Managing ketogenic diet mistakes with Eric Stein

Our guest today has authored many books, including the one we’re going to talk about today, Ketogenic Catastrophe. He found a passion helping others after he cured his own IBS, gum disease and insomnia using the Paleo Diet and ketogenic eating. Really cool guy; I know you’re going to enjoy this interview.

Allan (1:08): Eric, welcome to 40+ Fitness.

Eric (1:12): Thanks for having me on. Great to be here.

Allan (1:14): The title, Ketogenic Catastrophe, I really could take that one of two different ways. One is disaster pants kind of style. What you were going after was, what are some of the mistakes that we make when we’re trying to get into ketosis and why do most people fail doing this? Then the other would be, are people having bad experiences with keto? The truth of the matter is keto is not for everybody, but it is a tremendous tool for weight loss, and what I’ve found, for dietary freedom.

I got into ketosis on accident. For those that aren’t fully familiar with what ketosis is, it’s basically where your body starts learning how to burn fat rather than sugar for energy. And because you’re eating predominantly a higher fat diet and not many carbs, your body just gets more comfortable with that and using ketones as a fueling system. I stumbled on it because I was doing Paleo. My version of Paleo was eating more of the healthy fats, so I was eating a lot of avocado, fish and beef. As a result of filling up on the fat, wasn’t eating a lot of anything else. Most of the vegetables I was eating were wholefood, fibrous vegetables like asparagus, broccoli and spinach. So I wasn’t getting a lot of carbs. And then I noticed that my breath was a little sour, more so than not. And I noticed that my body was burning a lot of body fat all of a sudden. I had plateaued – in Paleo dropped about 15 pounds, and then keto took off about, I’d say 45 pounds in just a few weeks. So I fell into it. I figured out what it was. I’m like, “What’s going on with my body? Why am I suddenly losing all of this fat and why am I smelling this way?” Then I got into it and I was like, “Okay, that’s what that is and that’s why that’s happening.”

It’s become more of a seasonal lifestyle for me now, because I’ve lost most of the weight that I wanted to ever lose. I got my body where I wanted to for what I wanted, and then I’m good. But in the book you’re actually talking about the mistakes that keep people from doing this, and I think that’s really important. I was reading a study, and it was a Harvard doctor that had done this study, and they found that the high fat, low carb diet helped people lose more weight than the people who ate the low fat, high carb diet. But in the end his conclusion was, it’s so hard to eat this high fat diet that we’re just going to keep prescribing the low fat diet. My hands hit my head and I’m like, “Oh my gosh.” But it’s not simple; there are some mistakes people make. And that’s what your book is getting into is, what are those mistakes that most people make that would keep them from being successful with this? And what are the tips and tricks and things that we can do to get past them?

Eric (4:12): Yeah, that’s basically what I’ve covered. I had a lot of stumbling when I first started with this whole keto diet thing. This was basically my attempt to share with whoever wants to read it, all of the mistakes that I went through. I think it was Warren Buffett who said, “You can learn from your own mistakes, but you don’t have to. You can learn from other people’s mistakes.” So, my goal with this whole thing was to just share everything that I personally went through in hopes that it will help others become more enlightened about the whole keto thing and just get through it, because it can be difficult. Like you said, it’s not the easiest thing to start. But what people should definitely take from this whole thing is that after you do it for a while, after you get comfortable with it, it becomes much easier too. You can do it seasonally, like you do as well, where you don’t have to do it all the time. So this was my attempt to really help people feel better in the long run.

Allan (5:14): I think that’s the thing. I don’t have any kind of resistance, insulin resistance, any metabolic problems. So for me, keto is just a way to have clarity, to feel better, to have freedom from food, because I can go a day without eating and I don’t panic because my blood sugar’s going to crash or something. So, keto is very comfortable for me, but I don’t do it all year round because there are periods of time when I want to drink beer and go tailgating and enjoy my life and the things that I’m going to do. I’m going to go to Thanksgiving with my mother, I’m going to go do New Year’s Eve with my wife. So, since I know I’m going to have that period of time, I just plan around it and say, “That’s my time to go off keto. I’m not going to feel as good. I’m going to have as much fun as I can and I’m going to make good selections.” So, I do drink the higher quality beers. But beyond all that, when it’s time to go back into my season of famine, so to speak, I get into it. I think a lot folks think it’s a lifestyle, yes. Once you get into it, then you have to stay in it, and that’s not entirely true for everybody. That’s why I think this book is particularly poignant because if you go in and out of ketosis on a regular basis, you’re going to deal with these things. The first one is what you call the “biggest mistake”, and I agree with you. Do you mind talking about what you think the biggest mistake is that most people will make when they’re trying to get into ketosis?

Eric (6:38): Sure. The biggest mistake by far – it’s very simple – it’s just giving up. If you can imagine training for a marathon, let’s say. You do all this prep work, and you get up to the race day, you’re feeling great. You start the marathon, you get through the first mile, 7th mile, 12th mile. You’re getting through it and all of a sudden you get to mile 25, right before the finish line, and you just give up. That’s what a lot of people do, is they get so close to the finish line, building this metabolic flexibility, this ability to burn fat instead of sugar, and right before they get there they just say, “You know what? I’m done.” To put it back to the marathon runner – it’s not like the marathon runner couldn’t finish. No, he just decided, “Well, I’m just not going to finish the race today.” So many people run into that because it’s difficult to get going in the beginning. It’s difficult because your body needs to produce the enzymes and all the wiring that’s required to burn fat for fuel. There’s an adjustment period, but once you get good at it, it becomes much, much easier, and over the long run obviously works out a lot better.

The biggest mistake that people make is they just can’t sack up and get through the first little part. And to give most people more credit here – a lot of keto diet books and a lot of keto diet advice is not the greatest advice out there. They tell people, “Cut your carbs down to 20 grams of carbs, even if you’re eating buckets of sugar each day, and then just do keto.” And you’re going to run into huge problems if you just make an abrupt switch like that. So, to give credit to everybody that’s tried and failed before – maybe you got some bad advice too. But absolutely the biggest mistake is just not pushing through and getting to the other side, because once you get to the other side, then it becomes much easier, even if you have those cheat days, like you say, go have a couple of beers. Once you get back on the train, it’s not nearly as hard to get going again, if that makes sense.

Allan (8:53): It does. I think the difference and the way I look at it is, when you’re talking about the marathon – the runner knows that there’s only 1.2 miles left to go in this race. They’re at mile 25 and there’s only a 1.2 to complete the race. Unfortunately with ketosis you don’t have that mile marker to tell you that it’s that close. I think that’s where that “quit” comes in. I remember I was in the army and I was going through air assault school. And at the end of air assault school you do this 25-mile run. And you’re carrying your M16 and you’re in boots and you do this 25-mile run. Each of the units has people in there, so my unit was there and they were cheering us all on. I was a front runner. I knew there was one guy in front of me, I just didn’t know how far he was in front of me. So I asked one of the guys, “How far is he ahead of me? Just tell me.” And they said, “Oh, he’s too far. You’re never going to catch him.” And I come around the corner and realize that I’ve got maybe half a mile to go and he’s only a hundred yards ahead of me. But by that time I had shut my mind down to the possibility that I could do this, and therefore I ended up coming in second.

