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Is Your Oatmeal is Killing You?

“Doc, if I don’t get my testosterone up, I’m just going to die!”

I’ve been hearing that statement from men more and more often lately.   And, the answer isn’t what you’d think.

If you’ve watched late night TV recently, you’ve probably seen the many advertisements for testosterone supplements for low testosterone in men or what is now being called “Low T” Syndrome.   It seems like this is the new advertising trend so much that patient’s use the term “Low T” as part of their conversations.

Watch the four minute short below about how your testosterone and sense of fatigue is being driven by your oatmeal or breakfast cereal . . .

Is it that men have just stopped making testosterone?  Suddenly, everyone’s testosterone is low and men are complaining about fatigue, libido, and erectile dysfunction . . . or are they?

It’s actually the oatmeal . . . and the breakfast cereals.  Clinically, when a man cuts the cereals and oatmeal out of his diet, he actually increases testosterone by 50-150 points within 1-2 months.

If you practice medicine long enough, you’ll see a trend that seems to have arisen as our waistlines have expanded.  About half of the men in my office with insulin resistance, pre-diabetes or diabetes have low testosterone levels.  But this shouldn’t be a surprise.  Type II diabetes, metabolic syndrome and insulin resistance are all driven by an over production in insulin in response to a carbohydrate load in the meal. Patients with these conditions produce between two to ten times the normal insulin in response to a starchy meal. A number of studies both in animal and human models demonstrate that insulin has a direct correlation on testosterone suppression in the blood. This has been demonstrated in both men and women.  In fact, glucose intake has been shown to suppress testosterone and LH in healthy men by suppressing the gonadal hormone axis and more predominant testosterone suppression is seen in patient with insulin resistance or metabolic syndrome.

Image Credit: http://www.townsendletter.com/July2012/metsyndrome0712.html

In fact, to put it simply, insulin increases the conversion (aromitization) of testosterone to estrogen in men (it does the opposite in women by interacting with the hormone FSH).  Interestingly, leptin resistance has a similar effect.  I tend to see the worst lowering of testosterone in men with both insulin and leptin resistance.

What that basically means is that your breakfast cereal or oatmeal decreases your ability to maintain testosterone by up to 50% (1), lowers your ability to stabilize muscle (2), increases your risk for heart attack and stroke and makes you fat!

Death by oatmeal  . . . really?

Yes.

How to you improve your testosterone?  Supplemental testosterone has been shown to help, but it comes with some risks, including prostate enlargement and stimulating growth of prostate cancer.  The most natural way to improve your testosterone is to change your diet.

A low carbohydrate or ketogenic diet turns down the insulin production and allows the testosterone to be available for use by the body. A ketogenic diet has the effect of reducing leptin resistance as well through weight loss.  A simple dietary change of this type is frequently seen in my office to increase testosterone by 100-150 points.

KetoOS

What is a ketogenic diet?  It is a diet that restricts carbohydrates to less than 30 grams per day, thereby causing the body to use ketones as the primary fuel source.  So, for breakfast tomorrow morning, hold the oatmeal (1/2 cup of Quaker Instant Oatmeal is 31 grams of carbohydrates) and have the bacon and eggs.  And, rather than have the cheesecake for desert this evening, have an extra slice of steak butter on your rib-eye and hold the potato.

Or, you might consider using a high fat shake with exogenous ketones.  This is my breakfast each morning:

Breakfastofchampions

Exogenous ketones mixed in sparkling water, 2 tablespoonfuls of coconut oil and my multi-vitamin and I’m usually full until after noon.

Either way, get rid of your breakfast cereals or oatmeal . . . it’s killing ya!

References:

  1. Ballester J et al., J Androl. “Insulin-dependent diabetes affects testicular function by FSH- and LH-linked mechanisms.” Sept-Oct 2004; 25(5): 706-19.
  2. Manninen AH, Nutr Metab (Lond). “Very-low-carbohydrate diets and preservation of muscle mass.” Jan 31, 2006; 3:9.

Low-Carb Maple Pecan Granola . . . (No More Frowney Faces) a DocMuscle’s Favorite

Frowney Face Child

The most exaggerated “frowney” face I get in the office seems to occur when patient’s find out that they cannot eat oatmeal or cereal any longer when following a low-carbohydrate dietary lifestyle.  No, oatmeal is NOT good for you . . . I don’t care what WebMD recently said.  No, steel-cut oats are even worse (1/4th cup of steel-cut oats is 27 grams of carbohydrate – Who only eats 1/4th cup of oatmeal? Most people eat at least 1/2 -1 cup at a sitting.  You do the math . . .)

