What is the most important ketosis question you can ask? Dr. Nally answers the really tough ones . . . You can see the answers below:
Or you can Katch it with the comments and hearts here:
https://www.katch.me/docmuscles/v/9395e522-213f-301d-8ef3-202c56009eff
In light of the fact that exercise DOES NOT cause weight loss, exercise has a fascinating ability to enhance ketosis. No, seriously, I don’t care what your trainer told you, you won’t loose weight with exercise, no mater how hard you try. However, exercise does help you body attain a ketogenic state.
When you exercise, the muscles take up glucose and oxygen to burn as their primary fuel. Exercise has actually been shown to enhance this process and reduce the “insulin resistance” effect that the the SAD diet (Standard American Diet) has on 2/3rds of the population (whether they realize it or not). Mild to moderate exercise like a walk or even a mild jog, and resistance training like weight lifting, yoga or Pilates increased the drive of the glucose into the cells and improves the ability of the cells to use the glucose.
In a person following a carbohydrate restricted diet (Ketogenic, Low-Carb, and even Paleolithic to some degree), the body maintains a stable level of blood sugar by releasing glycogen from the liver and gluconeogenisis as needed to support the 100 grams necessary per day required by the brain (the liver makes about 240 grams per day no mater what you do). In the absence of extra glucose as fuel, the body will then use triglyceride and/or ketones as fuel. Exercise improves the sensitivity to the small amount of glucose and actually ramps up the presence of ketones placing the person into a more ketogenic state.
This enhanced ketogensis is often experienced as “second wind” or “being in the zone” or even as an ability to “hyperfocus” during exercise. But the exercise levels must be in the mild to moderate range for this to be accomplished.
But, there’s a fine balance, if the muscles are pushed too hard to fast, lactic acid builds up because of a shift to an anaerobic state and the acid creates a stress response, triggering cortisol and increased glucose formulation, causing one to shift out of ketosis.
How do you know if you exercising too hard? You should be exercising hard enough to break a sweat, but not so hard that you can’t carry on a conversation with your partner at the same time. Over time, as the body becomes more effective at using ketones, you’ll find your exercise intensity can and will improve.
See Dr. Nally try to explain all this while riding his horse Bailey in the White Tank Mountains:
Or you can Katch it here: https://katch.me/docmuscles/v/ce43292a-296f-3de4-bf6f-d19cd688fc62
Have a great weekend!!
See this evenings PeriScope about things to expect in the first few weeks of a ketogenic or low-carb dietary change. Questions answered about carbohydrate restriction.
See the video here:
Or you can Katch it at the link below:
https://www.katch.me/docmuscles/v/a1fa544c-f124-38f6-a444-b24d90fcba8a
Have a great evening and a safe weekend.
Over the last few weeks, I’ve had the pleasure of talking to a number of patients and friends about what it means to live a ketogenic lifestyle. A low-carbohydrate or ketogenic lifestyle is different from a low-carb diet. It is different because the definition of lifestyle implies the way a person lives their life that reflects specific attitudes and values, not just how they eat. My recent posts, The Principle Based Ketogenic Lifestyle – Part I and Ketogenic Principles – Part II, focus on fundamental principles making the ketogenic lifestyle one in which balance and grounding in all aspects of life can occur. When the mind, the body or the spirit are out of balance or un-grounded, symptoms of metabolic inefficiency, sickness or disease result.
I have been fascinated, as a family practitioner, that the body produces “warning flags,” when there is dysfunction in one of these areas: mind, body & spirit. These warning flags are byproducts of inefficient inter-related functionality between the body’s systems and it is one of the foundation principles of osteopathic medicine. Prior to the advent of many of our diagnostic techniques today like MRI, CT scan, advanced laboratory evaluations, and ultrasound, these were the only indicators of disease that a physician could identify, and upon which diagnosis was made. These flags often show up on the skin, in the hair or nails, in the complexion, or in general appearance or mannerisms.
For example,”skin tags” are now recognized as pathognomonic, specifically indicative, of insulin resistance and will often occur up to 20 years before impaired fasting glucose or diabetes is ever recognized.
Exopthalmos, or protrusion of the eyes, is pathognomonnic for overactive thyroid function (hyperthyroidism), and spider angiomas occur as a somatic flag that cirrhosis of the liver is present.
Hair loss and dry skin, or “alligator skin,” represents the exact opposite with an under-active thyroid (hypothyroidism).