I only say that because it’s probably closer than you think it is. Once you get into this and you’re starting to really have that struggle, look for the things that are going to motivate you to keep going. You talk in the book about measurement, and I do think that’s important. The urine strips are really good when you first get started, because they’re going to allow you to see the ketones are starting to build up in there. And they’re color coded so you can see it happening. Since your body doesn’t know how to use the ketones effectively, you’re peeing them out. Eventually the urine sticks won’t be any good for you because your body’s using those ketones and now you’re going to have to be looking to your blood and your breath to understand if you’re in ketosis. But for the most part you are, and you can feel it and you know it. I agree with you – as people are going, just push to the next step. Just take that next step. Keep at it just a little bit longer and you’ll get there. It’s a dip, and once you get past that dip, you’re going to enjoy what you’ve done.

Eric (11:04): Sure. And you can always test and tweak things all along the way too. You don’t have to stick yourself into a rigid structure. Now, if something’s not working for you, you can always pivot and try something new – maybe increase your exercise a little or decrease your exercise a little if you’re working too hard. You can always play with the different approaches and find out what works for you. But keep pushing forward, absolutely.

Allan (11:31): I think that’s another important thing. You’ve got this as mistake number 8 in the book, and it’s bio individuality. You talked about how the basic advice is 20 grams of carbs, and then they kind of stop there. I know from experience working with clients that if you get down to 20 and you stay at 20, you will get into ketosis, but there are some people that can go as high as maybe even 100 grams of carbs, because they’re athletic and they’re doing things. And there are other people that can get to 50. You’re going to have a carb threshold in there and it’s going to be individual to you. You’re going to have nutritional needs that are based on your environment and everything else. Can you talk a little bit about bio individuality and how you’ve seen it work for or against people who are trying to get into ketosis?

Eric (12:23): Sure. That phrase actually was originally coined by the Institute for Integrative Nutrition. They’re the folks that came up with that. Basically at a high level, it just means we’re all different. Some people can eat a vegan diet, and they feel great and it seems to work really well for them. Some people, like myself, feel awful. I’ve tried to do the vegan thing and it doesn’t work for me at all. I had no energy. It just was not something that really worked for me. And we’ve always got to think about where we came from. What has our family’s bloodline been eating for the past 10 generations? That’s going to play a role in how we metabolize things, what we’re used to eating, what our genetics are used to. So, everybody is so different, and this is especially true for the carbohydrate threshold. I’ve talked to people who could not get into ketosis until they got down to that 20 grams of carbohydrate. Now me personally, I was more along the lines of, I could get back into ketosis after eating 80 to 100 grams of carbs for dinner one night, and then the next day around lunchtime be back into a ketogenic state. All the books that I was reading about this, they said, “That’s impossible. It’s going to take you days. You have to do this, you have to do that.” And really, it’s just about finding where you fit, where you feel best and what works for you. And the mistake that people make is having this mindset that everybody’s the same. It’s like this cookie cutter thing, and it’s definitely not true.

Actually there’s a great story. One of my roommates from many years ago, he and I lived together, and this is right around the time when I was trying to clean up my diet and try to lose the weight that I had been gaining. And living with him, I watched him every day just eat fast food. And it was constant drinking sodas, drinking beers all the time and doing whatever he wanted, and he stayed lean. I had no idea. Here I was, even trying to eat healthier at the time, but I was still gaining and gaining and gaining, and I just watched him not gaining a pound. It was very frustrating and really killed a lot of my motivation because it’s like, “Why me? Why can’t I be like him?” At the end of the day, bio individuality means that none of us are going to be the same. Individual results may vary. That phrase is so perfect for many different things in life, but especially people who are trying the ketogenetic diet. You’ve got to really look at yourself and what you’re going through, because everybody’s going to be different. Somebody might lose 30 pounds in a month doing the keto diet and you may sit there and lose a pound and a half. But it could be just because your body is working on fixing other things first, or whatever reason genetically that you’re going to be slower to lose the weight. We have a lot of similarities, but at the base level we have a lot of differences as well.

Allan (15:48): Part of it is genetics, part of it is your hormone mix. I know a lot of people are coming at this metabolically damaged. I was reading another book that actually said the Baby Boomers, which I’m just short of – I’m an X Gen – but 50% of Baby Boomers have some form of metabolic syndrome. I’m just trying to wrap my mind around that.

Eric (16:12): That’s a big number.

Allan (16:13): It’s a huge number. So, we’re approaching this because we want to get healthy. Like you said, your roommate may have had no problem whatsoever. You might run into him today and it may have caught up with him.

Eric (16:29): It did.

Allan (16:32): Okay. It’s not a happy story, but it’s a story. I think the core of this is, there’s that individual that smoked cigarettes from the time they were 14 years old and they’re 104 and they still smoke. And then there’s the individual who got lung cancer in their 40s after smoking only 20 years. So we’re all going to have our own individual path. I think the good thing about knowing that is if you can stop comparing yourself to others and just recognize that what you’re doing is positive for yourself, you’re going to have a lot better mindset going into this whole thing.

Eric (17:08): Yeah, you nailed it right there. The comparison to others is a very difficult thing. It’s something I struggled with tremendously when I first started out on this journey. You definitely want to be sure to remember that what you’re doing is for yourself, and you’re going to be different than everybody else. There are probably people that are going to react the same, but just keep in mind what you’re doing it for.

Allan (17:36): Another big area where mindset comes to play is what you call mistake number 5, “The Social Trap”. I know when I first started this and realized I was eating this way and wanted to keep eating this way, my wife thought I was out of my mind. She was like, “There’s no way.” She’d seen me try other things, and when she saw me try this she said, “I understood the Paleo thing. I do not understand this. I can’t do that.” But she has since turned around. I took her to Ketofest and she met some people and she listened to a few talks. She now knows about keto and for the most part will eat keto most of the time. But that’s not always the case; some people are going to look at you like you’re insane. How do I deal with that going into this? Like you said in the book, I go to order my burger and I say, “Just wrap mine in lettuce. I don’t want the bread.” And you see that look in their eyes.

Eric (18:37): The looks come to you. It can depend on the group of people you’re with as well. Me personally, I had some ruthless friends. We would kind of joke with each other and make fun of each other, but then it can be difficult when you continue to do this thing, you pass up on the beer. I remember sitting at a table at a restaurant and doing the lettuce-wrapped burger and just getting that, “What are you doing? Why are you doing that?” What that elicits in a lot of people, and I know this because it happened to me, is almost a fear to do it. The next time you hang out with everybody, you want to just be like everybody else. You don’t want to be out of the crowd. As humans, we want to be a part of the group. It feels safe. We want to be like everybody else.

