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I Can’t Do Keto Because . . .

I hear this all the time.  “I can’t eat keto because. . . ”

What is your excuse?

I am amazed at how tightly people cling to these excuses. They are just that excuses.  In the 16 years I’ve been training people how to use these diets to treat disease, I have yet to find one that is not just an excuse that covers up the real reason . . .

Check out my video on this:

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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.

Why Ketosis is the Best Gift A Father Can Get for Father's Day

I’m sitting here at my home-office desk, on this beautifully hot 118° Arizona afternoon, eating this luscious piece of ketogenic Key-Lime & Blue-Berry Cheese Cake that my wife made for Father’s Day . . . pondering all the reasons ketosis has been a blessing in my life, specifically as a father.  As I sit, reason after reason popped into my mind.

KeyLimeBlueBerryCheeseCake
Tiffini’s Luscious Low-Carb Key-Lime & Blue-Berry Cheese Cake

“Hmmm, I should share these . . . Why aren’t you sharing them?” I mused.  So, with the the sweet tart of blue-berry on my palate and with a wipe of whipped cream from the corner of my lip, my fingers begin to click away on the keyboard.

What makes a person a father?

Testosterone

Well, first, . . . Testosterone. I know. Leave it to a man to start with testosterone, but in the big picture, a man really isn’t a man if he doesn’t have a little extra testosterone, right?  I mean, it was during the 5th week of embryonic development that my Y chromosome began signaling the differentiation of male fetal growth in-utero.  And like every male, that same hormone testosterone continues to differentiate me from the human female counterpart throughout life.

Low testosterone has become a significant issue.  20-30% of the men in my practice suffer from some degree of suppression in testosterone when they first present in my office.   In fact, you can’t watch late night TV any longer without being asked the question about low testosterone (Low ‘T’).

We know that the primary nutrient shown to affect testosterone to the greatest extent is fat. Studies reveal that diets low in fat are associated with lower testosterone compared to diets high in fat (1, 2).  That begs the question, has 50 years of low fat diets made us less manly?

 

Symbolsofmanhood

When did this become acceptable?  And, does our diet of low fat have anything to do with it?  I actually think it plays a role.

Menthenandnow2

Testosterone is essential in providing energy, muscle mass & growth and actually keeping the waistline down. Adequate testosterone is one of the key components allowing the man to fill the father’s rolls of protector and provider, and if your diet doesn’t help stimulate its production, your less inclined to perform well in areas requiring its presence.  That means that the bacon and eggs you crave in the morning lends toward your manliness, and the bagel and orange juice may be a little feminizing.

Fathers Need Muscles

Second, father’s need muscles for all sorts of important things.  It’s often Dad who carries the child on his shoulders, or lifts you above his head.  It takes muscles for that.

father_child

We talked about the importance of testosterone in muscle development.  That that’s not all.  Many fathers can provide for their families specifically because of their ability to use that muscle.  That’s not saying women can’t use muscle, too.  I’m saying that a number of jobs that make our country function that require fitness, strength and muscle, like police, firefighters, construction, life-guards & delivery drivers.  These jobs require muscle.

Fathersdaybabycarry

We now know that ketones, the primary fuel in a ketogenic diet, restrain muscle breakdown by decreasing leucine oxidation and preserving muscle mass (3).   So, yes, visiting the donut shop actually does make you less manly by allowing the more rapid degradation of your muscles.

“Wasn’t it my muscles that first got your attention when we met and got this whole father thing started in the first place, honey?” I asked my wife in the kitchen.

“What?! No . . .” she responded.

“Oh, . . . never mind.”

Energy

Whether you have great muscles or not, you need energy for the muscles you have to fill your role as a father.  Work requires energy.  As fat is increasingly used as fuel instead of sugar, the liver breaks it down and produces ketone bodies, or ketones.  The liver itself, doesn’t use the ketones, so they are taken up by the muscles and brain for fuel.  Increased energy, mental clarity and suppression of inflammation are the key findings that are noticed while using fat as your primary fuel.  What father couldn’t us a little more of that?

KetoOSPacks

In fact, several studies report that fathers have the biggest impact on the overall fitness and on the overall weight of their children. It was found that the father’s, not the mother’s, total and percentage body fat was the best predictor of whether or not the couple’s daughters gained weight as they got older (4).  All the more reason to keep your waistline under control, Dad.

Another fascinating study showed fathers’ (again, not the mothers’) body mass index is directly related to a child’s activity level (5).

Energy and muscle is essential for “rough housing” and there is science to prove that “rough housing” makes your kids awesome!  Psychologist Anthony Pellegrini, in the book The Art of Roughhousing, has found that the amount of roughhousing children engage in predicts their achievement in first grade better than their kindergarten test scores do. What is it about rough and tumble play that makes kids smarter? Well, a couple things.

roughhousing1

Roughhousing makes your kids more resilient and resilience is a key in developing children’s intelligence. Resilient kids tend to see failure more as a challenge to overcome rather than an event that defines them.  Intellectual resilience that comes from energetic fathers helps ensure your children bounce back from bad grades and gives them the grit to keep trying until they’ve mastered a topic.

Intelligence for You and Your Family

Neuroscientists studying animal and human brains have found that bouts of rough-and-tumble play increase the brain’s level of a chemical called brain-derived neurotrophic factor (BDNF). BDNF helps increase neuron growth in the parts of the brain responsible for memory, logic, social intelligence and higher learning–skills necessary for academic success.  We,also, now know that the brain that uses fat, or ketones, as it’s primary fuel recovers from injury and makes BDNF more effectively (6,7).

That rib-eye with steak butter your kids gave you for dinner is actually making you and them smarter and more resilient.

Overall Happiness

The Harvard Grant Study completed in 1934, the longest longitudinal study ever done on the lives of men, found that a man’s father influenced his life in multiple ways exclusive to his relationship with his mother. Loving fathers imparted to their sons:

  • Enhanced capacity to play
  • Greater enjoyment of vacations
  • Increased likelihood of being able to use humor as a healthy coping mechanism
  • Better adjustment to, and contentment with, life after retirement
  • Less anxiety and fewer physical and mental symptoms under stress in young adulthood

It should be noted that “it was not the men with poor mothering but the ones with poor fathering who were significantly more likely to have poor marriages over their lifetimes.” Men who lacked a positive relationship with their fathers were also “much more likely to call themselves pessimists and to report having trouble letting others get close” (8).