When metabolic pathways get “clogged” or flow of blood, lymphatic fluid or hormones do not reach the destinations they were meant to reach, symptoms of accumulation or poor function begin to arise.
The osteopath is also trained to recognize a corollary Chapman’s Reflex Points that act as flags for dysfunction in specific organs or regions of the body. These points relate directly to what causes the pathognomonic flag. I frequently identify abdominal, adrenal, pancreatic and liver Chapman’s points present in those with insulin resistance, inflammatory diseases, pre-diabetes and diabetes. Understanding how to interpret and use these flags comprises four years of medical school and three to four years of residency and often years of clinical application.
Mental or spiritual pathways can often be bloc-aided by poor recognition of, or refusal to acknowledge, individual truths in our lives. Interestingly, the signs or warning flags of spiritual dysfunction are also expressed physically.
“Oh, no?! Dr. Nally are you going to get all religious on us?”
Maybe.
Over the last 15 years of my medical practice, I’ve witnessed the spiritual component of the “mind, body, spirit” unit, or lack thereof, have profound impact on the body’s ability to heal. Every one of us must defeat what Sigmund Freud called the pleasure principle – the human instinct to seek pleasure and avoid pain, including recollections or memories that are painful. Hiding from these memories because of pain is very common and is part of human nature. We often believe that thinking about or re-living the truth may cause us individual overwhelming un-survivable grief. So, we naturally bury the thoughts and emotions and feelings deep down into our subconscious minds.
In fact, we take irrational risks, busy ourselves, use food or drink for short term comfort and move from one distracting or debilitating relationship to another. We lose and then regain gain weight, become workaholics, hide behind thousands of texts, social media posts and emails in order to protect ourselves from the part of ourselves that we don’t want to think about.
However, when we step away from the distractions and courageously look at our individual history, our personal life story, honestly and completely, feelings of sadness, anxiety, regret and anger may often arise. These painful emotions bring with them essential insights into how experiences will help you and I individually grow, become a better people, and help others along the path. It takes faith to trust that these experiences will not destroy us, but were allowed to occur by a loving Father or Creator, understanding that for you and I to grow, we must each be given individual agency to chose. It takes faith to recognize that that Father has your individual best interest in mind. Hiding from these emotions clogs the mental and spiritual systems and fuels disabling depression, anxiety, insomnia and fatigue. These feelings, real as they are, persist when there is no other physical sign of illness. That’s because this illness is not physical. It is spiritual. When we are out of line with the truths that bring peace and balance to our lives, negative, self-limiting patterns of activity and fear stifle growth and development mentally.
It is fascinating to me that on more than one occasion, as an osteopath, when a patient suffering from these symptoms gets a massage or has an osteopathic or chiropractic manipulative treatment, they may suddenly become tearful or have unexpected release of emotion. Physical treatment over the areas of congestion can, and do, cause a reflex triggering of mental, emotional or spiritual release of tensions.
How do I know that it is truth we are hiding from? Take the words of the Buddhist teacher Sogyal Rinpoche found in The Tibetan Book of Living and Dying among many others throughout the ages:
“Saints and mystics throughout history have adorned their realizations with different names and given them different faces and interpretations, but what they are all fundamentally experiencing is the essential nature of the mind. Christians and Jews call it “God”; Hindus call it “the Self,” “Shiva,” “Brahman,” and “Vishnu”; Sufi mystics name it “the Hidden Essence”; and the Buddhists call it “buddha nature.” At the heart of all religions is the certainty that there is a fundamental truth, and that this life is a sacred opportunity to evolve and realize that truth.”
“Wait a minute, what does all this have to do with a ketogenic lifestyle?”
The ketogenic lifestyle is one that is based on values. A patient following a ketogenic diet recognizes that food has just as powerful effect on the hormones of the body as does prescription drugs. Understanding the value of hormone balance and the principles that effect weight, inflammation, blood pressure and cholesterol, the ketogenic lifestyle is one in which carbohydrates are restricted in an individually tailored way to obtain the end goal. How does a ketogenic lifestyle balance mind and spirit?
Step One –
Put down your force-field. This takes courage and it takes faith. Your force-field is any distraction that keeps you from thinking and feeling and identifying truth. These include excessive alcohol, illicit drugs, binge eating, smoking, gambling, working excessively or getting lost in repetitive dramatic romantic relationships .