So, to have that situation where you’re walking into a wedding or something or you’re going out with your friends and maybe you go to an Italian restaurant and the bread bowl comes around somewhere, and you’re put in that precarious situation where you have to make your decision now. The bread’s coming to you, and you have to make the choice and the people are looking at you. The mistake that people make is falling victim to that social pressure, because it’s, again, going back to being worried about what other people are thinking of you. It’s a very real mistake that most books that are written about the keto diet just kind of glaze over. But it’s such an important piece of this, because we are social creatures, we thrive on being social. I personally love being social. But it was a difficult transition to get over that fear of what other people are thinking of you. It can be one of the most difficult things. It can be actually the one thing that will stop you.

Maybe you have a group of friends, there’s like six of you and everybody’s overweight, let’s just say. All of a sudden you guys are going out to dinner and you start passing on the bread bowl. People are going to look at you funny and they might not even want you to do that, because it’s like, “Hey, where do you think you’re going? We’re all in this together”, that kind of thing. The social aspect of it is such a huge piece. I recommend that people, before they go somewhere like dinner or a party, and you know the temptation is going to be there but you’re not ready to start doing the cheat days yet – visualize it. Walk yourself through the scenario. Imagine yourself passing as the bread bowl comes to you. And then you’re going to have a lot higher chance of success, because you’ve already got the mental rep. You’ve already done it once in your head: “No, thank you”, so it’s going to be easier when game time comes around. The social aspect of it is such a huge piece, especially if you’re an extrovert, you like to go out, you have a lot of friends. People can be judgy. It’s very powerful to know going into this why you’re doing it, the reasons you’re doing it for yourself, and to understand that it’s okay for other people to have opinions. It’s okay for other people to think what you’re doing is crazy. Some people even say it’s dangerous, if you can believe that. So just remember why you’re doing it, and when the time comes and you have that social pressure, to be prepared for it is going to make you more successful.

Allan (22:18): You just hit on something I want to emphasize here – this is your “why”, this is why you’re doing this, and you need to keep that top of mind as you go into this. Yes, the bread bowl comes around and you just pass the bread without taking a piece and someone comments on it. Fairly simple – you can say, “I just got my A1C in and it’s high. I’m prediabetic, and I need to change how I eat.” And when they recognize this is not about you being thinner and more attractive than them, this is actually something you’re doing for your health, it does change the conversation. You can tell them, “I can’t have the simple carbs anymore. I can’t have the beer anymore, because my A1C is too high and I need to get it down. I don’t want to use medication to do that.”

Eric (23:07): Just to touch on one thing that came to my mind – a lot of people, once they’ve done keto and lost weight, want to continue to do it. You can still run into situations where you’re not prediabetic, you don’t need to lose any weight. It becomes easier to say, “I just feel better. I feel better not doing this. I feel better passing on the bread bowl.” Down the road when you don’t have those things to lean on, like, “I need to weight” or “I’m not feeling well. I’m sick for some reason”… There are other aspects of the social trap that can come up, but like you said, keep in the front of your mind why you’re doing it.

Allan (23:56): I call that the “crabs in the bucket”. If you’ve ever seen crabs, none of the crabs can get out of the bucket because the other crabs are pulling the crab down to get on top of it. So the crabs can’t get out of the bucket. Just realize that’s what’s going on. If people keep harassing you about what your choices are, you know what’s working for you. You know why you’re doing this. At that point just stop participating in the food conversation with them, because they’re not looking out for your best interests. I know that’s easier to say than to do, but you have to have this mindset, as I said, going into this to say, “This is what I’m doing and why I’m doing it.”

Now, the other thing that I wanted to get into – you mentioned this earlier and this was one you called mistake number 17. So much advice out there tells people, particularly during the adaptation period, to not exercise. And I don’t entirely agree with this. We talk about bio individuality. I think some people can continue to do their workouts. I know I did and didn’t have a problem in the world. Maybe I’m unique, and that’s great. But I believe people can still get the benefits of exercise during that period of time. They don’t have to forgo it. Your thoughts?

Eric (25:08): I think it probably goes back to that bio individuality thing. I was reading Mark Sisson’s book, The Keto Reset Diet, and I was listening to one of his podcasts. He was talking about how he recommends people not exercise during the adaptation period, because for some it can be difficult. If you’ve been consuming a lot of sugar and you’re metabolically damaged, the process of adaptation can be difficult. He recommends that you just rest through it, which there’s validity there. I think everybody needs to take a look and see how they’re feeling. I personally think it’s a huge mistake to not exercise while you’re doing the keto thing, because having personally gone through it, exercise is so much more enjoyable when you’re doing keto. I have more strength and more energy than I know what to do with when I’m in that keto state. That being said, if you’re just looking at this for, “I just need to lose some weight”, you don’t have to exercise. But I think it’s a huge mistake to not add on this component of it to get your blood flowing. Even if it’s the most basic exercise, like power walking or going up and down some stairs, doing some body weight stuff, push-ups, sit-ups, cleaning your house vigorously. We think of exercise as it has to be in a gym, but there are so many different ways to get your heart pumping, get your body moving. It’s just going to only compound the results that you get.

So, you can do the keto thing and not exercise, but again, I think it’s a big mistake to not do that. And when you realize it too, when you actually get into that keto state – you’re burning ketones for energy – you’ll have this incredible outpouring of motivation too. You will want to go exercise, and you’ll have more energy. I know it sounds funny. People think that if they exercise, they’re going to be tired and have less energy, and it’s actually the opposite. You exercise and you will have more energy – kind of that, “You don’t use it, you lose it” thing. Along with that I’ve noticed that the more you exercise, the greater the mental clarity that you’ll get as well. I’m not sure exactly the mechanics behind why, but I’ve noticed that I’ve become much more mentally clear. It’s almost like you’ve been wearing a pair of prescription glasses your whole life that weren’t even supposed to be yours, like they were the wrong prescription. You suddenly take them off and the world just looks clear. Or you get in your car in the morning and the window’s fogged up, and you turn the defroster on. That’s what happens as you keep going through this. And exercise I think is just a tool to accelerate these benefits and really compound them for everybody.

Allan (28:20): I agree with you. I don’t think there’s a reason to forgo exercise, unless you’re metabolically damaged and you know that this could be a problem for you. Then take it easy and don’t stress yourself. But the reality of life is our muscles and our liver hold roughly about 90 minutes to two hours of moderate intensity work. So when folks are running marathons, they bonk it at mile 18 because that’s about the time that the glycogen that’s in their muscles and their liver starts to run out. You have that in your muscles and your liver all the time. That glycogen’s there all the time to fire off for energy. So, doing moderate intensity work, lifting weights, doing bodyweight work, walking, maybe even some jogging – that’s going to use that glycogen. Now, you are still taking in some carbs. We’re not complete carnivores, zero carb here. You are taking in some carbs and your body has the capacity to take some of the protein you eat and some of the fat and actually turn it into glycogen that you can then use to restore what you need for your muscles and your liver. Your body’s going to still do that. I just think what you force your body to do if you do keep your activity at a good steady pace is you actually force the adaptation a little bit faster. That’s my opinion. Again, I don’t have any scientific proof that that’s the case, but I do know when I have clients cut their sugar back and I have them walk in a fasted state, they lose weight faster. That’s happening in their bodies because it’s forcing them to use more of the glucose that they are eating. It’s forcing them to use the glycogen in their muscles, they’ve got to restore that, so that process just starts working for them.

