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Erythritol, Will It Really Kill Me?
Don’t miss this podcast as Dr. Nally discusses the sugar alcohol, erythritol, and what the Cleveland Clinic’s study really means to those following a Ketogenic Lifestyle. Is there another reason behind attacking erythritol?
After hearing this podcast, you decide.
Myokines and Weight Loss
Since the very first muscle derived myostatin protein was identified as a myokine in 1997, over 600 myokines have been identified to date (Gorgens et al., 2015). However, the majority of these myokines are still not sufficiently characterized.
Why is this important? This frequently neglected topic plays a central roll in diet and exercise in those people trying to lose or maintain their weight. Myokines are the key actors in muscle development and size, and and they influence weight gain or loss in a pretty dramatic way.
The myokines are a subclass of interlukins. Interlukins are a group of naturally occurring proteins that mediate communication between cells. They are like the rapid text messages between teenagers in the same room communicating with each other. Interleukins regulate cell growth, differentiation, and motility. They are particularly important in stimulating immune responses, such as inflammation.
Muscles Make Their Own Interlukins
A few years ago, research demonstrated in the Journal of Experimental Biology that there is a notable increase in the plasma concentration of IL-6 during exercise (Pedersen and Febbraio, 2008). This is followed by the appearance of IL-1 receptor antagonist (IL-1ra) and the anti-inflammatory cytokine IL-10. Concentrations of the these cytokines, IL-8, macrophage inflammatory protein 1a (MIP-1a) and MIP-1b are elevated after strenuous exercise.
Thus, the cytokine response to exercise is not preceded by an increase in plasma TNF-a. Even though there may be a moderate increase in the systemic concentration of these cytokines, the underlying fact is that the appearance of IL-6 in the circulation is by far the most marked and precedes that of the other cytokines (Pedersen and Febbraio, 2008).
Muscle Interlukins Create Good Inflammation
When IL-6 is produced by macrophages, it leads to an inflammatory response, whereas muscle cells produce and release IL-6 without activating classical pro-inflammatory pathways. The fact that IL-6 can sometimes act as a pro-inflammatory and sometimes as an anti-inflammatory agent appears to be more dependent on the environment (muscle versus immune cell) than on whether IL-6 is activated in an acute or chronic fashion (Pedersen and Febbraio, 2008). This essentially means that strenuous exercise is a good form of stress, stabilizing the muscle, causing growth and not adversely affecting the immune system.
Interlukins From Muscles Talk to Fat Cells
At the same time, IL-15 is expressed in human skeletal muscle (Pedersen et al., 2007). C2C12 tubule contraction in the muscle stimulates the IL-15 release. It possesses anabolic effects on skeletal muscle in vitro and in vivo and may also take part in reducing adipose tissue mass (Pedersen et al., 2007). Therefore, IL-15 has been suggested to be involved in muscle–fat crosstalk. Recently, we demonstrated that IL-15 mRNA levels were upregulated in human skeletal muscle following a bout of strength training (Nielsen et al., 2007), suggesting that IL-15 may accumulate within the muscle as a consequence of regular training.
What is fascinating is that there is a negative relationship between IL-15 and truncal fat mass, but not limb fat mass. That means that the more resistance exercise you participate in regularly, the lower your truncal fat becomes.
BDNF Stays Active Even After Exercise
Another cytokine actor in this opera of human metabolism is Brain Derived Neurotrophic Factor (BDNF). BDNF is a fascinating hormone produced in the brain. In humans, a BDNF release from the brain was observed at rest and increased 2- to 3-fold during exercise. Both at rest and during exercise, the brain contributed 70–80% of the circulating BDNF, while this contribution decreased following 1h of recovery. In mice, exercise induced a 3- to 5-fold increase in BDNF mRNA expression in the hippocampus and cortex, peaking 2h after the termination of exercise.
Matthews and colleagues studied whether skeletal muscle would produce BDNF in response to exercise (Matthews et al., 2009) and found that BDNF mRNA and protein expression were increased in human skeletal muscle after exercise. However. muscle-derived BDNF appeared not to be released into the circulation. BDNF mRNA and protein expression were increased in muscle cells that were electrically stimulated.
You can augment the presence of BDNF with curcumin. Curcumin is a natural isolate derived from turmeric an has been show to have anti-inflammatory, anti-oxidant and anti-depressant properties through its ability to raise BDNF. Using curcumin daily with a regular exercise program helps to improve brain function and reduce mental and physical stress (4, 5)
How HIFEM Exercise Is Effective
Why is this important? Because, BDNF increased phosphorylation of AMPK and acetyl-CoA carboxylase (ACC) and enhanced fat oxidation both in vitro and ex vivo. In layman’s terms, that means that regular exercise stimulates the burning of fat for 1-2 hours after exercise. This can be exercise from resistance training or from HIFEM like EMSculpt or electromagnetic stimulus.
What is the take home message from all this geeky science stuff?
Resistance exercise improves muscle regeneration, fatty acid oxidation, fat metabolism, muscle repair, mitochondrial biogenesis (increasing numbers of mitochondria). So if you are not participating in at least 3 days of resistance exercise per week, I’d encourage you to do so.
If you are looking for a simple body weight exercise program that can be done at home. I’ll send you my program for free. Go to docmuscles.com/exercise and sign up.
References:
- Pedersen BK. Muscles and their myokines. J Exper Biol. 2011. 214:337-346. doi:10.1242/jeb.048074.
- Furuichi Y, Manabe Y, Takagi M, Aoki M, Fujii NL (2018) Evidence for acute contraction induced myokine secretion by C2C12 myotubes. PLoS ONE 13(10): e0206146. https://doi.org/ 10.1371/journal.pone.0206146.
- Han LJ & Hee-Sook J. Role of Myokines in Regulating Skeletal Muscle Mass and Function. Frontiers in Physiology. Jan 2019. Vol 10:1-9. doi: 10.3389/fphys.2019.00042
- Ga-Young Choi, Hyun-Bum Kim, Eun-Sang Hwang, Seok Lee, Min-Ji Kim, Ji-Young Choi, Sung-Ok Lee, Sang-Seong Kim, Ji-Ho Park, “Curcumin Alters Neural Plasticity and Viability of Intact Hippocampal Circuits and Attenuates Behavioral Despair and COX-2 Expression in Chronically Stressed Rats”, Mediators of Inflammation, vol. 2017, Article ID 6280925, 9 pages, 2017. https://doi.org/10.1155/2017/6280925
- Hurley LL, Akinfiresoye L, Nwulia E, Kamiya A, Kulkarni AA, Tizabi Y. Antidepressant-like effects of curcumin in WKY rat model of depression is associated with an increase in hippocampal BDNF, Behavioral Brain Research. 2013(239):27-30. ISSN 0166-4328, https://doi.org/10.1016/j.bbr.2012.10.049.
Dr. Nally’s Keto/Carnivore LiveStream Video Topics
I will be starting a twice weekly exclusive live-stream here for my amazing online followers and patient who are participating in the KetoClan Group on the following sixteen topics next week. Will be sharing the basics and my 22 years of clinical experience with each of these topics as it relates to health and weight management. These topics will take 10-30 minutes, then giving the remainder of the hour to you to ask questions.
The topics we will cover over the next 8 weeks are listed below:
1. Insulin
2. Monitoring Glucose – CGMs
3. Fat Adaptation
4. Things that make insulin go “bump in the night (or the day)” – (sweeteners, creamers, teas, Resveratrol, nuts, etc)
5. Protein
6. Basic Thyroid Function
7. Female Hormones
8. Male Hormones
9. Testing Ketones in Urine, Breath, Blood
10. Ketoacidosis
11. Medications and ketogenic diets (Metformin, DPP4s, GLP-1, SLT-2s, sulfonoureas, Berberine)
12. Stress – Cortisol & DHEA
13. Exercise – Cardiovascular and Resistance Exercise
14. Sleep
15. Food Cravings and the Subconscious Mind
16. Keto, Carnivore or Fasting – What should I be doing?
Not a member yet? Sign up here.
2022 Keto Awards
I’ve been told that many of you have nominated me. Thank you!!!
Every year Ketogenic.com hosts the Keto Awards with Metabolic Health Summit to highlight some of the best and brightest in our community.
There are five unique categories in which you can nominate and it would be an honor to me for you to add your vote:
Top Keto Educator
Top Keto Book
Top Keto Podcast
Top Keto Researcher
Making Positivity Louder
I’ll be sure to let you know who is selected.
Please take a minute to cast your vote for me.
Vote Here:
Why Am I Bloating On A Ketogenic Diet?
What is the cause of abdominal bloating when following a ketogenic or low-carbohydrate diet?
How Do You Use Exogenous Ketones (BHB)?
BHB stands for beta-hydroxybutyrate. This is one of three naturally occurring ketones formed in the body when metabolizing fat.
I’ve been asked what they are and how to use them quite a few times in the last week, so I thought I’d answer it here. . .
BHB can be used for a number of things:
1) to push you into a ketogenic state for 1-6 hours – I use them to jumpstart keto in people just starting a ketogenic diet (however, if BHB is being used while cheating on carbs at the same time, they often halt weight loss and in some cases can allow for weight gain).
2) I use it as a pre-workout drink for increased energy and stronger muscle contraction (I use them prior to sword fighting and it allows me more energy and endurance.)
3) For appetite suppression when the “munchies” try to kick in due to stress or anxiety.
4) To help enhance cognition in patients with Alzheimer’s dementia and Parkinson’s disease.
5) To improve mental clarity and focus in those with ADD/ADHD.
6) I also use them as a meal replacement while traveling.
7) I use them to help people who are morbidly obese experience a ketogenic state when they have never restricted carbohydrates before.
8) And, to prevent seizures when scuba diving with re-breather type equipment (bubble-less SCUBA).
You can find my exogenous ketones (BHB) at http://www.ketoliving.com
16 Years of Keto/Carnivore . . .
No, it’s not sustainable at all. What do you think?
High Fat? High Protein? Low Protein? What is really ketogenic?
The daily question that I get asked by my patients, and from those around the internet, relates to burning one’s own fat. “Don’t you have to limit the calories and limit fat you eat to burn your own body fat?”
It seems everyone has a differing opinion on this question and a few of them have two opinions (you know who you are). Very few of these opinions are grounded in the actual science of weight loss.
I hear coaches, trainers and even a number physicians argue, name call and rant about the need to cut calories to lose fat. Yet, most of my patients “cut their calories” 200-1000 per day without successful fat reduction. They may increase their exercise by 400-600 calories per day and still no weight loss. This is the same crazy ineffective instruction we’ve been given for the last 50 years.
To be honest, there is a percentage of those in the fitness and modeling worlds upon which this dogma is effective and that is because of normal insulin levels and significant exercise. However, for the other 85% of the world who work over 40-80 hours a week, have children and families, serve in our churches and occasionally have a social life, myself included, it doesn’t work. If we were all paid to exercise 2 hours a day and take “butt selfies” on Instagram, it might be easier.
Yes, you will probably lose 20 lbs. with calorie restriction, but your testosterone will drop by up to 50%, sex hormone binding globulin will double, and over time your basal metabolic rate will slow due to dramatic and often permeant reduction in thyroid function. This makes it nearly impossible to lose more than that 20 lbs, and then you will regain the weight once calorie levels return to normal within 18-24 months. (No one ever talks about that little problem, do they?)
For those of you that want to see success in weight loss, let’s outline a few essential principles that the trainers, keto-coaches and social media talking heads aren’t mentioning.
First, insulin has to be kept at a baseline. The reason that 85% of people don’t, won’t and can’t see effective weight loss beyond 20-30 lbs long term (greater than 2 years) with calorie restriction is that 85% of the population has some degree of insulin resistance. It’s not a disease, it’s a syndrome associated with the effect of the standard American diet. I wrote a whole book about it called The Keto Cure. We know that insulin and catecholamines increase the rate by which fat is stored.
Second, glucacon is a counter active hormone to keep your blood sugar from bottoming out. The presence of glucagon stimulates fat burning. Intermittent fasting and ketogenic dietary intake allow blood sugar to drop below 70 mg/dL (3.9 mmol/L) causing glucagon release and stimulate increased release of free fatty acids from the fat cells.
Third, two hormones, epinephrine and norepinephrine, are produced when blood sugar drops below 67 mg/dL (3.7 mmol/L). Exercise lowers blood sugar to this level and stimulates additional burning of fat by engaging the release of glucagon and epinephrine and norepinephrine. Exercise, also, has three other myokine hormonal effects making weight loss more successful when the diet is correctly balanced.