Believe me, the force-field gets heavier every day. After my father passed away at age 58 from the major complications of diabetes and my sister committed suicide a few years later, I threw myself into work and church service. I worked 16-18 hour days, completed a second board certification in Obesity Management and a fellowship in Health Policy, all while serving as a bishop and counselor in my church. I found that I could raise my force-field of justification to hide from the pain and emotions of family illness and depression.
But the force-field saps your energy and cheats you out of seeing your full potential. I found that as long as I held up my force-field (and some of us care more than one), I couldn’t see the experiences that made me who I am and connect me with those I was trying to serve and help. As long as I was holding up my force-field, I was living in the fear of re-experiencing the pain of loss and the worry of future disease, . . . and people sense that.
You don’t have to drop the force-field all at once. You don’t have to quit work and become a hobbit. You just have to lower the field a little bit, enough to peek over and let the Eternal Truth shine on you. Truth is a funny and powerful thing. The more we overcome our reluctance, face the pain and the fear, the more we realize just how often things begin to go well for us. Living in the presence of great truth and eternal law and being guided by permanent values is what keeps a man patient when the world ignores him, and calm and unspoiled when the world praises him.
Step Two –
Identify emotional or behavioral patterns that you want to change. If you don’t know, ask a trusted friend, your spouse, or your relatives. As I think back over the years, I had a couple trusted friends pull me aside and identify a few of those patterns face to face. I appreciate that, and I’ve never forgotten it.
Step Three –
Realize that today’s negative emotional and behavioral patterns are connected with painful memories and unsolved past conflicts.
Do you get a gut feeling that you want to change the subject when someone brings up a financial setback? Do you want to reply with one liners like, “I’m sure it will all work out?” Are there other topics that make you uncomfortable? Ask yourself why that topic makes you uncomfortable . . . seriously, ask yourself, and then answer yourself. Do you suspect your spouse of cheating when there is no objective evidence to support the suspicions? Recognize these uncomfortable feelings are our subconscious waving flags to make us each aware of unresolved conflicts within our mind and spirit.
Remember, we attract the type of energy we give off.
Step Four –
Pray to whatever higher power you believe in. Meditation, prayer and “ponderizing” brings a reservoir of faith and courage to find and to face the truth. If you have the faith, get on your knees and sincerely ask God for help facing your truth and the challenges, fears and sadness that reflecting upon it may initially bring. I promise you that you will gain the strength to accomplish the task. It will bring the strength to overcome the hidden trauma in your earlier life and will give you the strength to resist the call of ice cream at 3 am.
Following these four simple steps, keeps you vigilant to the physical and spiritual warning flags that may arise on your ketogenic journey and will bring great confidence while modifying your diet to balance your body’s hormonal milieu. Confidence inspires courage. Those with courage and confidence in themselves, and faith that they are on the right path, are unstoppable. Good luck . . . I look forward to seeing you on my journey down the same path.
My family and I enjoyed some “moist brisket” from Rudy’s Country Store and Barbecue this evening. This is one of my favorite meals. I ordered up 2 lbs knowing that I’d have some to save for later this week. How do you calculate up the ketotic nutritional values for this meal? Easy.
Nutritional values can often be found on the menu or on the web (you might have to ask for it). Rudy’s Country Store kindly places their nutritional information on the web and you can locate it here.
Now, the image above is 2 lbs of moist brisket (with extra bark) and nutritional values are calculated per 1/2 lbs. serving size as noted below. (No, I did not eat this whole thing.) I saved 3/4’s of it for another meal sometime in the next few days.
The Nutritional facts above can be somewhat misleading if you add up the grams of protein, fat and carbohydrate you end up with 93 grams total (the misleading part is that 93 grams does not equal 1/2 lbs. The assumption is that the values are “pre-cooked”). But what I am looking for is the ratio of fat per serving. One serving size has 50 grams of fat and 41 grams of protein. 54% of this brisket is from fat. If you eat the entire 1/2 lbs you’ll go over you protein needs for that meal (assuming that I need only 30-35 grams of protein per meal – 3 meals a day). I only at about 1/3rd lbs. (totally stuffed afterwards) and so 54% of my meal was fat (keeps me in ketosis) and 1/3 lb of the brisket has about 27 grams protein.