On the mental clarity note, I don’t know if you’ve read the book Spark, but this was an excellent book that talked about exercise and cognitive health. They found that just having the kids do a PE class in the morning before school helps their grades immensely. Their test scores went up, they had more clarity in class, they were more focused in class. So, there is an exercise–neurological connection that you’re going to get clarity from exercising and yes, you’re going to get mental clarity from powering your brain on ketones. So I think there can be a multiplicative effect there if you’re doing both.

Eric (30:47): Yeah, absolutely. That makes perfect sense. That’s very interesting to hear about the kids. I’m just seeing my path and how my mental state has changed over the years now. I think that would be brilliant to make sure that kids did PE before school and didn’t get rice crispy cereal before school.

Allan (31:14): That’d be a lot better.

Eric (31:17): I look back on my upbringing. That’s what I had.

Allan (31:21): It was the standard American diet, what our government was telling us to eat. That goes to this whole thing, that ketogenic diet is not new. It’s been around for a long time, but it’s just starting to get to a point where people are recognizing they can get great health benefits from it, they can get weight loss from it. And the people that are on it become evangelists for it. It’s a growing trend as a way of eating. It’s not that it’s better than being a vegan or a vegetarian or anything else; it’s just a way of eating. It can benefit you, but it’s not for everybody, as I said earlier. I think if you’re wanting to lose some weight or you’re concerned about your metabolic numbers – your A1C is high, you’re prediabetic – there have been some great results using this. And again, most people that get onto it just feel great.

Eric (32:14): Absolutely.

Allan (32:16): The book is called Ketogenic Catastrophe. Eric, if someone wanted to get in touch with you, learn more about the book, learn what you’re doing, because you and your wife are doing a lot of great stuff over there – where would you like for me to send them?

Eric (32:29): My wife and I run a blog called AncestralJunkie.com, and that’s where we’ll be posting some articles. We’ve been a bit inactive lately. We have our son now and things have been a bit hectic, but we’re back on AncestralJunkie.com. And then you can find my other books – I’ve written a few others – on Amazon. If you search for Ketogenic Catastrophe, my name will pop up and there’s a couple of other things. If you go to the blog, you can get a free meal plan, a free grocery guide and some other goodies for just visiting. And we have a nice little newsletter that goes out. Today’s Friday, so Friday we send out a weekly newsletter where we’ll give you our top five articles and neat products that helped us or quotes that were motivating us, that kind of stuff. So you can get us at AncestralJunkie.com or on Amazon, is where my other books are located.

Allan (33:27): Okay. This is going to be episode 337, so you can go to 40PlusFitnessPodcast.com/337 and I’ll be sure to have links to all of those available there. So again, Eric, thank you so much for being a part of 40+ Fitness.

Eric (33:43): Thank you, Allan. I really appreciate you having me on, and thank you so much for what you’re doing for the health community and just the world at large here. You’re really making a difference, so thank you for that.

Allan (33:52) Thank you.

Thank you for being a part of the 40+ Fitness podcast. I’m really glad you’re here. I hope you enjoyed the conversation we had with Eric. Anyone that’s trying to use the ketogenic lifestyle as a way of eating often finds that they make mistakes, and Eric’s put together a really good book to talk you through how to manage those mistakes. So do check that out – Ketogenic Catastrophe. I have a link to that in the show notes, if you’re interested. And if you enjoyed today’s show, I really would appreciate if you would go to the “Review” section on your app, or go to 40PlusFitnessPodcast.com/Review, which will take you to the iTunes page. Leave a review for the podcast. I really read each and every one of these reviews. The ratings and reviews help us get noticed out there. So really, really important – please do take the time to give us a review; takes you a few minutes, and it can mean the world to someone finding the podcast and finding health. So, 40PlusFitnessPodcast.com/Review. Thank you for that.

A little bit on a personal note, I’ve kind of indicated over the course of the last few episodes that my wife and I are traveling around looking for potential retirement / downscaled life. It looks like we’re going to settle on Panama. That’s not set in stone at this point and it might not be a permanent move, but we are looking to potentially within the next six months sell our house and move out of the country, which will be a very different lifestyle. It’s a change that I’m doing because it will reduce risk from stress and will keep me kind of a in a lower keel, slow things down. I’m really looking forward to something like that. In looking at my health and fitness, that’s the one area where I can get the most bang for the buck. That’s my big rock. If you get into The Wellness Roadmap book once I get that issued, you’re going to learn a lot about how to identify those big rocks. For me, stress is the next big rock that I need to deal with.

I wanted to mention that I am setting up a mini Ketofest. I know I talked about going to Ketofest in July and doing a talk there. I’m going to do that talk again here at my home in Pensacola Beach, and that’s going to be on October 5th. Right now we’re looking at probably having it between 4:00 and 8:00 PM on October 5th. There will be food provided, there’s a small charge to cover off some of the costs of that food. Carl Franklin from 2 Keto Dudes is coming down here and he’ll also be giving a talk, and you’ll be able to meet him here at the mini Ketofest in Pensacola Beach. So do check that out – you can go to 40PlusFitnessPodcast.com/Ketofest. There you’ll find a link to the Eventbrite page. We can only handle a certain number of people. I do have a nice size house, but we still are going to have to limit the number of people that come so everybody can enjoy the food and the talks. So, you do want to go ahead and make sure you get yourself on that list. Go to 40PlusFitnessPodcast.com/Ketofest.

Now on the book, I’m not going to spend a lot of time on it, but it’s gone very, very well so far. I’m getting some blurbs back from folks which basically are just reviews. They’ve seen the book and they felt compelled to help me market the book by writing some really cool, really nice things. And I’m humbled by that. It’s really coming together. The next week I should get the proofs back from the editor and at that point I’ll be able to sit down and batten down and spend some quality time on the book to get that final finish in there. But we’re getting really close to having everything locked down and ready to go, so I’m pretty excited about that. If you want to be a little bit more in the know, get a little bit more detail on how the book is going, you can go to WellnessRoadmapBook.com. You can join the list and become a part of our launch team. That launch team is my go-to group, they’re the folks that I’m going to share the most information about the book. I’ll tell you a little bit about it on the podcast, occasionally I’ll mention it in the groups, but really if you want to be in the know about the book, when it’s coming live, discounts, bonuses, all kinds of stuff that I’m going to be putting out there – you need to join the launch team. So go to WellnessRoadmapBook.com and join the launch team today. Thank you.

