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).
Hair loss is an issue that I am asked about quite frequently. With any dietary change, transient hair loss can occur in the first 2-3 months but will usually resolve. Continued hair loss is a problem with any diet and if you are experiencing hair loss it could be due to one of five issues:
1. Medication
2. Lack of protein or caloric restriction
3. Hypothyroidism
4. Iron Deficiency
5. Hormone imbalance (especially estrogen dominance or poly-cystic ovarian syndrome)
Dr. Nally discusses these and how to address them in his most recent YouTube video. Check it out below.
Founded by the Secret Society of Happy People in 1999, August 8th was officially named the National Day of Happiness. It was a day created to recognize and express happiness. (I personally think it should involve the sharing of bacon, but some may disagree.) Most people, whether they admit it or not, are searching for happiness. (Most people are searching for bacon, too, . . . but that is for another article.) We hope for happiness, we aim for happiness, and we wish happiness upon our family, friends and neighbors at holidays and birthdays. It appears to be a desired condition of the soul.
In medical school, we learn that the body is almost 80% water. One of my professors intelligently quipped, “if you’re unhappy all day, that means you are essentially a cucumber with anxiety.” For many people, happiness is really hard to find. Money is hard to find . . . but, that’s because it gets wasted by people trying to find happiness
What exactly is happiness? It is a transient condition or state of cheerfulness, contentment, satisfaction or pleasure. Many people mistake meaningfulness as happiness. Meaningfulness to one’s life is more enduring. For example, suddenly having a wind-fall of cash may make you happy for the short term. However, what you actually do with that cash over the next few days, months and years is what brings degrees of meaning to your life.
Basics of Happiness
Happiness is based upon your emotional & spiritual vision, and how living your life aligns with the principles you hold most valuable. You can’t control all of the circumstances of your life. Things both good and challenging will happen to you that you never expected. However, you have control of your own happiness. You and I are the architects of it.
In working with a majority of patients who are over 65 years old, I have found that the older we get, the more we look back and realize that external circumstances don’t really matter or determine our happiness. We determine our happiness.
How do we increase our level of happiness? There are 10 Simple Steps to Happiness:
1. Improving Health
As a doctor, I’m a huge advocate of improving your health which plays a dramatic role in happiness. Losing as little as 10 lbs has been shown to improve energy, decrease your risk for major disease, improve sleep, improve sex life, and decrease inflammation. Improvements in any of those areas will reduce stress and anxiety and increase happiness so you can imagine while improvements in ALL of these areas could dramatically change your life.
As an advocate of the ketogenic lifestyle, I’ve found that the majority of my patients are able to lose 5-15 lbs each month for the first three months using this approach. They average 2-5 lbs pf weight reduction each month there-after while following a ketogenic approach over the long term. Understanding that this is one of the long term keys to success in happiness I want to make sure you know that I’ve developed some custom strategies to help with this and will share them with you below. This lifestyle decreases risk for diabetes by 75%, improves mental clarity, and slows the aging process. (Who wouldn’t want those side effects while eating bacon?)
2. Savor Daily Experience
First, savor the daily experiences. We live our lives at such a high speed, we often neglect to take time to enjoy the experiences around us. A recent trip in down town Amarillo, Texas, brought me to the front doors of a restaurant that served cream-cheese & sausage stuffed, bacon wrapped, jalapenos (try saying that 5 times fast). I had a bit of time and decided to try them. It was the first time in 3-4 days that I actually had the chance to slow down and savor the place around me, the flavors of the food, and the atmosphere of the restaurant.
Just taking a bit of time to savor these things made this experience a very memorable and happy experience that I probably won’t soon forget.
Take 3-5 minutes today to just think about where you are. Savor the smell of a rose, the color of the sky, the shape of the clouds or the sight of a bird. These sensory images can, and will, leave indelible memories and release dopamine and serotonin naturally in the brain. Savoring the daily experiences of life can be part of the process of meditation we will talk about below.
3. Volunteer
Get involved and volunteer in meaningful activities around your neighborhood, church & community. Research shows that voluntarily giving of time increases happiness in the giver. It also allows one to see, participate with and help those around you who may be less fortunate. Volunteering your time and energy regularly increases your gratitude we will discuss further below.