You, as a father, matter.  And, being in ketosis makes you an even better father! Seriously.

 

J Nally & Robert Nally

When all is said and done, a man’s relationship with his father very significantly predicted his overall life satisfaction at age 75 — “a variable not even suggestively associated with the maternal relationship” (8).

So, back to my key-lime blue-berry cheese cake, my wife just made me a better husband and father.  Thanks, Dear!!

References:

  1. Hamalainen, E., H. Aldercreutz, P. Puska, and P. Pietinen. Diet and serum sex hormones in healthy men. J. Steroid Biochem. 20:459-464, 1984.
  2. Reed, M.J., R.W. Cheng, M. Simmonds, W. Richmond, and V.H.T. James. Dietary Lipids: an additional regulator of plasma levels of sex hormone binding globulin. J. Clin. Endocrin. Metab. 64:1083-1085, 1987.
  3. Nair KS, Welle SL, Halliday D, Cambell RG. Effect of β-hydroxybutyrate on whole-body leucine kinetics and fractional mixed skeletal muscle protein synthesis in humans. J Clin Invest. 1988;82:198–205.
  4. Figueroa-Colon R, Arani RB, Goran MI, Weinsier RL.  Paternal body fat is a longitudinal predictor of changes in body fat in premenarcheal girls. Am J Clin Nutr. 2000 Mar;71(3):829-34.

  5. Finn, Kevin et al. Factors associated with physical activity in preschool children. J of Ped., Vol 140, Issue 1, 81-85

  6. Vizuete AF1, de Souza DF, Guerra MC, Batassini C, Dutra MF, Bernardi C, Costa AP, Gonçalves CA. Brain changes in BDNF and S100B induced by ketogenic diets in Wistar rats.  Life Sci. 2013 May 20;92(17-19):923-8.

  7. Masino SA, Rho JM.  Mechanisms of Ketogenic Diet Action.  Jasper’s Basic Mechanisms of the Epilepsies [Internet]. 4th edition. Bethesda (MD): National Center for Biotechnology Information (US); 2012.
  8. Valliant GE. Triumphs of Excellence: The Men of the Harvard Grant Study. 1934

 

Adapt Bars

Ketogenic Lifestyle Rule #3: Be BOLD or Be Italic, but never be Regular: Why Size Matters with Cholesterol


On this evenings PeriScope video we talked about cholesterol.  And, and you can see an updated, in depth discussion about cholesterol on my YouTube channel here.  Please go check it out and if you find it helpful, please follow me here and on YouTube.   The is the burning question on everyone’s mind who starts a Low-Carb, High Fat or Ketogenic Diet: “What will happen to my cholesterol if I lower my carbohydrates and eat more fat?”

The answer . . . it will improve!

How do I know this?  I’m an obesity specialist.  I specialize in FAT or lipids (to put it kinder scientific terms).  To specialize in fat, one must know where it came from, what it’s made of and where it is going. And,  this has been the case with every single patient I have used this dietary change with for the last ten years, myself included.

Lets start with the contents of the standard cholesterol or “Lipid Panel”:

  • Total Cholesterol
  • HDL-C (the calculated number for “good” cholesterol)
  • LDL-C (the calculated number for “bad” cholesterol).
  • Triglycerides

The first problem with this panel is that it makes you believe that there are four different forms of cholesterol.  NOT TRUE!  Actually cholesterol is cholesterol, but it comes in different sizes based on what it’s function is at that moment in time.   Think of cholesterol as a bus.  There are bigger busses and smaller busses.   Second, triglyceride is actually the passenger inside the HDL and the LDL busses.  And third, Total Cholesterol is the sum of the HDL, LDL, as well as ILDL & VLDL which aren’t reported in the “Lipid Panel” above.

The fourth thing that this panel doesn’t tell you is that HDL & LDL are actually made up of sub-types or sub-particles and are further differentiated by weight and size.

Cholesterol Size

For our conversation, we need to know that the number of LDL particles (LDL-P) can actually be measured in four different ways and these measurements have identifed that there are three sub-types: “Big fluffy” large dense LDL, medium dense LDL, and small-dense LDL.  Research has identified that increased numbers of small-dense LDL correlates closely with risk for inflammation, heart disease and vascular disease (1).

Microsoft PowerPoint - ADA Otvos LDL size talk_modified.ppt [Com

If you’ve been a follower of my blog for a while, you’ve seen this picture before. This picture illustrates why an LDL-C (the bad cholesterol measurement) can be misleading. Both sides of the scale reflect an LDL-C of 130 mg./dl. However, the LEFT side is made up of only a few large fluffy LDL particles (this is the person with reduced risk for heart disease) called Pattern A  or a LDL healthy cholesterol level.  Even though the LDL-C is elevate above the recommended level of 100 mg/dl, the patient on the left has much less risk for vascular disease (this is why you CAN’T trust LDL-C as a risk factor).

The RIGHT side of the scale shows that the same 130 mg/dl of LDL-C is made up of man more small dense LDL particles (called “sd LDL-P”) with a Pattern B type that is as increased risk for heart or vascular disease.  This is where the standard Lipid Panel above, fails to identify heart disease and it’s progression.

Research tells us that the small dense LDL particle levels increase as the triglycerides increase.  And we know that Triglyceride levels increase in the presence of higher levels of insulin leading to a cascade of inflammatory changes.  Insulin is directly increased by the ingestion of simple and complex carbohydrates.  Insulin also increases with the ingestion of too much protein.  So, that chicken salad or the oatmeal you ate, thinking it was good for you, actually just raised your cholesterol.   If you are insulin resistant, your cholesterol just increased by 2-10 times the normal level (see my article here on how insulin resistance causes this.)

Adapt Your Life

“Ok, but Dr. Nally, there are four different companies out in the market measuring these fractional forms of cholesterol. Which one should I choose?”

There are actually five different ways you can check your risk.

