, and others like him, blame our country’s law-abiding gun owners for the acts of deranged murderers and people who are truly mentally ill.
Of note,dDepression and suicidal behavior increases 40-60% with vegetarian and vegan diets.  Maybe we should focus on the dangers of dementia, depression, schizophrenia and violence that arises while following a vegetarian or vegan diets.  Until, then keep your hands off my guns and pass the bacon!

What You MUST Know about Total Cholesterol & LDL-C on a Ketogenic Diet

Is following your Total Cholesterol and LDL-C really that important?

You may be quite surprised.

Watch as we discuss the important markers of heart disease and vascular disease risk.  We will talk about how these markers can help you understand what your body is doing in the process of making or reversing atherosclerosis (plaque in the vessels).  And, should you really be taking that STATIN (cholesterol lowering) drug?  Get the scoop here as Dr. Nally very simply points out how the right diet can and will lower your cholesterol without the use of medications.

Research in the last 10 years points to the small-dense LDL particle as the atherogenic component of cholesterol (Hoogeveen RC et al., Arterioscler Thoromb Vasc Biol, 2014 May; Ivanova EA et al., Oxidative Med Cell Longevity, 2017 Apr). Studies in the last five years have identified that elevated small-dense LDL cholesterol correlates much more closely with risk for inflammation, heart disease and vascular disease (Williams PT, et al. Atherosclerosis. 2014 April; 233(2): 713-720.)

Recent research in the last three years demonstrates that small dense LDL cholesterol is a better marker for prediction of cardiovascular disease than total LDL-C (Hoogeveen RC et al., Arterioscler Thromb Vasc Biol. May 2014, 34(5): 1069-1077l; Ivanova EA et al., Oxidative Med Cell Longev. 2017).

Additionally, higher LDL-C is actually predictive of longer life and has been demonstrated to correlate with longevity (Ravnskov U et al., BMJ Open, 2016 Jun 12;6(6): e010401).  And, a low LDL-C actually increases risk of early mortality (Schwartz I et al., Lancet 2001, 358: 351-55).

It is commonly understood that LDL-C will rise with increased saturated fat intake on a ketogenic diet. This has been know and reported in the scientific literature for over twenty years. This is to be expected, because LDL-C is really a measurement of three different LDL sub-particles (“big fluffy, medium, and small dense”). Increased saturated fat intake, while at the same time lowering carbohydrate intake, actually causes a shift in these low density particles to a bigger “fluffier” particle conformation (Griffin BA et al., Clin Sci (Lond), 1999 Sep).
The 2015 British Medical Journal, referenced above, analyzed the relevant 19 peer reviewed medical articles that included over 68,000 participants. This review showed that there is no association of high LDL-C with mortality (meaning that an elevated LDL-C does not lead to an increased risk of death from heart or vascular disease). I realize that, in stark opposition to the landmark review above, The American Heart Association’s Presidential Advisory published their position in the June 20, 2017 issue of Circulation. They stated that saturated fat is the cause of increased LDL-C and they further extrapolated that elevated LDL-C is associated with an increase in death by cardiovascular disease. This boldfaced claim is only based on one single small four year (2009-2013) literature review completed by the World Health Organization with a total of only 2353 participants, most of these studies only lasting 3-5 weeks (not nearly long enough to see fully effective cholesterol changes) and none of which had any focus on carbohydrate intake, insulin levels or LDL sub-particle measurement (Mensink RP, Geneva: WHO Library Cataloguing-in-Publication Data, 2016).

Based upon the most current scientific evidence above and my clinical experience, the large body of evidence above demonstrates the use of total cholesterol and LDL-C to determine vascular disease risk to be ineffective tools. A low carbohydrate/ketogenic diet lowers small dense LDL cholesterol, triglycerides and blood sugar and in many cases, the use of cholesterol drug (STATIN) therapy is not needed and ineffective in comparison with a ketogenic/carbohydrate restricted lifestyle.

 

All About Fat on a Ketogenic Diet (Can You Eat Too Much Fat?)

Catch my new video. I go into depth regarding why the type of fat you eat is very important on a ketogenic lifestyle. I reviews the effects of short, medium and long chain fats and how they are absorbed and used. We talk about starting a ketogenic diet and answer multiple viewer questions. Check it out!

 

Did you know . . . ?

Rice is rice.  Potato is a carbohydrate that will halt your weight loss and please do not bring me a bagle.

And, NO, I did not just give you permission to go eat a jelly donut!!

You’d be amazed at how many people don’t realized the carbohydrate content (sugar equivalents) of various foods that we’ve been told are “good for us.”  Check out my youtube.com video here on eight steps to getting started with a ketogenic lifestyle.

Now you know!

Dr. Nally’s Favorite Low-Carb Peanut Butter Bars

My son was craving Reese’s Peanut Butter Eggs during the Easter holiday.  My wife came up with these peanut butter bars and I think this is now one of my favorite low-carb treats.   Be aware, you have to restrict portion sizes.  Too much peanut butter and peanut flour can kick me out of ketosis.  But if you are looking for something to satisfy a craving, this will do it and you can still maintain ketosis with two servings.