4. Express Gratitude
Expressing gratitude daily has been shown to dramatically increase your sense of well-being and happiness. Expressing gratitude requires awareness. It requires you to take inventory of everything around you (something you will already be doing if you are savoring your daily experiences). Gratitude can be expressed in a journal, through prayer & meditation, or directly to those around you. However, expressing gratitude requires effort.
In the Judaeo-Christian view, expressing gratitude is actually a method of expressing faith. The 17th chapter of Luke holds a biblical example of this concept. When the leper returned to express his thanks to Jesus Christ for being healed, he wasn’t told “Your gratitude made you whole.” Christ told him, “Thy faith hath made thee whole.” He implied that the act of expressing gratitude is a demonstration of faith, a necessary and essential process in human development.
5. Recognition of Personal Value
I’m not talking about your bank statement or personal financial statement. I’m talking about recognizing the value of your soul. The only successful non-medication based program to help people overcome addiction is the 12-Step Program through Alcoholics Anonymous. The essential second step of the twelve is recognition that a power greater than ours is involved in our lives. Whether, you believe in God or a greater universal power, recognition of your value is an essential perspective to gaining happiness. This has been demonstrated thousands of times through the 12-Step Programs.
Often, the feeling we have of our personal worth is based on the love and interest we receive from those around us. Yet, this love is sometimes lacking. The love of men is often imperfect, incomplete, or selfish. What if you looked at yourself with the same benevolence, love, and confidence that God does? Imagine the impact it would have on your life to understand your eternal potential as God understands it. If you could view yourself through His eyes, what influence would that have on your life? Recognition of this principle is essential to making any lasting change.
6. Become Who You Are
The celebrated Greek poet, Pindar, said, “Become who you are.” Isn’t this a paradox? How does one become who they already are?
Many of my and the younger generations grew up to the sounds and images of The Lion King. You probably remember the scene where Simba receives a visit from his father, Mufasa, the deceased king. After his father died, Simba fled from the kingdom because the guilt he felt about his father’s death. He wanted to escape his responsibility as heir to the throne.
His father appears to him and warns him: “You have forgotten who you are and so have forgotten me. Look inside yourself, Simba. You are more than what you have become. You must take your place in the circle of life.” Then this invitation is repeated several times: “Remember who you are. … Remember who you are.”
Simba, completely shaken by this experience, decides to accept his destiny. He confides in his friend, the shaman monkey, that it “looks like the winds are changing.”
The monkey replies, “Change is good.”
And Simba says: “But it’s not easy. I know what I have to do. But going back means I’ll have to face my past. I’ve been running from it for so long.”
“Where are you going?” the monkey asks him.
“I’m going back!” cries Simba.
(This is also a great movie because of the “bacon references:”)
Admit it. You smiled didn’t you!
7. Meditation
Meditation and prayer have been shown to actually change areas of the brain that relate to stress management and mood regulation. People who meditate regularly over long periods of time have better ability to find and maintain positive states like joy and compassion. Richard Davidson and his colleagues found that meditation increases brain activity in areas related to happiness as well.
8. Relationships
Happiness has been linked to quality relationships as well. Robert Wallinger, psychiatrist at Harvard University, conducted a 75 year multi-generational study on happiness. He found that the quality of the relationships was powerfully connected to happiness. Lonely people were less happy and had poorer health. People with higher-quality relationship or social ties were the happiest.
However, it wasn’t just having a relationship, but having one with a stable and consistently caring person that made the difference. Having lots of acquaintances or being in a relationship with an unreliable or abusive partner did not make people happier. Amazingly, listening (savoring shared experiences) and complimenting (expressing gratitude) improve the quality of relationships. (Sharing your bacon improves relationships as well.)
9. Food
A number of studies have demonstrated that a ketogenic diet increases gamma-aminobutyric acid (GABA), a key neuro-hormone signaling satiety and pleasure, in the brain. GABA increases sensations of happiness and euphoria. (Yes, this is why eating bacon makes you and I happier. It’s probably why the thought of bacon in the video above made you smile.) Shifting into a ketogenic state at least periodically has the effect of increasing your sense of happiness throughout the day. It is actually the ketone that does this. Whether you get into ketosis through diet alone, or through the use of exogenous ketones, both methods are effective in aiding you in your quest for happiness.