  1. Apolipoprotein levels.  This can be done through most labs; however, this test doesn’t give you additional information on insulin resistance that the other tests can.
  2. Berkley Heart Lab’s Gradient Gel Electrophoresis – This test gives a differentiation based on particle estimation between Pattern A and Pattern B
  3. Vertical Auto Profile (VAP-II) test by Arthrotec – This test determines predominant LDL size but does not give a quantifiable lipoprotein particle number which I find very useful in monitoring progression of insulin resistance and inflammation.
  4. NMR Spectroscopy from LipoScience – This test measures actual lipoprotein particle number as well as insulin resistance scores and will add the Lp(a) if requested.  I find the NMR to be the most user friendly test and useful clinically in monitoring cholesterol, vascular risk, insulin resistance progression and control of the inflammation caused by diabetes.  This test has the least variation based on collection methods if frozen storage is used.
  5. Ion-Mobility from Quest – This test also measures lipoprotein particle number but does not include insulin resistance risk or scoring.  Because the test is done through a gas-phase electric differential, the reference ranges for normal are slightly different from the NMR.

In regards to screening for cardiovascular risk, the use of all five approaches are more effective than the standard lipid panel.  However, I have found that clinically the NMR Lipo-profile or the Cardio I-Q Ion-Mobility tests are the most useful in additionally monitoring insulin resistance, inflammation, and disease progression.

It is was the use of these tests that demonstrated to me the profound effect of carbohydrate restriction and ketogenic lifestyles on vascular and metabolic risk.  We talk more about these tests on my YouTube video .

Hope this helps.

KetoOS Image

References:

  1. Williams PT, et al. Comparison of four methods of analysis of lipoprotein particle subfractions for their association with angiographic progression of coronary artery disease. Atherosclerosis. 2014 April; 233(2): 713-720.

Ketogenic Diet Halts Tumor Growth

 

Prostate Cancer Cell Replication
Prostate Cancer Cell Replication

It has long been understood that tumor cells of any kind require high levels of glucose to grow and spread (1,2).  It is also recognized that higher levels of insulin, commonly found in patients with insulin resistance or type II diabetes, are 2.4 times more likely to stimulate the development of breast cancer (3). A diet low in glucose has thereby been theorized to be an adjunct to cancer treatment.

Ketogenic diets have been demonstrated to be therapeutically useful in the treatments of epilepsy and cardiovascular disease (4). A ketogenic diet is one in which carbohydrate levels are kept below 50 grams per day and fat intake is increased to the point that the body shifts its metabolism to use triglycerides, and the ketones derived from triglycerides, as the primary fuel source for the majority of the cells within the body.  With this understanding in mind, the application of a ketogenic diet, one high in fat and protein with limited carbohydrate or glucose has been suggested as a adjunct to cancer treatments (5).

KetoOS
KetoOS – Drinkable Exogenous Ketones

A recent study (6) in the Oncology Letters evaluated the benefits of a ketogenic diet in 78 cancer patients in clinical practice.  A novel marker measuring the tumor cells use of glucose called transketolase-like-1 (TKTL1) was closely monitored, as was each of the 78 patients adherence to a ketogenic diet.  Increased TKTL1 was noted in more aggressively active and growing tumors (7,8).

Among the 43 males and 35 females, 7 patients agree to and followed a fully ketogenic diet and 6 of them followed a partially ketogenic diet.  Ketogenic meals were provided by a German company called Tavarlin that would prepare and mail ketogenic meals including oil, fat, snacks, bread, protein and energy drinks.  Dietary journals were reviewed every three months over a period of about 10 months.

40 % of these patients experienced a halting of the tumor progression and 60% experienced improvement noted by normalization of TKTL1 or reduction in TKTL1, respectively.  Those on a ketogenic diet demonstrated an average reduction of TKTL1 by approximately 50%.

This is the first study of its kind and has significant potential.  Could dietary carbohydrate restriction be an effective cancer treatment or adjunct to cancer treatment?

Because the food diaries were based on reporting only, the sample study was very small, and patients treated in the outpatient setting have the possibility of variability in the standard oncologic treatments,  the results must be interpreted with caution.  However, the data is very promising.   This study is one in which I have great interest as I have seen similar results in my clinic on a case by case basis.

Based on the limitations noted above, rigorous randomized control studies are needed, but this is an exciting an promising first step.  Additionally, the presence of a marker for tumor growth that correlates with diet is remarkable.  And, it provides the ketogenic specialist a possible measurement tool that could be used clinically.

 

References: 

  1. Klement RJ and Kämmerer U: Is there a role for carbohydrate restriction in the treatment and prevention of cancer? Nutr Metab (Lond) 8: 75, 2011
  2. Vaughn AE and Deshmukh M: Glucose metabolism inhibits apoptosis in neurons and cancer cells by redox inactivation of cytochrome c. Nat Cell Biol 10: 1477-1483, 2008.
  3. Gunter MJ, Hoover DR, Yu H, Wassertheil-Smoller S, Rohan TE, Manson JE, Li J, Ho GY, Xue X, Anderson GL, et al: Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Cancer Inst 101: 48-60, 2009.
  4. Paoli A, Rubini A, Volek JS and GrimaldiKA: Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr 67: 789-796, 2013.
  5. Ruskin DN and Masino SA: The nervous system and metabolic dysregulation: Emerging evidence converges on ketogenic diet therapy. Front Neurosci 6: 33, 2012.
  6. Jansen, N., Walach, H.”The development of tumours under a ketogenic diet in association with the novel tumour marker TKTL1: A case series in general practice”. Oncology Letters 11.1 (2016): 584-592.
  7. . Schwaab J, Horisberger K, Ströbel P, Bohn B, Gencer D, Kähler G, Kienle P, Post S, Wenz F, Hofmann WK, et al: Expression of Transketolase like gene 1 (TKTL1) predicts disease-free survival in patients with locally advanced rectal cancer receiving neoadjuvant chemoradiotherapy. BMC Cancer 11: 363, 2011.
  8. Zhang S, Yang JH, Guo CK and Cai PC: Gene silencing of TKTL1 by RNAi inhibits cell proliferation in human hepatoma cells. Cancer Lett 253: 108-114, 2007

The Ketogenic Diet & Multiple Sclerosis

Multiple Sclerosis (MS) is a neurological disease caused by demyelination or breakdown of the myelin coating around the nerve cells (1).   This is referred to as a neurodegeneration where the physical structure of the nerve is compromised, much like the coating around an electrical wire being chipped or stripped away. Common symptoms of MS are sensory symptoms in the extremities or face, unilateral visual loss, acute or subacute motor weakness of the muslces, diplopia (double vision), gait disturbance and balance problems, Lhermitte sign (electric shock-like sensations that run down the back and/or limbs upon flexion of the neck), vertigo, bladder problems, loss of control of a limb,  and pain.

