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.
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.
Over the last few months, I’ve found myself amid the center of vehement nutritional arguments about fat, carbohydrates, calories and diet. I have found it fascinating that very intelligent men and women, over the last 50 years, have accepted, without reservation, a dogma taught them by their eighth grade nutrition teachers. This dogma is interlaced and interwoven throughout the textbooks, manuals, and college cafeterias throughout the world.
Very few souls have questioned this dogma, and even in light of it’s utter failure to improve one’s health, it becomes the fall back point upon which millions have accepted nutritional disease and defeat. It makes no sense that a dogma of this nature, without anything more than a scientific corellation in the 1960’s, could sway the minds of intelligent researchers, physicians and scholars for over 50 years.
It is a well known fact, however, that hydrogen is the most common element in the universe and is used as a basic building block for most molecular structures. What many don’t realize is there exists another element yet to be added to the periodic table that is almost as prevalent called moronium (pending symbol approval – Mu). It fills the blank space on the table of elements between Hydrogen and Helium. I, and those who have been able to identify this element, suspect that moronium is a gas at room temperature and has some affinity to binding the white matter of the brain responsible for catechol-O-methyltransferase (COMT) gene regulation of the prefrontal cortex. It is suspected by some that when it is inhaled by a person of low intellect, it has only a mild effect. However, when combined with either oxygen (O), hydrogen (H) or Helium (He) and inhaled by those of higher intelligence, it has a much wider, more potent and even stupefying diffusion effect, that is quite surprising to witness.
Moronium reacts adversely when diffused into blood with a higher alcohol concentration and seems to spontaneously combust when it is exposed to old paper and libraries. Moronium is very difficult and very expensive to isolate. Moronium seems to be more prevalent during the summer and winter solstices, which may be why moronium intoxication seems to appear around holidays. Recent attempts in a nearby lab to synthetically create even small crystals of moronium cause an explosion, physically and psychologically stupefying all of the researchers involved and inducing them to leave the study of science and pursue individual careers as drummers.
The presence of moronium seems to be higher in those that do not read, or have an aversion to reading. There is some correlation that moronium drops in proportion to listening to iTunes podcasts, however, follow-up reading does appear to have a potential lowering affect on the moronium levels within the brain.
Why do I bring this up?
I suspect that this little known element may be responsible for intelligent men and women introducing questionable theoretical science as incontrovertible truth. Those with suppressed COMT regulation seem to have a propensity to accept theoretical science because it sounds good, even when there’s really no way to actually prove the theory at the time, or when colleagues have accepted the theory in a peer-pressure instead of peer-review situation.
The stupefying effect of moronium bound COMT produces dogma like:
The amazing thing about science is that it is self-correcting (at least it used to be). A scientist makes a set of observations about nature, and then identifies a plausible theory within the laws of nature to fit those observations. Then, researchers take that theory and test it in as many ways as possible, attempting to disprove the theory and isolate the cause of the observation. If the theory withstands scrutiny it becomes widely accepted.
At any given point in the future, if contradicting evidence emerges, the original theory is discarded and a new theory is then identified. In essence, this is the simple scientific method, however, in modern day application, it has become a great deal more messy than you’d think.
This approach (application of “the scientific method”) was skirted during the 1960’s and 1970’s regarding the “fat causes heart disease” theoretical proposition. Interestingly, there was also a notable increase in the number drummers and musicians during the 1980’s Hair Bands era. This begs the questions, which I wholly agree needs further study: Does moronium exist? and . . . . Did levels of moronium actually increase between 1960 and 1990 causing a surge in the presence and popularity of Hair Bands?
It only took us 20 years to get past the Era of the HairBands, hopefully we can turn the nutritional ship around and recognize the real culprit causing the Diseases of Civilization.
(Author’s Note: For those who may possibly be under the influence of moronium toxicity, the post above is written in sarcastic jest, and to be clear, there IS NOT an element currently under investigation called moronium!)
The image above has nine dots within a square. Your task, using only four lines is to connect ALL nine dots WITHOUT ever raising your pen, pencil or finger (Please don’t use a sharpie on your computer screen . . . it doesn’t come off).