The fourth principle that is essential to understand relates to growth hormone. Growth hormone stimulates and preserves muscle tissue, has a suppressive effect on insulin. Growth hormone increases with exercise, sleep, intermittent fasting and when protein intake is at least greater than 90 grams per day in women and around 1 gram of protein per body weight in men. This is notably higher than previous calculations on protein that I have written about in the past. Recent research, also found here, here and here, demonstrates that increased protein above 90-100 grams per day enhances muscle growth and stabilization and further suppresses insulin production beyond what we previously understood.
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Contrary to what the media has been saying about protein sources, not all protein is absorbed in the same way. When it comes to absorption in the human gut and use by the human metabolism, protein sources differ in their effectiveness:
-
- Egg protein utilization – 50%
- Meat protein utilization – 40%
- Cheese protein utilization 35-40%
- Whey protein utilization – 18%
- Vegetable protein utilization – 14%
Lastly, release of fat from the fat cell is mediated by natriuretic peptides and cGMP through the release of catecholamines, prostaglandins and nicotinic acid. Interestingly, the major positive regulators of human lipolysis are catecholamines and natriuretic peptides (NPs). Fatty acid release from fat cells triples when catecholamines and natriuretic peptides are released. Catecholamines are produced by exercise, stimulants and stress, and natriuretic peptides are stimulated by short change fatty acids (ketones).
For the science geeks in who follow my blog, I’ve included the following picture that summarizes the effects of these hormones on the fat cell. The figure below shows the major pathways by which insulin, thyroid, catecholamines, testosterone and sympathomimetics effect fatty acid release from adipose tissue.
The take home message from this information is this, effective long term weight loss cannot be achieved by calorie restriction. Effective weight loss (specifically fat loss and muscle gain) is most effectively achieved when carbohydrates are restricted, protein is optimized, and proper exercise adequately triggers the release of fat burning hormones.
Click HERE and get a copy of my ketogenic diet.
Get a copy of my diet and 13 learning modules with coaching and online assistance by becoming a member of Dr. Nally’s KetoClan.
I’d like to know, what combination has been most effective for you?
Have a great day!
Adam (eat your bacon) Nally, DO
Keto Approved Foods
I’ve been living and teaching patients about using a low-carb/ketogenic and carnivorous lifestyles for over 16 years. I get thousands of questions each month about what to eat. People ask:
- “What foods are ketogenic lifestyle approved?”
- “Can you just give me a list of approved keto foods?”
- “But, can’t I just have some oatmeal?”
In the past, I’ve given people seven day diets, and I’ve given them food lists. But, you know the proverb, “give a man a fish . . .” People still seem confused. I’ve tried teaching people the simple ketogenic principles, “teach a man to fish . . .” and this helps a few others. However, there still seems to be great confusion about what foods can and should be used in a ketogenic lifestyle. Today, I thought I would try to combine both approaches and discuss the basic macro-nutrients that make up a well formulated ketogenic diet.
Carbohydrates
Let’s start with carbohydrates. The first principle that must be followed to enter and stay in ketosis is keep insulin from spiking. This is done by keeping total carbohydrate intake less than 20 grams per day. The liver produces a small amount of carbohydrate every day to protect the brain. Therefore, a low baseline level of continuous insulin production is essential to maintain life. However, it’s the large spikes of insulin after ingesting carbohydrate containing meals that cause the problems. We talk about this at length in my book The Keto Cure.
Carbohydrates are the foods that most commonly cause insulin to spike. It is the rapid rise or spike of insulin levels that drive weight gain, arterial plaque formation, heart disease, inflammation, neuropathy, kidney stones, gout and thyroid problems. Simple and complex carbohydrates cause insulin to surge. Those same simple and complex carbohydrates are the sugars (monosaccharides & disaccharides) and starches (polysaccharides) found in foods.
Fibers are also complex carbohydrates (polysaccharides) in the form of cellulose, lignin and pectin that are more difficult for human digestive enzymes to break down into simple digestible forms of carbohydrate. However, juicing, blending or cooking fibers releases the carbohydrate from the complex form and makes them available to our bodies.
Carbohydrates in their various forms are present in varying amounts in foods like fruit, vegetables, grains, beans, legumes, milk, and processed foods like candy, soda & sweets. (These are the foods to limit or completely avoid).
In general, raw leafy greens contain cellulose and the carbohydrates in these vegetables when eaten raw do not need to be counted. You are free to eat as much as you desire. However, cooking, blending or juicing the leafy green (as noted below) does break the cellulose bonds and increases carbohydrate absorption (that is why cooked, blended, or juiced vegetables taste “sweeter”).
NOTE: I recommend 1-2 cups of raw leafy greens per day. Leafy greens are one of the highest sources of folic acid (spinach, asparagus & okra) and without them in the diet, there is a potential risk of folate deficiency if it isn’t present in animal fat sourcesa. This is especially problematic in pregnant and breast feeding mothers. Yes, I hear you, eggs and meat are another source of folic acid; however, leafy greens like spinach contain four times the folic acid that eggs and meats do. Even iceberg lettuce contains more folic acid than eggs (this is why I caution pure carnivore diets in women of child bearing age without folic acid supplementation).
Foods that are loaded with sugars and starches that should be AVOIDED or USED WITH GREAT PRUDENCE include:
Non-Leafy Green Vegetables (1 cup raw or 1/2 cup cooked) – 10 grams of carbohydrate
Asparagus
Bamboo Shoots
Beans (yellow or green)
Beets
Broccoli
Brussell sprouts
Cauliflower
Cabbage
Celery Leaves
Egg Plant
Leeks
Mushrooms
Okra
Onions
Green Onions
Scallions
Pea Pods
Peppers: Green, Red, Sweet, Hot
Sauerkraut
Spinach
Summer Squash
Turnips
Tomato
Zucchini
(Corn, Carrots and Potatoes are not listed here due to their higher carbohydrate content)
Fruits (portions below) – 15 grams of carbohydrate
Apple (1 small)
Apple Juice (1/2 cup)
Apple Sauce (1/2 cup)
Apricots (2 fresh) Page | 5
Banana (1/2)
Berries (blueberries, black berries, strawberries, loganberries, raspberries – 1 cup)
Cantaloupe (1/4 of a 6 inch melon)
Cherries (12)
Cranberries (1 cup)
Dates (3)
Figs (Fres
Grapefruit Juice (1/3rd cup)
Grapes (17 small)
Honeydew melon (1/8th of a 7inch melon)
Kiwi (1)
Lemons (2)
Mango (1/2)
Nectar (1/3rd cup canned)
Nectarine (1)
Orange (1 small orange)
Orange Juice (1/2 cup)
Peach (1 medium)
Pear (1 small)
Pineapple (1/2 cup chopped)
Plumbs (2)
Prune Juice (1/3 cup)
Prunes (2 fresh or dried)
Raisins (2 Tbsp)
Rhubarb (1 cup cooked)
Tangerine (1)
Watermelon (4 inch x 1 ½ inch thick wedge)
Breads (portions below) – 20 grams of carbohydrate
Bread: white, wheat, French, rye, pumpernickel (1 slice)
Bagel (1/3rd)
Biscuit or Roll (1 small)
Breadcrumbs (1/4th cup dry, grated)
Bread-stick (1)
Buns: hamburger, hot dog (1/2 bun)
Cereal – cooked (1/2 cup)
Cereal – puffed (1 cup)
Cereal – flakes (1/2 cup)
Corn (1/3rd cup or 1 small cob)
Crackers:
Graham (three 2 ½ inch squares)
Oyster (1/2 cup)
Saltines (5)
Soda (3)
Zwieback (2)
Macaroni noodles (1/2 cup cooked)
Matzo (one 5 inch square)
Muffin – English (1/2 plain)
Muffin – bran (1 small) Page | 6
Toast – Melba (4 rectangles)
Pasta (1/2 cup) Peas – green (1/2 cup)
Pita bread (1 small)
Popcorn – air popped, dry (3 cups)
Potato – New, Russet or sweet (1/2 cup)
Pretzels (3/4th oz)
Rice – cooked (1/3rd cup)
Rice Cakes (2 plain)
Tortilla (1 small)
Dairy (portions below) – 25 grams of carbohydrate
Milk – whole, 1%, 2% and skim (1 cup)
Powdered Skim Milk – dry (1/3rd cup)
Yogurt:
Plain (1 cup)
Light – sweetened with NutraSweet (1 cup)
Regular – fruit filled (1/2 cup)
Cottage Cheese (2 cups)
American Cheese (12 slices)
You may use hard cheeses, cream cheese, sour cream, and mascarpone as great options on a ketogenic diet because they contain very little carbohydrate and are high in fats.
Proteins
Proteins are large molecules made of of long chains of amino acids and are essential for a vast array of functions within the human being including structural formation, enzymatic reactions, immune response, cell adhesion, DNA replication, and molecular transport to name just a few. There are 22 amino acids that make up the protein molecules used in the human body. Interestingly, microorganisms and plants can make all 22 of these amino acids on their own. However, humans (and a number of other mammals) can’t make 15 of these amino acids on our own and we must obtain them from our diets.
How much protein do you actually need? Understanding your individual needs baseline protein needs can be calculated from your ideal body weight (IBW). IBW can be very easily calculated from your height and your level of activity. I give you this calculation because many female patients I see do not eat enough protein. Lack of protein will halt weight loss (as the body thinks it is starving.)
Your daily protein need can be calculated by the following:
Males: IBW = 50 kg + 2.3 kg for each inch over 5 feet. Males need 1.2 g protein per kg of IBW.
Females: IBW = 45.5 kg + 2.3 kg for each inch over 5 feet. Females need 1.0 g protein per kg of IBW.
If you are exercising more than 30 minutes 3 days per week then those values increase to 1.4 grams per kg for females and 1.6 grams per kg for males.
Example:
A 6 foot male’s IBW would be 50 kg + (2.3kg x 12 inches) = 77.6 kg x 1.2g/kg if sedentary or 1.6g/kg if exercising 4-5 days per week.
A 5 foot 4 inch females IBW would be 45.5 kg + (2.3kg x 4 inches) = 54.7 kg x 1.0g/kg if sedentary or 1.4g/kg if exercising 4-5 times per week.
This will give you a starting point for your daily protein needs and you can divide this number by the number of meals per day to get the protein needs at each meal. However, many of my patients after three months of ketogenic living need more protein to continue seeing weight loss.
What if I eat too much protein? There is still significant controversy over exactly how much protein is necessary on a daily basis. The reason is that many amino acids when ingested in significant amounts stimulate an insulin surge by themselves. These include arginine, lysine and tryptophan. Eating proteins that are high in these three amino acids in my very insulin resistant patients will raise insulin enough to halt weight loss, cause worsening inflammation, raise blood pressure and cholesterol.
Do you have to avoid these foods on a ketogenic diet? No, however, when you are using them more than 2-3 times a week, weight loss is inhibited and one’s ability to maintain ketosis is blunted.
However, two recent studies(1, 2) demonstrate that when protein intake is increased beyond a certain threshold, growth hormone counterbalances the insulin response and stimulates muscle growth instead of weight gain. That threshold seems to be around 90 grams of protein per day as women and 150 grams of protein as men.
Yes, this is much higher protein in take than the calculation for baseline protein needs we’ve used for years outlined above. We are learning a great deal about protein. For years, we’ve been missing the mark on protein needs. This revolves around the need of leucine to stimulate muscle growth.
What proteins can you use? The following list should be helpful. Remember that protein and fat often come packaged together in nature. As we discuss below, to maintain adequate ketosis, total fat intake should between 70-90% of your total calories. In order to maintain fat contents greater than 70%, you’ll want to use proteins sources that are the highest in fat (like red meat and pork) or add fat (like cooking in butter or coconut oil) to those that are lower in fat content.