10. Allow Others to Help
I know you are probably familiar with the term it is better to give than receive but did you know there is evidence to support the reverse is true too? That happiness also comes from allowing others to help? Think about it. When you are helping others, especially when they appreciate it, you feel happiness or joy. Others experience those same feelings when they are able to help you. Think of a child that wants to make you a meal. No matter what it looks like when it gets to you, you smile and feel happy at the effort, the child smiles back proud at their success. There is happiness in giving and receiving.
So today’s your chance to receive. As a doctor, I find myself shying away from sharing this information with you directly because I never want anyone to feel like my efforts are about me. I’ve spent years learning and understanding the benefits of a Ketogenic lifestyle and spent additional years researching products that work and my local patients are experiencing tremendous results! A friend told me that not sharing this information with people directly was actually being selfish. (Ouch!) “When you know someone has a problem that you can solve, shouldn’t you share it and let them make their own decisions?”
Although that was painful to hear, it helped me commit to being more direct about how I can help all of you to feel better. If you are ready to change the way you feel and want to live a happier, healthier life, the time is NOW. Put these 10 steps in action and enjoy the benefits of a KetoLifestyle. If you want to know more about what I do, keep reading my blog, join my weekly newsletter and watch me Live Stream every week on Facebook Live & Periscope giving you free tips and tricks to stay healthier. If you know you are ready for a change, and you want to see how I can help, check out the variety of Ketogenic programs I offer to help you find the Happiness inside You! Because we all love gifts and they make us Happy, in honor of #NationalHappinessDay, you should see a pop up here for something special! ] Be sure to click here to go to the Keto Kart and cash in on better health!
However you decide to approach your day today, choose to be happy. It really is up to you.
Join me as we discuss gout and how insulin resistance is really the underlying cause, driven by the body’s metabolism of fructose. Yes, your orange juice is making your gout worse, really. We discuss the metabolism of fructose and it’s affect on the formation of uric acid crystals and gout.
Pull up some pork rinds and a glass of KetoMax and check out my video blog on Insulin Resistance 101. Let me know your questions as we go and I will add them to future videos or blogs.
I’ve become a big fan of exogenous ketones for myself and my patients with a little more challenging insulin resistance. My clinical experience has been great, both personally and with my patients, in helping people to get into, and maintain, a more successful level of ketosis that drives energy, fat loss, improved mental clarity & focus, and diminished inflammation throughout the body.
I’ve been using a packet 2-3 times a day for the last year, personally, and have found these to be the greatest addition to my ketogenic lifestyle. I’m stocking up right now. . .
If you haven’t tried exogenous ketones, now is the perfect time. Buy yours now before this special ends.
This week on Episode #50 of KetoTalk.com we talked about those proteins highest in arginine and lysine with the greatest potential for spiking your insulin and kicking you out of ketosis. Here is a Graphic to give you a little help:
Listen and watch as we talk about how ketosis, or the absence thereof plays a role in the formation of the Diseases of Civilization (It’s not rocket science, or maybe it is?)
We touch on non-alcoholic fatty liver disease, carbohydrate restriction, the use of protein and even exercise (Did you say “eggs are sides . . .” or exercise?). So pull up a piece of string cheese and spend 20 minutes that may just change your life.
You can find the vitamin supplements that Dr Nally developed and uses himself and with his patients at KetoLiving.com.
You can find exogenous ketones referenced in the video at DynamicKetones.com
How does ketosis help the diseases of civilization? Find out as Dr. Nally answers these and many other pertinent dietary questions this evening.
You can learn more about his multi-vitamin supplement he designed for insulin resistance/diabetic/weight management patients that he mentions in the video here at KetoLiving.com.
You can learn about exogenous ketones that he mentions helps to augment ketosis here at DymaicKetones.com.