You may have seen this puzzle previously . . . it’s made its rounds in corporate training circles. But the underlying principle remains true. The solution requires you to expand your thinking or to “think outside the box.”
Whenever you find yourself on the side of the majority, it is time to pause and reflect. (Mark Twain)
Why should we limit ourselves to thinking outside the box. Can’t we just get rid of the box?
True discovery consists in seeing what everyone has seen . . . then, thinking what no one has thought.
The answer can be found when those four lines are used beyond the box our mind creates:
What good has the box done us? People were burned at the stake because they refused to believe the Earth was not the center of the universe. People were beheaded because they had a sneaking suspicion that the world was not flat.
Why is it so very hard to accept that our weight gain and diabetes are driven by a hormonal signal, and not by gluttony or caloric intake of fat? The definition of insanity is doing the same thing repetitively and expecting a different outcome. How long have you been restricting calories and fat with only minimal or no improvement in your weight, blood sugar, cholesterol or general feeling of health?
The main problem with the current thought model, or dogma, on the obesity’s cause is that it does not account for metabolic syndrome. Metabolic syndrome is insulin resistance. It is an over production of insulin in the presence of ANY form of carbohydrate (sugar or starch).
In the practice of medicine over the last 15 years, I noticed that a very interesting pattern emerged. There was always a spike in fasting and postprandial insulin levels 5-10 years prior to the first abnormal fasting and postprandial blood sugars. These patients were exercising regularly and eating a diet low in fat. But they saw continued weight gain and progressed down the path of metabolic syndrome. 10-15 years later, they fall into the classification of type II diabetes. What I now lovingly refer to as stage IV insulin resistance.
The only thing that seems to halt this progressive process with any degree of success is carbohydrate restriction. Fasting insulin levels return to normal, weight falls off, and the diseases of civilizations seem to disappear as insidiously as they arose.
So you tell me, is the world flat? Is the Earth the center of the universe?
What is a low carbohydrate or ketogenic diet? 15 years of practical in the trenches experience have helped me develop a very simple program to help you lose and maintain your weight. Access to this program, video help and access to blog articles at your fingertips are offered through my online membership site.
You can also hear me each week a I discuss low carbohydrate, paleolithic and ketogenic diets with the Legendary Jimmy Moore on KetoTalk.com
This evening we covered the 5 myths of weight loss identified through the National Weight Control Registry’s research findings. What causes “wrinkle face” for Dr. Nally? We also talked about & answered 20 minutes of rapid fire questions ranging from the amount of protein you need daily to the likelihood a human could be a bomb calorimeter . . . exciting stuff!!
You can watch the video stream below. Or you can Katch the replay with the rapid stream of exciting comments here at Katch.me/docmuscles.
What laboratory testing is necessary when you start your weight loss journey on a Ketogenic, Low-Carbohydrate, Paleolithic or any other dietary changes? Why do you need them and what are you looking for? We discuss these questions and others on today’s PeriScope. Lots of questions from around the world to day . . . this one lasted a bit longer than normal . . . 45 minutes to be specific. But it’s a good one because of all of your fantastic questions! You really don’t want to miss this one.
You can see the video below or watch the video combined with the rolling comments here on Katch.me/docmuscles.
A list of the labs that we discussed are listed below:
This list will at least get one started, provide the screening necessary to identify insulin resistance (Diabetes In-Situ), Impaired fasting glucose, diabetes and allow for screening for a number of the less common causes of obesity.
I would highly recommend that you get these through your physician’s office so that appropriate follow up can be completed. These labs will need to be interpreted by your physician, someone who understands and is familiar with various causes of obesity.
Until next time . . .
Diseases seem to arrive in three’s each day in my office. Today I had three different patients with cholesterol concerns who were notably confused about what actually makes the cholesterol worse, and what causes weight gain. Each of them, like many patients that I see, were stuck in a state of confusion between low fat and low carbohydrate lifestyle change. My hope is to give my patients and anyone reading this blog a little more clarity regarding what cholesterol is, how it is influenced and how it affect our individual health.