 

Peanut Butter Bar Recipe: 

Peanut Butter Bar Base
1/2 cup butter
3/4 cup Confectioner’s Swerve
1 tsp liquid sucralose
1 cup peanut butter
1 scoop Iso-100 vanilla protein powder
1/2 cup peanut flour
Stir in all ingredients into pan on medium heat on stove-top. Once mixed, press onto half-sized cookie sheet. (caution it is hot)
Chocolate Topping
4 oz unsweetened baking chocolate
1/2 cup cream
3/4 cup Confectioner’s Swerve
1 tsp liquid sucralose
1/2 tsp vanilla.
Wisc together in pan on medium heat.  Once mixed, pour over the peanut butter bar base in the cookie sheet.
Refrigerate until solid.
One serving is approximately a 2 inch x 2 inch square.
Enjoy.
Salt #DocMuscles

Why Salt is So Important on a Ketogenic Diet?

The most common complaint that I get in my office when someone has started a ketogenic diet is, “Doc, I feel fatigued. Will this ever go away?”

That feeling of fatigue, some refer to as the “keto-flu,” is usually due to a couple of things.  First, you may not be eating enough fat (I recommend a 1 gram to 1 gram ratio of protein to fat when getting started). Second, you’re not taking in enough salt (specifically sodium, potassium, magnesium and/or zinc).  These four salts are essential electrolytes our body requires for proper function.

If salt is the problem, the you will be experiencing leg cramps.  Cramps during daytime activity are usually due to low sodium or potassium levels. Cramps that wake you up at night are usually due to low magnesium or zinc.  Leg cramps can also be due to hypothyroidism or significant blood sugar swings. Dr. Nally will usually check for this during your visit with him.

“But isn’t too much salt bad for you?” I am frequently asked.

Too much salt is only bad for you if you’re eating a “low-fat” diet.

What if increasing salt intake actually lowered your blood pressure?

Did you know that increasing your salt intake can actually improve your diabetic blood sugar if you are following a correct diet?  Could it be that easy?

Almost every patient that I see in the office has a significant worry about salt intake, some greater than others. In fact, some people are so fearful about salt that when I initially began encouraging its use, they told me that I was crazy, and they left my practice.

Has restricting salt over the last 50 years really worked, or is it doing more damage than we think?

That was the question that was asked by Dr. Ames in the American Journal of Hypertension 17 years ago.  However, his answer never got a mention.  In fact, I’ve been in practice for almost 20 years, and incidentally stumbled upon this article when it was mentioned by a colleague of mine.   Granted, the study is a small sample size of people, only twenty-one.  However, the results are profound.

Twenty-one patients with hypertension were randomized to periods of no salt (placebo) and periods of 2 grams (2000 mg) of sodium chloride four times a day (a total of 8 grams of salt per day).  Glucose tolerance tests were completed with insulin levels at the end of each intervention period.

Insulin Resistance and Hypertension Improve by Adding Salt

Three very noteworthy results happened. First, those patients with insulin resistance and diabetes had improvement in their glucose levels while on 2 grams of sodium supplementation.

Second, those with hypertension also, shockingly, showed improvement in their blood pressure while on the 2 grams of sodium supplementation.

Third, those with insulin resistance had a lowering of their insulin levels during the period of increased sodium intake.  These findings fly in the face of the dogma that’s been drilled into our heads that “salt is bad!”

“But, Dr. Nally, you can’t base your findings on a small group of 21 people,” the experts say.

Yes, it is a small study group.  However, these findings are identical to what I, also, see clinically every day in my practice for over 20 years.

We know that the average human needs at a minimum 3 grams of sodium per day and 3 grams of potassium per day.  The standard American diet (SAD diet) including processed foods contains 2-3 grams per day of sodium and potassium.  In fact, the CDC claims the worst salt containing meals for you are:

  • Bread
  • Processed chicken dinners
  • Pizza
  • Pasta

Insulin also stimulates additional retention of sodium at the kidney level.  If you are insulin resistant, producing excess insulin in response to starches or sugars, you retain notably larger amounts of salt when eating the standard American diet (SAD diet) or a “low-fat” diet.  However, if your following a low-carbohydrate or ketogenic lifestyle, you won’t be eating the meals above and you’re probably not getting near enough salt.

Salts, or electrolytes, are essential in normal cellular function.  Low salt in the body is like running your car without oil.  It will run, but not very efficiently and over the long term will cause problems. This is the cause of the keto-flu I wrote about previously.  And, according to the study above, it is a potential driver of our persisting insulin resistance, diabetes and hypertension.

How Much Salt Should I Use?

In my office, I encourage use of 3-4 grams of sodium and 3-4 grams of potassium daily when using a ketogenic lifestyle.  That’s approximately 1 ½ – 2 teaspoons of salt per day.  I like the Redmond’s RealSalt or pink Himalayan salt because these products contains all four types of salt (sodium, potassium, magnesium and zinc).

It is probably that your salt restrictions is making your insulin resistance and blood pressure worse.  That’s what the clinical evidences are pointing toward, and it is what I see every day in my office.

Want to know more about a ketogenic life-style?  Click the KetoLife link to get some basics.

If you’re already following a ketogenic lifestyle, then let me help you navigate the bumps and turns by going to the KetoKart and checking out the products I recommend to jump-start ketosis DocMuscles-style!

Until then, I’ll have another piece of bacon, please . . . and, oh, pass the salt!