 

Effects of Ketosis on Multiple Sclerosis

Initially, and for many years, the degeneration seen in multiple sclerosis (MS) was thought to occur because of an acute inflammatory attack on the cells by dis-regulated immune cells crossing the blood brain barrier.  However, treatments focused on modulating the inflammatory attack seem to have no effect on the degeneration and demyelination.  Thus, the actual definitive cause of this demyelination and neuro-degeneration has eluded us since 1868, when Jean-Martin Charcot first described it.

Recent studies point to evidence that this demyelation may be due to degeneration or breakdown of the nerve cell’s ability to use glucose as a primary fuel (2, 3).  It is now theorized that MS may be due to a combination of degeneration and localized inflammation related to poor glucose uptake causing the demyelination which is seen in a number of MS cases (4, 5, 6).

Demyelination of Nerve
A. Normal nerve cell with intact myelin sheath around the axon. B. Demyelinated axion nerve losing its ionic charge due to escape of potassium. C. Radio-labled tracer allowing visualization of demyelination on PET Scan

With this dual concept in mind, ketogenic diets have demonstrated some promising results when used with neurological diseases including MS.  Ketogenic diets have been used in the treatment of epilepsy since 500 B.C. and in the treatment of obesity since 1860.  It is now becoming apparent that ketogenic diets may play a very significant role in the treatment of neurological disease because of two-fold effects that arise when ketones become the primary fuel for the body.

First, when a person becomes keto-adapted and ketones are used as the primary fuel, instead of glucose, the body up-regulates mitochondria to use the ketones for fuel. As the ketone level rises,  the need for glucose diminishes.   This provides the nerve cell an alternative fuel source if glucose metabolism is impaired. It also decreases the need and production of insulin, a known hormone heavily involved in stimulating inflammation and inflammatory responses.

The second effect of a ketogenic diet is this favorable effect on inflammation.  It has been demonstrated that a ketogenic diet decreases reactive oxygen species, increased production of superoxide dismutase and catalayse, all of which notably decrease the inflammatory effects of oxidative stress (9,10, 11).  A ketogenic diet also is well known to raise glutithione levels, another anti-oxidant that decreases inflammation and oxidative stress (12-16).  This same anti-inflammatory and keto-adaptation effect can be obtained from intermittent fasting.

To date, studies in patients with neurologic diseases like MS, Alzheimer’s disease using ketogenic diets have had positive results in memory, cognition and diminished inflammation with evidence of halting or reversing the chronic demyelination (17,18, 19).  Still somewhat theoretical, the evidence points to effective dietary treatment and prevention for multiple sclerosis and other degenerative neurological diseases like Alzheimer’s Disease.

KetoOS

References:

  1. J. M. Pearce, “Historical descriptions of multiple sclerosis,” European Neurology, vol. 1, no. 1, pp. 49–53, 2005.
  2. C.-A. Castellano, S. Nugent, N. Paquet et al., “Lower brain 18F-fluorodeoxyglucose uptake but normal 11C-acetoacetate metabolism in mild Alzheimer’s disease dementia,” Journal of Alzheimer’s Disease, vol. 43, no. 4, pp. 1343–1353, 2014.
  3. S. Nugent, S. Tremblay, K. W. Chen et al., “Brain glucose and acetoacetate metabolism: a comparison of young and older adults,” Neurobiology of Aging, vol. 35, no. 6, pp. 1386–1395, 2014.
  4. H. Lassmann, W. Brück, and C. F. Lucchinetti, “The immunopathology of multiple sclerosis: an overview,” Brain Pathology, vol. 17, no. 2, pp. 210–218, 2007.
  5. C. Confavreux and S. Vukusic, “Natural history of multiple sclerosis: a unifying concept,” Brain, vol. 129, no. 3, pp. 606–616, 2006.
  6. P. K. Stys, G. W. Zamponi, J. van Minnen, and J. J. G. Geurts, “Will the real multiple sclerosis please stand up?” Nature Reviews Neuroscience, vol. 13, no. 7, pp. 507–514, 2012.
  7. P. G. Nijland, I. Michailidou, M. E. Witte et al., “Cellular distribution of glucose and monocarboxylate transporters in human brain white matter and multiple sclerosis lesions,” Glia, vol. 62, no. 7, pp. 1125–1141, 2014.
  8. L. C. Costantini, L. J. Barr, J. L. Vogel, and S. T. Henderson, “Hypometabolism as a therapeutic target in Alzheimer’s disease,” BMC Neuroscience, vol. 9, supplement 2, article S16, 2008.
  9. P. G. Sullivan, J. E. Springer, E. D. Hall, and S. W. Scheff, “Mitochondrial uncoupling as a therapeutic target following neuronal injury,” Journal of Bioenergetics and Biomembranes, vol. 36, no. 4, pp. 353–356, 2004.
  10. P. G. Sullivan, N. A. Rippy, K. Dorenbos, R. C. Concepcion, A. K. Agarwal, and J. M. Rho, “The ketogenic diet increases mitochondrial uncoupling protein levels and activity,” Annals of Neurology, vol. 55, no. 4, pp. 576–580, 2004.
  11. T. Shimazu, M. D. Hirschey, J. Newman et al., “Suppression of oxidative stress by β-hydroxybutyrate, an endogenous histone deacetylase inhibitor,” Science, vol. 339, no. 6116, pp. 211–214, 2013.
  12. S. G. Jarrett, J. B. Milder, L.-P. Liang, and M. Patel, “The ketogenic diet increases mitochondrial glutathione levels,” Journal of Neurochemistry, vol. 106, no. 3, pp. 1044–1051, 2008.
  13. J. B. Milder, L.-P. Liang, and M. Patel, “Acute oxidative stress and systemic Nrf2 activation by the ketogenic diet,” Neurobiology of Disease, vol. 40, no. 1, pp. 238–244, 2010.
  14. N. Dupuis, N. Curatolo, J. F. Benoist, and S. Auvin, “Ketogenic diet exhibits anti-inflammatory properties,” Epilepsia, vol. 56, no. 7, pp. e95–e98, 2015.
  15. D. Y. Kim, J. Hao, R. Liu, G. Turner, F.-D. Shi, and J. M. Rho, “Inflammation-mediated memory dysfunction and effects of a ketogenic diet in a murine model of multiple sclerosis,” PLoS ONE, vol. 7, no. 5, Article ID e35476, 2012.
  16. Y.-H. Youm, K. Y. Nguyen, R. W. Grant et al., “The ketone metabolite β-hydroxybutyrate blocks NLRP3 inflammasome—mediated inflammatory disease,” Nature Medicine, vol. 21, no. 3, pp. 263–269, 2015.
  17. A. Ramm-Pettersen, K. O. Nakken, I. M. Skogseid et al., “Good outcome in patients with early dietary treatment of GLUT-1 deficiency syndrome: results from a retrospective Norwegian study,”Developmental Medicine and Child Neurology, vol. 55, no. 5, pp. 440–447, 2013.
  18. Y. Ito, H. Oguni, S. Ito, M. Oguni, and M. Osawa, “A modified Atkins diet is promising as a treatment for glucose transporter type 1 deficiency syndrome,” Developmental Medicine and Child Neurology, vol. 53, no. 7, pp. 658–663, 2011.
  19. M. Storoni and GT Plant, “The Therapeutic Potential of the Ketogenic Diet in Treating Progressive Multiple Sclerosis,” Multiple Sclerosis International, vol. 2015, Article ID 681289, 9 pages, 2015.