Another episode you may enjoy

Keto Cure with Dr. Adam Nally

 

Intermittent fasting made easy with Brian Gryn

Allan (0:48): Our guest today has been a personal trainer and health coach for over 10 years. In effort to maintain his own body fat percentage, he fell into intermittent fasting and he realized they didn’t have a journal or anything on the market to help someone with this process. So he wrote one. I introduce you to Brian Gryn. Brian, welcome to 40+ Fitness.

Brian (1:10): Thanks so much, Allan.

Allan (1:12): I’ve got your Simple Intermittent Fasting Journal here. It’s a 21-day program that you run through folks with the journal opportunity to help them move from not really knowing what intermittent fasting is, to actually implementing it in their lives. I’m a big fan of simple things, and this really fits it because it just gives them the basic information that someone needs without overwhelming them, and then gives them the basic guidance. I really like how each day you left a little tip in there to help people along to learn more about this as they go.

Brian (1:47): Thank you. That was the whole idea behind coming out with that. I was looking to doing fasting myself, and there are books and information you can find online, but I really didn’t find a guide, something that could sort of take you step by step to get into it. So, that was my main reason for creating a journal was to, like you said, keep it simple. I think fasting can be intimidating. People need a guide for a lot of things, but fasting I thought would be a perfect way to help people. I picked 21 days. It can be different for everybody, but I thought three weeks was sort of a good time table to get you into it and see how you like the experience.

Allan (2:32): I had a job and it had me traveling to Malaysia, and Malaysia is a Muslim state. So when Ramadan comes along, they fast basically from sunrise to sunset. So they do intermittent fasting as a function of their religion. When I first realized they were doing it and watching them, realizing it wasn’t the easiest thing in the world for them, particularly for the first couple of days. And then they sort of got more and more comfortable with it. In my story I basically started eating Paleo, and you sit down with a plate of real food – so I’ve got either a steak or a fish or whatnot there, and I’ve got some vegetables. If I’m going to leave something on my plate, it always tended to be the vegetables. I was going to eat that steak and I was going to eat that fish, because that was where I saw the value of the meal at that point in my life. And so I ended up falling into ketosis, because I was eating a lot more meats and fish and eggs, and I wasn’t eating a lot of vegetables. I ended up in ketosis; I didn’t know exactly what it was when it first started happening, I started doing research and understanding it. But another kind of side effect of getting into ketosis was that I was seldom hungry.

So I ended up getting into intermittent fasting just on the function of saying, “If I’m not really hungry, then my body must be doing okay with my body fat.” And I had plenty of body fat to feed my energy for a long, long time – Energizer Bunny kind of power. So I ended up doing intermittent fasting and I still do it today. It was interesting when I started talking to you because you’re like, “You do it like two days and then you don’t do it for another month or so, right?” No, no. Every day I wake up, I don’t think about breakfast. I cook breakfast for my wife, but I don’t feel like I need to eat then. So I go and I just don’t eat, and I’ll wait. And usually about sometime between 2:00 and 4:00, I’ll start to feel like maybe I could eat something. And that’s when I open up my window and start eating. And because I’m “early to bed, early to rise” kind of person, I won’t eat after 7:30. So my eating window is really, really restricted to basically 2:00 to 8:00, for the most part. And sometimes just 4:00 to 8:00. I do it because it just feels natural and I like it. I feel good when I’m fasting. But why would someone fast? What are some of the reasons why people choose to use fasting as a protocol?

Brian (5:16): There are a lot of reasons, but I think I would say the number one reason people come to me and I get them into fasting or they’re looking to get into fasting is pretty much to lose weight, lose body fat. But another reason that comes along with that is increased energy. And I don’t know, Allan, how you feel, but for me, yesterday I fasted almost pretty much the whole day, probably about 22 hours. And I always feel my most energy towards the end of the day, just because obviously we all know when we have a big lunch, after that we tend to crash a little bit, especially if it’s something unhealthy like refined carbs or some pizza, or whatever it is. We have those blood sugar swings and those insulin swings and we tend to get tired afterwards. But when you’re in a fasting state, the blood doesn’t have to rush to your digestive organs, it can go other places and you just feel that adrenaline minute and that energy throughout the day. I would say the big things would be the increase in energy, they want to lose body fat. And then there are other reasons – the rested digestive organs, the clear thinking. And there’ve been studies regarding growth hormone increase as well.

Allan (6:35): For me a big part of it has become the freedom aspect. I have a property near here. I’m now trying to sell it because I can’t deal with it anymore, but that’s a whole another story. It’s about seven acres, and it gets kind of soupy back there when it’s wet. And I was back there doing some work. I drove my little tractor up on my trailer and was pulling it out and my truck got stuck. So I had planned to go down there and do some work for about three or four hours in the morning before it got hot. And I did that work, fasted and then I was getting ready to leave and come home; it was around noon time. And I got stuck. So I’m calling AAA, asking them to pull me out of my own yard. The truck shows up an hour later. He hooks himself up and then his truck breaks down. So he has to call for a part, they deliver the part, he puts the part on his own truck, and then he’s got his truck working and he pulls me out.

So I’m driving home and it’s about 6:00 in the evening, and I’m realizing at this point I’ve gone probably 23 hours without eating. And I wasn’t famished, I wasn’t freaking out. There were no blood sugar issues. My body had acclimated to using fat as a fuel, so I was fine to be out there. Now I did spend the afternoon just lazy fishing, because that’s why I bought the property – to go do some fishing there. But I had done that hard work in the morning and there was never a lack of energy, a lack of clarity or a freak-out that I had to have food because I was starving. I think that’s a big part of it. You have a lot of tips in here as far as what you should eat during your window, and I want to talk about that, but I think what I have found is that when you’re looking to do this, you really do have to start focusing on the quality of your food, because you’ve still got to get that nutrition in there and you don’t want it to necessarily be refined carbs, because as soon as you finish your eating window and your body has burned through that rocket fuel of refined carbs and sugar, your body’s going to want you to refeed. So it’s going to be really, really hard if you’re doing the refined foods. So I’m sitting down now; I’ve gone through my fast and I’m coming off my fast. What are the types of foods that I need to get into my body during my feeding window to sustain intermittent fasting?

Brian (9:02): Yeah, you hit on a good point. Obviously, I think the whole fasting process becomes easier when you eat better during your eating window. I would say to someone that’s looking to get into fasting is maybe clean up your eating habits first, and then once you clean up your eating habits, then you can use guides per se, like my journal or any other guide or a coach to help guide you into fasting. I know in my guide, we talk about pushing back breakfast an hour every day, whatever it is. As far as basic guidelines for eating, I would just say eat real whole foods, foods that expire actually. So that’d be avoiding most packaged goods, and then avoiding things like refined carbs, sugars, grains, starches. Obviously you talk about the keto worlds – eating natural fats helps keep you full longer, so that will help make the fast easier, and it doesn’t raise insulin as well. So natural fats, avocado. I probably have an avocado every day in my salad that I make. Olive oil, coconut oil, butter, natural butter. And then obviously avoid artificial fats, like things that come from fried foods and things like that. I would say that would be a good place to start. You don’t have to eat perfect, but it will help.