Food: Protein Content: Fat Content:
Ground Beef (75% Lean) – 16 grams per 4 oz. 78%
Steak (Ribeye) – 39 grams per 8 oz. 74%
Steak (Top or Bottom Round) – 33 grams per 6 oz. 53%
Bacon (pan fried) – 3 grams per 1 slice 69%
Sausage (beef) – 14 grams per 3.5 oz. 79%
Sausage (pork) – 17 grams per 3.5 oz. 75%
Pork Chop (boneless) – 18 grams per 3 oz. 31%
Ham (cured whole boneless) – 19 grams per 3.5 oz. 28%
Sockeye Salmon – 23 grams per 3 oz. 22%
Halibut – 23 grams per 3 oz. 19%
Chicken Breast (boneless, skinless) – 24 grams per 3 oz. 18%
Turkey Breast – 24 grams per 3 oz. 15%
Tilapia – 21 grams per 3 oz. 13%
Yellowfin Tuna – 25 grams per 3 oz. 10%
Light Tuna – 22 grams per 3 oz. 8%
Deli Meats:
Pepperoni – 18 grams per 3 oz. 83%
Roast Beef – 21 grams per 3 oz. 48%
Canadian bacon – 17 grams per 3 oz. 42%
Roast Turkey Breast – 18 grams per 3 oz. 15%
Snacks:
Beef Jerky (Jack Links) – 13 grams per 1 oz. 9%
Peanut Butter (Peter Pan Crunchy) – 8 grams per 2 tbsp. 76%
Macadamia nuts, raw 2.2 grams per 12 nuts 89%
Mixed Nuts – 6 grams per 2 oz. 79%
Almonds, raw – 6 grams per 1 oz. 66%
Walnuts, raw – 4 grams per 1 oz. 85%
Sunflower seeds, raw – 6 grams per 1 oz. 76%
Tofu – 12 grams per 3 oz. 30%
Greek Yogurt – 23 grams per 8 oz. 0%
Cheeses:
Cream Cheese – 11 grams per 3.5 oz. 79%
Cheddar Cheese – 24.6 grams per 3.5 oz. 74%
Swiss Cheese – 24 grams per 3 oz. 66%
Ricotta cheese – 10 grams per 3.5 oz. 63%
Eggs – 6 grams per 1 large egg 70%
Look for foods who’s ratio of protein to fat is close to or greater than 1:1. For example, eggs are 6 grams of protein and 6 grams of fat.
It is essential to understand that not all sources of protein are equal in their absorption in the human gut.
- Egg protein utilization – 50%
- Meat protein utilization – 40%
- Cheese protein utilization – 40%
- Whey protein utilization – 18%
- Vegetable protein utilization – 14%
Therefore, the two most important things you can do to optimize your ketogenic lifestyle is lower the carbohydrate intake to less than 20 grams per day, and use adequate high quality protein. Muscle gain and fat loss are most effectively achieved when high quality protein is used.
If you are struggling or just getting started, get a copy of Dr. Nally’s Ketogenic Diet here.
Are You the King or the Second Queen?
When you were a boy, much like me, you likely dreamed of the day you would be a king. You dreamed of the day you would marry a beautiful maiden, have children, own lands . . . You dreamed of the day you would be loved, feared, and venerated.
You saw the way of the king, and you knew in your belly that this was your call:
- To build the kingdom that you dreamed about
- To live a life of benevolent power
- To be admired, respected and beloved.
But somewhere along the way, the dream was corrupted. For we saw that kings can be craven.
We saw that some kings can be cruel.
And when the queens of the land bristled in unison . . . men, seeking to appease them, broke their scepters over their knees. And, men, the world over, resolved not to be king, but to be a second queen. They resorted to work in cheerful cooperation as a second wife, without the danger or the terror that lives within the man, that husband king.
Thus, the path of misery for man, and wife alike, was paved. . . the emasculated king, living his life as a second queen. Yet, man was never meant to take a wife and father children only to relinquish his God given dominion to become the “second queen.”
You and I, we come to marriage and family for kingship:
- To provide safety and shelter for your queen and her cubs
- To ravish the queen and see the animal heat in her eyes
- To live in glory and honor
- And when called upon, to willingly go heart-in-mouth into the fray
You may not have servants or lands or chests of gold. But, if you have a wife, if you have children, if you have an audience to serve . . . you have everything required for true, abiding kingship.
For a king is king not by the command he claims for himself or the fealty others pay him. He is king by pressing and wielding his dangerous power to the noble service of others in the creation of value and honor.
Kingship is the exercise of dangerous magic nobly. It is an exercise in unconditional love applied. Through force of will and force of imagination, you make your visions manifest.
Kingdoms are not won, they are not granted, they are not inherited . . . Kingdoms are CREATED.
Do not wait for your wife to become the queen. Do not wait, grumbling, for her to adulate or serve you. The principle buried by the softened souls of this civilization, by generations of absentee fathers, by generations of fatherless homes, by generations of men without their scepters is this . . .
It is the KING that makes the queen, not the other way around.
You stare foggy and angry at the hole in your drywall, at the un-replaced light bulbs, at the broken fence in the yard . . . at the mind-numbing banality all around you. Yet you want to feel alive again . . . deeply, lastingly, the way you dreamed as a young boy that you would feel when you became king.
That feeling doesn’t come from a manicured yard, a check in the mail, or even from some bestowed title from an Ivy League tower. It comes from indwelling and OWNING the role you’ve already won. You “have” a family, but it will not glow until your breathe everything you have into it . . . until you animate it with all your might and mind and heart and lungs.
Why are you waiting for some outside appointment? Rise up. Stand up. Throw out the box of cereal. Give the macaroni to the neighbor. Eat the bacon, fire up the smoker. Take on that task that’s been gnawing at you for months.
Create your kingship NOW. Do it TODAY: one kiss, one meal, one light bulb, one filled hole-in-the-drywall, one meal, one poem-in-the-lunchbox at a time. Stop sitting there braiding each other’s hair.
BE THE DAMN KING because the queen is already taken. Whether or not she returns that love does not matter. It is the act of loving her that actually fires you, it is not the reciprocation. Any love or adoration she returns is immaterial. The essential magic has already happened inside you. The fire has already been lit.
“Why would I kiss that mouth?” you say. “Why would I gaze into those cold, bitter eyes? How could I treat as queen this woman who sneers and scorns so unbearably?”
And that, there, is the double-bind that has been holding your very kingship, holding your marriage captive. This love, this respect, this adoration you long for her to give to you . . .
It is not hers to give, but for YOU TO CREATE within her.
You see, it is the KING that molds the maiden into the queen, into her best and highest self. Not with silence or criticism or ultimatums, but with acts of imagination and love. No matter how deep your disillusionment, it is the only way. You must create the queen.
The power is within you . . .
Click Here Now To Learn How.
(Adapted from Brian Ward’s Third Way Man)
Ten Reasons Why I Will Never Support Black Lives Matters
I have been very vocal this week about the new narrative for racism that permeates every air-wave and smartphone across the country, “The criminal justice system is to blame.” The logic states that Black men are being rounded up for little reason by a White-run criminal justice system dedicated to the eradication of a burgeoning minority middle class. If it weren’t for the dastardly system, all would be well. All is to blame on “white privilege” they claim. And, the narrative is being driving by the organization called Black Lives Matters.
A significant number of the ketogenic and carnivore world “elites” have significant buy in to this narrative and have come down hard on my position during the last week. I’ve been called a white racial supremacist, a bigot, a fanatic, and I’ve even had a few death threats arise in my “in-box” because I disagree with the agenda of this organization. But those of you who know me, know that I don’t make statements lightly. Any time I take a position, it will be based in scientific fact.
All of this has occurred as protests, riots, looting and murder have flooded the news, social media feeds and airwaves of the world. Anger that justice has not been served was the initial outcry. True it is that any life unjustly taken deserves restitution. Yet, in the attempt to make things right, I refuse to join with a movement that stands for nearly everything wrong and evil in this world.
As of today, more innocent lives have been taken (20 as of today’s count) since these violent protests began over the horrible death of George Floyd. But what about the other black lives that have been lost in the chaos. What about the Black business owners that lost their businesses? What about the families of those that lost fathers and mothers to this violence in response to violence?
“Dr. Nally, you don’t have to agree with everything. Just because it’s on their website, doesn’t make them bad. Just agree with the good things this movement is doing. Just drop to a knee with your sign and show your support for the good parts,” I’ve been told by quite a few people I used to admire.
Let’s apply that logic to other examples. Would you hold your church social on the lawn of the Playboy Mansion because Hugh Hefner was a Methodist who believed in God and had a copy of “The Purpose Driven Life” on his nightstand table?
I am not a racist. Just because I disagree with your position on social justice does not make me a racist either. The definition of racism is the belief that race is the primary determinant of human traits and capacities, and that racial differences produce an inherent prejudicial superiority of a particular race. I do not view, interact with or treat anyone of a different skin color any differently than I would treat my own family.
This may offend you, but according to scientific evidence, “white privilege” isn’t real. If it were a real issue, you would not see statistical success of the Asian populations in the United States. Just look at the graph of ethnic incomes below.
And, it’s not just income. Asian students score higher on educational testing like the SAT. How does the argument of “white privilege” explain this anomaly? It doesn’t. If race provided privilege, then these graphs would be notably different.
Those of us that have been raised to abide the law, pay our taxes, set aside our instinctual urge to provide justice by allowing for due process in the civilization we’ve contributed to, act with civility toward leadership, give honor to the experience of our parents and our elders, follow basic civil instructions, provide for our families, protect them and serve our neighbor are horrified that someone would claim we are “subconsciously racist.” This is an attack on and an attempt to verbally disarm the good men and women of this country by creating guilt, claiming that because of your heritage, a part of you is unwilling to protect your neighbor.
Because of this, I cannot sit idly by and watch this country spiral down the drain without making my position loud and clear. Based upon additional thoughts I contemplated after reading Ryan Bomberger’s article in TownHall this morning, here are:
Ten Reasons I Will Never Support #BlackLivesMatters (BLM)
- Their Premise Isn’t True. I despise racism. It is never appropriate. It is even worse when racism is used as a political weapon like is has been this week. According to the FBI’s latest homicide statistics, a black man is 11 times more likely to be killed by another black man than by a white man. The comprehensive 2019 study by PNAS, “White officers are not more likely to shoot minority civilians than non-White officers.” Even the Washington Post’s database on police-involved deaths put this into perspective. In 2020, among those killed by police officers (all male):
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- 2 Native Americans
- 9 Asians
- 46 Hispanics
- 76 Blacks (Incidentally only 9 of those 76 Blacks were unarmed)
- 149 unlabeled individuals
- 149 Whites (whose deaths are never reported by national mainstream media.)
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2. Goals for Forgiveness or Reconciliation are not Present. On none of the Black Lives Matters websites are there any mention of healing wounds, forgiveness or moving forward. You cannot talk about the sins of distant past and expect to move forward if there is no intention of forgiveness. Ask any counselor, psychiatrist or physician, when your spouse brings up old wounds or grievances with every argument, does the marriage get better? Absolutely not. They’ve never forgiven you and neither will Black Lives Matters. Their paradigm is not centered in any gospel of forgiveness. It is a prejudicial oppressor/oppressed race theory paradigm that is completely flawed. This seems strange when the majority of Blacks in the U.S. are Christian (79%) and profess a belief in Jesus Christ.
Most Christians believe that we are individually responsible for our own actions and, not Adam’s transgression from the fall (that was the whole point of the atonement of Christ). Yet, belief that white people living today are responsible for the slavery their for-bearers participated in is diametrically opposed to Judaeo-Christian philosophy. I am not responsible for my father’s transgressions and neither are you. You can’t stand on both sides of the fence.
What is the solution? Whether you are a believer or not, Jesus Christ taught an inspired model that leads to peace and harmony — to love God first, and then to love our neighbors as ourselves. I don’t pretend that either of these pursuits is easy, but in the 50 years I have been upon this earth, it is the only action that yields the promised fruit.
3. The Focus is 100% Black Power. That’s all you’ll ever see on their websites at M4BL and BLM. Both of these organizations focus on “organizing and building Black power across the country.” This is not what Martin Luther King promoted. He promoted “God’s power and human power.” That’s dramatically different. I agree with Dr. Martin Luther King, Jr.’s statement, that “hate cannot drive out hate. Only love can do that.” Only this kind of love and empathy can inspire us to do the rigorous work of rebuilding bridges of cooperation instead of walls of segregation and alienation. I will happily stand and march with the principles outlined by Dr. King.
4. Both Organizations Heavily Promote Homosexuality and Transgenderism. “We foster a queer-affirming network. When we gather, we do so with the intention of freeing ourselves from the tight grip of heteronormative thinking.” Any group that claims normative thoughts and attractions as a heterosexual male or female are abnormal is embracing confusion, dubiety and promotes chaos. These are the last people I want my children associating with. Loving every human being is NOT the same as loving every human action. Teaching from this platform is teaching half-truths and is devious and vile.
5. Black Lives Matters Intentionally Ignores and Suppresses the Importance of Fatherhood. From their own website: “We disrupt the Western-prescribed nuclear family structure requirement by supporting each other as extended families and ‘villages’ that collectively care for one another, especially our children, to the degree that mothers, parents, and children are comfortable.” Notice “fathers” is intentionally missing from that statement. We know from years of research that every “village” that has fatherless families is a village that suffers higher crime rates, higher drug usage, higher abortion rates, higher drop-out rates, higher poverty rates, and so much more.
Prejudice, hate and discrimination are learned behaviors. We are not born with them. This is why parents, family members, and teachers must be the first line of defense. Teaching children to love all, and find the good in others, is more crucial than ever. Oneness is not sameness in America. We must all learn to value the differences.