When I mentioned this to a disabled patient, even her service dog frowned.

Frowny Face Dog

Now, before you go running to Larry, the Quaker Oats Mascot (he’s been around for over 140 years), and ask his weight loss advise, I have the solution.

Larry, the Quaker Oats mascot loses 10 lbs for new 2012 cover (He finally figures it out after 137 years)
Larry, the Quaker Oats mascot loses 10 lbs for new 2012 cover (He finally figures it out after 137 years)

My angelic wife, Tiffini, the amazing homestead chef and animal husbandry specialist on our little farm, started making low-carb granola for our horseback trail rides.  Prior to our discovery of a ketogenic lifestyle, granola was a staple in our pantry, on road trips and in the saddle bags on the trail.  This has now replaced any craving either of us had for granola.  It carries nicely all day in a Ziplock bag on horseback.  It even tastes fantastic in a bowl with unsweetened almond milk as a breakfast alternative if you’re tired of eggs and bacon (but, who ever tires of eggs and bacon? I know . . . Right?!!)

Low Carb Granola

I’ve been nibbling from this actual cookie-sheet of low-carb granola while writing this post. . . I wish you were here to share it with.  Soooooo very good, and good for your ketogenic lifestyle.  I think I’m going to eat another handful while I finish up Part II of the Principle Based Ketogenic Lifestyle post.  Enjoy . . .

—————————————————————————

Tiffini’s Maple Pecan Granola (Low-Carb)

1/4 cup butter
1 1/2 cup almonds
1 1/4 cups pecans, divided
1 cup flax seed meal
1/2 cup sunflower seeds – salted
1 cup coconut flakes, unsweetened finely chopped
1/2 cup vanilla whey protein powder – we like ISO-100
1/2 cup pepitas (pumpkin seeds), salted
1/8th tsp stevia extract
1 pinch of salt
2 egg whites
1 tsp EZ Sweetz (or 1/2 cup of Sweet Perfection)
In a food processor, process the almonds and 1 cup of the pecans until it resembles coarse crumbs.   Using a knife (preferably a sharp one – remember all bleeding stops eventually), chop the remaining 1/4 pecans coarsely.
Melt the butter and place it in mixing bowel or mixer (We use a Kitchen Aid Mixer).    Pour the coarsely chopped nuts into the mixing bowl.  Stir in flax seed meal, sunflower seeds, coconut flakes, pepitas and vanilla whey protein powder.  Blend in the remaining wet mixture, egg whites and add a pinch of salt.  Mix until it forms “clumps.”
Spread the mixture evenly on a large wax paper covered baking or cookie sheet and bake at 350 degrees F for 20-25 minutes or until golden brown.  Let it cool on the baking sheet to crisp up for a few hours.
It can be stored in a Ziplock bag in the refrigerator.
Yields 10 servings
1/3rd cup per serving
~ 4 g net carbs
14 g protein
30 g fat
Recipe was modified from Carolyn Ketchum’s Maple Pecan Flax Granola in Low-Carbing Among Friends, Volume – 1, pg. 169, Eureka Publishing, 2011.

Why Your Oatmeal is Killing Your Libido

Have you noticed that there are a large number of advertisements in the media about checking your testosterone or “Low T” Syndrome?  It seems like this is the new advertising trend on the radio and late night TV.

Suddenly, everyone’s testosterone is low and men are complaining about their libido,  . . . or are they?

Low testosterone
Benefits of Testosterone Optimization. (Image Credit: ArtOfManliness.com)

If you practice medicine long enough, you’ll see a trend that seems to have arisen as our waistlines have expanded.  About half of the men in my office with insulin resistance, pre-diabetes or diabetes have low testosterone levels.  But this shouldn’t be a surprise.  Type II diabetes, metabolic syndrome and insulin resistance are all driven by an over production in insulin in response to a carbohydrate load in the meal. Patients with these conditions produce between two to ten times the normal insulin in response to a starchy meal. A number of studies both in animal and human models demonstrate that insulin has a direct correlation on testosterone suppression in the blood. This has been demonstrated in both men and women.  In fact, glucose intake has been shown to suppress testosterone and LH in healthy men by suppressing the gonadal hormone axis and more predominant testosterone suppression is seen in patient with insulin resistance or metabolic syndrome.