Listen in as Dr. Nally discusses how we got to be the fattest and sickest country in the world after 50-60 years of bad science influenced by the media and politics. How can a ketogenic diet help the diseases of civilization? Listen in and then click the link in the menu above to get my six-part mini course instruction.
We also discuss Dr Nally’s daily diet and his use of exogenous ketones.
Watch as we talk about how insulin stimulates the Na-K-ATPase pump leading to increased leg edema, varicose veins, bloating, hypertension and swelling. I see it all the time. Watch the video to find out why.
Watch further as I, Dr. Nally, answer some of the very common misconceptions and confusing factors about the ketogenic lifestyle, ketosis, supplements and exogenous ketones. Enjoy!!
Benefit #10 in my 25 part series on “Why Be In Ketosis?”
This evening we briefly discuss PPAR-α, a powerful hormone that is stimulated by the ketogenic state. It has a number of known benefits. A number of great questions also popped up that we answered. Listen and watch as we discuss them here:
Stay tuned for more great content on Facebook Live, Periscope and Instagram.
Ketosis plays a major role in lowering blood glucose, insulin and notably improving memory in those with Mild Cognitive Impairment and risk for Alzheimer’s Disease (1). Watch this short 5 minute segment on how a ketogenic lifestyle helps. You can learn about a Ketogenic Lifestyle by reading my blog post: A Principle Based Ketogenic Lifestyle. And you can ramp up your blood ketones in less than 30 minutes by getting exogenous ketones at DynamicKetones.com.
Enjoy!!
References:
Krikoria R et al. “Dietary ketosis enhances memory in mild cognitive impairment.” Neurobiology of Aging. Feb 2012, Vol 33:2 p 419-425.
How does being in ketosis and living a ketogenic lifestyle lower your blood pressure, decrease risk of kidney stones and gout? Listen in to the way nitrous oxide is raised by being in ketosis . . . Enjoy!
I had the chance to appear for an interview on Vicki Fitch’s podcast last night: A Fresh Perspective. We talked about bacon, ketogenic diets, hypoglycemia, sweeteners, food cravings, #FitchSlaps, exogenous ketones and we answered a bunch of great questions from the Facebook Live audience. You can see video of the show below:
Had a great time. Let me know what you think. Thanks, Vicki!!
KEY QUOTE: “For those of us that are insulin resistant, which is two-thirds of the patients in my practice, you really have to use the ketogenic diet to see the true effects of the exogenous ketones as an adjunct to the diet.” — Dr. Adam Nally
You’re not going to want to miss this one, listen in by down loading KetoTalk on your IOS device or here at iTunes. Or, you can use your computer to listen on KetoTalk.com to hear Dr. Nally & Jimmy Moore talk about the benefits of Ketones, Abdominal Pain and Ketones, & “To Cheat . . . or Not To Cheat.”
I want you to think about bacon for a minute . . . here are some images to help:
Now admit it . . . your problems went away for just a moment . . . didn’t they!? That’s the power and influence of ketones on your brain.
See, your brain loves ketones. Bacon is the bearer of ketones. Bacon contains saturated, polyunsaturated and monounsaturated fat. Fats that have the ability to be converted to ketones in the short run, in a couple of hours and 4-5 hours from now. Isn’t that exciting?
I know my brain feels a little kick start just thinking about it.
As long as you are putting that bacon into the system without the stimulus due to an insulin surge from carbohydrates, you’ll do fantastic.
This is the same feeling I get when I use exogenous ketones like Keto//OS. If you haven’t tried them, you’re missing out.
So, if your feeling a little foggy today, stop and think about bacon wrapped avocado fried to a crispy golden brown in coconut oil for a moment, and while you’re making them . . . drink a Keto//OS . . .
There . . . doesn’t that feel better?
(Yes, I just used pictures of bacon to advertise for exogenous ketones, but really, . . . . you feel better don’t you!?)