Did I calculate all this up before I ate. Absolutely not. I just ate and amazingly, I got full somewhere between 1/4 lb and 1/3 lbs. The key is listen to your body. It will tell you when you are full (unless you are cheating and eating carbs with it, then all bets are off and the satiety signal is delayed).
By the way, it was delicious.
Running some errands this morning and the tummy became a little rumbly. That’s my sign that it’s time to fuel the Doc’s Muscles. My son and I love Five Guys. They make a mean burger and cater to my every Ketogenic whim.
Here was today’s burger:
The lettuce wrapped bacon burger with mustard (and a pickle just for some flair). Pure saturated fat awaiting ketosis wrapped in foil. (Kind of makes your mouth water, doesn’t it?)
Add the bacon for a little more fat and the mustard for flavor and to prevent leg cramps (yellow mustard contains just enough quinine that it stops leg cramps) that can occur with dehydration in the Arizona heat (it was 93 degrees F today) and I’m a happy man.
Hope your lunch was just as good.
It has been resoundingly clear to me over the last couple of weeks that there is a tremendous need for a principle based approach to a ketogenic diet. This approach, however, must be simple. So many of the approaches to weight loss I read about are complex and the questions that arise from these approaches are innumerable. Losing weight should not be as difficult as putting a man on the moon. To quote a patient recently, “If it ain’t simple, Doc, I ain’t doing it. . .”
I agree.
Any approach that requires the conversion of food to numbers or calories or exchanges becomes cumbersome, and I personally won’t follow it for more than a week. The principle based approach should be simple and is really based upon the mantra:
Give a man a fish and he will eat today. Teach a man to fish and he will eat for the rest of his life.
Ketogenic diets are wrongly referred to as diets. What I’m talking about is a ketogenic lifestyle. Simple lifestyle design should not be hard. So, what do you say? Shall we learn to fish?!
I assume that if you’re reading this article, you already understand that weight gain is not due to an over intake of calories. Weight gain is due to hormone signals throughout the body leading to the storage of fat . . . specifically, triglycerides being taken up into the fat cells. The hormone that independently controls uptake of fat into each fat cell is insulin. Insulin is an essential hormone, but too much of it stimulates the adipose (fat cells) to over-stock triglycerides or essentially “get fat.” It, actually, is that simple. There’s really only one rule to this lifestyle: If it raises your insulin it will halt or stall your weight loss. Write that on your hand or your forehead or in your planner, the lifestyle revolves around that one rule.
Most people start a ketogenic diet because they want to lose weight and have failed at multiple other dietary approaches. Reasons for weight control failure are often multi-faceted, but they all start with from a position of flawed understanding. The majority of approaches to weight management come from the false assumption that weight is gained because of an over-consumption of calories or a lack of physical activity to burn excess calories. People have faithfully been restricting calories and exercising to exhaustion since the early 1980’s to no avail. (Well, 1% of people succeed, but the rest of us failed this approach). The definition of insanity is repetitive completion of an ineffective action and expecting a different outcome each subsequent time around. If you still think that caloric restriction and exercise is successful, I’ll be shipping your drawstring white vest and your invitation to a padded cell shortly.
Let me put it clearly. We’ve been exercising and cutting our calories since 1975 and look at what it’s gotten us . . .
. . . . a country that is now recognized as the “United States of Corpulence.” Super-Size me has become literal. “Houston . . . we have a problem . . . !”
The rule above is based on foundational principles. Understanding of the principles allows one to successfully apply the rule above.
PRINCIPLE 1
The first principle in a ketogenic lifestyle is understanding that the problem is not caloric, but hormonal. Choices and actions from here on out must be based on this understanding. Anything that will raise insulin will thwart ketosis. Insulin stimulates lipoprotein lipase, the enzyme that pulls the triglycerides into the fat cells. Without insulin, we don’t gain weight. (That’s why type I diabetes are usually very slender and skinny).
The standard lab value for normal fasting insulin levels reflect 10-22 uIU/L as the normal. However, in my office, glucose tolerance tests and postprandial glucose tests consistent with impaired fasting glucose are routinely positive when the fasting insulin level is >5 uIU/L.
Point of Focus: If your having trouble, look at the hormones. Food stimulates hormone responses. Focus on the hormone response to your diet.