How does the absence of a father play a role in this? Isn’t it interesting that the ethnicity that is the most successful at income and education is also the group that has the lowest number of fatherless homes.
6. They Demand Reparations. On the same BLM website above, they demand, “Reparations for . . . full and free access for all Black people (including undocumented and currently and formerly incarcerated people) to lifetime education . . . retroactive forgiveness of student loans, and support for lifetime learning programs.”
Ummmm, question? What about the mixed racial peoples? Will the white half of their bodies have to pay the Black half of themselves?
7. Complete Abolition of Police Forces. These people assert that complete abolition of prisons, police and any other institution related to civil safety is their goal. Across 30 cities this week you’ve heard the cry, “Defund the police!” This would leave total anarchy in any community. Yet, police chief’s and commissioners around the county have begun to stand with these groups at the behest of their officers. Reforming department codes to control use of force, continued training in use of aggressive force and monitoring systems that identify officers who abuse these policies have been show to be effective and are essential, but abolishing police forces is utter insanity.
To paraphrase Winston Churchill, people who buy this mindset are guilty “Of not understanding the difference between the fire department and the fire.”
8. BLM IS Anti-Capitalistic. They declare “We are anti-capitalist. We believe and understand that Black people will never achieve liberation under the current global racialized capitalist system.” The video and recordings that identify incidences of police brutality and misuse of force are captured on phones and body-cameras that were made possible by capitalism. We have known for over 100 years that the best way to raise people out of poverty is capitalism. Capitalism is what makes the United States of America the most charitable nation on the earth and the nation with the most freedom.
9. Collin Kaepernick Supports It. I want nothing to do with a man who idolizes Fidel Castro and Che Guevara and worships Malcom X (check out his social media feeds and you see all the proof you need). Malcom X was an anti-integration, pro-violence member of the Nation of Islam (virulently racist). Interesting that this #SocialJusticeWarrior is absolutely silent about the fact that he makes millions from Nike whose entire Executive Leadership Team is White, and according to Kaepernick makes its shoes in the most “murderous regime in the world.”
10. Not All Black Lives “Really” Matter. The pro-abortion Black Lives Matter further declares: “We deserve and thus we demand reproductive justice [aka abortion] that gives us autonomy over our bodies and our identities while ensuring that our children and families are supported, safe, and able to thrive.” Aborted children don’t thrive.
Many even argue that Planned Parenthood’s founder Margaret Sanger, a strong believer in eugenics, intentionally used abortion to lower the Black birth rate. Something is amiss when over one-third of all abortions occur in Black mothers.
BLM has claimed solidarity with “reproductive justice” groups since February 2015 and have been officially adopted into the Democratic National Convention platform since August 2015. Sorry folks, you cannot simultaneously fight violence while all the while celebrating it by destroying lives before they take their first breath.
Will I be ostracized from the keto/carnivore community for my position? Probably, but my conscience is clear, and I can sleep at night.
Using Quinine to Prevent Coronavirus is Really BAD Advice
I’ve had multiple people send me links to people and/or “supposed experts” recommending the use of quinine to prevent coronavirus or COVID-19. In my perspective, this is really bad advice and borders on malpractice.
Quinine was and still is used for the treatment of malaria. Yet, there are some significant reasons using quinine is, and should continue to be, limited. Anyone recommending liberal daily use of quinine does not have any grasp of the potential for harm and death that can arise with the use of this substance. I have seen quinine toxicity on a number of occasions in my 20 years of medical practice, and it ain’t pretty.
There is NO Evidence that Quinine Prevents COVID-19
There is absolutely no evidence that using quinine prevents infection from coronaviruses or COVID-19. Quinine differs in its mechanism of action from hydroxychloroquine, one of the drugs currently under investigation for use with COVID-19. Please, DO NOT confuse the two.
Even Small Amounts of Quinine Can be Deadly
Quinine use is the most common cause of immune-mediated drug induced thrombotic microangiopaty (DITMA), a life threatening condition caused by small-vessel platelet clots. In a systematic review of all published reports describing drugs and other substances as a suspected cause of thrombotic microangiopathy (TMA), quinine was responsible for 34 of 104 cases in which there was definite evidence for a causal association (33 percent) [1].
The Oklahoma Thrombotic Thrombocytopenic Purpura-Hemolytic Uremic Syndrome (TTP-HUS) Registry found quinine-associated TMA in 19 of 509 patients (4 percent) referred for a possible TMA over a 25-year period and found quinine as the cause of DITMA in 20 of 23 patients (87 percent) for whom a drug could be implicated as having a definite or probable causal association with the TMA [2, 3].
A 2017 report describing the 19 individuals included in this registry found the following features [3]:
- All were white. This is distinctly different from Thrombotic Thrombocytopenic Purpura (TTP), in which approximately one-third are black (seven-fold higher than the reference population).
- Eighteen (95 percent) were women. This is greater than the increased frequency of women (75 percent) among patients with TTP.
- Eight (42 percent) had a prior history of quinine-related symptoms (nausea, vomiting, fever, chills, headache, confusion, ataxia).
- Thirteen (68 percent) could recall the precise timing between quinine ingestion and symptom onset (all ≤4 hours).
- Eighteen (95 percent) were caused by a quinine tablet; one was caused by quinine in tonic water of a vodka/tonic drink.
- Eighteen (95 percent) had evidence of quinine-dependent antiplatelet (or antineutrophil) antibodies.
- All had acute kidney injury; 17 of 18 required dialysis; three developed end-stage renal disease; and two underwent kidney transplantation.
- One died from complications of central venous catheter insertion. Of the remaining 18, eight died a median of nine years following diagnosis, five from cardiovascular disease or stroke that may have been related to the TMA.
Quinine is implicated in causing neutropenia (decrease of white blood cells in the immune system). When it occurs, neutropenia is often accompanied by other organ-system findings that may include thrombocytopenia (low platelet count), microangiopathic hemolytic anemia (the most common being DITMA referenced above), rash, acute kidney injury, fever/chills, and others. The mechanism in many cases appears to be an acute, immune-mediated reaction to the drug. Evidence to support these associations was evaluated in a 2016 systematic review of published reports, which found neutropenia in 24 (17 percent) of the 142 patients who had an immune-mediated quinine reaction.
Quinine + Sugar is A Perfect Storm
The problem that many physicians find is that quinine tablets may be borrowed from a friend or family member, or the exposure may occur from a beverage like Schwepps (eg, tonic water, bitter lemon). And tonic water is loaded with sugar or high fructose corn syrup. This high carbohydrate content, in combination with quinine is a perfect storm for kidney failure.
In the United States, the only available quinine tablet (Qualaquin) requires a prescription, and the only approved indication is for malaria treatment. This restricted availability of quinine tablets may explain why we have not seen a patient with quinine-induced TMA since 2009 [3]. There are also several over-the-counter tablets and herbal remedies for leg cramps available in the United States that may contain quinine, and quinine tablets can be purchased over-the-counter in Canada and other countries. Quinine may also be added to drugs of abuse such as cocaine.
Just One Dose of Quinine Can Be A Trigger
Importantly, TMA from quinine can be triggered either by a single ingestion (eg, one quinine tablet, one quinine-containing beverage) occurring many months or years after a previous exposure, up to 10 years in our experience. This is because the drug-dependent antibodies can persist for many years, but they cannot react with target cells in the absence of the drug. Acute immune-mediated tissue damage can occur within hours of re-exposure. It is not known whether the homeopathic doses of quinine present in remedies for leg cramps in the United States can trigger TMA, but in principle, immune-mediated DITMA can occur with extremely low levels of re-exposure.
Chronic kidney disease is common following quinine-induced TMA [3].
So, please, don’t follow bad advice about using quinine from people who have no concept of what these drugs can really do.
Please see my Coronavirus Page for information and recommendations on prevention and treatment.
References:
- Al-Nouri ZL, Reese JA, Terrell DR, et al. Drug-induced thrombotic microangiopathy: a systematic review of published reports. Blood 2015; 125:616.
- Reese JA, Bougie DW, Curtis BR, et al. Drug-induced thrombotic microangiopathy: Experience of the Oklahoma Registry and the Blood Center of Wisconsin. Am J Hematol 2015; 90:406.
- Page EE, Little DJ, Vesely SK, George JN. Quinine-Induced Thrombotic Microangiopathy: A Report of 19 Patients. Am J Kidney Dis 2017; 70:686.
What Can You & I Do To Prevent Viral Infections?
The following general measures are recommended to reduce transmission of infection:
- Diligent hand washing, particularly after touching surfaces in public. Use of hand sanitizer that contains at least 60 percent alcohol is a reasonable alternative if the hands are not visibly dirty.
- Respiratory hygiene (for example – covering the cough or sneeze).
- Avoiding touching the face (in particular eyes, nose, and mouth).
- Avoiding crowds (particularly in poorly ventilated spaces) if possible and avoiding close contact with ill individuals.
- Cleaning and disinfecting objects and surfaces that are frequently touched. The CDC has issued guidance on disinfection in the home setting; a list of EPA-registered products can be found here.
Dr. Nally talks about each of these in his latest YouTube video below:
“Keep the carbs low and the fat high.”
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For more information about any of the things mention above and in other videos, you can find the links below:
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Keto Misconceptions – Have You Heard Any Of These?
The keto misconceptions abound and this week is no different. A popular health website recently published an article warning people about the “dangers” of a ketogenic diet, including the keto-flu, kidney disease, gut bacteria, nutritional deficiency, bone health and low blood sugar. They claimed these dangers are “evidence based.” Dr. Nally very quickly debunks these dangers, explains how the naysayers “spin” the science and talks about why these misconceptions are false.
Check it out:
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:
My Feet Are Tingling (Polyneuropathy and Hyperinsulinemia)
One of the common complaints that I see in my office is chronic numbness and tingling of the hands, fingers, feet & toes. There are multiple causes of these symptoms, but by far the most common cause in my practice is polyneuropathy caused by insulin resistance (hyperinsulinemia).
Before we dive into this particular type of nephropathy, it is important that we define a few terms. The terms “polyneuropathy,” “peripheral neuropathy,” and “neuropathy” are frequently used interchangeably, and although they can be easily confused, they are distinctly different.
Definitions
- Polyneuropathy is a specific term that refers to a generalized sensation of tingling or numbness that uniformly affects many nerves at the peripheral sites (ends of the extremities like hands, fingers, lower legs, feet and toes).
- Peripheral neuropathy is a less precise term. It is frequently used synonymously with polyneuropathy, but can also refer to any disorder of the peripheral nervous system. However, this term includes pain or numbness that radiates from nerve roots like “sciatica” of the leg and “brachial plexopathy” causing symptoms in one hand and/or arm (mononeuropathies).
- Neuropathy, which again is frequently used interchangeably with peripheral neuropathy and/or polyneuropathy, can refer even more generally to disorders of the central (brain & spinal cord) and peripheral nervous system (nerves of the arms and legs) and their connections to sensory organs, such as the eye and ear, and to other organs of the body, muscles, blood vessels, and glands.
Why spend time defining all this? Because, neuropathy can be very confusing, even for the experienced physician. And, because I am seeing, more and more frequently, cases of insulin resistance induced polyneuropathy. The polyneuropathies must be distinguished from other diseases of the peripheral nervous system, including the mononeuropathies and mononeuropathy multiplex (multifocal neuropathy), and from disorders of the central nervous system.
- Mononeuropathy refers to focused involvement of a single nerve, usually due to a localized trauma, compression, or nerve entrapment. Carpal tunnel syndrome is a common example of a mononeuropathy. Sciatica due to a lumbar disc bulge is another form of mononeuropathy.
- Mononeuropathy multiplex refers to simultaneous involvement of non-adjoining sections of nerve trunks. Used loosely, this term can refer to multiple compressive mononeuropathies. However, in its more specific meaning, it identifies trauma, infection, auto-immunity or damage to multiple nerves outside the central nervous system. This is often due to lack of blood supply due to disease based inflammation of blood vessels supplying blood to these peripheral nerves.
- Diseases of the central nervous system such as a brain tumor, stroke, or spinal cord lesion occasionally present with symptoms that are difficult to distinguish from polyneuropathy.
Insulin Resistance and Neuropathy
Insulin resistance, or better defined hyperinsulinemia, begins 10-15 years before a person is considered “pre-diabetic” and 20 years before the onset of type II diabetes. This “over production of insulin” in response to carbohydrates, starches and sugars causes a subtle and progressive form of inflammation. This excessive production of insulin will damage the smallest arteries (capillaries) carrying oxygen and fuel to the back of the eyes, the kidneys and the peripheral nerves of the hands, fingers, lower legs, feet and toes.