Character, Judgement & Health

With the recent escalating volatility of events in the news, the vitriolic comments that are ever present on social media, and people’s deep seated feelings and convictions on the political stage, I’ve been thinking a great deal about our individual responsiblities for making judgements, our obligations in society to stand upon our convictions and the effect of this upon our health.  Comments about my convictions or opinions that I have made online and/or via social media have at times been polarizing for a number of people.

In attempting to ground myself in regards to my positions and feelings, I came across an essay in William George Jordan’s book, The Crown of Individuality, published in 1909.   The text, over 100 years old, is some of the most profound wisdom I’ve read in understanding our character and the use of judgement.

William George Jordan

Part of our health comes from mental and emotional stability.  I have found, in my 25 years of providing patient care, that many good people in society still lack competant ability to know how and when to make judgements.  This leads to significant stress, anxiety, and insomnia in many peoples lives.  In the long term , it effects one’s character and it effects one’s health.

Fourty percent of what I do every day relates to psychiatry and the effect of thought, decision and action upon our lives.  Often, just defining where and when judgement becomes essential can be very helpful.  William George Jordan was editor of The Saturday Night Post (1888-1889) and The Ladies Home Journal until 1891.  He was a prolific author and his comments regarding character and judgement are fitting for a read, especially on a Sunday afternoon. So, what follows is Mr. Jordan’s essay in its entirety:

“Sitting in the Seat of Judgement” by William George Jordan

Character is not a simple, uniform product. It cannot be judged as dress goods—by a yard or so of sample unrolled from a bolt on the counter. It is complex, confused, uncertain, changing, subject to moods that contradict our conclusions. While knowing all this we dare to construct the whole life and character of one we may have never even met. We build it from a few hints, slurs, idle comments, or the vague rumors or absolute lies of newspaper reports—as scientists reconstruct an unknown prehistoric animal from a few bones. One judges a painting by the full view of the whole canvas; separate isolated square inches of color are meaningless. Yet we dare to judge our fellow man by single acts and words, misleading glimpses, and deceptive moments of special strain. From these we magnify a mood into a character and an episode into a life.

There is entirely too much human judging, too much flippant criticism of the acts of others. Suspicion is permitted to displace evidence, cheap shrewdness to banish charity, prejudice to masquerade as judgment. We imagine, we guess, we speculate—then pass on through the medium of indiscreet speech and idle gossip what may bring bitterness, sorrow, heartache, and injustice to others. The very ones we condemn may be battling nobly under a hail of trial and temptation where we might fall faint in the trenches or, lowering our colors, drop back in hopeless surrender.

We have a right to our preferences, our likes and dislikes, our impressions, our opinions, but we should withhold final judgment—as an honest unprejudiced juryman keeps his verdict in suspense until he has heard and tested all of the evidence. We have no right to let prejudice tyrannize over judgment and kill—the justice of the soul. We may see an act but have no luminous revelation of the motive behind it.

We idly condemn the gaiety of some man who has suffered a terrible loss, and term him heartless. Perhaps he laughs only to keep back tears that would gush like a torrent from his heart were he less brave. We criticize the parsimony of some one when it really means consecrated generosity to some one else. Over-generous forgiving may seem weakness—when it is the “ninety times nine” of a great nature. Love at its height may seem indifference. What appears conceit may be only some one’s attempt to recover a lost self-confidence he hungers to regain.

Some one’s fretfulness, or occasional outbursts of temper, may be but sparks of protest from the hidden fires of a sad life-story or some bravely borne illness unknown but to a chosen few. Meanness may in reality be poverty too proud to confess itself. We hear one side of many a story and judge by that alone. We judge often along the line of our least mental resistance. Ignorantly we condemn a man for vanity because we would be vain had we accomplished his work. There is wide difference between putting yourself in another’s place and putting him in yours. The one is an attempt at wisdom; the other a speculation in prejudice. We misinterpret motives, do not know facts, and judge from wrong standards.

In the individual life we realize that there are times when everything we do or say misrepresents us. We mean kindness but somehow the words sound cross, cruel, or misleading. Without intending it we hurt those who are dearest; we regret it, know the sad effect we are creating, yet we blunder on into deeper pitfalls. We may be even too falsely proud to explain. We are all out of key. We are tobogganing down the incline of a mood. We may not understand ourselves and in a spirit of heart-hunger may long for some one sweetly and gently to comprehend us, to see us truly, despite—ourselves and our acts.

Knowing this labyrinthic quality in us and even in human nature at its best, let us throw the golden mantle of love and kindness and justice over every thought of condemnation. How can we judge others harshly when we do not know ourselves and while we suffer so much from the misjudging from others? Let us live in the open sunlight of love, shutting our eyes in charity from adverse judging—just forgetting much, forgiving much.

Let us sweetly, sincerely, sympathetically seek in the best side of some one we know—his real, fine, true self. Let us think of the fine flowers and ignore the weeds as temporary invaders. This may prove an inspiration to some one near and dear to us to live up to our ideal of him, to be worthy of the higher levels to which our faith has raised him.

Sometimes situations arise between friends that demand rapid judgment and action. Then should we check off the items carefully, considering truly both sides of the ledger of our experience. Before pronouncing sentence let us see if in our heart of hearts we honestly believe our verdict fair, just, and true. Let us be assured it is justice—not prejudice, pique, temper, disappointment, distorted gossip, or aught else that is eclipsing the justice of our judgment. Our injustice, if such there be, may change bitterly the life of both.