Ketotalk with Jimmy & the Doc Podcast #24 is now available on KetoTalk.com or on iTunes
If you are interested in the low-carb, moderate protein, high-fat, ketogenic diet, then this is the podcast for you. We zero in exclusively on all the questions people have about how being in a state of nutritional ketosis and the effects it has on your health. There are a lot of myths about keto floating around out there and our two amazing cohosts are shooting them down one at a time. Keto Talk is cohosted by 10-year veteran health podcaster and international bestselling author Jimmy Moore from “Livin’ La Vida Low-Carb” and Arizona osteopath and certified bariatric physician Dr. Adam Nally from “Doc Muscles” who thoroughly share from their wealth of experience on the ketogenic lifestyle each and every Thursday. We love hearing from our fabulous Ketonian listeners with new questions–send an email to Jimmy at livinlowcarbman@charter.net. And if you’re not already subscribed to the podcast on iTunes and listened to the past episodes, then you can do that and leave a review HERE. Listen in today as Jimmy and Adam have some fabulous questions to answer for you in Episode 24!
KEY QUOTE: “Initially you’ll see a higher level of ketones (when you begin eating ketogenic). But as the body becomes better able to use the ketones, the overall level will drop to more normal readings.” — Dr. Adam Nally
Listen in to Ketotalk Podcast #19 where we talk about inflammatory foods, building muscle with a ketogenic diet & how ketosis affects the Baby Boomer Generation.
Keto Talk is cohosted by 10-year veteran health podcaster and international bestselling author Jimmy Moore from “Livin’ La Vida Low-Carb” and Arizona Osteopath and Board Certified Obesity Medicine physician Dr. Adam Nally from “Doc Muscles” who thoroughly share from their wealth of experience on the ketogenic lifestyle each and every Thursday.
We love hearing from our fabulous Ketonian listeners with new questions–send an email to Jimmy at livinlowcarbman@charter.net. And if you’re not already subscribed to the podcast on iTunes and listened to the past episodes, then you can do that and leave a review HERE. Listen in today as Jimmy and Adam answer more engaging questions about nutritional ketosis from you the listeners.
A patient recently asked me how bad being in nutritional ketosis was for her. I responded that the worse problem I’ve seen recently is the patient that broke his toe when he slipped on bacon grease. Are there risks with a ketogenic diet? Yes, but these usually only occur when you cheat or fall off the wagon. What problems can arise? Lets talk about them individually.
First, as I stated above, make sure you don’t slip on bacon the grease. It really can be an issue if you’re not used to using increased amounts of fat in your kitchen. So, be prepared for how to cook and use fat. Grandma understood this well, we could learn a great deal from her if you ask her about using bacon grease.
Second, let’s define the difference between ketosis and keto-acidosis and try to clarify the misinformation that is being spread around the blogosphere.
A ketone is a molecule the body produces from the breakdown of fat (specifically triglycerides) and some proteins (amino acids). There are specifically three types of ketones: beta-hydroxybutyric acid, acetoacetic acid and acetone. If ketosis was “bad,” then why would our bodies produce these molecules? They are not bad, and in fact, multiple studies show that the body is often more efficient in weight loss, inflammatory reduction, bowel function, epigenetic influence and maintenance of lean body mass more effectivly when it functions on ketones rather than glucose as its primary fuel source. You can see these studies here, here, here and here.
The body can only supply a limited amount of sugar or glucose for fuel. If you talk to runners, marathoners or triathletes, they will tell you that after about 45-90 minutes of continuous endurance exercise the glucose supply runs out and they will experience what is termed a “bonk” (have a low-blood sugar or hypoglycemic episode). Unfortunately, our bodies can only store about 18-24 hours of glucose.
However, the body can store days upon days of fat in the form of triglyceride in the fat cells. Triglyceride is broken down into ketones. If glucose is the “unleaded” fuel, you can think of ketones as the “diesel fuel” that is easier to store and runs longer.
The average body functioning on ketones as the primary fuel will have a ketone level measured in the blood somewhere between 0.4 and 4 mmol/L. Because of a balance that is created by the use of ketones and a feedback mechanism that kicks in when the ketone level rises, the body will maintain a pH of around 7.4.
Ketoacidosis is dramatically different. If you are a type I diabetic, you don’t produce any insulin. The feedback mechanism regulating ketone use is broken and the ketone levels and triglyceride breakdown speeds up because the body can’t access glucose and can’t produce insulin. The ketone levels spike and the level can rise to > 25 mmol/L. In the presence of a high blood sugar and high ketone level, the acid level in the blood shifts to a pH of less than 7.3. This is referred to as metabolic acidosis and can be life threatening as the low pH shuts down the bodies’ enzymatic processes and a person becomes critically ill and without treatment, can die. Further information on ketoacidosis can be found here.