Often not identified until a person is actually diabetic, the mechanism underlying the development of this type of neuropathy is extremely complex. It is driven by years of subtle and progressive damage to the blood vessels, and inability of the nerves to use essential B vitamins damaging the genetics of the cell. This leads to inflammatory, metabolic, and ischemic effects causing the nerves to function poorly over time.
What Causes Polyneuropathy?
The mechanism of polyneuropathy damage in the patient with hyperinsulinemia three-fold.
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- The presence of high insulin stimulates increased fat storage. As fat cells begin to get filled, they begin to over-produce a number of inflammatory hormones including TNF-alpha, IL-6, IL-1, Adiponectin, Leptin and Resistin. These inflammatory hormones turn on auto-immunities and abnormal immune system function.
- At the same time, the high insulin levels suppress appropriate testosterone and estrogen production causing microscopic damage to the lining of the smallest arteries and capillaries of the body (found predominantly at the extremities, kidneys and back of the eyes).
- 65% of patients with insulin resistance (hyperinsulinemia) have a malformation of one or both genes that encode the MTHFR enzyme (methylenetetrahydrofolate reductase) that uses folic acid (Vitamin B9) inside the cells of the body. Because this is genetic and is a process occurring inside the cell, it has been difficult to identify until recent advances in measuring genetic SNPs. Single nucleotide polymorphisms, frequently called SNPs (pronounced “snips”), are the most common type of genetic variation among people.
Interestingly, MTHFR deficiencies are also strongly correlated with depression, anxiety and other forms of mental illness. MTHFR is a SNP that can easily be tested through a simple blood sample at your local lab or doctors office. And, nerve testing can be done through a simple sudomotor function test in the doctors office. In fact, Medicare encourages this testing yearly through part of the Annual Wellness Exam.
The polyneuropathy that I see most commonly in my office can and will improve. In fact, polyneuropathy will completely resolve if you catch it early enough. We treat it in two ways.
What Can I Do To Treat Polyneuropathy?
First, restrict carbohydrate intake. A ketogenic or carnivore diet is the perfect approach to this. If you don’t have a copy of my book, The KetoCure, please pick one up on my website or on Amazon. if you are just looking to fine tune the nuts and bolts of your diet, you can get a copy of my diet recommendations here. Carbohydrate restriction corrects the high insulin levels. Within a few weeks, people start seeing improvement in inflammation, testosterone, estrogen and leptin resistance.
Second, get your MTHFR SNPs tested. This can be ordered through a simple blood test through your doctor or nearby lab. If you have one or both MTHFR mutations, treatment is simple. A mutation of the MTHFR SNP directly causes polyneuropathy, anxiety, depression and in severe cases, schizophrenia. It can also cause significant problems with homocysteine metabolism and is a significant risk factor in heart disease.
Third, use the correct form of folic acid. If you have the MTHFR mutation, regular folic acid is ineffective. Instead of using regular folic acid (Vitamin B9), 1000-5000mcg per day of L-methyl folate (premethylated Vitamin B9) solves the problem. Within 90 days, over 50% of my patients feel dramatic improvement in their neuropathy and many have compete resolution of the numbness and tingling. I see this so frequently, that a few years ago I had my multivitamins designed to include L-methyl folate instead of regular folic acid. You can find them here at Ketoliving. com. If you want more information on why I designed my own vitamin supplement a few years ago, you can read about them here.
So, restrict your carbs, use the appropriate form of folic acid for you, and pass the bacon!
If you are interested in getting more help on this issue, schedule an appointment with me in my office. Or, consider one of my membership options if seeing me in my office isn’t convenient for you. Sign up today!
References:
- Yigit, Serbulent et al. “Association of MTHFR gene C677T mutation with diabetic peripheral neuropathy and diabetic retinopathy.” Molecular vision 19 1626-30. 25 Jul. 2013.
- Wan, Lin et al. “Methylenetetrahydrofolate reductase and psychiatric diseases.” Translational psychiatry 8,1 242. 5 Nov. 2018, doi:10.1038/s41398-018-0276-6.
- Shelton, Richard C et al. “Assessing Effects of l-Methylfolate in Depression Management: Results of a Real-World Patient Experience Trial.” The primary care companion for CNS disorders 15,4 (2013): PCC.13m01520. doi:10.4088/PCC.13m01520.
- Hughes R. Investigation of peripheral neuropathy. BMJ 2010; 341:c6100.
- Morrison B, Chaudhry V. Medication, toxic, and vitamin-related neuropathies. Continuum (Minneap Minn) 2012; 18:139.
- Pareyson D, Piscosquito G, Moroni I, et al. Peripheral neuropathy in mitochondrial disorders. Lancet Neurol 2013; 12:1011.
- Rutkove SB, et al., Overview of Polyneuropathy. UpToDate.com. Online Jan 2020, https://www.uptodate.com/contents/overview-of-polyneuropathy?search=neuropathy&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Did you know . . . ?
Rice is rice. Potato is a carbohydrate that will halt your weight loss and please do not bring me a bagle.
And, NO, I did not just give you permission to go eat a jelly donut!!
You’d be amazed at how many people don’t realized the carbohydrate content (sugar equivalents) of various foods that we’ve been told are “good for us.” Check out my youtube.com video here on eight steps to getting started with a ketogenic lifestyle.
Now you know!
The Shovel will Fail You in Obesity, Finances & Life
A few years ago, my family and I set out to build a pond.
I have always loved Koi and the serenity of a Koi pond in my own back yard was very enticing. I spent about a year planning my design and the location. I dreamed of a serene evening after a very long, hectic day seeing patients relaxing beside the pond. The sound of trickling water, the occasional splash from fish, the cool breeze passing over the mist from a water-fall would sooth my soul after a busy day in the office.
I envisioned the perfect area. An unused access path, previously worn by the previous owner with truck and trailer traffic, beside my now expanded patio. Twenty feet wide, thirty feet long and four feet deep. . . that seems just perfect.
I pulled out my shovel and set about digging. Eager to begin and filled with the energy of the final product, I set to digging. What could be so hard about digging my own pond? Think of the exercise I will be getting. Thoughts spurred me on.
Minutes later, chest heaving, face glistening with sweat, I stared in dismay at the ground. All I had to show for my wild digging was a small 1/2 inch dent in the dusty Arizona top soil.
Sonoran Clay
Over time, calcium-carbonate, along with other minerals, accumulates and dissolves into the topsoil of the very arid regions of Arizona Sonoran Desert. It forms a two to three-foot layer of soil called “caliche.” Periodic rains carry the calcium as far as three feet down into the soil, then the water rapidly evaporates in the blistering Arizona heat. This often forms two to three feet of soil that is “literally” harder than concrete.
With tremendous zeal, a great deal of sweat and a round of painful blisters, I broke my third shovel on this impenetrable ground. I realized this was much more difficult than I thought. I pulled out the back-hoe attachment for my small farm tractor. After a few hours and few gallons of diesel fuel later, still very little progress occurred.
Multiple weekends and evenings of digging in the Arizona caliche left me with three broken shovels, a ruptured hydrolic line in my tractor, anger that my expensive back-hoe attachment didn’t work, and only a small dent in the ground near my patio. Even the brute force from the tractor would not budge the clay. I wondered if dynamite would be effective? (My wife would have none of this idea).
With my exuberance quashed, I concluded that this would require much more measured exhuming.
Escape From the Prison
We often imagine, with great delight, the removal or destruction of that which enslaves or imprisons us. We dream that just a little sweat, exertion of a few shovel scoops of dirt and the foundation to our prison of obesity, addiction, debt, and depression are exposed. A few extra scoops and we imagine freedom from that prison cell.
If only I had a jack hammer and a bigger, more powerful scoop, I imagine . . . I could make short work of these manacles that bind me.
But, our manacles and prison cells do not so easily give way.
The failings of our sharpened spades and powerful back-hoes form a new, even stronger fetter – the belief that our prison cell is unbreakable, that our challenge is just too great. These failings usually leave a person cured of any further desire to break free. It quashs the dream and solidifying the depression of stagnation.
The in-fecundity of my shovel, no matter the strength and effort put behind it, was not cause to quit. It was life’s lesson that prisons and shackles often only need a simple tool.
Enter the pick-axe. During this process my wife said, “Honey, why don’t you use the pick in the garage?”
“If my shovel and the back-hoe didn’t work, there was no way I was going to break through this clay with a pick axe.” That was absurd, I thought.
Yet when I humbled myself to try, it was simple. The pick-axe was unpretentious. This simple tool allowed for an almost effortless stroke to a small area of weakness in the caliche. A large flake of soil would pop free with each stroke. The process was repeated.
Scale by scale, the dragon’s flank was exposed. Careful work of the pick-axe began to loosen layer after layer, section after section, pellicle after pellicle. Yes, it was slow work. But, each swing was a small victory.
At each little victory, my heart would leap, the dream would become ever clearer.
Working this magic again and again until finally the specter was weakened enough to pull out the shovel. And, further work, allowed for bringing back the powerful back-hoe, in gratifying scoops.
The excavation that I thought would take two months took me fourteen. But, it was gratifying.
I learned a powerful lesson. Wherever life has pinned you, fettered you or barred you in, put down the shovel, and pick up the pick-axe. Second, if you really listen, your spouse may point out the tool you really need. Don’t be afraid to chip away at it a piece at a time.
Finances
Stop waiting for the sharper shovel or the bigger back-hoe to dig yourself out of your harrowing debt, mega mortgage, or your income dwarfing spending. The jackpot or financial windfall won’t come. While others await the jackpot, put down your shovel and shoulder your pick-axe.
- Pick one small debt and begin to pick at it by applying just a little extra each month until it is gone.
- Cancel your extra cable, sell the motorcycle and payoff the 21% interest credit card.
- If you must, pick up a side-hustle for extra to sharpen the pick.
Once you’ve lifted one flake, chip away at the next. Making progress will make it easier to continue. It doesn’t matter how long it takes, just keep at it.
Marriage
You long for resolution of the apathy, progressive resentment and mutual stalemate that permeates your relationship. You look in vain for the bigger shovel that will uncover the treasure that years of apathy have buried. You long to uncover your dreams and needs that have been covered and hardened under the clay of resentment. The shovel and the back-hoe won’t help you here.
Drop the shovel. Shoulder your pick-axe.
- Kiss your wife every time you leave, even if it’s just for a ten minutes to run to the convenience store.
- Hold her for five seconds longer every time you hug.
- Find a gift you can give her once a week, just because.
- Put down your phone and look her in the eyes when she talks to you and listen. Really listen and the flakes of hard clay will unveil the beauty of her soul.
- Find a way to praise her every day, even if it is through a simple text.
Health
You long to rid yourself of your addiction to sugar, bread, stress, and sleep deprivation. You’ve tried to scoop them out of your life. You even hired a trainer with some muscle to force you to change. You’ve tried in vain to save yourself from yourself.
Trying to use the shovel here is like trying to use the shovel on steel forged walls of your life’s prison fortress. Forget the shovel. Shoulder your pick-axe.
- Start with one meal and make some substitutions. My dietary plan can help you with this.
- Go to bed an hour earlier. Really, you’ll be surprised that the focus you have will more than compensate for the hour of lost time in the evening.
- Add a quality vitamin to your morning routine.
- Take ten minutes and do 20 push-ups and 20 sit-ups, then take a 10-minute walk.
- Simply remove the “white stuff” from your meals. You will be amazed at the results.
- Put down your phone for 30 minutes and read that book you’ve been meaning to read, instead of surfing Facebook.
Grand-standing with your back-hoe doesn’t help you. Just swing the pick-axe once or twice. Simple daily picking with the sharp point weakens the hardest of ground and the prison walls in our lives. It takes time, so be patient.
Find the weak point, apply the pick. Day by day, little by little you will be free.
I’ve been there. I’m with you. Keep me posted on your journey.
If you’re looking for a program that teaches you how to do this, check out my membership site.
Will A Low-Carbohydrate Diet Kill You?
Will a ketogenic diet or very low carbohydrate diet kill you? Will it increase your likelyhood of death? That’s what the media and the dietary world is saying this week. Is it really true? How do you know? That’s the question that I ponder as I smoke my brisket while reading the headlines this week.
My inbox has exploded with patients and acquaintances suddenly worried that my very low-carb lifestyle is bad. This all revolves around the publishing of a study in the Lancet this week, and the interpretative spin that has been placed on it by “those in the know.” To quote one of the NHS dietitians, Catherine Collins, RD FBDA, “In summary, this paper will disappoint those who, from professional experience, will continue to defend their low-carb cult, but contributes to the overwhelming body of evidence that supports a balanced approach to calorie intake recommended globally by public health bodies.” Either she didn’t actually read the paper, or she clearly doesn’t understand the low-carbohydrate/ketogenic dietary world. Before you go throwing out your bacon, turning off my smoker and buying bags of rice, let’s talk about some principles that seem to be completely misunderstood by the “low-fat, calorie restricting” nutritional aristocracy.