One of the hardest lessons of life is to learn not to judge. Perhaps ninety percent, of the adverse criticism, comment, and judging of humanity is unnecessary and serves no useful purpose. It is not our business. It is simply our mere impertinent meddling in the affairs of others, without even a hope of being helpful or useful. It is often what we would most quickly resent—were the situations reversed.

There are times in every life when we must judge, when we should judge, and when it is vitally important that we should judge wisely and justly. There are those closely associated with us in love, friendship, or business—where it may be important for us to understand their words, their acts, their motives, and their emotions in so far as they affect ours. The very attitude of not judging until it becomes necessary gives ever dignity, calmness, poise, and fineness to these enforced judgments. The judgment that has been dulled by constant misuse, like a razor that has been used to sharpen pencils, is of little value in real need.

The wisest judgment means the best head cooperating with the best heart. It is kind, honest, charitable—seeking truth, not the verifying of a prejudice. It says ever, in prefacing its conclusions on the evidence: “As it seems to me,” “If I understand it aright,” “So far as I have been able to reason it,” “Unless I am mistaken,” or similar phrases. These represent the suspended judgment—with no tone of absolute finality. They show a willingness to modify the verdict, to soften the sentence, or to order a new trial if new evidence, new illumination, or new interpretation can be produced.

Estrogen Dominance – The Dead Man’s Curve on the Road to Ketogenic Happiness

Over the last 18 years of my practice, I’ve seen tremendous success in helping people improve their health when low-carbohydrate dietary changes are anchored as the foundation of treatment.  However, there is still a group of people that struggle with seeing success.  Even with the most effective ketogenic dietary control, there are those that see abnormal weight gain, inability to lose weight, poor libido, fatigue, foggy thinking, mood swings, persisting depression, headaches, bloating, breast tenderness, fibro-cystic breast changes, hair loss, and hot flashes.  They may not experience all these symptoms, however, many are often present.  If you have been following a ketogenic lifestyle and are still experiencing any of these symptoms, you are probably suffering from estrogen dominance.

Estrogen dominance is a condition that elusively effects thousands of women (and men) and your doctor probably doesn’t even know about it.  I didn’t know about it.  I, like all of my physician colleagues, were trained in school that the symptoms above are related to fluctuations of estrogen as a woman ages (or dropping of testosterone as a man ages).  We were, and still are, taught that they are fixed by giving more powerful doses of estrogen or testosterone.

Over the years of my clinical experience, giving more estrogen frequently didn’t work.  And, giving men more testosterone didn’t work either.  What I found very effective, for many, was changing the diet.  And, for about 85% of people, the symptoms list above resolved.  However, the cause of the symptoms above in that last 15% of patients I see was still elusive.  Examinations, blood tests, and even psychological evaluations never revealed the answer.  Giving synthetic estrogen, progestin or testosterone when the blood work showed abnormality partially alleviated some of the symptoms for a few months, but then the patients would end up back in my office with the symptoms having returned.

I’ve found a number of problems following the “standard” medical approach to using synthetic sex hormones.

The first problem is that estrogen, progesterone and testosterone are heavily bound to proteins in the blood. It is only the free component of the three forms of estrogen and progesterone in the body and the free testosterone that acts upon the delicate cells located throughout the body.  Blood testing does not account for the levels of free estrogen forms and progesterone effectively.  These can only be tested through salivary testing.

The second obstacle is that the synthetic forms of progesterone (progestin), cannot effectively enter the brain. When synthetic forms are used, a person only gets half the benefits of progesterone found in the human body.  This is why so many women have depression, anxiety and foggy brain feelings when using the synthetic versions.

The third challenge is that pharmaceutical companies cannot patent a drug that is identical to your human hormones.  The chemical structure of the synthetic estrogen, progestin or testosterone must be slightly different. Hormones effectively work on certain aspects of various cells throughout the body, however, progesterone and progestin (the synthetic version found in medroxyProgesterone) DO NOT have the same hormonal effect on each cell.  Natural progesterone is broken down by the stomach when ingested. That’s why progestin was invented, however, it doesn’t act the same in the body and only does half the job.

The fourth dilema is that much of our food in the standard American Diet stimulates increased estrogen production or inhibits clearance of estrogen excess through the gut and digestive tract.  This happens in men and women.  We can get excess estrogen from animals treated with hormones in meats, milk and dairy products.  Hydrogenated oils in processed foods change the way estrogen and progesterone are handled in the body.  These unstable fats increase the effects of estrogen on the body and amplify the risk for cancers.  Excessive omega-6 fatty acids in the diet magnify estrogen receptor response to estrogen.

Estrogen metabolism in the liver and removal in the gut are dependent on vitamins B & E, magnesium  and idol-3-carbinol (IC3).  Diets without adequate IC3 from glucobrassicin found in leafy green and crucirferous vegetables allow re-uptake of estrogen in the gut leading to high estrogen levels and estrogen dominance.  This is where gut health is even more important, and where I see failure in the “carnivore” approach to a ketogenic lifestyle.