Today’s Weight Loss Rx . . .

A few of my patients have recently asked me, “Dr. Nally, why to you post pictures of your horsekoi and farm animals on instagram?”

Let me answer that question with the following questions:

  • Do you find yourself longing for the apocalypse?
  • Do you find yourself looking for a reason to live?
  • Are you feeling tired, irritable, stressed out?
  • Do you or you family find yourself to be overly cynical, jaded or emotionally numb?

If you can answer “yes” to any of the questions above, then I highly recommend prescription strength nature . . .

All parody and humor aside, full strength prescription nature is one of the very best treatments for stress.

I find that sitting outside with my animals, watching the birds, dogs, horses and ducks dramatically helps with lowering my stress levels and helps me re-focus.  You can see my favorite place to sit on my farm and watch nature . . . here on Katch.me

You may find the following posts very insightful in explaining how stress wreaks havoc on your weight loss, mood & emotions and how to go about fixing it:

For someone like me, who spends 14-18 hours a day taking care of illness and sickness, I have found that spending time in nature is often more therapeutic than any pill available in the pharmacy.  So, this afternoon, if your looking for me, I’ll be taking my own medicine, a prescription of Nature Rx on my horse.

Definition of Insanity: Cutting Calories/Restricting Fat & Expecting Weight Loss

Have you been cutting your calories and reducing fat and exercising your brains out and still not seeing the needle on the scale move that much?  Persistently and repetitively performing an action that doesn’t produce the desired result is insanity.  Cutting calories and reducing fat while expecting weight loss is akin to pouring water in the gas tank of your car and expecting it to run smoothly. Why do we do it? Are the 53, 000, 000 people with health club and gym memberships this year really insane?

This evening on PeriScope we touch on fat phobic insanity  and the limiting step that actually turns weight gain on or off. (We knew about this in the 1960’s, we just ignored it.)

You can see tonight’s PeriScope with the rolling chat-box questions here at Katch.me/docmuscles.  Or, you can watch the video stream below:

The only way to successfully loose weight is to modify or turn off the mechanisms that stimulate fat storage.  For years we have been told that this was just a problem of thermodynamics, meaning the more calories you eat, the more calories you store. The solution was, thereby, eat less calories or exercise more, or both. We are taught in school that a 1 gram of carbohydrate contains 4 kcal, 1 gram of protein contains 4 kcal, and 1 gram of fat contains 9 kcal.

If you ascribe to the dogma that weight gain or loss is due to thermodynamics, then it’s easy to see that cutting out fat (the largest calorie containing macro-nutrient) would be the best way limit calories.  For the last 65 years, we as a society have been doing just that, cutting out fat, exercising more (with the idea of burning off more calories) and eating fewer calories.

What has this dogma done for us? It’s actually made us fatter! (1)

World Obesity Rates
Obesity Rates Around the World

Some may argue that we really aren’t eating fewer calories and exercising more. But most people I have seen in my office have tried and tried and tried and failed and failed and failed to loose weight with this methodology. In fact, the majority of my patients attempt caloric restriction, exercise and dieting multiple times each year with no success. The definition of insanity is “doing the same thing over and over and expecting a different result.”

Most of my patients are not insane, they recognize this and stop exercising and stop restricting calories . . . ’cause they realized, like I have, that it just doesn’t work!

If you’re one that is still preaching caloric restriction and cutting out fat, I refer you to the figure above and the definition of insanity . . . your straight-jacket is in the mail.

So, if reducing the calories in our diet and exercising more is not the mechanism for turning on and off the storage of fat, then what is?

Before I can explain this, it is very important that you appreciate the difference between triglycerides and free fatty acids.  These are the two forms of fat found in the human body, but they have dramatically different functions.  They are tied to how fat is oxidized and stored, and how carbohydrates are regulated.

Fat stored in the adipose cells (fat cells) Triglycerides-and-Glycerol1as well as the fat that is found in our food is found in the form of triglycerides. Each triglyceride molecule is made of a “glyceride” (glycerol backbone) and three fatty acids (hence the “tri”) that look like tails. Some of the fat in our adipose cells come from the food we eat, but interestingly, the rest comes from carbohydrates

(“What! Fat comes from sugar?! How can this be?!!“)

de novo lipogenesis
De Novo Lipogenesis

We all know that glucose derived from sugar is taken up by the cells from the blood stream and used for fuel, however, when too much glucose is in the blood stream or the blood sugar increases above the body’s comfort zone (60-100 ng/dl), the body stores the excess. The process is called de novo lipogenesis, occurring in the liver and in the fat cells themselves, fancy Latin words for “new fat.”  It occurs with up to 30% (possibly more if you just came from Krispy Kream) of the of the carbohydrates that we eat with each meal.  De novo lipogenesis speeds up as we increased the carbohydrate in our meal and slows down as we decrease the carbohydrate in our meal. We’ve known this for over 50 years, since it was published by Dr. Werthemier in the 1965 edition of the Handbook of Physiology (2).