Ketogenic Diets are Powerfully Effective
First, ketogenic diets are powerfully effective. They are effective in weight loss, reduction of blood sugar, reversal of diabetes, decreasing cardiovascular risk and reduction in blood pressure. These are just a few of the powerful effects of a ketogenic lifestyle. (I wrote a whole book on the 16 different diseases dramatically improved by carbohydrate restriction.) It’s why I’ve been using carbohydrate restriction for over 14 years both personally and in my clinical practice. 85% of the people in my practice don’t respond effectively to anything other than carbohydrate restriction. This is because their insulin levels are 2-20 times normal. The question the Lancet should be asking is “why do 85% of people fail calorie restriction?” But, that is for another article.
Few Diets Keep the Weight Off Long-Term
Does the ketogenic diet keep weight off in the long term? All diets seem to fail in this regard, even the ketogenic diet will show rebounding of weight after 1-2 years. Yes, I hate to be the bearer of sour news, but as an obesity specialist, this is what I do for a living. The Lancet article implies that the low-carb diet is singular in the issue of weight rebound, but that is not the case. The only diet I have found to effectively keep the weight off long-term is a ketogenic diet, combined with pulsed eating and the correct type of physical activity.
Definition of a Very Low-Carbohydrate Diet
Third, commentary, and the researchers themselves, extrapolate that based on the results, very low carbohydrate diets increase the risk of mortality. However, this study wasn’t even “low-carb.” It was Paleolithic at best. The lowest calorie intake group was just under 1600 kcal per day and the carbohydrate restriction was only 120 grams per day. A low-carb diet is defined as less than 100 grams per day. A very low-carbohydrate diet is defined as less than 50 grams per day, and a ketogenic diet is defined as less than 20 grams per day. This study and the cohort studies involved in it weren’t even low-carb!!!
Only Two Data Gathering Points in 25 Years?
Fourth, although people were followed for 25 years, there were only two data gathering points consisting of 66 questions spaced 5-7 years apart asking the 15,428 participants to “remember what they ate” over previous 3-5-year intervals. Seriously?! I can barely remember what I ate last week and I take pictures of my food and journal my meals frequently. How can you publish an article with only two data collection points over 25 years? And, how can extrapolated data over 25 years be accepted as valid in a premier medical journal? It is beyond my understanding.
You Gotta Lower Insulin to Reduce Mortality
Fifth, insulin must be lowered to a “baseline level.” Increasing fat intake in the presence of abnormally elevated insulin will actually increase risk of cardiovascular disease, peripheral vascular disease, diabetes, hypertension, gout, kidney stones, and death by multiple causes. This cohort of people only partially lowered carbohydrate intake, and raised fat and or protein intake. Those of us who’ve been treating obesity and practicing in the trenches are well aware that if you don’t bring the insulin levels under control, raising fat and protein is just a ticking time bomb. Of course, the all-cause mortality went up in this group. I’d expect nothing less. This is what I saw with a large portion of my Paleolithic dietary patients.
This is also why caloric restriction doesn’t work. These participants had average calorie restriction of 1600-1800 kcal per day. Yet their risk for all-cause mortality (death by all causes) increased.
Weight Gain Continued
Sixth, all of the groups continued to gain weight. Body mass index increased by almost a full point ever 6 years. Carbohydrates were NOT restricted enough to be effective. It also, demonstrates another example of calorie restriction failure in 15,000 plus people.
That’s what I’d call successful – not really!
Smokers Not Excluded
To make matters worse, 60-70% of the population were smokers or former smokers and this study did not specifically eliminate this as a risk factor for all-cause mortality. We know that smoking dramatically increases risk of heart disease, peripheral vascular disease, hypertension, stroke, lung cancer, chronic obstructive pulmonary disease, etc. The contribution of tobacco in this cohort was not adequately isolated.
Follow the Money
Lastly, I’ve learned that when you look closely at research, it is very important to follow the money. The National Institutes of Health funded the study. They openly state that a healthy eating plan “emphasizes vegetables, fruits, whole grains, and fat-free products.” Their position falls right in line with the WHO Millennium Development Goals established at the United Nation’s Sustainable Development Conference in 2000 and reconfirmed in September, 2015.
The World Health Organization has developed sixteen goals as their “Call to Arms.” Goals 12 and 13 specifically discuss “ensuring sustainable food consumption patterns throughout the world.” These goals specifically outline a transformational vision of the world. This will occur by “doubling agricultural growth” and restricting food production that worsens the “carbon footprint.”
Really?!
Over the last ten years, multiple progressive groups and sites have made the claim that the greatest threat to Climate Change is the cattle industry. They link cattle, livestock and our consumption of red meats to global warming and have been preaching the politics of nutrition. They claim that the only real way to stop climate change and global warming is to “eat less red meat and dairy products.”
Low-carbohydrate and ketogenic diets are a threat to this transformational vision. Because of this, we will likely see more and more scientific research used as propaganda, let’s call it what it is, to sway the general populous in their buying and eating patterns.
So, if you’ll excuse me, my smoked brisket is ready to pull off the smoker. . .
Long-Term Weight Loss: Why So Many Fail
Over fifty years of data have demonstrated that creating energy deficit through the reduction in caloric intake is effective in reducing weight. . . However, it is only for the short term (1, 2). The biggest challenge physicians face in the treatment of obesity is that calorie restriction fails when it comes to long-term weight loss.
Isn’t Fasting Effective in Long-Term Weight Loss?
With the craze and popularity of intermittent fasting, some have claimed that intermittent fasting is more effective in weight reduction. Recent results demonstrate that this may also be incorrect. In the short term evaluation of caloric restriction and intermittent fasting, reduction in 15-20 lbs of weight is effectively seen and the highly publicized Biggest Loser’s losing ~ 120 lbs. Intermittent fasting and alternate day fasting have been shown to be more effective in lowering insulin levels and other inflammatory markers in the short term.
There is, however, controversy over maintaining weight loss beyond 12 months in the calorie restriction, intermittent and alternate day fasting groups. Forty different studies in a recent literature review, thirty-one of those studies looking at forms of intermittent fasting, demonstrate that the majority of people regain the weight within the first 12 months of attempting to maintain weight loss(3, 5). This is, also, what I have seen for over 18 years of medical practice.
Is Calorie Restriction the Only Way to Lose Fat?
Numerous “experts” claim that the only way to reduce fat is “caloric deficit.” Variations through the use of intermittent, long-term or alternate day fasts can be found all over the internet. In regards to calorie restriction, these “experts” with nothing more than a personal experience and a blog to back their claims preach this louder than the “televangelists” preach religion. Based on the faith that many place in this dogma, it could be a religion. What causes belief in this dogma is that weight and fat loss actually does occur with caloric restriction to a point. The average person will lose 20-25 lbs, however, within 12 months of achieving this goal, most people regain all the weight. (No one ever mentions the almost universal problem with long-term weight loss, especially those “experts.”)
Prolonged calorie restricted fasts, intermittent fasts, and alternate day fasts are often grouped together into the fasting approach, causing significant confusion among those that I speak to and counsel in my office. There is great data that alternate day fasts do not have the reduction in resting energy expenditure that prolonged fasting, intermittent fasting and calorie restriction cause. However, none of these approaches appears to solve the problem of weight re-gain after long-term (12-24 months into maintenance) weight loss (3). And, a recent study of 100 men participating in alternate day fasting showed that there was a 38% dropout rate, implying that without close supervision and direction, maintenance of this lifestyle is not feasible for over 1/3rd of those attempting it.
Long-Term Weight Loss Failure Brings Tears
Failure on calorie restricted diets, low fat diets, and intermittent fasting diets with weight regain at twelve to twenty-four months is the most common reason people end up in my office in tears. They’ve fasted, starved themselves, calorie restricted, tried every form of exercise, and still regained the weight. Trainers, coaches and “experts” have belittled them for “cheating” or just not keeping to the diet. Yet, we know that calorie restriction and intermittent fasting cause a rebound in leptin, amilyn, peptid YY, cholecystikinin, insulin, ghrelin, gastric inhibitory peptide and pancreatic poly peptide by twelve months causing ineffective long-term weight loss (6). The dramatic rise in these hormones stimulates tremendous hunger, especially from ghrelin and leptin.
Although less problematic in alternate day fasting, these calorie restricted approaches also cause dramatic slowing of the metabolism at the twelve month mark. In many cases, the metabolic rate never actually returns to baseline, creating even more difficulty in losing further weight or even maintaining weight (6).
Is Gastric Bypass or Gastric Sleeve the Solution?
Gastric bypass and the gastric sleeve procedures have been touted as the solution to this problem, as they decrease ghrelin, however, 5-10 years later, these patients are also back in my office. They find that 5-10 years after these procedures the weight returns, cholesterol and blood pressure rise, and diabetes returns. These hormones kick into high gear, stimulating hunger in the face of a slowed metabolism, that to date, has been the driver for weight regain in the majority of people. People find it nearly impossible to overcome the hunger. You may have experienced this, I know I have.
It’s the Hormones, Baby!
So, what is the answer? It’s the hormones. (WARNING – You’ll hear that when your wife is pregnant, too, gentlemen). We are hormonal beings, both in weight gain, and in pregnancy. Trying to preach calorie control to a hormonal being is like showing up at the brothel to baptize the staff. You might get them into the water, but you’re probably not getting them returning weekly to church or pay a tithe.
So, how do you manipulate the hormones in a way to control the rebounding hunger and suppression of metabolism? This is where we put a bit of twist on the knowledge we’ve gained from alternate day fasting. Recent research shows that “mild” energy deficit in a pulsatile manner, that has the ability to mimicking the body’s normal bio-rhythm’s is dramatically effective in reducing weight and maintaining normal hormonal function without cause of rebound metabolic slowing (4).
Pulsed Mild Energy Restriction
What does this mean in layman’s terms? It means that if we provide a diet that maintains satiety hormones while providing a period of baseline total energy expenditure needs and a period of mildly reduce caloric intake in a pulsed or cyclic manner, greater weight loss occurs and there is no rebound of weight 1-2 years later.
The main reason I’ve not jumped on the intermittent fasting band wagon is the shift in leptin, amylin, ghrelin and GLP-1 signaling that regularly occurs at the 6-12 month mark. The rebound of these hormones causes weight re-gain and is what prevents successful long-term weight loss. A number of people come to my office and tell me they couldn’t follow a ketogenic diet, so they’re doing intermittent fasting and it works . . . for a while. Then, they end up in my office having hit a plateau or fallen off the wagon and regained all the weight. They are completely confused and don’t understand what happned. Most of them are convinced it’s their thyroid or cortisol and they’ve seen every naturopath and functional medicine doctor in town.
What people really need is a simple approach to long-term weight loss without having to spend the night in the physiology lab every two weeks sleeping under a ventilated hood system.
The Ketogenic Lifestyle is a Pulsed Energy Lifestyle
- First, it is essential to turn off the insulin load. Insulin is the master hormone. This is done by a ketogenic lifestyle that restricts carbohydrates.
- Second, providing adequate protein to supply maintenance of muscle and testosterone is key.
- Third, providing adequate fat is the simple way to maintain leptin, ghrelin, amylin, GLP-1 (among the others) and long-term weight loss. Can you eat too much fat? Of course you can. But, because each of us have differing levels of stress and activity each day, this fat intake becomes the lever for hunger control.
- Fourth, the use of exogenous ketones ensures easily accessible ketone (short chain fatty acids) to modulate adipose (white fat) signaling of the liver without large caloric intake through the portal vein by first pass of liver metabolism. The ketones also help stabilize the gut bacteria. The combination of hormone balance between the liver and fat cells and improvement of gut bacteria suppresses key hunger hormones and aids glucose regulation between the fatty tissues and the liver. Ketones, both endogenous and exogenous, suppress production of TNF-alpha, IL-6, resistin, and stabilize production of adiponectin and leptin from the adipose cells (7, 8, 9).
In my office, once we calculate the basic protein needs daily, we start with a 1:1 ratio of protein to fat. Then, the fat is adjusted up or down based on hunger. Remember, hunger occurs, because your body produces hormones. The addition of fat to a diet that is not stimulating large amounts of insulin resets the hormone patterns back to normal without causing weight gain.
Give Obese People Fat Ad Libitum?
“Sure, Dr. Nally, but what about those people who don’t know if they are hungry, bored, stressed or just have a bacon fixation? You can’t just give them all the fat they want?!”
Why not? Implying that people aren’t smart enough to know when they are full is a bit of a fascist philosophy, don’t you think?