If you’re not a type I diabetic, you have nothing to worry about. Regardless of what the “ketogenic nay-sayers” blog about, your liver makes approximately 240g of glucose per day, 24 hours a day, 7 days per week, this stimulates a basal release of insulin which keeps the pH in check. It’s also what keeps weight loss at a consistent pace of around 2-10 lbs per month.
If you are a type I diabetic, don’t fret. Carbohydrate restriction can still be used very effectively. It just takes some balancing and understanding of your individual metabolism. It does require close blood sugar and insulin monitoring. If you are a Type I diabetic, please talk to your physician, obesity specialist and/or bariatrician about how to follow a carbohydrate restricted diet while using insulin. It can be done and it can be done very effectively, but monitoring is essential.
What are the other potential problems that can arise when you follow a ketogenic diet?
Gastrointestinal (GI) Disturbances – Yes. Any time you change your diet you may experience diarrhea, constipation or gassiness. Most of the time, this is because you are either 1) not eating enough leafy greens (fiber) or 2) you’re using a supplement that contains an artificial sweetener. Most of the studies on ketogenic diets did not incorporate fiber and the studies used to make this point were on children who used a ketogenic fat supplement shake or liquid preparations containing these artificial sweeteners to make them palatable. If you have spoken to any obesity specialist, they will tell you, the best way to follow a ketogenic diet is to eat real food. If you want to read about the anecdotal GI effects of sweeteners, read the comment section in Amazon about the Haribo Sugar Free Gummy Bears.
Oh, by the way, 65% of patients in my practice following ketogenic diet see improvement in gastroesophageal reflux (GERD) symptoms. This was seen in a 2006 study looking at ketogenic diets and reflux.
Hair Loss/Thinning– Yes. This does happen initially and if you are not eating enough fat. It is important to note that hair loss/thinning can occur with any form of weight loss. You can see data on this here. Hair loss is very common if you are restricting calories, which was occurring in a number of the ketogenic dietary studies previously published. You do not, and should not, need to “restrict calories” if you are following a ketogenic diet correctly, and in fact, most people take in more than 1800 calories on a ketogenic diet.
Inflammation Risk– In every patient that I have placed on a ketogenic diet in the last 10 years, all inflammatory markers including CRP, Sedimentation Rate, Apo B, HOMA-IR and Uric Acid have all decreased. Inflammation gets better on an appropriately formulated ketogenic diet. The older studies of ketogenic diets in children contain most of their fat from Omega-6 fatty acids from vegetable oil which will increase inflammation and oxidative stress, spike the cortisol levels and have the secondary effect of actually raising the triglycerides. You can find more information on this here & here.
Kidney Stones/Gout – These (kidney stones & gout) are both commonly caused by spikes in uric acid. As noted above, I’ve seen multiple cases in my practice where a ketogenic diet lowers uric acid. Only a small clinical trial has been published in the literature (and it wasn’t truely ketogenic), but the results point to the potential for ketogenic diets to lower uric acid. Ketogenic diets also have the capacity to lower the formation of calcium oxalate stones through a secondary mechanism where calcium oxalate formation is driven by uric acid formation. Older small case reports in the pediatric seizure literature identify calcium oxalate stones, however, dehydration (too little fluid/water intake) is the primary cause of kidney stones.
So, are ketogenic dietary patients at risk? Only if you cheat on your carbohydrate restriction and you let yourself get dehydrated. So, I warn patients. Don’t cheat and make sure your drinking adequate amounts of water.
Muscle Cramps/Weakness– The process of weight loss occurs by burning fat into CO2 and water. We breathe the CO2 out, but the water produced has to follow salts out through the kidneys. Hence, we lose water and salts. This can cause weakness and muscle cramps. The solution? Stop restricting salt on a low carbohydrate diet. We are the only mammal that restricts salt and we do it because low-fat diets cause us to retain water. Low carbohydrate diets do the opposite. Use sea salt or sip beef or chicken bouillon broth with your dinner. You may consider adding magnesium to your diet. The use of yellow mustard also helps (the small amount of quinine in yellow mustard stops the cramping). If you have congestive heart failure, talk to your doctor about monitoring your salt intake in balance with your diuretic or water pill.