PRINCIPLE 2
A ketogenic diet is one where the body uses fatty acids as the primary fuel. Those triglycerides mentioned above are made up of three fatty acids linked to a glycerol molecule. To use the triglycerides, the three fatty acids must be broken away from the glycerol by hormone sensitive lipase (HSL). Insulin directly inhibits HSL. Keeping insulin levels low is the first step in shifting to a ketogenic metabolism. Lowering insulin allows access to the fatty acids in your fat cells. Triglycerides are not water soluble and the rate by which they can be taken up and burned in the mitochondria limits the speed by which triglycerides can be used as fuel. The by product of triglyceride burning is ketones. Ketones themselves can be used as fuel and over 4-6 weeks, the body can enhance its ability to use ketones when fat is the primary fuel. This is called “Keto-Adaptation.”
Point of Focus: Too much carbohydrate in the diet shifts the body from it’s use of fat and triglycerides back to glucose. In general, to become “keto-adapted,” limit carbohydrate to < 20 grams per day. Keep protein at around 0.8 to 1 gram of protein per pound of body weight.
PRINCIPLE 3
Wait a minute!? Where do the ketones come in? When fatty acids are burned or oxidized in the mitochondria of cells within the liver, they are converted into Acetyl-CoA. The Acetyl-CoA is used to form ATP for energy in the Citric Acid Cycle.
IF excess Acetyl-CoA production occurs or if inadequate oxaloacetate is present, the extra Acetyl-CoA is transformed into ketone bodies – specifically beta-hydroxybutyric acid and acetoacetic acid. Fat can be oxidized or burned for fuel while ketones are being produced. Ketones are much smaller molecules and can more easily be transported in the blood than triglycerides, as they are water soluble. The ketones themselves can also be used or burned as fuel as the body upregulates the mitochondria’s ability to use the ketones as fuel as well. As I mentioned above, this process of “keto-adaptation” can take 4-6 weeks. Keto-adaptation results in humans having a greater desire to be physically active – the miraculous conversion of the couch-potato into the bacon-burning triathlete.
Point of Focus: Sugar is a drug. Its byproduct has the same hedonic effect on the brain as morphine. Sugar withdrawal can commonly cause headache, anxiousness, insomnia, dizziness, fatigue and moodiness within the first week of carbohydrate restriction on the road to keto-adaptation.
PRINCIPILE 4
For the average person to become “ketotic” or reach a state of ketosis, it takes lowering the carbohydrates to less than 20 grams per day (and sometimes less than 10 grams per day) for at least 3-7 days. Yes, it can actually take a week to reach ketosis. I have a few patient’s that are so insulin resistant that it takes longer. This means that to reach that fat burning state, one must maintain a low insulin response by restricting starch or carbohydrate intake to less than 20 grams per day for a minimum of a week. For your body to efficiently use the fuel it can take up to 6 weeks. This is why many people state that they “don’t feel good” or “can’t maintain their exercise levels” when starting a ketogenic diet. For most people, once they reach the 6 week mark, mitochondria have been unregulated and “fine tuned” to burn ketones, fat burning becomes efficient and energy levels begin to increase. In fact, for many like myself, you’ll finally feel like exercising for the first time in you life.
Point of Focus: If you’re already exercising, don’t be surprised if you feel more sluggish for the first four weeks. If you’re not exercising, I don’t recommend starting until after you pass through the Keto-Adaptive phase.
PRINCIPLE 5
Clinically, the average patient in my office will lose 5-15 lbs each month for the first three months. Then the weight loss will slow to 2-5 lbs per month. However, 1/2-1 inch continues to disappear off the waist circumference measurement every month. THIS IS NORMAL. Continued weight loss of 15 lbs a month will leave you looking like the Michelin Tire Man – rolls of skin without fat. The body slows the weight loss to keep up with skin and connective tissue remodeling. As long as ketosis is maintained, the fat will continue to melt away. At this point, I’m not so worried about scale weight as I am your waist circumference.
Point of Focus: Successful ketosis does not always affect the scale, but usually causes your pants to fall down.
PRINCIPLE 6
It has been my experience that it takes about 18 months for the average patient to reverse the insulin resistance while following a carbohydrate-restricted, high-fat ketogenic lifestyle. There is no quick fix for this. If there was, I’d be sitting on a beautiful beach in the Caribbean.
Point of Focus: The Ketogenic dietary lifestyle is actually the antidote to insulin resistance, diabetes and the diseases of civilization.