Do people over eat? Sure they do. But, I’ve found that when you give people an antidote to hunger (using fat intake in the presence of stabilized insulin levels) over a few months, people begin to recognize true hunger from other forms of cravings. This is especially true when they keep a diet journal. This gives people the ability to begin listening to their own bodies, responding accordingly and governing their stress, eating, exercise and activity. Keeping a diet journal is key to long-term weight loss. And, isn’t helping people use their own agency to improve their health really what we’re trying to do?
Interestingly, doing this over the years seems to line up with the findings of this year’s MATADOR study in the International Journal of Obesity. They found that mild intermittent energy restriction of about 30-33% for two weeks, then interrupting this with two weeks of a diet that was energy balanced for needs improved both short and long-term weight loss efficiency (4). In looking at my, and my patient’s diet journals, this energy restriction of about 1/3 of needed calories cyclically seems to happens naturally with a ketogenic lifestyle, without even counting calories. (Calories are a swear-word in my office).
What does the correct long-term wight loss program look like in a diet or meal plan? Well, you’ll have to join the Ketogenic Lifestyle 101 Course to see what that really means to you individually. I look forward to seeing you there.
Want to find out more about the Ketogenic Lifestyle 101 course? CLICK HERE.
Have you read my book The Keto Cure? Get a signed copy from me by clicking HERE.
References:
- Bronson FH, Marsteller FA. “Effect of short-term food deprivation on reproduction in female mice.” Biol Reprod. Oct 1985; 33(3): 660-7. https://www.ncbi.nlm.nih.gov/pubmed/4052528?dopt=Abstract&holding=npg
- Connors JM, DeVito WJ, Hedge GA. “Effects of food deprivation on the feedback regulation of the hypothalamic-pituitary-thyroid axis of the rat.” Endocrinology. Sep 1985. 117(3): 900-6. https://www.ncbi.nlm.nih.gov/pubmed/3926471?dopt=Abstract&holding=npg
- Seimon RV, Roekenes JA, Zibellini J, Zhu B, Gibson AA, Hills AP, Wood RE, King NA, Byrne NM, Sainsbury A. “Do intermittent diets provide physiological beneftis over continuous diets for weight loss? A systematic review of clinical trials.” Mol Cell Endo. 15 Dec 2015. 418(2): 153-172. https://www.sciencedirect.com/science/article/pii/S0303720715300800
- Byrne NM, Sainsbury A, King NA, Hills AP, Wood RE. “Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study.” Int J Obes. 2018. 42:129-138. https://www.nature.com/articles/ijo2017206
- Trepanowski JF, Kroeger CM, Barnosky A. “Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults.” JAMA Intern Med. Jul 2017. 177(7): 930-938. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2623528?redirect=true
- Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, Proietto J. “Long-term persistence of hormonal adaptations to weight loss.” N Engl J Med. 27 Oct 2011. 365: 1597-1604. http://www.nejm.org/doi/full/10.1056/NEJMoa1105816
- Asrih M et al., “Ketogenic diet impairs FGF21 signaling and promotes differential inflammatory responses in the liver and white adipose tissue.” PlosOne. 14 May 2015. Open Access. https://doi.org/10.1371/journal.pone.0126364
- Veniant MM et al. “FGF21 promotes metabolic homeostasis via white adipose and leptin in mice.” PlosOne. Jul 2012. Open access. https://doi.org/10.1371/journal.pone.0040164
- Whittle AJ, “FGF21 conducts a metabolic orchestra and fat is a key player.” Endocrinology. 1 May 2016. 157(5): 1722-1724.
Ketones – One of the Keys to the Fat Lock-Box
Do you have the keys to your “fat lock-box?”
Lock-boxes have always fascinated me. Lock-boxes with special keys are even more fascinating. The more I’ve learned about fat cells (adipocytes), the more I think about them as special fuel depositories or fat lock-boxes. Before the invention of refrigerators, fast-food, Bisquick and beer, our bodies preserved and reserved fat as a precious commodity.
The body, when given fat with carbohydrates or excess protein, quickly places the fat into a lock-box for safe keeping. It does this for two reasons. First, the body can store fat very efficiently. Second, hormone signals stimulate fat storage when other fuel sources (carbohydrate & protein) are present in excess. The body can access this stored fuel only when the right presentation of hormonal keys are present. Fascinatingly, we now know from recent research, there are actually three types of lock-boxes for fat in the human body (white adipose tissue, brown adipose tissue, and tan adipose tissue).
The greatest challenge for the obesity doctor is getting into the fat lock-box. Some people’s boxes are like the “Jack-in-the-Box” you had as a child – just add a little exercise spinning the handle and the box pops open (These are those people that say, “Oh, just eat less and exercise and you’ll lose weight.”) For the majority of the people I see, it’s more like the lock above with a four or five part key required to turn the gears just right. (And, that key often only seems available on a quarter moon at midnight when the temperature is 72 degrees.) Fat cells, called adipocytes, require four, and possibly more, keys to open them up and access the fuel inside. Exercise is only one of those keys. However, exercise alone often fails.
Over the last 18 months, I have been surprisingly impressed with the results patients have by the addition of both medium chain triglycerides and exogenous ketones. A number of people have asked me, “Why do you encourage the addition of exogenous ketones to a person already following a ketogenic diet?”
Others just accuse me of self promotion, saying, “You’re just trying to sell a product!”
Or they exclaim, “Giving more ketones is just a waste of time and money.”
A few of the uneducated holler from across cyberspace, “You’re just going to cause ketoacidosis!”
Believe me, I’ve heard it all. And, the skepticism is understandable. I work with people every day, looking closely at weight gain/loss, metabolism, cholesterol, blood pressure, inflammation, etc. With any “low-carb” or “ketogenic product,” I test it out on myself and my family, before I offer it to my patients or even consider encouraging its use in my practice. I have this desire to understand “the how” and “the why” before I prescribe the who and when.
The Fat Lock-Box Keys
First , let’s talk about the adipocyte as a fat lock-box – and where you find the keys. Then, we’ll discuss how products may or may not help.
Insulin
There is only one door INTO the adipocyte for the fat, and the key to that door is insulin. Insulin stimulates an enzyme called lipoprotein lipase that essentially pulls the fat from the cholesterol molecule into the fat cell. Without insulin, fat doesn’t enter the fat cell. As a result, type I diabetics (those that make absolutely no insulin) look anorexic if they don’t take their needed insulin. Insulin is also the first key to the back door on the adipocyte. Actually, if there is too much insulin in the system, fat enters easily through the front door but cannot exit the back door (Picture 1). Insulin seals up the back door so that fat cannot exit very effectively.
That’s why insulin is the master hormone when it comes to obesity. You’ve got to lower the over-all insulin load to get the adipocyte slowing fat entry and increasing fat exit. If you don’t do that, I don’t care how much you exercise, 85% of the population will struggle with weight loss. Hmmm, seems kind a familiar to the last 50 years of our obesity epidemic, No?
Catecholamines
The second key to the back door of the fat cells are the catecholamines. These are adrenaline (epinephrine), norepinephrine, adrenocorticotropic hormone (ACTH) and even serotonin. These hormones are produced in the adrenal glands through exercise, fear and even recollection of powerful memories. Medications can also stimulate production of these hormones. The catecholamines stimulate cAMP. cAMP opens the fat cell, releasing fatty acids for fuel.
The thyroid hormone conversion of T4 to T3 also plays a role in uptake of the catecholamines by adnylyl cyclase (AC). Low levels of T3 (like those seen in hypothyroidism or in cases of thyroiditis) also inhibit unlocking of the fat lock-box. Conversion of T4 to T3 is driven by the presence of bile salts in the gut. Increase fat intake increases the presence of the bile salts which naturally leads to better T3 conversion. Hence my constant references to eating more fat and bacon. .
Inflammation & Medications
The third key is an inhibitory effect on adenylyl cyclase (AC) activity by alpha and beta adrenoreceptors, adenosine, prostaglandins, neuropeptide Y, peptide YY, HM74-R & nicotinic acid. These inhibitory and inflammatory hormones produced in the brain, gut and other areas decrease cAMP activity in the fat cell and slow fat loss. The fancy long names are all hormones causing inflammation. Of note, many are also stimulated by medications including blood pressure lowering drugs. Check with your doctor if the medications you are taking may be causing weight gain, or halting your weight loss.
Please note that the first three keys have effect on the cAMP pathway for release of fat from the adipocyte. These three keys turn on or off effective function of cAMP leading release of fatty acids from the fat cell.
Naturitic Peptides
The fourth key follows a separate pathway. This is why I’ve clinically seen patients experience weight loss even in the presence of higher insulin, inflammatory disease or hypothyroidism. This key activates release of the naturitic peptides (ANP, BNP). These hormones are released from the heart when it squeezes more powerfully. As the cardiac muscle contracts, it releases ANP & BNP hormones. These hormones stimulate the cGMP pathway in the adipocyte. It then activates hormone sensitive lipase (HSL) and perilipin to release free fatty acids. Again, this pathway is separate from the pathway by which the first three keys released fat. Exercise increases heart contractility, but is inhibited by high insulin levels. However, ketones themselves also stimulate this increased contractile effect.
Hypothalamus-Pituitary-Gonadal (HPG) Axis & Testosterone
There actually is a fifth key not referenced above. The fifth key to the fat lock-box amplifies testosterone’s presence through the HPG axis. Insulin resistance and leptin resistance lower testosterone in men and raise it in women, causing poly-cystic ovarian syndrome (PCOS). Normalizing insulin levels (with a ketogenic diet) while at the same time increasing ketones as the primary fuel powerfully resets the HPG axis through a complex series of hormonal reactions. Growth hormone is balanced and testosterone returns to a normal range.
Clinically, 60% of the people I see in the office have abnormal testosterone due to insulin resistance. This leads to hypogonadism in men and PCOS (abnormal periods, facial hair growth and/or infertility) in women. Restricting carbohydrates and maintaining nutritional ketosis by diet and/or addition of exogenous ketones has a powerful corrective factor in these people.
Testosterone influences the up-regulation of the alpha & beta adrenergic receptors (the 2nd & 3rd key above). Hence, if your testosterone is low, it has a suppression on the way that the catecholamines influence fatty acid release from the fat cells. If your testosterone and growth hormone are normal, muscle development and adrenaline stimulus from exercise helps amplify the use and mobilization of fat from the fat cell. In people with insulin resistance and leptin resistance, exercise and the catecholamines don’t have the same fat burning effect.
What Does This Actually Mean?
Yes, I have greatly simplified a series of very complex hormonal pathways in the explanation of the keys above. Why do you think understanding obesity has been so difficult? Think of your adipocytes as a fat lock-box.
What’s even more important is the knowledge that the fat cell DOES NOT open or close because of calories. There is no dogmatic calorie-meter on the wall of the fat cell. There is no calorie key to the fat lock-box. Really, . . . in the 50 years of studying fat, researchers haven’t found one. (Prove me wrong when you show me an electron micro-graph of a calorie-meter in the wall of a cell). Science has demonstrated multiple times that the lack of food from starvation or excessive fasting suppresses thyroid function (an inhibitory effect on key #3). Restricting calories actually inhibits fat loss in many people.
The fat lock-box keys I refer to above are hormone responses to the presence of macro-nutrients (food). That means, first reduce your carbohydrate intake by eating real food from good sources. You can learn how to get started by registering for my FREE six part weight loss mini-course. Second, be as active as you can. Third, reduce stress and medications that have inhibitory effect on catacholamines. Fourth, balance your thyroid. And, fifth, get into ketosis and consider adding exogenous ketones to your dietary regimen. It really is that simple.
References
(For those of you that still believe there is a calorie key – or just need something to do while in the bathroom):
- Lafontan et al. Arterioscler Thromb Vasc Biol. 2005
- Lenard NR, Obesity, 2008
- Li XF et al, Endo (April 2004) Vol 145
- Liu YY& Brent GA, Trends Endocrinol Metab. 2010 Mar; 21(3): 166–173
- Max Lafontan et al. Arterioscler Thromb Vasc Biol. 2005;25:2032-2042
- Skorupskaite K et al, Hum Rep Update, Mar 2014, vol 20
Podcast #32: Hereditary Angioedema, Lower Blood Ketones, Statins, Healthy Keto Lifestyle
Listen to KetoTalk Podcast #32 where we talk about hereditary angio-edema, adequate ketone ranges, statin use while in ketosis and healthy keto questions. You can listen in by going to KetoTalk.com or you can listen in on iTunes.