Allan (10:27): I’m actually working on a book and I was writing a section for the book this last week. I was sitting there and I just had to stop myself because hearing I’m talking about high quality whole food, I’m thinking to myself, “Why do I even have to write the word ‘whole food’?” There are the things that come in boxes and bags that are not food, and there are things that basically you get from your butcher or from the produce section that are basically your food. It was just kind of sad to me that we do have to explain that a whole food is something that expires, it’s something that you recognize as an animal or a plant at some level, and it’s not processed, it doesn’t come from a factory. I’ll even go as far as to say when you start talking about where it’s coming from, that matters as well. If it’s not grown in a good, conducive soil, it’s not getting the minerals that you need. If it’s not a well-cared-for animal, if it’s a sick animal… Out in the wild, if there’s a sick animal, the other animals won’t eat it; they let it lay there. We don’t seem to have that instinct, and it’s kind of bad.

So, focus on the quality of your food. Like you said, you don’t have to put it all in there overnight, but this is a great opportunity for you to really take some time to think about your food, because that’s another cool thing about the eating window and the freedom that you get is, you’re not spending all day preparing or sitting down for meals. I get that extra half an hour or so in the morning that I would be eating my breakfast to do something else, to learn something else, to read something, to write something, to do the things that are adding value in my life. I love eating, don’t get me wrong. I take full advantage of my eating window with some really good foods. And I think that’s the whole point – if you’re getting the nutrition your body needs, intermittent fasting can be easier. It is easier and it’s not really so much the way of eating. Keto works well for me, but you may have reasons that you want to be a vegan, and you can easily do intermittent fasting with vegan. You just have to make sure, again, that you’re getting the nutrition that you need, you’re getting the volume of calories, because when we’re talking intermittent fasting we’re not talking eating less. I think a lot of people think that’s what it’s all about. It’s not actually that.

Brian (12:55): I agree with you. I will say this – you will find – at least this is what I find with a lot of my clients, is that when you start doing it and you have a smaller window to eat, you realize your body doesn’t really need as much as maybe you thought it needed when you were just eating normal and throughout the day and grazing six, seven meals a day. I know we might talk about tips, but if you’re starting to do this, do this on days where you’re busy – maybe at work, or you have something that is just going to take up time and your mind’s going to be busy. Yesterday I was busy, ended up just happening. I just fasted all day and at the end of the day I was like, “I’m just going to have dinner”, but I got full quick. I wasn’t going to overstuff, which is another tip. When you do feed in that feeding window, don’t overdo it. You might think, “I need to stuff three meals into this eating window.” Well, you’ll be surprised your body will not want that.

Allan (13:58): It’s a little bit of both, because I think if you’re getting adequate nutrition, your body’s going to do the things it’s supposed to do. Your leptin and ghrelin are going to play their roles to tell you, “Okay, that’s enough. Let’s stop this.” And you’re going to eat just the right amount of food. I think if people are not getting the nutrition, that’s where they’re going to start to run into trouble. And obviously, again, a lot of people are doing this for weight loss, for fat loss specifically. So you have to realize that a portion of the calories that your body is burning is coming from that fat. I’ve read somewhere – I can’t validate this – but your body can basically use about 700 calories of body fat in any given day for energy. So, if you’re getting at least 1,200 in that meal, you’re probably getting enough calories at that point to sustain whatever you’re doing. Unless you’re a heavy duty athlete or your work is very intense, a good 1,900 calories on a given day is probably enough to keep you where you need to be. So, let’s take a moment and go through some of those tips, because these were really good.

Brian (15:06): So like I said, obviously staying busy really helps. So if you know you have a busy day at work or a busy morning and you’re like, “This is a good morning where I’m just going to skip breakfast” – maybe just have some black coffee, obviously no sweeteners or anything in that coffee, or have some tea. So just staying busy, keeping your mind active, and then drinking plenty of water too. I always have water on me throughout the day, whether I’m fasting or in my eating stage. And another one too that I think doesn’t get talked about a lot is, when you’re starting to do this, don’t tell someone that might not be supportive of it, because I think there are people who initially think you’re starving yourself and they might even be worried about you, because we’re so programmed by mainstream media, and I say this all the time – no one makes money when you fast, right?

Allan (15:58): But the other side of it is, they are actually coming from a very real paradigm. If you’re eating crap food, if you’re eating carbs, if you’re eating sugars, if you’re drinking regular sodas, or even diet sodas for that matter – if that’s your food, if that’s what you are eating today, you can’t go more than four hours without eating, or your blood sugar is going to plummet and your body’s going to scream, “Feed me!” So really narrowing that down and saying other people won’t necessarily understand what you’re doing. You’re following a protocol – get into it, understand it, and then it’ll be a little easier to talk about when they realize that you’ve dropped more than five pounds during these 21 days. At least that’s what I would expect for most people that get into it, they’re going to lose something like that, or can expect to lose something like that if they have it to lose. I think you’re right there. They’re not coming from a bad place. They’re not trying to sabotage you for bad reasons. They know they can’t go more than four hours without eating because that bagel they had for breakfast has them screaming for more food. That’s why they’ve come up with the term “second breakfast”, and most fast food places serve breakfast all day long because they want to keep feeding you those carbs and keeping you coming back for more.

Brian (17:22): Right. Once you get into the fasting protocol and it’s feeling more natural, because like anything else, it gets easier and easier the more you do it – then maybe you can tell some people or tell people who maybe would have been against it at first and they’ll be like, “Wow, you’re getting great results. You’re feeling great. I’ll support you.” And things like that. People know now that I do intermittent fasting, but when I first started doing it, I don’t think many people knew. I just sort of did it. Those are the main tips. I would say one more tip would be, drink a warm liquid. It could be a tea or black coffee. And I talk about this a little bit. People go, “What if I get hunger pains?” And you will get that. You might even get headaches. I always say for headaches that can be avoided or can be helped, to have some water and put some salt in it. I know it doesn’t sound the most appetizing, but…

Allan (18:24): But we’re not talking lots of salt. A pinch or two.

Brian (18:29): Pinch of salt, exactly. Some Pink Himalayan salt.

Allan (18:33): It’s not like drinking sea water.

Brian (18:38): No. A little bit of salt, you can taste it, but it’s doable. So, drinking the coffee or the tea. And I’ll just say this – I recently got an email from a client saying, “I like to put cream in my coffee or I won’t drink it.” I will say, if you can do the fasting protocol and if you have to have a little bit of cream in your coffee, then go ahead.