Hypoglycemia– If you read the ketogenic diet research, most of it was done on epileptic children. The diets called for a period of starvation, and then the introduction of a ketogenic liquid based shake following the John’s Hopkin’s protocol. It is a well-known fact in medicine that starvation in children can frequently cause hypoglycemia, especially in children with other genetic or congenital defects leading to forms of epilepsy. In clinical practice, with ketogenic diet use in adults, hypoglycemia is rare. The only time I see hypoglycemia is when patient’s with significant insulin resistance or diabetes cheat on a large amount of carbohydrate and get a secondary insulin surge leading to hypoglycemia 3-5 hours after cheating.
Low Platelet Count (Thrombocytopenia)– Again, this was seen in epileptic children who were placed into starvation first, then introduced a liquid fat replacement shake to stop intractable seizures. These liquids or shakes were often nutrient deficient in other essentials. Folic acid, B12 and copper deficiency can occur when not eating “real food.” Low platelet counts are rarely seen on ketogenic diets based around “real food.” Many children in the ketogenic studies had been on or were concomitantly on valproic acid for their seizures. Valproic acid is commonly known to cause thrombocytopenia and this is another reason that thrombocytopenia was seen in this population. (Barry-Kravis E et al, Bruising and the ketogenic diet: evidence for diet-induced changes in platelet function. Ann Neurol. 2001 Jan;49(1):98-103.; Kraut E, Easy Bruising, http://www.uptodate.com, May 2015.)
Impaired Concentration/Mood– A number of patients starting carbohydrate restriction will go through 2-4 weeks of carbohydrate withdrawal. This carbohydrate withdrawl can be experienced just as powerfully as morphine withdrawal in some patients. Sugar is a drug and has a powerful effect on the same hedonic receptors that morphine does in the brain. Some patients will experience headache, tremor and decreased concentration while “withdrawing” off of starches and carbohydrates. Studies show that after the 4-8 week period of keto-adaptation, cognitive function dramatically improves.
Easy Bruising – This is usually due to inadequate protein supplementation as was the case in much of the ketogenic literature where protein levels were also restricted. (Kraut E, Easy Bruising, http://www.uptodate.com, May 2015.)
Pancreatitis – Patients who are insulin resistant or have impaired fasting glucose commonly have high triglycerides. Elevation in triglycerides itself is a cause of pancreatitis. Ketogenic diets lower the triglycerides. However, if a patient has not been following their diet as directed, spikes in the triglycerides can occur placing the person at risk for pancreatitis.
Long QT Intervals/Heart Arrhythmias – The list of things causing Long QT intervals and abnormal heart rhythms is long and variable (Acquired Long QT Syndrome. Berul C et al. www.uptodate.com, May 2015). It is well know that starvation, rapid weight loss and liquid protein diets can cause a delay in the conduction signal in the heart. Anyone wishing to start any diet should have an electrocardiogram (EKG) through their doctor to ensure that the diet (of any type) doesn’t exacerbate a prolonged QT interval.
Cardiomyopathy– Prolonged QT intervals have been associated with cardiomyopathy and the former can stimulate the later. Any diet that has the potential to prolong a QT interval has the potential to cause cardiomyopathy. Hence the need for regular EKG monitoring on any diet (Acquired Long QT Syndrome. Berul C et al. www.uptodate.com, May 2015).
Lipid/Cholesterol Changes – In the 10 years I have been prescribing ketogenic diets to patients, I have seen dramatic improvement in the triglycerides, small dense LDL particle and HDL levels. The only time triglycerides rise over 100 is if the patient is using artificial sweeteners, is cheating on the carbohydrate restriction, or is taking in too much protein. Total cholesterol commonly rises, however, this is indicative of the fact that there is a shift in the LDL particle size and this affects the calculation of both total cholesterol and LDL-C. In light of this, most of my patients have dramatic improvement in triglycerides and small dense LDL particle number.