While we know that fat from our diet and fat from our food is stored as triglyceride, it has to enter and exit the fat cell in the form of fatty acids.  They are called “free fatty acids” when they aren’t stuck together in a triglyceride.  In their unbound state, they can be burned as fuel for the body within the cells. I like to think of the free fatty acids as the body’s “diesel fuel” and of glucose as the body’s version of “unleaded fuel.”  The free fatty acids can easily slip in and out of the fat cell, but within the adipose cell, they are locked up as triglycerides and are too big to pass through the cell membranes.  Lipolysis is essentially unlocking the glycerol from the free fatty acids and allowing the free fatty acids to pass out of the fat cell. Triglycerides in the blood stream must also be broken down into fatty acids Insulin and Triglyceridesbefore they can be taken up into the fat cells. The reconstitution of the fatty acids with glycerol is called esterification. Interestingly, the process of lipolysis and esterification is going on continuously, and a ceaseless stream of free fatty acids are flowing in and out of the fat cells.  However, the flow of fatty acids in and out of the fat cells depends upon the level of glucose and insulin available. As glucose is burned for fuel (oxidized) in the liver or the fat cell, it produces glycerol phosphate. Glycerol phosphate provides the molecule necessary to bind the glycerol back to the free fatty acids. As carbohydrates are being used as fuel, it stimulates increased triglyceride formation both in the fat cell and in the liver, and the insulin produced by the pancreas stimulates the lipoprotein lipase molecule to increased uptake of the fatty acids into the fat cells (3).

So when carbohydrates increase in the diet, the flow of fat into the fat cell increases, and when carbohydrates are limited in the diet, the flow of fat out of the fat cells increases.

Summarizing the control mechanism for fat entering the fat cell:

  1. The Triglyceride/Fatty Acid cycle is controlled by the amount of glucose present in the fat cells (conversion to glycerol phosphate) and the amount of insulin in the blood stream regulating the flow of fatty acid into the fat cell
  2. Glucose/Fatty Acid cycle or “Randle Cycle” regulates the blood sugar at a healthy level.  If the blood glucose goes down, free fatty acids increase in the blood stream, insulin decreases, and glycogen is converted to glucose in the muscle and liver.

These two mechanisms ensure that there is always unleaded (glucose) or diesel fuel (free fatty acids) available for every one of the cells in the body. This provides the flexibility to use glucose in times of plenty, like summer time, and free fatty acids in times of famine or winter when external sources of glucose are unavailable.

The regulation of fat storage, then, is hormonal, not thermodynamic. Unfortunately, we’ve know this for over 65 years and ignored it.

We’ve ignored it for political reasons, but that’s for another blog post . . .

References:

1. James, W. J Intern Med, 2008, 263(4): 336-352

2. Wertheimer, E. “Introduction: A Perspective.” Handbook of Physiology. Renold & Cahill. 1965.

3. Taubs, G. “The Carbohydrate Hypothesis, II” Good Calorie, Bad Calorie. Random House, Inc. 2007, p 376-403.

Pre-, Post-Workout Meal on Ketosis. Is it Important?

Today’s Periscope was an exciting one.  Do you really need a pre- or post-workout shake or meal?  How much protein do you need?  What’s the difference between ketosis and ketoacidosis?  Is Dr. Nally a ketogenic cheerleader? Get your answers to these and many more questions asked by some wonderful viewers this evening on today’s PeriScope.

https://katch.me/embed/v/5def6bce-4f67-363a-b5f9-3bbec8a8aea2?sync=1

Be sure to check out Dr. Nally’s new podcast called “KetoTalk with Jimmy and the Doc” with the veteran podcaster Jimmy Moore on KetoTalk.com.  The first podcast will be available on December 31, 2015.  KetoTalk with Jimmy and the Doc will be available for download for free on iTunes.

Stay tuned . . . !

The 3 Weight Loss Necessities to Weathering the Holidays

What are the three things you need to successfully weather the holidays with your ketosis lifestyle? What does a raindeer on a motorcycle look like? How does insulin resistance effect kidney stones and gout? How do you get back on track if you fall off the ketosis wagon? These and many more questions are answered by Dr. Adam Nally on tonight’s PeriScope.

You can see the video stream including the comment roll here at katch.me/docmuscles.  Or you can watch the video below:

Common Ketosis Killers

“I’ve tried your low-carb diet, Dr. Nally, and it didn’t work.”

“Hmm . . . really?”  If you’re mumbling this to yourself, or you’ve said it to me in my office, then lets have a little talk.  You’ve probably been subjected to the common ketosis killers.

Scale HelpI’ve heard this statement before.  It’s not a new statement, but it’s a statement that tells me we need to address a number of items.  If you’ve failed a low carbohydrate diet, I’d suspect you are pretty severely insulin resistant or hyperinsulinemic.  You probably never really reached true ketosis.   I’d want to have you checked out by your doctor to rule out underlying disease like hypothyroidism, diabetes, other hormone imbalance, etc.

Nutritional Ketosis is Most Effective as a Lifestyle Change

Next, switching to a low-carbohydrate lifestyle is literally a “lifestyle change.”  It requires that you understand a few basic ketosis principles.  And, it takes the average person 3-6 months to really wrap their head around what this lifestyle means . . .  and, some people, up to a year before they are really comfortable with how to eat and function in any situation.

I assume, if you are reading this article, that you’ve already read about ketosis and understand the science behind it.  If not, please start your reading with my article The Principle Based Ketogenic Lifestyle – Part I and Ketogenic Principles – Part II.  If this is the case, then please proceed forward, “full steam ahead!”

There are usually a few areas that are inadvertently inhibiting your body transformation, so let’s get a little personal.

Nutritional Ketosis is a Very Low Carbohydrate Diet

First, this is a low carbohydrate diet.  For weight loss, I usually ask people to lower their carbohydrate intake to less than 2o grams per day. How do you do that?  (A copy of my diet is accessible through my membership site HERE.)  You’ve got to begin by restricting all carbohydrates to less than 20 grams per day.  Any more than 20 to 30 grams per day will cause an insulin release from the pancreas and stimulate fat storage of both carbohydrate and fat for the next 10-12 hours, commonly killing ketosis.  Keep a dietary journal to record your progress, your cravings, your successes and failures.  I’m going to want to see it and review it with you if you see me.