Allan (19:05): The one thing I will say on this, and I don’t mean anything against Dave Asprey at all – I appreciate that he has developed a protocol and a product he calls Bulletproof Coffee. He sells coffee and he sells the MCT oil, and he doesn’t sell the butter. But if he could, he probably would. He just found Kerrygold works for him, so he didn’t have to make his own butter. But when you do that coffee, the way they protocol it, the way they put it forward, that can be upwards of 700 calories. To me that’s not fasting anymore. You’re feeding your body and you’re choosing to feed it fat, which is great, but your body’s going to use that fat for energy. It’s not going to use the body fat that we’re trying to get our body to be more accustomed to using. So in my mind it’s like, if you can avoid the creams, if you can avoid the butters and take your coffee to black… And this is the same thing as I think what you have in the book, which is great for a protocol, is you walk yourself into it. So maybe it was two ounces of cream and you can cut that down to one and three quarters, and then one and a half. And over the course of these three weeks going through your program, maybe they can get to a point where they’re not having to put cream in their coffee at all.

Brian (20:21): Yeah. It’s sort of that “one step at a time” approach. That’s what I did when I started fasting – just pushing back breakfast an hour a day. Some people might be like, “Oh, screw that. I’m just going to go right to lunch.” That might be your protocol, but my protocol was I took it one step at a time. Same thing with little things like that with cream in your coffee – if you want to slowly start taking that out, that would be obviously the best, perhaps the easiest way to do it.

Allan (20:52): Yeah. As we look at this, the cool thing about your Simple Intermittent Fasting Journal here is that you have a space for each of the 21 days for them to walk through the process. And you’re giving them guidance each time, you’re giving them a tip each day. I think for the folks that want a tool that’s going to walk them through this and get them to a point where they understand intermittent fasting, they understand their body’s response to it, and the 21 days gives them plenty of time to understand how it’s going to affect them. Some people will take this and they’ll just keep going. Other people will say, “This will be my period of detox”, for lack of a better word, “Where I just use this protocol from time to time.” Are you using it all the time or is this something you implement just from time to time?

Brian (21:46): For my own good or for a client?

Allan (21:48): For you in general.

Brian (21:50): For me I don’t use it anymore. I did test it on myself when I was first creating the journal, and so I did use it early on, but now I’m to the point where it’s just become… And that’s what I say on the cover – it’s become a lifestyle for me. I don’t use the journal anymore.

Allan (22:12): I didn’t mean so much the journal. It’s just that you do intermittent fasting and it’s just a lifestyle. With me I have gotten to the point where I don’t eat what would be a standard breakfast in the morning and I’m typically not eating until somewhere between 2:00 to 4:00. And a lot of times that’s still breakfast for me, and sometimes it’s still breakfast foods. It just depends on my mood and what I want to eat. I have found that once you kind of get into that process of not being dependent on eating a meal every three hours, it almost becomes a natural, “Let your day decide when you’re going to eat, when you’re hungry”, and it’s not so much, “I have a fixed time that I have to eat each meal.” You can have a lot more flexibility with this.

Brian (22:58): Yeah, I would agree. I would think that’s the biggest benefit. For me at least one of the biggest benefits is you’re in control of your food. A lot of times with people, food controls them, and a lot of that is almost just in your mind because we’re programmed to eat at certain times. But once you get into this protocol, you realize, like you said – if something happens, like you got stuck in your own yard – you were fine. You weren’t like, “Oh my God, I need to run to Starbucks or get something.” It gives you that flexibility, and I think you’re just in control. I think that’s the biggest thing – you have more time to do things that maybe you want to do, like you said, in the morning. So, it really gives you that flexibility.

Allan (23:41): And I also want to emphasize that there is an energy aspect to this. When your body starts learning how to use your own body fat for energy, you have an abundance of energy. And a question I get a lot from clients is, “I’m going to start this intermittent fasting, I’m going to start this protocol. So I should stop exercising for a few days, right?” And my short answer is, “Why?” It’ll be hard the first few days of this protocol, the first few days of keto. For me, when I tried pescatarian, the first three days were hard. Once you kind of get through that dip, things get easier. But to me, unless you’re really having some blood sugar issues or whatnot, you can continue to train.

And that’s the only other thing I would leave off with this conversation – before you start any kind of protocol like this, particularly if you’re diabetic or pregnant or on any medication at all – have the conversation with your doctor because this is not a protocol for everybody. It does have a special use, and you include a lot of that information in the book here. So Brian, I really appreciate you coming on and talking to us about intermittent fasting and your guide Simple Intermittent Fasting Journal. If someone wanted to get in touch with you, learn more about what you’re doing and learn more about the book, where would you like for me to send them?

Brian (24:58): They can go to my website, which is my name, so BrianGryn.com. They can reach out to me, order the journals on there and ask any questions.

Allan (25:12): This is going to be episode 334, so you can go to 40PlusFitnessPodcast.com/334, and I’ll be sure to have a link to Brian’s website there. Brian, thank you so much for being a part of the 40+ Fitness podcast.

Brian (25:26): Thanks, Allan. Really enjoyed it.

Allan (25:32): I hope you enjoyed today’s conversation with Brian. If you’re interested in managing your body fat percentage, intermittent fasting can be a great strategy for you, and I encourage you to check out his journal if you want to try that out.

 

I am very happy to announce that I have gotten my manuscript over to the publisher, so at this point we’re about to lock it down, as they say, which I feel really good about. But I still need your help. I need you on my launch team. If you can go to WellnessRoadmapBook.com, you’ll learn more about the book and you can also then there sign up to join the launch team. Launch teams are very, very important to help books get off the ground, and I need you on my team. So please go to WellnessRoadmapBook.com and be a part of the launch team. Thank you.

 

Another episode you may enjoy:

Fasting for weight loss with Dr. Jason Fung and Jimmy Moore

 

 

Keto energy! Now what?

Here is the video of the re-recorded KetoFest presentation

Another episode you may enjoy

Keto Cure with Dr. Adam Nally

Guy gone keto with Thom King

Our guest today is the founder and CEO of Steviva Brands – one of the largest importers, manufacturers and distributors of natural sweeteners. He is a self-described biohacker, and he’s made his life work trying to figure out ways to get people off of sugar. Today we’re going to talk about his book, Guy Gone Keto, and his journey from finding himself a busy executive who was not taking care of himself to being as healthy as he can be. I know you’re going to enjoy this conversation, so with no further ado, here’s Thom King.

Allan (1:15):  Thom, welcome to 40+ Fitness.

Thom King (1:21): Thanks, Allan. I appreciate you having me on your show. It’s truly an honor. So thank you.

Allan (1:28): So, the book today we’re going to talk about is Guy Gone Keto, and I really enjoyed the book from the perspective of your story and how it really did in a sense parallel mine, although I think you fast-tracked a lot better than I did in getting from the decision point to actually making things happen. Mine took nearly eight years; yours took slightly over a year. But we both were sitting in what I would call a very miserable state and we were frustrated with that, and we made a decision that we were going to change that. I happened to be in Puerto Vallarta when I did mine; you happened to be in Las Vegas. Would you mind sharing your story about that and how that frustration then led to your change?