Image Credit: http://www.townsendletter.com/July2012/metsyndrome0712.html
Image Credit: www.townsendletter.com/July2012/metsyndrome0712.html

In fact, to put it simply, insulin increases the conversion (aromitization) of testosterone to estrogen in men (it does the opposite in women).  Interestingly, Leptin resistance has a similar effect.  I tend to see the worst lowering of testosterone in men with both insulin and leptin resistance.

How to you improve your testosterone?  Supplemental testosterone has been shown to help, but it comes with some risks, including prostate enlargement and stimulating growth of prostate cancer.  The most natural way to improve your testosterone is to change your diet.

A low carbohydrate or ketogenic diet turns down the insulin production and allows the testosterone to be available for use by the body. A ketogenic diet has the effect of reducing leptin resistance as well through weight loss.  A simple dietary change of this type is frequently seen in my office to increase testosterone by 100-150 points.

KetoOS
KetoOS – Drinkable Exogenous Ketones

What is a ketogenic diet?  It is a diet that restricts carbohydrates to less than 50 grams per day, thereby causing the body to use ketones as the primary fuel source.  So, for breakfast tomorrow morning, hold the oatmeal (1/2 cup of Quaker Instant Oatmeal is 31 grams of carbohydrates) and have the bacon and eggs.  And, rather than have the cheesecake for desert this evening, have an extra slice of steak butter on your rib-eye and hold the potato.

Carb Thoughts

A number of patients come in to the office struggling with loosing weight.  When I review their dietary journals with them, I notice that many of them never stop eating fruit (because, fruit is good for you, right?!).  Well, lets put it this way:

One banana for breakfast is equal to . . .

banana

. . . just over seven (7) teaspoons of sugar.

teaspoon sugar

Count them . . . seven (7) teaspoons.

If your eating a banana for breakfast, it is halting your weight loss for up to 12 hours.  Give the banana’s to the monkeys and cook up some sausage and eggs for breakfast tomorrow.

Cured . . . by Definition.

Cured Ham Low Carb Humor

A friend posted this image and I couldn’t help but think about this little cartoon throughout the day.  In the 15 years that I have been in medical practice, it was re-emphasized to me that my definition of cure and the patient’s definition of cure may at times be notably different or even in opposition.

I am reminded of a sweet a patient in her early nineties that was brought in by her three well meaning and very caring daughters.  This patient was a type II diabetic and, for the most part, her blood sugar was in pretty good control.  To put it in medical terms, her morning blood sugars were in the 120 range and her Hemoglobin A1c (HbA1c) was a 6.4%.  She was obese by the standards of her body mass index (BMI) and her cholesterol was elevated.

The concern of her three daughters, “there to rat her out,” as the patient put it, was that she was eating donuts for breakfast each morning for the last few months. I noted that her HbA1c had gone up from 5.9% at the last visit.  We discussed the fact that the change in her dietary intake appeared to have caused the rise in her blood sugar and her cholesterol.

With my affirmation of the cause as ammunition, the patient’s daughters began to individually take shots at her choice of meals over the last year. They did it, I could see because they loved and cared for heir mother.  But I noticed the patient’s demeanor change suddenly, and a bit of trust between me and my patient began to slip.

This sweet centenarian turned and looked at me, square in the eye, and then proceeded to give me an education.

“Dr. Nally, do you know how old I am?” she asked.

“Why, yes, you are 93 years old,” I replied.

“And do you know how much longer I am going to be alive on this earth?” she inquired.

“Well, no. I do not know how much longer you will be alive, but I can tell you that you have out lived most of your peers and the average age of most Americans.”

“Then, why the hell are you, and my daughters, worried about me eating a damn do-nut?” she yelled.  “My blood sugar is still pretty good and I figure that if I have to be around on this earth any longer, then by stars, I am going to enjoy my favorite breakfast. If it kills me, then so be it. I am going to enjoy it.”

Well, that was that.  The cure was to enjoy her last few years upon this earth.

She did just that.

New Year Resolution Project

A few of my patient’s have fallen off the carbohydrate restriction waggon this last year.  In celebration of restarting your low-carb lifestyle and resolutions to improve your health, I propose the following celebration.

1) Go home right at 5pm

2) Pull out your favorite skillet (mine is a well used Lodge Cast Iron pan)

3) Remove your favorite full fat sausage from the freezer.

4) Look up your favorite cream cheese waffle recipe.

5) Make your self a Sausage Sanctuary, a Bacon Bungalow or a Low-Carb Cabin (whatever tickles your fancy) in celebration of restarting your carbohydrate restriction and removing the carbage from your life.

Sausage House

I suggest you use a Low-Carb cream cheese waffle you can find here for the roof.