No, I don’t believe in “Net Carbs.”  Net Carbs are a sales gimmick to get you to buy “artificial food” that keeps you coming back for “artificial food” and halts your weight loss (you’ll see why shortly).   You’re going to lose the most weight and feel your best when you eat real food. I do allow for the subtraction of real fiber, specifically non-cooked, non-blended, non-juiced leafy greens (If you cook, blend or juice a leafy green, it activates more carbohydrate availability).  Leafy greens are real fiber.  You can subtract them.  In fact, I recommend eating 1-3 cups of leafy greens per day to help bowel function & provide necessary folic acid, but, everything else is “carbage.”  Avoid it.

Yes, cottage cheese and yogurt contain carbohydrates.  Be very cautious with them.

No, oatmeal and Cream of Wheat™ are not helpful. See my article on Why Your Oatmeal is Killing Your Libedo.Alcohol

Alcohol also halts your weight loss.  It’s not the sugar in the alcohol I’m worried about, the distilling process changes the sugar to alcohol, however, alcohol stimulates an insulin response after the alcohol is metabolized in the liver with a SIMILAR RESPONSE to regular sugar.

 

To Effectively Maintain Nutritional Ketosis, You MUST get adequate Protein

Second, this is a low carbohydrate, moderate protein, high fat lifestyle.  N0 . . . it is NOT a high protein diet! However, so many of my patients don’t eat enough protein that they feel like it is a “high protein diet.”

Protein is essential for the building and maintaining of muscle, connective tissue and a number of other enzymatic reactions in your body.  However, in patients who are morbidly obese [people with a body mass index (BMI) over 50], excess protein intake can cause fat to be stored by producing an excessive insulin response.  In these patients we initially moderate protein.  Excess sugars and a number of proteins, in the presence of a high insulin response, are converted to triglyceride (the soft squishy stuff inside the fat cells that make them plump) and stocked away inside your adipose tissue.  Excessive protein, especially the amino acids argenine, leucine and tryptophan are common ketosis killers, not because they are converted to sugar, but because they stimulate and insulin response all by themselves.

If you don’t fall into the morbidly obese category (BMI over 50). Then, I encourage you to use the protein levels below.

Initially, I ask my patients to focus on lowering their carbohydrate intake and I don’t really worry about protein.  (It is often hard enough to figure out what the difference between a carbohydrate and a protein in the first month or two if you’ve never had any nutrition background.)  Most people begin losing weight just by lowering carbohydrates over the first few months.  Once you figure out how to lower your carbohydrates, if your weight loss is not moving and your pants are not getting looser, then you’re probably eating too much protein.

How much protein do you need?  It’s pretty easy to calculate and is based on your height and gender.  Your basic protein needs to maintain muscle, skin and hair growth are as follows:

  • 70 grams or higher for women per day
  • 120 grams or higher for men per day.

However, these levels are WAY TOO LOW for weight loss and maintaining good health.  Because we now know that protein acts as a hormone in a number of ways, in my office I recommend women get 80-90 grams of protein per day, and men should get > 150 grams of protein per day.

ProteinIf you’re still a little confused about protein, read my article on Why Your Chicken Salad Stops Your Weight Loss.

This also goes for protein powders and protein shakes.  Many of these have 25-40 grams of protein in them per serving, so be careful with their use.

Nutritional Ketosis is a High Fat Diet

Third, this is a high fat lifestyle.  Yes, I want you to INCREASE your fat intake.  I’m going to repeat that, again, just for clarity, . . . . INCREASE your fat intake.  Increase it to around 50% of your total calories, . . . 70% of your total calories if you can do it.  Not enough fat is a common ketosis killer.

“What?! Won’t that cause heart disease and stroke and make my cholesterol worse?!!!”

I know, take a big deep breath . . . (you may even need to breath into a paper bag for a minute if you begin hyperventilating).

No, it will not raise your cholesterol, cause heart disease, or cause a stroke.  If you have lowered your carbohydrate intake to less than 20 grams per day, then there is NO hormonal signal for you to make more bad cholesterol, worsen heart disease, or cause a stroke.  In fact, there is great data showing that increasing your fat and lowering your carbohydrates reverses the blockage in the arteries.  I see this reversal every single day in my clinic through the application of ketogenic diets.

If we remove carbohydrate as your primary fuel, you must replace it with something else.Food Pyramid WrongThat something else should be fat.  Protein must be moderated, as it will also be stored as fat if you eat too much.  So, if the carbohydrates are kept low, fat intake can be increased and the body will pick the fat it wants and essentially throw the rest out without raising cholesterol, causing weight gain or causing heart disease.  This is why we want you to use good natural animal fats like butter, hard cheese, olive oil, coconut oil, avocado, etc.  Look for fats highest in omega-3 fatty acids as these decrease inflammation and improved weight loss.  Look for meats highest in fat like red meat (55% fat) and pork (45% fat).  Take the food pyramid and flip it over.

Check Your Sweeteners At the Door

The fourth common ketosis killer and culprit in halting your weight loss is  artificial sweeteners.  There are quite a few of them.  Most of them WILL cause an insulin response (exactly what we don’t want for weight loss) with minimal to no rise in blood sugar.  Raising blood sugar doesn’t matter, if the insulin is being stimulated  . . . “you’re gonna gain weight for the next 10-12 hours.”  I wrote an article for you to print off and hang on your fridge, upload it to your iPhone or carry it with you in your purse to the grocery store. (If you’re a man and you’re carrying a purse, please don’t tell me about it.)  You can find the article here: The Skinny About Sweeteners.  The short list of those sweeteners that are OK to use and cook with, and do not increase insulin response, can be found here in my Amazon Store.

Don’t Even Start with Coffee Creamers

CoffeeCreamersFifth on my list is coffee creamer.  Coffee creamer contains corn syrup solids (another very special name for  . . . SUGAR!!) and/or maltodextrin (SUGAR’s married name!).  If you must put something in your coffee, then use real heavy cream (pure tasty fat) or real butter.   It will taste much better (I’m told – I don’t drink coffee personally) and you won’t get an insulin spike 2-3 hours later and begin craving more coffee and donuts.

Yes, “Half & Half” is half fat and half sugar. . .  avoid it too!!