The fifth problem is that the more estrogen I give a person, the more estrogen receptors are unregulated to the surfaces of the cells in the body.  When that happens, more estrogen is required.  Excess estrogen can actually cause many of the same symptoms present in progesterone deficiency including:

  • Irregular or heavy bleeding
  • Breast tenderness
  • Depression
  • Fatigue
  • Poor concentration
  • Fibrocystic breast changes
  • Decreased libido
  • Fibroid growth on the uterus
  • Endometriosis
  • Water retention and bloating
  • Fat gain around hips and thighs
  • Bone mineral loss (osteoporosis)
  • Hair loss
  • Skin thinning
  • Disturbed sleep
  • Breast and uterine cancer

More estrogen isn’t needed. Balancing natural progesterone with the current estrogen the body is already making is the solution in most cases.  This can only be effectively assessed through a salivary hormone test.

In my clinical experience, a ketogenic lifestyle is foundational to balancing these hormones consistently and naturally.  Carbohydrate restriction by itself corrects many of the diseases of civilization.  I addressed this in my book The Keto Cure.  For many, there are few more steps necessary to living a long, happy and healthy life.

The treatment to this issue isn’t difficult.  For that reason, much more is to come on this subject.  I will address each of the points above in future blogs. However, the first step is get your hormones checked by someone who understand this problem.  And, then knows how to interpret it and treat it.

The Shovel will Fail You in Obesity, Finances & Life

A few years ago, my family and I set out to build a pond.

I have always loved Koi and the serenity of a Koi pond in my own back yard was very enticing. I spent about a year planning my design and the location.  I dreamed of a serene evening after a very long, hectic day seeing patients relaxing beside the pond.  The sound of trickling water, the occasional splash from fish, the cool breeze passing over the mist from a water-fall would sooth my soul after a busy day in the office.

I envisioned the perfect area.  An unused access path, previously worn by the previous owner with truck and trailer traffic, beside my now expanded patio. Twenty feet wide, thirty feet long and four feet deep. . . that seems just perfect.

I pulled out my shovel and set about digging. Eager to begin and filled with the energy of the final product, I set to digging.  What could be so hard about digging my own pond?  Think of the exercise I will be getting.  Thoughts spurred me on.

Minutes later, chest heaving, face glistening with sweat, I stared in dismay at the ground. All I had to show for my wild digging was a small 1/2 inch dent in the dusty Arizona top soil.

Sonoran Clay

Over time, calcium-carbonate, along with other minerals, accumulates and dissolves into the topsoil of the very arid regions of Arizona Sonoran Desert.  It forms a two to three-foot layer of soil called “caliche.” Periodic rains carry the calcium as far as three feet down into the soil, then the water rapidly evaporates in the blistering Arizona heat.  This often forms two to three feet of soil that is “literally” harder than concrete.

With tremendous zeal, a great deal of sweat and a round of painful blisters, I broke my third shovel on this impenetrable ground.  I realized this was much more difficult than I thought.  I pulled out the back-hoe attachment for my small farm tractor.  After a few hours and few gallons of diesel fuel later, still very little progress occurred.

Multiple weekends and evenings of digging in the Arizona caliche left me with three broken shovels, a ruptured hydrolic line in my tractor, anger that my expensive back-hoe attachment didn’t work, and only a small dent in the ground near my patio.  Even the brute force from the tractor would not budge the clay.  I wondered if dynamite would be effective?  (My wife would have none of this idea).

With my exuberance quashed, I concluded that this would require much more measured exhuming.

Escape From the Prison

We often imagine, with great delight, the removal or destruction of that which enslaves or imprisons us.  We dream that just a little sweat, exertion of a few shovel scoops of dirt and the foundation to our prison of obesity, addiction, debt, and depression are exposed.  A few extra scoops and we imagine freedom from that prison cell.

If only I had a jack hammer and a bigger, more powerful scoop, I imagine . . . I could make short work of these manacles that bind me.

But, our manacles and prison cells do not so easily give way.

The failings of our sharpened spades and powerful back-hoes form a new, even stronger fetter – the belief that our prison cell is unbreakable, that our challenge is just too great. These failings usually leave a person cured of any further desire to break free.  It quashs the dream and solidifying the depression of stagnation.

The in-fecundity of my shovel, no matter the strength and effort put behind it, was not cause to quit.  It was life’s lesson that prisons and shackles often only need a simple tool.

Enter the pick-axe.  During this process my wife said, “Honey, why don’t you use the pick in the garage?”

“If my shovel and the back-hoe didn’t work, there was no way I was going to break through this clay with a pick axe.” That was absurd, I thought.

Yet when I humbled myself to try, it was simple.  The pick-axe was unpretentious.  This simple tool allowed for an almost effortless stroke to a small area of weakness in the caliche.  A large flake of soil would pop free with each stroke. The process was repeated.

Scale by scale, the dragon’s flank was exposed. Careful work of the pick-axe began to loosen layer after layer, section after section, pellicle after pellicle.  Yes, it was slow work. But, each swing was a small victory.

At each little victory, my heart would leap, the dream would become ever clearer.

Working this magic again and again until finally the specter was weakened enough to pull out the shovel.  And, further work, allowed for bringing back the powerful back-hoe, in gratifying scoops.

The excavation that I thought would take two months took me fourteen.  But, it was gratifying.