Good Luck! And, may the ketones be with you!

Don't Fear Fat

Dont Fear Fat

 

Don’t fear the fat.  If you haven’t seen the movie Cereal Killers, you should watch it by clicking here.   D.J. O’Neill ditches wheat and sugar in a food plan consisting of 70% fat – under the guidance of legendary South African Sports Scientist Prof. Tim Noakes.

Coconut Flour Conversion Chart

For those on a ketogenic or low-carbohydrate diet, whole wheat flour or almond flour is often substituted for with coconut flour. Found this cool chart at “Maria Mind Body Health.” Maria Emmerich has given me permission to post it here for you, my wonderful patients and followers.

We use many of Maria’s recipes in my home, but occasionally you may want to convert your own recipe and this chart will help. My wife is the cook in our family, and probably already knows how to do this, but for those just beginning your ketogenic journey, this will be a big help in recipe conversion.

Coconut flour conversion

I’ve had patient’s ask me in the room how to substitute for flour.  Here’s the answer. Remember, you have to double the eggs per cup. Thanks Maria!!

 

The Self-Discipline Muscle

Many patients come to my office desiring to loose weight, but complain of no self-control.  They feel they cannot loose weight because they don’t have the willpower.  Willpower, or self-control, is an elusive and mysterious thing. “If only I had more self-control,” I hear people say, “I could . . . ” exercise regularly, eat right, avoid drugs and alcohol, save for retirement, stop procrastinating, achieve a noble goal, or loose weight.  A 2011 American Psychological Association study reveals that almost 30% of those interviewed felt that lack of willpower was the greatest barrier to making a change in any of these areas.

So what is “willpower” or “self-control?” It is the ability to resist short-term temptations in order to fulfill a long-term goal. Image

I meet and work with people every day who feel they have no willpower.  In actuality, will power and self-control are learned behaviors that develop over time.  Anyone can have willpower, you just have to understand how willpower in certain areas can be strengthened and what makes it weak.  In fact, a 2005 study showed that self-discipline or willpower was more important than IQ in academic successes.  This study also found that increased self-discipline lead to less binge eating, higher self-esteem, higher grade point averages, better relationship skills and less alcoholism. Fascinating isn’t it!?

The answer can be found in a quote from Henry P Liddon, “What we do upon some great occasion will probably depend on what we already are; and what we are will be the result of previous years of self-discipline.”  This means that willpower or self-control can be learned or improved.  How, you ask?

First, you must establish and write down a reason or motivation for change.  In addition, that change must fulfill a clear goal. Just wanting to loose weight isn’t good enough.  You have to be motivated because of a consequence that arises from the obesity or overweight.  And, you “loosing weight” isn’t a clear goal.  You must set a weight reduction goal. It has to be clearly written down with your motivational reason.  Willpower or self-control cannot begin to form until these two steps occur.

Second, you must begin to monitor your behavior toward that goal.  When it comes to weight loss, I ask every one of my patient’s to keep a diet journal.  In this journal they are asked to write down every thing they eat and drink.  The night before, they are to write down their plan for tomorrow’s meals, then the next evening, they account for their success or failure by journaling on that same page what they actually ate and drank, then after comparing what they did, they plan for tomorrow and journal why they were successful or why they weren’t.  It’s the last part that is so powerful, a short 3-5 minutes of self-introspection. Self-introspection is the key to behavioral change.  It is the key that allows a person to see their habits and then make very small changes that break bad habits, solidify good habits and strengthens willpower.

Third, willpower is developed over time.  It is developed by being accountable to ones-self on very little things every single day.  But it MUST be written down. If I planned to eat bacon and eggs for breakfast and I didn’t, why?  When I look at my day, I may realize that I went to bed too late to get up early and cook bacon and eggs. So, instead, I ate a yogurt that was in the fridge. I am accountable to myself.  If I plan to eat bacon and eggs tomorrow, I must either go to bed earlier, prepare them the night before, or throw out the yogurt . . . so not to be a temptation again.  This is written down and I make a very small change tomorrow.

kid-musclesOver time, this self-introspection becomes easier and easier, to the point that you do it sub-consciously.  It is this sub-conscious self-introspection and change will be seen by others as self-control or willpower.  Just like a working or strengthening a muscle, recording short goals and and accounting for them makes your self-discipline stronger.  The self-discipline muscle becomes more powerful. In time, a split second decision not to binge on that piece of cake will be seen as strong willpower by those around you. You’ll recognize that it’s just flexing your self-discipline muscle.

So, my next question to you is . . . where’s your diet journal?

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