Ketosis Killing Medications

The sixth culprit in halting weight loss is medications.  Please talk to your doctor before making ANY changes in your medications as suddently stopping them can be hazardous to your health.  Those highest on my list for stopping your weight loss are Glyburide (glipizide), insulin, & steroids like prednisone.  A more complete list of medications that will halt your weight loss can be found on my on my ketogenic diet plan.  If you are on any prescription medications, please talk to your doctor or to a physician board certified in obesity medicine treatment about how to adjust or wean these medications in a way that is safe and appropriate for your individual needs.

Estrogen

The seventh common culprit in halting weight loss is a lack of estrogen in menopausal or post-menopausal women.  About menopause-cartoon-02420% of women that I see in my practice who are over 55 years old, need some degree of estrogen replacement before they are able to lose weight.  Estrogen plays a very large role in regulation of the metabolism and when deficient, causes weight retention or weight gain.  Talk to your doctor about the risks and benefits of estrogen for you individually in this situation.

Stress

The eighth reason for shifting out of ketosis is stress.  Acute and chronic stress can be caused by a number of issues. The most common is lack of sleep.  You can read about stress and ways to address it in two of my articles: How Does Stress Cause Weight Gain? and Adrenal Insufficiency, Adrenal Fatigue and PseudoCushing’s Syndrome – Oh My!

For many years, we’ve thought that caffeine was great for weight loss.  However, we are finding, clinically, that too much caffeine can also cause a stress response by raising cortisol, releasing glycogen, thereby stimulating an insulin response and bringing your weight loss to a screeching halt.  How much caffeine? . . . The jury is still out . . . and remains to be determined.  But, I am currently under going an n=1 experiment on myself (as many of you know, I loved Diet Dr. Pepper.  But I had to give it up).  I’ll keep you posted . . .

Look closely at these eight issues.  Correcting them usually solves most plateaus with weight loss and improves blood pressure, blood sugar and cholesterol control dramatically.

The 5 Myths of Weight Loss

This evening we covered the 5 myths of weight loss identified through the National Weight Control Registry’s research findings. What causes “wrinkle face” for Dr. Nally?  We also talked about & answered 20 minutes of rapid fire questions ranging from the amount of protein you need daily to the likelihood a human could be a bomb calorimeter . . . exciting stuff!!

You can watch the video stream below.  Or you can Katch the replay with the rapid stream of exciting comments here at Katch.me/docmuscles.

Four Most Common Weight Loss Mistakes that Halt Your Weight Loss

What are the four most common mistakes I see in the office when it comes to weight loss?  Watch Dr. Nally on today’s PeriScope as he answers that question and many others.  You can see it here with the live stream comments on: https://www.katch.me/docmuscles/v/392e5d3e-bb28-3176-a03a-83433878a5ce

Or see the video below:

Homemade Rootbeer – Ketosis Style!!

ery October I get a hankering for homemade root beer.  But it is usually loaded with sugar.  Thanks to Maria Emmerich and her amazing recipes, that doesn’t have to happen this year.   She just posted this on her site today and I can’t wait to try this as I sit by my fire pit roasting some hot dogs with my kids . . . Thanks Maria.

I pasted a copy of her root beer image below just to make you drool, too  . . .

Homemade Rootbeer - Low Carb

Link on the recipe at her site HERE.

(Another great use for the SodaStream as well . . . the day just keeps getting better!)

Mom’s Cream Cheese Waffles

Mother’s Day is a great event in our home, and traditionally, it is a chance to make breakfast for Mom.

In our home, Mom has always loved waffles.  But changing to a low carbohydrate diet put a damper on the waffles for a while, until my sweet wife found and perfected the following recipe. (She adapted this recipe fromJennifer Eloff’s Cream Cheese Bran Waffle recipe found in her book, Splendid Low Carbing for Life Vol 1.) These waffles are amazing! They are now lovingly referred to in our home as “Mom’s Cream Cheese Waffles.”

Because I’ve found that Splenda© spikes the insulin and slows weight loss in a significant percentage of my patient’s we’ve changed up the sweetener below.

Breakfast for Mother’s Day in our home consisted of Mom’s Cream Cheese Waffles, freshly grilled thick slice bacon and strawberry flavored homemade whipped cream to top off the waffles and was easily prepared by my 13 year old daughter.  It’s a perfect Low Carb Mother’s Day meal that’ll satisfy the waffle craving and still give the gift of “ketosis”.
Enjoy!

 

CreamCheeseWaffles
Cream Cheese Waffles


Mom’s Cream Cheese Waffles
:

16 oz regular cream cheese (softened)
6 eggs
1 cup wheat germ
1/4 cup heavy cream
1/4 cup water
1/2 cup erythritol
1-2 drops liquid Stevia (add to taste)
1 tsp baking soda
1 tsp baking  powder
1/4 tsp salt
In a food processor or electric mixer, blend the cream cheese until smooth.  Add the eggs and continue to blend.  Add the Carbalose flour, wheat germ, cream, water , Splenda, baking soda, baking power and salt.  Continue to blend.
Pour 1/4-1/2 cup onto hot greased waffle iron. Close and cook for approximately 3 minutes.
Yeild: 12-16 “plate sized” waffles
1 Waffle: approx. 7g protein, 9g fat, 1g carbs

 

Low Carb Cheese Cake

My amazing wife, among her many talents, makes a wonderful low carb cheese cake.  She has taken the recipe found in Maria Emmerich’s “Secret Weight Loss Recipes” and modified it to our family’s taste.  It has quickly become one of my family’s favorites.

Low Carb Cheesecake = 1 gram carb per serving
Individual spring-form serving pans
Crust:
2 cups almond flour
1/4 cup coconut flour
1/2 cup butter melted
Pinch of salt
1/2 cup erythritol
Mix and press into spring-form pan.
5 (8 oz) packages cream cheese, softened
1 cup erythritol and 1 tsp liquid Stevia
1 TBS vanilla
1/2 cup whey Protein
1 cup sour cream
3 eggs
Preheat oven to 350F. Mix cream cheese, sweetener, protein and vanilla with an electric mixer until blended. Add eggs one at a time, mixing on low after each until blended. Blend in sour cream and pour over crust. Place a pan of water on the lower rack place cheesecake on rack above. Bake for approximately 45 minutes until set. Watch carefully!
Refrigerate overnight.
Freezes well too!
My wife will often bake them in individual sized pans (as in the picture above) so that I can pull one out of the freezer, let it thaw and cover it in whip cream and a sprinkle of berries.  Tastes fantastic!
One serving is = 1 gram of carbohydrate.