First, the standard cholesterol profile does not give us a true picture of what is occurring at a cellular level. The standard cholesterol panel includes: total cholesterol (all the forms of cholesterol), HDL (the good stuff), LDL-C (the “bad” stuff) and triglycerides. It is important to recognize that the “-C” in these measurements stands for “a calculation” usually completed by the lab, and not an actual measurement. Total cholesterol, HDL-C and triglycerides are usually measured and LDL-C is calculated using the Friedewald equation [LDL = total cholesterol – HDL – (triglycerides/5)]. (No, there won’t be a quiz on this at the end . . . so relax.)
However, an ever increasing body evidence reveals that the concentration and size of the LDL particles correlates much more powerfully to the degree of atherosclerosis progression (arterial blockage) than the calculated LDL concentration or weight (1, 2, 3).
There are three sub-types of LDL that we each need to be aware of: Large “fluffy” LDL particles (type I), medium LDL particles (type II & III), and small dense LDL particles (type IV).
Second, it is important to realize that HDL and LDL types are actually transport molecules for triglyceride – they are essentially buses for the triglycerides (the passengers). HDL can be simplistically thought of as taking triglycerides to the fat cells and LDL can be thought of as taking triglycerides from the fat cells to the muscles and other organs for use as fuel.
Third, it is the small dense LDL particles that are more easily oxidized and because of their size, are more likely to cause damage to the lining of the blood vessel leading to damage and blockage. The large boyant LDL (“big fluffy LDL particles”) contain more Vitamin E and are much less susceptible to oxidation and vascular wall damage.
Eating more fat or cholesterol DOES NOT raise small dense LDL particle number. Eating eggs, bacon and cheese does not raise your cholesterol! What increases small dense LDL particles then? It is the presence of higher levels of insulin. Insulin is increased because of carbohydrate (sugars, starches or fruits) ingestion. It is the bread or the oatmeal you eat with the bacon that is the culprit. The bread or starch stimulates and insulin response. Insulin stimulates the production of triglycerides and “calls out more small buses” to transport the increased triglyceride to the fat cells (4, 5, 6, 7).
Fourth, following a very low carbohydrate diet or ketogenic diet has been demonstrated to decreased small dense LDL particle number and correlates with a regression in vascular blockage (8, 9). So, what does this really mean to you and me? It means that the low-fat diet dogma that that has been touted from the rooftops and plastered across the cover of every magazine and health journal for the last 50 years is wrong. . . absolutely wrong.
I talk about this and answers questions on today’s Periscope. You can see the recording on Katch.me with the comments in real time here:
https://www.katch.me/docmuscles/v/2f0b6d07-d56a-368b-b4f6-34a5ab3da916
Or, you can watch the video below:
References:
Click the link below to see today’s PeriScope on navigating the diet world confusion.
Or, see it here on Katch: https://www.katch.me/docmuscles/v/953117bd-3843-3abf-af37-bad8b30e18dc
Have a great day!!
As our children return to school this year and the pencils are sharpened, our questions should focus on whether the minds of our youth being sharpened. If not, then do something about it.
For over 50 years we accepted the indoctrination of rote fact about the calorie-in/calorie-out dogma of weight gain. The consequence of learning rather than thinking is of the diseases of civilization now prevalent in over 2/3rds of the population.
I found these charts to be very helpful when trying to calculate your fat intake with a meal. Fish can be challenging in calculating fat content. After reading these charts, I’m craving some sashimi’ed mackerel and salmon.
Great charts like these can be found at http://mariamindbodyhealth.com/charts/
Enjoy!!
A recent study, published in JAMA Surgery, this week compares the three-year outcomes of bariatric surgery versus lifestyle intervention for type II diabetics. This particular study made the headlines of the Wall Street Journal because the outcomes revealed “Weight-Loss Surgery Better Than Diet and Exercise in Treating Type 2 Diabetes…”
Really?! That is news to me, a baratrician that’s been treating type II diabetes for over 15 years! This simple three year study in 62 patient contradicts what I’ve seen in my office for 15 years. This study and the media-hype associated with it are a serious problem. Why? Because the study was based on a flawed design.