I learned a powerful lesson. Wherever life has pinned you, fettered you or barred you in, put down the shovel, and pick up the pick-axe.  Second, if you really listen, your spouse may point out the tool you really need. Don’t be afraid to chip away at it a piece at a time.

Finances

Stop waiting for the sharper shovel or the bigger back-hoe to dig yourself out of your harrowing debt, mega mortgage, or your income dwarfing spending. The jackpot or financial windfall won’t come. While others await the jackpot, put down your shovel and shoulder your pick-axe.

  1. Pick one small debt and begin to pick at it by applying just a little extra each month until it is gone.
  2. Cancel your extra cable, sell the motorcycle and payoff the 21% interest credit card.
  3. If you must, pick up a side-hustle for extra to sharpen the pick.

Once you’ve lifted one flake, chip away at the next. Making progress will make it easier to continue.  It doesn’t matter how long it takes, just keep at it.

Marriage

You long for resolution of the apathy, progressive resentment and mutual stalemate that permeates your relationship.  You look in vain for the bigger shovel that will uncover the treasure that years of apathy have buried. You long to uncover your dreams and needs that have been covered and hardened under the clay of resentment.  The shovel and the back-hoe won’t help you here.

Drop the shovel.  Shoulder your pick-axe.

  1. Kiss your wife every time you leave, even if it’s just for a ten minutes to run to the convenience store.
  2. Hold her for five seconds longer every time you hug.
  3. Find a gift you can give her once a week, just because.
  4. Put down your phone and look her in the eyes when she talks to you and listen. Really listen and the flakes of hard clay will unveil the beauty of her soul.
  5. Find a way to praise her every day, even if it is through a simple text.

Health

You long to rid yourself of your addiction to sugar, bread, stress, and sleep deprivation.  You’ve tried to scoop them out of your life.  You even hired a trainer with some muscle to force you to change.  You’ve tried in vain to save yourself from yourself.

Trying to use the shovel here is like trying to use the shovel on steel forged walls of your life’s prison fortress.  Forget the shovel.  Shoulder your pick-axe.

  1. Start with one meal and make some substitutions.  My dietary plan can help you with this.
  2. Go to bed an hour earlier. Really, you’ll be surprised that the focus you have will more than compensate for the hour of lost time in the evening.
  3. Add a quality vitamin to your morning routine.
  4. Take ten minutes and do 20 push-ups and 20 sit-ups, then take a 10-minute walk.
  5. Simply remove the “white stuff” from your meals. You will be amazed at the results.
  6. Put down your phone for 30 minutes and read that book you’ve been meaning to read, instead of surfing Facebook.

Grand-standing with your back-hoe doesn’t help you.  Just swing the pick-axe once or twice.  Simple daily picking with the sharp point weakens the hardest of ground and the prison walls in our lives.  It takes time, so be patient.

Find the weak point, apply the pick.  Day by day, little by little you will be free.

I’ve been there.  I’m with you.  Keep me posted on your journey.

If you’re looking for a program that teaches you how to do this, check out my membership site.

Will A Low-Carbohydrate Diet Kill You?

Will a ketogenic diet or very low carbohydrate diet kill you? Will it increase your likelyhood of death?  That’s what the media and the dietary world is saying this week. Is it really true? How do you know? That’s the question that I ponder as I smoke my brisket while reading the headlines this week.

My inbox has exploded with patients and acquaintances suddenly worried that my very low-carb lifestyle is bad. This all revolves around the publishing of a study in the Lancet this week, and the interpretative spin that has been placed on it by “those in the know.”  To quote one of the NHS dietitians, Catherine Collins, RD FBDA, “In summary, this paper will disappoint those who, from professional experience, will continue to defend their low-carb cult, but contributes to the overwhelming body of evidence that supports a balanced approach to calorie intake recommended globally by public health bodies.” Either she didn’t actually read the paper, or she clearly doesn’t understand the low-carbohydrate/ketogenic dietary world. Before you go throwing out your bacon, turning off my smoker and buying bags of rice, let’s talk about some principles that seem to be completely misunderstood by the “low-fat, calorie restricting” nutritional aristocracy.

Ketogenic Diets are Powerfully Effective

First, ketogenic diets are powerfully effective. They are effective in weight loss, reduction of blood sugar, reversal of diabetes, decreasing cardiovascular risk and reduction in blood pressure. These are just a few of the powerful effects of a ketogenic lifestyle. (I wrote a whole book on the 16 different diseases dramatically improved by carbohydrate restriction.) It’s why I’ve been using carbohydrate restriction for over 14 years both personally and in my clinical practice. 85% of the people in my practice don’t respond effectively to anything other than carbohydrate restriction. This is because their insulin levels are 2-20 times normal.  The question the Lancet should be asking is “why do 85% of people fail calorie restriction?”  But, that is for another article.

Few Diets Keep the Weight Off Long-Term

Does the ketogenic diet keep weight off in the long term?  All diets seem to fail in this regard, even the ketogenic diet will show rebounding of weight after 1-2 years.  Yes, I hate to be the bearer of sour news, but as an obesity specialist, this is what I do for a living.  The Lancet article implies that the low-carb diet is singular in the issue of weight rebound, but that is not the case. The only diet I have found to effectively keep the weight off long-term is a ketogenic diet, combined with pulsed eating and the correct type of physical activity.