“About 40 percent of my older patient population who take statins while eating ketogenic experience some form of myalgia they didn’t have before. And there’s an amplified side effect profile: muscle ache, joint pain, generalized fatigue, liver enzyme elevation, and cloudy headed.” — Dr. Adam Nally
Calculating Protein Needs for Your Ideal Body Weight
Too much protein, too little protein? How do you know how much protein to eat? This has become a very confusion question for many of my patients in recent years. There a a large amount of “mis-information” in the ketogenic world about the effect of protein of gaining and losing fat.
For the person exercising 5-6 days a week, 1 gram of protein per pound of ideal body weight is the formula that works quite well. However, for the average Joe or Mary who doesn’t work out for an hour a day 5 days a week, I’ve provided the calculation below. This calculation is a baseline starting point. It is the basic amount of needed protein to maintain muscle on a ketogenic or carnivorous diet:
Ideal Body Weight (IBW) is based on your height:
Males: Protein in g/day of IBW = 50 g (for the first 5 feet of height) + 2.3 g for each inch over 5 feet. Then multiply the number you found by 1.2 (multiplier for sedentary male). [This lets you calculate the average male needs that are approximately 1.2 g of protein per kg of ideal body weight (IBW) per day.]
Males: Protein in g/day of IBW = 50 g (for the first 5 feet of height) + 2.3 g for each inch over 5 feet. Then multiply the number you found by 1.2 (multiplier for sedentary male). [This lets you calculate the average male needs that are approximately 1.2 g of protein per kg of ideal body weight (IBW) per day.]
Females: Protein in kg/day of IBW = 45.5 g (for the first 5 feet of height) + 2.3 g for each inch over 5 feet. (This lets you calculate the average female needs 1.0 g per kg of ideal body weight per day.)
Example:
A 6 foot male’s protein calculation for IBW would be 50 g of protein (for the first 5 feet )+ 27.6 g (2.3 g x 12 inches) = 77.6 g x 1.2 = 93.2 g.
A 5 foot 4 inch females protein calculation for IBW would be 45.5 g (for the first 5 feet) + 9.2 g (2.3 g x 4 inches) = 54.7 g.
If you are exercising more than 60 minutes 5 days per week then the values above should be multiplied by 1.4 grams per kg for females and 1.6 grams per kg for males.
Heavy Exerciser Protein Calculation Example:
6 foot male’s base protein needs: 77.6 g per day (IBW calculated number before using the multiplier).
77.6 g x 1.6 = 124.5 g max
5′ 4″ female’s base protein needs: 54.7. g per day
54.7 g x 1.4 = 76.6 grams per day max
If you eat three times per day, then simply divide your protein needed for you IBW by 3 to get the maximum protein you need per meal.
I hope that helps.
KetoTalk: Episode 27 -Mailbox Blitz, Low Energy, Headache, Stomach-Ache, Breast-Feeding While On Keto
Listen in today as Jimmy and Adam blaze through a bunch of listener questions in Episode 27 of KetoTalk with Jimmy and the Doc!
KEY QUOTE: “Children are born in ketosis, so ketones are perfect for babies. The level of fat in breast-milk is essential for them to maintain their health and their growth.” — Dr. Adam Nally
Here’s are the 12 questions Jimmy and Adam answered in this special Keto Talk Mailbox Blitz extended podcast today:
– Testimonial from someone who learned his lesson why it’s important to stay ketogenic all the time
– Three-decade study confirms saturated fats are bad for health
– Is increased testosterone from a ketogenic diet a bad thing for women?
– Why am I still struggling with low energy and low ketones after months of being in ketosis?
– Can being in nutritional ketosis above 1.0 mmol cause painful headaches?
– Do artificial sweeteners and stevia raise insulin?
– Is my ketogenic diet causing me to cramp up before and during my half marathon racing?
– Is MCT oil a better fat to use on a ketogenic diet than other fats like coconut oil, cream, or butter?
– Why do I have a constant stomachache while I’m on a ketogenic diet?
– Do you have to be in ketosis to burn fat?
– Does being in ketosis lead to daily spotting and extended periods?
– Are ketones in my baby’s breastmilk safe for her to consume? And why did my milk supply drop when I went keto?
– What is the impact of the supplement creatine on ketones, blood sugar, and insulin levels?
– Can I ease into ketosis as a way to avoid the dreaded “keto flu?”
KEY QUOTE: “If you’re not feeling energy after that adaptation period of 2-4 weeks at the very most, then you’re doing something wrong. Let that be your wakeup call to change something.” — Jimmy Moore
Listen in here at KetoTalk.com or you can download the episode for free on iTunes.
How Fat Lowers Your Blood Pressure
Hypertension (elevated blood pressure) is one of the triad symptoms of metabolic syndrome. Most of the hypertension that I see clinically is driven by insulin resistance as 
the underlying cause. I see this problem in a very large majority of the people in my office and I am seeing people younger and younger show up with continually increasing blood pressure.
In medical school, we were taught to treat “borderline” or “slightly elevated blood pressure,” through “lifestyle changes” which was another way of saying exercise, caloric restriction & hold the salt. But most physicians today will tell you that exercise, salt & caloric restriction doesn’t work. When asked why the 34 year old male in my office suddenly has elevated blood pressure, the only explanation we had was it is a “genetic problem,” or “blood pressure naturally goes up as we get older,” or “you’ve been eating too much salt,” and they are started on blood pressure medication and sent on their way. But, as time went on, I found that I had to keep adding more and more blood pressure medication to control the continually rising blood pressure of the patients in my practice.
Most of these people will have a progressive elevation in blood pressure over time, and these blood pressure (anti-hypertensive) medications are/were continually raised until the person is on four or five different blood pressure pills at maximal doses. Again, when questioned why, their genetics are blamed and that is the end of it. Or is it?!
What shocked me was that when I took patients off of salt & caloric restriction, and placed them on low carbohydrate high fat diets (and yes, I gave them back their salt), their blood pressure normalized. I noticed that as their fasting insulin levels began to fall, their blood pressure began to return to normal.
What?! Blood pressure rise is caused by insulin?!
Ummm . . . Yes!
I am a prime example. During the first few years of my medical practice and reserve military service, we had routine vitals checkups. I was working out 3-5 days a week with weights and running 3-5 miles 2-3 times a week and restricting my calories to 1500 per day. So, I thought I was in pretty good shape. However, it was not uncommon for for the nurse to raise her eyebrows at my blood pressure readings in the 140-160 systolic and 85-98 range diastolic. “Oh, it’s the lack of sleep last night,” or “it’s the caffeine I had this morning,” would be my excuse. But I was making a lot of excuses, and in light of those excuses, my caloric restriction, exercise and salt restriction, I was also still gaining weight.
By the 5th year of my medical practice, I weighed 60 lbs heavier than I do today and I struggled to keep my blood pressure under 150/95. I was violating my own counsel . . . don’t trust a fat doctor for nutritional advise. (Or, was that advise from Dr.House?)
After cutting out the carbohydrates (I’ve kept my carbohydrate intake < 20 grams per day), moderating my protein intake and eating all the fat I am hungry for each day, my recent physical examination at the beginning of June 2016 revealed my blood pressure at 112/64. I don’t remember ever having blood pressure that low. And to be honest, I didn’t sleep well the night before my exam due to a number of middle of the night patient calls.
When I first started treating the insulin resistance problem in the human, rather than the blood pressure problem, I began to see immediate reductions in blood pressure within one to two weeks. So much of a reduction that if I didn’t warn the patient that they should 
begin to back down their blood pressure medications, they would experience symptoms of dizziness, light-headedness, headache and a few patient’s nearly passing out. On a low-carbohydrate, high-fat (ketogenic) diet you need salt (sodium, potassium, & magnesium).
The process of burning fat as fuel causes you to lose increased amounts of sodium & potassium, and you have to replace these electrolytes. A number of my patients begin a low-carbohydrate, high-fat diet and are afraid of increasing their salt intake. Not replacing these electrolytes while on a ketogenic diet can also lead to low blood pressure, dehydrate and dizziness.
I often wondered why applying a ketogenic diet had such a profound effect on blood pressure so quickly. Dr. Robert Lustig helped answer that question for me.
In order to understand how the Standard American Diet (we call it the SAD diet in my office) raises your blood pressure, it is important to understand how the body processes the basic sugar molecule. Sugar is one glucose molecule bound to a fructose molecule. This is broken down in the body and 20% of the glucose is metabolized in the liver, the other 80% is sent on to be used as fuel throughout the body. Fructose, however, is where the problems arise. 100% of the fructose is metabolized in the liver, and the by product of fructose metabolism is increasing the liver’s production of MORE glucose and the byproduct of uric acid. Uric acid is produced and this inhibits the production of nitric oxide. The diminished nitric oxide in the presence of an increased level of glucose (stimulating increased insulin production due to eating starches) constricts the blood vessels and raises blood pressure. Yes, that donut you just ate raised your blood pressure for the next 12 hours.
The mechanism that fructose containing carbohydrates, sugars and starches raise blood pressure, cholesterol and cause weight gain can be seen in the really complex diagram found in Dr. Lustig’s 2010 article:
So, how do you lower your blood pressure through diet?
First, cut out all the simple sugars. These include anything with table sugar, high fructose corn syrup and corn syrup. (This is why people with any change in diet see some improvement in weight and blood pressure as they remove the simple sugars like candy, sugared drinks and pastries from their diet.)
Second, limit your overall intake of other sources of carbohydrates including any type of bread, rice, pasta, tortilla, potato, corn and carrots. Realize that carbohydrate in fruit is fructose, and when taken with other forms of glucose can have the same effect as table sugar – it can and will raise your blood pressure, as well as halt or cause weight gain.
Third, if you are taking blood pressure medications for hypertension, see your doctor about close monitoring of your blood pressure as it can and will drop within 2-4 weeks of making these dietary changes.
Maintaining ketosis is really important for weight loss and blood pressure or hypertension control. I am very much an advocate of using real food for this process, but I have also found that the use of exogenous ketone salts aid significantly in maintaining ketosis. I have found that exogenous ketones are the next step in bridging the difficulty of day to day maintenance of ketosis.
It isn’t making the mistakes that’s critical; it’s correcting them and getting on with the task that’s important. If you’ve been calorie restricting and exercising to lower you blood pressure, don’t fret. A simple change in your diet focused on restricting starches and carbohydrates has been demonstrated in my office to be more powerful than many of the blood pressure medications we’ve used for years.
Learn how to get started on a low carbohydrate, high fat (ketogenic) diet here. You can also read about the basic principles in my recent articles The Principle Based Ketogenic Lifestyle – Part I and Ketogenic Principles – Part II.
KetoTalk Podcast #21
Listen to Dr. Nally & Jimmy Moore as they answer the following questions in KetoTalk Podcast #21.
- How can I get back started on keto again?
- Do I need to quit keto once I hit my weight loss goal?
- Is flax and flaxseed oil okay on a ketogenic diet?
- What to do when you are sleepy on a low-carb ketogenic diet?
- I know that some people lose fat on a low fat diet. When people lose fat on a low-fat diet are they they also in a state of ketosis?
Get the answers to these questions and much more when you listen to KetoTalk.com or download the podcast for free on iTunes.
Healthy Ketogenic Bio-Hacking…Come Learn How
Ever wondered if it is possible to change up your metabolic genetics for the better? Come join me this week. I’ll be speaking about Ketogenic BioHacking, Thursday, March 31st, in Scottsdale, Arizona. Meet me from 7-8:30pm and learn how to improve fat burning, bio-hack your epi-genetic metabolism for improved blood sugar, cholesterol, blood pressure and so much more . . .
You’ll also get to meet Kim Minert who will be signing her new book, Burn Fat for Fuel. And, you’ll get a chance to meet the amazing Abigail Epps-Kluttz, body builder, fitness model & Pruvit Ambassador.
You can sign up at the Eventbrite link here. I look forward to seeing you!!
Ketogenic Lifestyle Rule #1: There should ALWAYS be bacon in the fridge
I thought that over the next few weeks I’d address a number of Ketogenic Lifestyle Rules that I have adopted. These seem to help and bring a little clarity to one following a Ketogenic Lifestyle or someone on the road to becoming a true “Ketonian.”
The first of these rules is that there should ALWAYS be bacon in the fridge!
We address this rule and some interesting facts around having bacon in the fridge in this evening’s Persicope below. We also address the benefits of journaling, how to help stop binge eating, what are your real protein needs, and red-meat fear-mongering. We even discuss whether or not pigs like bacon. Enjoy!
Links referenced in this video:
Red & Processed Meats: Bacon Fear-Mongering
Calculating Your Protein Needs from Ideal Body Weight
(Just a note: I love Katch.me’s service; however, due to the contract language allowing Katch.me to have unlimited rights to my Periscope Videos, I have withdrawn from Katch and my videos are no longer available on this medium until the contract usage can be modified.)