PRINCIPLE 7
Improvement in insulin resistance has also been demonstrated with mild to moderate intensity resistance exercise. Moderate intensity resistance exercise is 20-30 minutes of exercise like walking, easy jogging, cycling, lifting weights, yoga or Pilates with speeds or weight heavy enough to break a sweat, but not so fast or heavy that you cannot carry on a conversation with your exercise partner. Exercise improves insulin resistance – BUT IT DOESN’T CAUSE WEIGHT LOSS! Yes, I know, Jack LaLanne just rolled over in his grave. But, let me say that again. Exercise improves insulin resistance, but it does not improve weight loss!! The three largest and most intensive studies of exercise involving over 67,000 people demonstrate that you can exercise till the cows come home and you’ll average about 1% weight loss. If you exercise, realize it WILL make you hungry. Eating the wrong food (carbohydrate containing foods) will stimulate insulin release causing your exercise to be fruitless (Actually, your diet should be “fruit-less” anyway)
Point of Focus: Exercise because you feel like it, it improves insulin sensitivity and it decreases stress, not for weight loss.
PRINCIPLE 8
If you are eating enough fat, you won’t be hungry. Although this doesn’t always hold true in the case of patient’s with lepin resistance. 40-60% of patients with insulin resistance have a concomitant leptin resistance (see the article on lepin resistance here). A ketogenic diet is one in which 50% or more of total calories come from fat. No, you don’t have to count calories, just pick foods that contain 45% fat or more. Look for grass fed products as they will be higher in Omega 3 fatty acids. Red meat is 55% fat. Pork is 45% fat. This is where the chicken salad or turkey wrap fails (see Why Does Your Chicken Salad Stop Weight Loss). Look for alternatives to replace your basic meals and snacks. If you love chips, try pork rinds or make chips from fried cheese or pepperoni. Guacamole is a great replacement for bean dip.
Point of Focus: There is no need to eat 3-6 times per day. As you increase the fat in your diet you will feel more full. Eat when you are hungry, whether that is 3 times a day or once day, listen to your body.
PRINCIPLE 9
I’ve been following a ketogenic diet for over 10 years. The most common complaint I hear is, “Dr. Nally, I’m tired of eating eggs.” Ketogenic diets don’t have to be boring. There are hundreds of resources on the web for spicing up your ketogenic diet. See the Recommended Sites page above for some ideas to start. The Ketogenic Cookbook by Jimmy Moore and Maria Emmerich is a recent edition to the literature and a fantastic resource. Check out Franziska Spritzler’s Low Carb Dietitian website and new book as well. If you live in the UK, you should see Emily Maguire’s website and blog. She just completed a world tour, sampling all the low carbohydrate foods and restaurants around the world. If you are a picture person, check out the Best Keto Meals of 2015 Pinterest page followed by almost 16,000 people. If you haven’t takent the time, you should visit Dr. Andreas Eenfeldt’s website. He is one of Sweden’s premier ketogenic doctors has an immense number of resources at his website, Diet Doctor. Finding someone that can help you fine tune your diet is also essential. You can find a list of doctors that use ketogenic diets here.
Point of Focus: This lifestyle will require you to use real, whole food and cook like your grandmother or great grandmother did in the past. Unfortunately, we’ve lost a great deal of the art of cooking that needs to be re-discovered. If your lifestyle is too busy to cook and prepare real food, that busyness is probably causing you stress, another culprit in the weight gain cycle. The truth will set you free, but it will probably make you miserable first.
PRINCIPLE 10
WARNING! A very sweet patient of mine was given these instructions to treat her weight and blood sugar abnormalities. She applied these principles and they worked marvelously. She called me a few weeks later, however, mad as a wet hen. She placed her husband (not my patient at the time) on the same dietary changes. Her husband, who had significant blood pressure problems and was on four different blood pressure medications I later found out, had a sudden drop in his blood pressure and passed out. As happens to many of my patients, blood pressure, ejection fraction of the heart and blood sugars quickly begin to normalize. However, he never saw his doctor and never had is blood pressure medications adjusted. Because of the normalization that can occur in as rapidly as 1-2 weeks, the medications became much too strong, he passed out and ended up in the emergency room. These dietary principles are effective. They are often just as powerful as a number of the medications that we routinely prescribe.