Definition of a Very Low-Carbohydrate Diet

Third, commentary, and the researchers themselves, extrapolate that based on the results, very low carbohydrate diets increase the risk of mortality.  However, this study wasn’t even “low-carb.”  It was Paleolithic at best.  The lowest calorie intake group was just under 1600 kcal per day and the carbohydrate restriction was only 120 grams per day.  A low-carb diet is defined as less than 100 grams per day. A very low-carbohydrate diet is defined as less than 50 grams per day, and a ketogenic diet is defined as less than 20 grams per day.  This study and the cohort studies involved in it weren’t even low-carb!!!

Only Two Data Gathering Points in 25 Years?

Fourth, although people were followed for 25 years, there were only two data gathering points consisting of 66 questions spaced 5-7 years apart asking the 15,428 participants to “remember what they ate” over previous 3-5-year intervals.  Seriously?!  I can barely remember what I ate last week and I take pictures of my food and journal my meals frequently. How can you publish an article with only two data collection points over 25 years?  And, how can extrapolated data over 25 years be accepted as valid in a premier medical journal?  It is beyond my understanding.

You Gotta Lower Insulin to Reduce Mortality

Fifth, insulin must be lowered to a “baseline level.” Increasing fat intake in the presence of abnormally elevated insulin will actually increase risk of cardiovascular disease, peripheral vascular disease, diabetes, hypertension, gout, kidney stones, and death by multiple causes. This cohort of people only partially lowered carbohydrate intake, and raised fat and or protein intake.  Those of us who’ve been treating obesity and practicing in the trenches are well aware that if you don’t bring the insulin levels under control, raising fat and protein is just a ticking time bomb.  Of course, the all-cause mortality went up in this group.  I’d expect nothing less.  This is what I saw with a large portion of my Paleolithic dietary patients.

This is also why caloric restriction doesn’t work. These participants had average calorie restriction of 1600-1800 kcal per day.  Yet their risk for all-cause mortality (death by all causes) increased.

Weight Gain Continued

Sixth, all of the groups continued to gain weight.  Body mass index increased by almost a full point ever 6 years.  Carbohydrates were NOT restricted enough to be effective.  It also, demonstrates another example of calorie restriction failure in 15,000 plus people.

That’s what I’d call successful – not really!

Smokers Not Excluded

To make matters worse, 60-70% of the population were smokers or former smokers and this study did not specifically eliminate this as a risk factor for all-cause mortality. We know that smoking dramatically increases risk of heart disease, peripheral vascular disease, hypertension, stroke, lung cancer, chronic obstructive pulmonary disease, etc. The contribution of tobacco in this cohort was not adequately isolated.

Follow the Money

Lastly, I’ve learned that when you look closely at research, it is very important to follow the money. The National Institutes of Health funded the study. They openly state that a healthy eating plan “emphasizes vegetables, fruits, whole grains, and fat-free products.”  Their position falls right in line with the WHO Millennium Development Goals established at the United Nation’s Sustainable Development Conference in 2000 and reconfirmed in September, 2015.

The World Health Organization has developed sixteen goals as their “Call to Arms.” Goals 12 and 13 specifically discuss “ensuring sustainable food consumption patterns throughout the world.” These goals specifically outline a transformational vision of the world.  This will occur by “doubling agricultural growth” and restricting food production that worsens the “carbon footprint.”

Really?!

Over the last ten years, multiple progressive groups and sites have made the claim that the greatest threat to Climate Change is the cattle industry.  They link cattle, livestock and our consumption of red meats to global warming and have been preaching the politics of nutrition.  They claim that the only real way to stop climate change and global warming is to “eat less red meat and dairy products.”

Low-carbohydrate and ketogenic diets are a threat to this transformational vision.  Because of this, we will likely see more and more scientific research used as propaganda, let’s call it what it is, to sway the general populous in their buying and eating patterns.

So, if you’ll excuse me, my smoked brisket is ready to pull off the smoker. . .

Is Keto For Everyone? Dr. Nally’s Three Principles of Health

Is a Ketogenic Lifestyle What Everyone Needs?

“Do I really need to be doing that ‘Keto Thing’?”

I get asked this question all the time.  And, my answer is that 85% of the people that walk through the doors of my clinic will not be fully successful in weight loss, reversal of diabetes, normalization of blood pressure and reversal of heart disease and/or vascular disease without it.

I am frequently asked, “Is Keto for everyone?”  Does everyone need to follow a ketogenic lifestyle?  The answer is “No.”  15% of the population will be able to maintain great health with calorie restriction and exercise.  However, the principles that provide a successful ketogenic lifestyle are easily understood and incorporated by anyone looking for improved health, energy and weight control.

Principle #1 – Insulin is the Master Hormone

Insulin is the master hormone when it comes to weight loss and the diseases of civilization. Whether you are insulin resistant or not, insulin is essential for life and proper function of the cells of the body, but too much insulin production in response to sugars, starches or complex carbohydrates causes disease.

How do you know if you are insulin resistant (producing too much insulin)?

Skin tags are pathognomonic (a characteristic indicative of the presence of disease) for insulin resistance. If you have skin tags, you may want to focus your diet on increased carbohydrate restriction.