We all know that baratric surgery has significant weight loss as a result. And, we all know that most of those patients with diabetes have significant improvement in their diabetes at the 2-5 year mark (what happens after 5 years is a completely different story). But why compare that to a poorly designed lifestyle protocol that failed to show successful weight loss? Yes, poorly designed.
This study was based on protocols from the Diabetes Prevention Program and the Look AHEAD trial, both of which were very large trials restricting calories, fat and increasing exercise. Both of these trials failed to show any significant weight loss and failed to produce any significant reduction in overall mortality. Why? Because both trials used the wrong dietary approach. We’ve know for years, as was emphasized by the Women’s Health Initiative study as well, that caloric restriction combined with exercise doesn’t reduce body weight in the long run by more than 1%. So the bariatric surgeons in the study above compare a known effective treatment to a known ineffective treatment? And, it gets Wall Street Journal Headlines. It’s a sad day for medicine. And an even sadder day for the treatment of obesity.
Is no one listening? Weight loss is not a question of thermodynamics – it is not the calorie in / calorie out dogma we’ve been brainwashed into believing over the last 50 years. Weight loss is hormonal. The study published in JAMA Surgery this week proves that. Baratric surgery effects grelin and the forced dietary changes reduce insulin (patients receive what equates to a low carbohydrate diet post bypass surgery). Both of which have significant effect on weight gain and loss. Caloric restriction and exercise affect neither of these.
Carbohydrate restriction, on the other hand affects insulin dramatically. Carbohydrate restriction turns off the tremendous excess insulin hormonal response that occurs in up to 85% of the patient’s I see in my office. Call me when the bariatric surgeons actually compare bariatric surgery to a true ketogenic diet.
Have you noticed that there are a large number of advertisements in the media about checking your testosterone or “Low T” Syndrome? It seems like this is the new advertising trend on the radio and late night TV.
Suddenly, everyone’s testosterone is low and men are complaining about their libido, . . . or are they?
If you practice medicine long enough, you’ll see a trend that seems to have arisen as our waistlines have expanded. About half of the men in my office with insulin resistance, pre-diabetes or diabetes have low testosterone levels. But this shouldn’t be a surprise. Type II diabetes, metabolic syndrome and insulin resistance are all driven by an over production in insulin in response to a carbohydrate load in the meal. Patients with these conditions produce between two to ten times the normal insulin in response to a starchy meal. A number of studies both in animal and human models demonstrate that insulin has a direct correlation on testosterone suppression in the blood. This has been demonstrated in both men and women. In fact, glucose intake has been shown to suppress testosterone and LH in healthy men by suppressing the gonadal hormone axis and more predominant testosterone suppression is seen in patient with insulin resistance or metabolic syndrome.
In fact, to put it simply, insulin increases the conversion (aromitization) of testosterone to estrogen in men (it does the opposite in women). Interestingly, Leptin resistance has a similar effect. I tend to see the worst lowering of testosterone in men with both insulin and leptin resistance.
How to you improve your testosterone? Supplemental testosterone has been shown to help, but it comes with some risks, including prostate enlargement and stimulating growth of prostate cancer. The most natural way to improve your testosterone is to change your diet.
A low carbohydrate or ketogenic diet turns down the insulin production and allows the testosterone to be available for use by the body. A ketogenic diet has the effect of reducing leptin resistance as well through weight loss. A simple dietary change of this type is frequently seen in my office to increase testosterone by 100-150 points.
What is a ketogenic diet? It is a diet that restricts carbohydrates to less than 50 grams per day, thereby causing the body to use ketones as the primary fuel source. So, for breakfast tomorrow morning, hold the oatmeal (1/2 cup of Quaker Instant Oatmeal is 31 grams of carbohydrates) and have the bacon and eggs. And, rather than have the cheesecake for desert this evening, have an extra slice of steak butter on your rib-eye and hold the potato.
Weight loss, better put as “fat loss,” is a journey. A journey brought you to where you stand today, and it will be an even more exciting journey getting back to that size you’ve been daydreaming about. So, how do you most effectively start down the path of this journey?