Point of Focus: Please see your doctor before beginning any of these dietary recommendations, especially if you have any underlying medical conditions including Hypertension, Diabetes, Congestive Heart Failure, Coronary Artery Disease, Gout, Kidney Stones, etc., please do not try the dietary changes alone. Find a physician trained in the use of this type of dietary lifestyle in combination with close monitoring of your blood pressure, blood sugar and other key vital signs.
Stay tuned for Ketogenic Principles . . . Part II in the series where we’ll address Food Psychology, To Cheat or Not to Cheat, and Keeping it Real . . .
While at the house last night, Jimmy Moore, his wife Christine, and my wife Tiffini made this delicious cinnamon swirl cheese cake from The Ketogenic Cookbook. I think I have a new favorite!!! I seriously have not had a better cheesecake and this one is lowcarb, gluten free and keeps you in ketosis. Thank you Jimmy Moore and Maria Emmerich for such a yummy recipe. (I even had some for breakfast this morning . . . . mmmmm).
If you want a great low carb recipe, pick up a copy of the book and turn to page 336.
Until next time . . . keep the ketones high!
85% of the people that walk through my office doors have some degree of insulin resistance.
What is “insulin resistance?” It is an over production of insulin in response to ANY form of carbohydrate intake (yes, even the “good carbs” cause an insulin over-response in a person with insulin resistance.)
How do I know this? Because I routinely check insulin levels (I check them every three months) and the down stream markers of insulin on a large number of the patients that I see. I have been fascinated by the fact that a diet high in both sugar and fat [like the Standard American Diet, (SAD) diet] turn on the genetics leading to insulin resistance. Starch and sugar load the genetic gun.
Insulin acts like a key at the glucose doorway of every cell in your body. In many people, the insulin signal is blocked by hormones produced in the fat cell and the the insulin, acting like a “dull or worn out key” – can’t open the glucose doorway as efficiently.
So, the body panics, and releases extra insulin in response to the same load of carbohydrate or glucose. People with insulin resistance will produce between 2-20 times the normal amount of insulin in response to a simple carbohydrate load. Recent studies(1, 2) reveal high cholesterol and diets high in both fat and carbohydrate cause insulin resistance to progress or worsen.
So, instead of producing enough insulin to accommodate the one slice of bread or the one apple that you might eat, the insulin resistant person produces enough insulin for an entire loaf of bread or an entire bushel of apples. This excess insulin then stimulates one or all of the following:
If you are plagued by any or all of these, my first suggestion is to see your doctor and get screened for insulin resistance. I treat patients with these every day and have reversed these effects in thousands of patients with the correct diet and/or medications. Having seen these signs and patterns over the last 20 years of medical practice, I am still astonished every day by the dramatic effect our diet plays on the hormonal changes within the body. Remember that the food you eat is actually the most powerful form of medicine . . . and the slowest form of pernicious poison.
A ketogenic or carnivorous diet is your first step.
We take most insurances, however, check out my concierge program or my Direct Primary Care program if you are interested in an alternative to insurance.
References:
To maintain ketosis, the key is keeping the fat content high and the carb content low . . .while moderating the protein intake. Unless you are running triathalon’s, body building daily or exercising more than 45 minutes daily, most women don’t need more than 70-80 grams of protein per day. Most men don’t need more than 80-90 grams per day.
Now, stop looking at your phone and go make some bacon chips . . . 🙂
I found these charts to be very helpful when trying to calculate your fat intake with a meal. Fish can be challenging in calculating fat content. After reading these charts, I’m craving some sashimi’ed mackerel and salmon.
Great charts like these can be found at http://mariamindbodyhealth.com/charts/
Enjoy!!
I am always impressed by good pictures, great recipes and and scrumptious food. My wife knows this. Finding great ketogenic recipes is essential. The reason, is that to loose weight and remain in ketosis, it is often essential to increase fat intake to at least 50% of your total calories. Fat Bombs are a great snack idea that helps one accomplish this task. Increasing fat to that level can be challenging for some. Maria Emmerich has posted another tasty and tantalizing high fat, low carbohydrate snack. Check out her recipe for the Crispy Fat Bomb. This is one of those great high fat, low carb tools to keep you in ketosis.
On of my patient’s was just asking about another good Fat Bomb Recipe. So, thanks, Maria!! And, my patient’s thank you too. Try this one out. Please let me know what you think of the crispy versus Tiffini’s Fat Bombs.
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.
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| Low Carb Cheesecake = 1 gram carb per serving Individual spring-form serving pans |