You may not need to completely remove carbohydrate from your diet, however, recognizing that not all carbohydrates are created equal and avoiding those with higher carbohydrate content will help many improve weight and halt the progression of disease. I have many patients that with just partial carbohydrate restriction they are able to lose 20-30 lbs, improve their cholesterol profiles and improve their blood pressure.

There are sixteen different diseases that respond very effectively to carbohydrate restriction.  You can read about them and how the ketogenic lifestyle effectively reverses them in The Keto Cure.

Principle #2 – Saturated Fat & Cholesterol Aren’t the Demons We’ve Made Them Out to Be

Saturated Fat and cholesterol aren’t the demons we’ve made them out to be. Another way to put it is: “Don’t blame the butter for what the bread did.”

Since 1984, nutrition experts treat fat and cholesterol containing foods like the witches of Salem.  Experts castigate their use as if they were the “Avada Kedavra“ curse of the fantasy world.

As an example, eggs, specifically the egg yolk (the part of the egg containing all the cholesterol and saturated fat), have been demonized by just about every health magazine I’ve ever read. (To this day, the chef at every breakfast bar I’ve ever visited asks if I want an ‘egg white only’ omelet.) Interestingly, there is actually no scientific data association between whole egg consumption and heart disease. The science simply does not exist. Seriously, check for yourself.

I personally eat 6-8 eggs a day and my cholesterol is perfect. Back 1000 years ago, only the aristocrats at the chickens.  All laborers and serfs ate the eggs . . . who would be dumb enough to eat your food source? (Don’t answer that.)

For example, the MR-FIT study, the largest cholesterol study ever completed, is incessantly quoted as the study that demonstrates reduction in cholesterol leads to reduction in cardiovascular disease, but this trial was actually a failure and did not demonstrate improved risk by lowering cholesterol. In fact, the Director of the study, Dr. William Castelli stated, “. . . the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower people’s serum cholesterol…”

Researchers found that people who ate the most cholesterol, including the most saturated fat, weighed the least. They were also the most physically active. In fact, the British Medical Journal published a 2015 study demonstrating that saturated fat is NOT linked to vascular disease, diabetes or increased mortality (de Souza RJ et al., BMJ 2015,351:h3978).

In my clinic, the basis of appetite suppression is eating adequate protein that includes saturated fat and cholesterol. This is the most powerful tool in my clinical approach to the treatment of weight loss.  I can use foods like red meat, bacon, butter and coconut oil without concern or worry of heart disease as long as you are keeping your carbohydrate intake less than 20 grams per day.

Baseline insulin levels allow for peace of mind about heart disease risk. Heart disease risk goes down when insulin levels are maintained at normal baseline levels. Increasing saturated fat, while at the same time lowering carbohydrate intake has been demonstrated to shift the cholesterol to a more heart protective form (Griffin BA et al., Clin Sci [Lond], 1999 Sep).

Principle #3 – Nutritional Ketosis Has Anti-Inflammatory & Age Slowing Effects On the Body

Ketones in the blood at a nutritional level (0.5-4 mmol/L) have tremendous anti-inflammatory and age slowing effects on the body.  Even having them present intermittently has dramatic improvement on overall inflammatory changes and disease in the body.

Ketones are the usable fuel of the body when the liver breaks down fat for energy. They suppress the NLRP3 inflammasome in every cell in the body. This is important because it allows for more rapid recovery from exercise. It also dramatically decreases pain and fatigue that comes from diseases like arthritis, rheumatoid arthritis, multiple sclerosis and auto-immune disease (Y.H. Youm, et al., Nature Medicine, vol. 21, no. 3, pp. 263–269, 2015.)

If full blown ketosis isn’t for you, partially restrict starch and carbohydrates for a mild to moderate benefit.  Even small amounts of ketones in the blood are helpful.  This provides increased recovery time, and improved inflammation control.

So, even if you don’t follow a strict ketogenic lifestyle, the principles above are powerful.  These three principles make this dietary approach universally effective for weight loss.  They are also very powerful for disease management.  Even partial application of carbohydrate restriction can benefit just about everyone.

You can learn much much more about the Ketogenic Lifestyle as a member of DocMuscles.com.  Click the link and sign up now.

And, don’t forget to get your signed copy of my book, The Keto Cure.

Ketogenic Weight Loss Class

I’ve opened up my ketogenic weight loss class to the public.  Come and join us if you are struggling to lose weight. Many people are struggling to understand how a ketogenic diet works, or finding confusion with all of the different “experts” teaching people to live a ketogenic lifestyle.

Come join me this Friday, and lets put you on a course for success.

What Blood Tests are Important In a Ketogenic Lifestyle?

So, you’ve started a ketogenic lifestyle and you’re a few months in . . . but, is it really working? How do you know? You should be seeing your waist shrink. But, is all that butter really good for my cholesterol? What about my blood tests?

I commonly get these questions over the last 12-13 years of using a low-carbohydrate or ketogenic lifestyle approach in the treatment of obesity, diabetes, cholesterol and high blood pressure. We can determine the effectiveness of the diet on your metabolism with some simple blood testing.

What Lab Tests Do You Need?

Watch the video below to find out what tests are right for you:

Why don’t you check all the other inflammatory markers like HS-CRP, Lp(a), etc?  Because, I know that these test will be elevated if insulin is > 5 mmol/L and if sdLDL particle is > 500 nmol/L.

Check out our membership site and the benefits that come with it.