Myocardial Infarction – In older papers, elevated total cholesterol was noted and the authors made the “assumption” that myocardial infarction “could” be a risk. We now recognize that elevated Total Cholesterol is NOT a causitive risk for heart disease.
These previous assumptions have been interpreted by the blogosphere ketogenic “nay-sayers” as actual risk. However, a correlation and causation was never made. Again, in the 10 years I have been using and prescribing ketogenic diets, I have seen dramatic improvement in cholesterol profiles, inflammatory markers, atherosclerosis and carotid intimal studies (Shai I et al, Circulation 2010; 121:1200-1208).
Menstrual Irregularities / Amenorrhea– It is well known that any diet causing protein or other nutritional deficiency will affect the menstrual cycle first and growth in stature second. The only time menstrual irregularities occur with a ketogenic or Low-Carb diet is when a patient is not taking in enough protein and/or fat, and is not eating real food. What amazes me is that a properly applied ketogenic diet actually causes normalization of the menstrual cycle, and in my practice, I’ve had a number of women successfully be able to conceive after making a ketogenic dietary change.
Is a ketogenic diet bad for you? You be the judge.
If you are following a ketogenic diet correctly and with real food, the only thing you really need to worry about is slipping on bacon grease.
In an era where over 70% of us (35.7% obesity & 34% overweight in 2015 according to the CDC) have started to resemble the food pyramid, seeing the effect of a carbohydrate heavy diet should give a clue.
Our bodies were meant to burn ketones. We have a parallel system within us designed to use ketones as an energy source. Ketones are faster and more efficient than the way our bodies use glucose. Ketones give you 38% more energy than you can get from glucose. We as a society are following a deceptive food pyramid.
When we limit or remove carbohydrate from our diet, we are left with ketones as a primary fuel. It is time that we recognize what Dr. Yudkin was trying to tell us in 1970’s, that our carbohydrate and sugar intake is the driver for heart disease, diabetes and the diseases of civilization. (Yudkin, John. Sweet and dangerous: the new facts about the sugar you eat as a cause of heart disease, diabetes, and other killers. PH Wyden, 1972.)
I get this question almost daily. Sorry to burst your bubble, but there is NO exercise program that will give you “six-pack” abs.
Really. You can do sit-ups, leg lifts and crunches ’till the cows come home and it will do nothing other than give you abdominal cramps. It will also make you hungry. I don’t care what Men’s Fitness, Bodybuilding.com, Muscle Magazine, Shape or even Doctor Oz said. There are no “6 Best Exercises for Ripped Abs.” There is only one exercise . . . throwing the carbs in the trash (or giving them to the neighbor you don’t like.)
The “12 Step Ab Program” really only has ONE STEP . . . cut the carbs. Let me repeat that. There is only ONE STEP to “six-pack abs,” . . . cut the carbs. Cardiovascular exercise does nothing for amazingly toned abdominal muscles, other than make you hungry. Resistance exercise improves insulin resistance, but doesn’t build the abs. Avoiding the milk, rice, wheat, oatmeal and fruit allows the abs to appear. Yes, I’m serious. What do bears eat? Berries.
When did you last see the a bear with “six-pack abs?”
The only way to see your “six-pack” is to remove the fat covering your “six-pack.” The only way to get rid of fat covering your “six-pack” is to stop drinking it and lower the carbohydrate content to less than 20 grams per day. Seriously . . .
So you’ve done 100 crunches a day for six months? Do you see your “six-pack” now? Exactly.
I’ve said it before and I’ll say it again. Insanity is doing the same thing over and over and expecting a different result.
Staying in ketosis and adding 2-3 days of resistance training will melt 2-5 lbs of abdominal fat away each month. Yes, I know it is slow . . . but that is weight (fat) that will stay off. Use whole foods high in fat, moderate in protein and low in carbohydrate. Use supplements like Keto//OS & Adapt bars to help when you don’t have access to a good meal or as a snack when you are hungry. Look at the list of Low Carb Links above to get great ideas for meal preparation and sweeteners that you can use.