That is the great question. It is the most important question I get asked every day. In the words of Napoleon Hill, “Desire is the starting point of all achievement, not a hope, not a wish, but a keen pulsating desire which transcends everything.”
First, Know Where You Are Coming From.
A journey requires knowing where you were, were you are today and where you want to go. Get a journal and weight yourself. Write it down and then check your weight every 3-5 days. DO NOT weigh yourself every day. I repeat DO NOT weight yourself every day. This can be discouraging because is is normal to fluctuate 2-5 lbs every day based on meals and water intake. Many people see this fluctuation and thing they are failing, then give up. The journal helps this. Recording your weight helps you see the progress.
The journal is also to help you record what you eat. Plan and record your meals IN YOUR JOURNAL. If you are being followed by a weight loss specialist, they will want to see your journal. If you are seeing me in my office, bring the journal with you to EVERY visit. Record every thing you eat. 
And, record your water intake. I am amazed at how many of my patient’s are dehydrated and just putting water back into their systems help them loose weight.
Second, Plan Your Day.
Planning is the key to weight loss on any program.
You should plan your exercise and plan your meals the night before. Failing to plan is really just planning to fail. Your plan should include 1) keeping carbohydrate intake less than 20 grams per day and 2) getting adequate proteins to match your goals.
Third, What’s the Underlying Cause of Your Weight Struggles?
You can’t effectively lose weight unless you understand why you are gaining weight. Two thirds of my patients are hyperinslinemic – they produce too much insulin in response to any sugar, starch or carbohydrate. This is also called “insulin resistance.” This is the primary cause of weight gain in 85% of the population. People produce between two to thirty times the normal amount of insulin in response to a piece of bread or a bowl of cereal. When they eat a single piece of bread, their bodies respond as if they ate the whole loaf. If they eat a bowl of cereal, their bodies respond as if they ate the whole box of Captain Crunch.
This variable over production of insulin is why some patient’s gain more weight than others eating and exercising the same way. Your doctor can easily identify this through blood work. For starters, if your waist circumference is larger than 40 inches as a male or larger than 35 inches as a female, you’re probably insulin resistant. Most men complain they don’t have a tape measure to measure their belly, so I tell them if they walk toward the wall and the first thing that touches the wall is their belly, “you’re insulin resistant.”
Skin tags or the presence of thickened browning skin at areas of skin folds (acanthosis nigricans) are classic signs of insulin resistant.
Hypoglycemia or low blood sugar is another sign of hyperinsulinemia or insulin resistance. This is where a person gets light headed or dizzy 2-5 hours after eating a meal that contains mainly starch or sugar.
Insulin resistance requires a dramatically different dietary approach than the standard diets we’ve been taught all our lives. The “heart healthy” diet, DASH diet, vegetarian/vegan diet, low fat diet or calorie restricted diet just don’t work with hyperinsulinemia or insulin resistance. If you are insulin resistant, a low fat/calorie restricted diet will not be very effective, and you may even gain weight with this approach as many of my patients have experienced.
If you have any of these symptoms, you need to follow up with your doctor or weight management specialist. Find out where your insulin levels are in relationship to your diet. Losing weight is possible. You can get started here with my ketogenic dietary program.
As this is a journey, it will probably have a number of twists and turns that are often made easier with a road map. Getting checked out with your doctor, and evaluating your metabolic status is your road map. Check out the health programs I offer to my patients to get this road map. I’ve also produced hundreds of videos on YouTube and DocMuscles.Locals.com to help you down the road. Either way, enjoy the journey!!
I frequently hear patient’s tell me, “Dr. Nally, I’m eating RIGHT, but I’m just NOT losing weight!”
A recent study published in the Annals of Internal Medicine demonstrate significant improvement in overall inflammation in type II diabetic patients following a carbohydrate restricted diet versus a low fat calorie restricted diet. Another bit of proof demonstrating what I’ve been seeing in my office over the last 8 years. The study reveals significant improvement in glycemic (blood sugar) control in those following a low carbohydrate diet as well as significant lowering of C-reactive protein, IL-1 and IL-6 over those following a low fat diet. You can see the study here.