Thom King (2:19): It was definitely frustration, but I think that the biggest part was just being disappointed in myself and feeling like I had poor integrity. I run a food ingredient company and we cater to ketogenic products and sports nutrition, and I was exceptionally unhealthy. My blood pressure was 199 over 99 and I was 35 pounds heavier than I am now. I was drinking a bottle of wine every night and eating bread and cookies and all sorts of garbage. I think I bottomed out when I was in Las Vegas. I was there for a trade show. I went to dinner with a client and way overate, had a couple of glasses of wine, came back to the room. The room that I stayed in smelt like stale booze and regret. And I found myself waking up the next morning, not feeling really great and looking in the mirror and seeing really how fat I was and how disgusted I was with myself. And at that point, I think that the pain of being out of integrity and the pain of my sloth and overweightness exceeded the pleasure that I was deriving from drinking too much wine and eating too many sweets and carbohydrates. So at that point I just told myself, “This is the end. I’m going to be making a major shift in my lifestyle.” That’s when I got on board with leading a ketogenic lifestyle from that point forward.

Allan (4:10): Okay. And I like the way that you approach that. It’s a unique way to approach it, where you’re talking about the pain of failure is greater than the value you’re getting from the activities you’re doing. I’ll be honest with everyone here – when I go to a tailgate, I drink the beer and I hang out. I typically try to get a higher quality beer, but I drink the beer nonetheless and know that I’m not going to feel so great. But the social interaction in those events – I actually do feel they are valuable enough to me at this point in my life that I don’t want to forego those. So I go through what I call my “feasting period”, where I back away from keto a little bit. I’m really interested in your thought patterns around using pain as a leverage tool to get something going, to basically make you change something in your life.

Thom King (5:11): For me, pain is the great teacher. I don’t avoid pain. I probably seek it out more than I avoid it. I think that human beings are driven by two things. I think they’re driven by the avoidance of pain and they are driven by seeking pleasure. If you’re seeking pleasure and the pleasure that you’re seeking is drinking too much, eating too much, whatever habit you’ve got – if you’re able to really attach pain to that, like when you take a look at, “Is eating this donut going to be painful or is it going to be enjoyable?” It’ll be enjoyable for that first few minutes, but if you really are mindful and present in what you’re doing, you can take a good look at what eating the donut really means. It’s going to raise your blood sugar level, it’s going to contribute to metabolic disease. It’s also going to lead to lower self-esteem, because are you going to really feel good about yourself after you eat the donut? If you start associating so much pain with something that you’re deriving pleasure from, once the pain exceeds the pleasure, you’ll be able to break that habit.

Allan (6:41): I liked your example of a donut, because I don’t have the same draw to a donut, and I know the reward is not worth the pain. For me the time with family and friends, and the socializing aspects of all of it, and not being that guy that’s not having the beer – to me is a little different. But I get that, particularly if you’re in a bad state and if you’re looking to improve yourself. It’s a very stoic kind of approach to thinking about how to solve that problem.

Thom King (7:12): Yeah, and I do derive a lot of that from stoicism. One of my daily practices is to read from The Daily Stoic, and I do leverage that quite a bit. So, being able to find answers in pain and in situations that are challenging – that’s part of my routine.

Allan (7:39): I have a copy of that book sitting on my desk right here, along with your book. Now, in the book Guy Gone Keto, you have your first steps. I really liked your approach to this. I really liked how you lay this out, that these are the things that need to be going through your mind, this is what you need to be doing to get this whole process going. In the case of the book, we’re talking about getting ourselves into ketosis, but I think this really applies to anytime you want to address a health or fitness issue.

Thom King (8:14): Definitely. Anything that you do want to achieve – it’s being able to set the goal. I think it is creating the intention and really being able to outline the outcome you’re looking for. And then on top of that, using a lot of data collection so you can see where you started and where you’re going. If you can see progress and you’re starting to see yourself getting closer to the outcome that you’re looking for, those are the best first steps that you can take.

Allan (8:52): There was another thing you had in here that I liked, and this is really something that’s hard for people to wrap their minds around when they want to lose weight. They want that 35 pounds or 55 pounds gone tomorrow. And I can say from my start to finish of when I really got committed and started doing the right things, it started with the Paleo, found myself naturally in ketosis, started reading on what ketosis is and then really bear down on that. But this was not something that just happened in a day or a week, or even a month. It took me nearly 11 months to really drop that kind of weight. So it was a slow progression – a few plateaus, but just a slow progression. I like how in the book you explain to us why going slow is important.

Thom King (9:43): I think that if people are looking to lose weight fast, that’s more of a diet situation. I also think that’s pretty unhealthy, because I think that if you adopt a diet, you’re going to get yo-yo weight. So you’re going to be on the diet, you’re going to lose the weight, then you’re going to go off the diet, you’re going to gain the weight back, and maybe a little bit more. So that’s the big difference. There’s a difference between diet and adopting a particular lifestyle. I think that if you adopt the particular lifestyle, it becomes more about the process than the outcome. You can definitely define the outcome – say, “I want to lose 35 pounds”, but the process is what you do every day to get there. And I would say don’t be in a hurry, don’t lose the weight too fast. Lose it a pound at a time, because if you lose a whole bunch of weight really fast, you’re going to be dealing with other issues like loose, saggy skin, and also it’s very taxing on your liver. So take your time and immerse yourself in the process, and then naturally the outcome will manifest itself.

Allan (11:06): Cool. Now, I do want to get into a little bit of discussion about ketosis. One of the things that you also had in your first steps was to avoid the high glycemic foods, because those are definitely not going to allow us to be in ketosis, but they’re also the items that are going to spike our blood sugar and get us to a point where we’re not able to lose weight or keep ourselves from potentially gaining weight.

Thom King (11:38): The shift from getting into ketosis is your body actually shifting from burning glucose as a form of energy to burning fat as a source of energy. So the ketogenic lifestyle or ketogenic diet basically is 70% fat, 20% proteins, and 10% vegetables. And these vegetables are going to be green leafy vegetables, cruciferous vegetables like broccoli and cauliflower. Basically if it grows underground, meaning a potato or a carrot or something like that, those are going to tend to be more on the high-glycemic end. So you’ve got this pretty big option of food that you can eat.

Allan (12:26): Yeah. When we start talking about these types of macros, it’s easy to think that you’re in that macro range, but if you’re really not paying attention to what you’re eating, you can easily slide one way or the other and not get the benefits that you’re after. This leads me to the next area I want to talk about, which is journaling. I’ve had clients that were on the calls or with me and they’re saying, “Allan, I just don’t understand it. I’m eating really, really well and I don’t understand why I’m not losing the weight. I’m doing the exercises, I’m eating well. Everything is going great.” I’m like, “Get yourself a notebook and start a journal.”

Thom King (13:12): 100%. That’s the data collection part of your journey. Definitely go out, buy yourself a journal and start doing data collection. Do data collection on how much you weigh, what your ketones are, what your blood sugar level is. This is a process, and the more data collection you do and the more you journal, the more you’re going to find the areas where you can make improvements. If you’re writing down everything that you ate in a day and you think, “I’m eating 2,000 calories a day. I’m probably burning 2,200 calories a day, so I’m at a 200-calorie deficit” – that might not be true at all, because particularly when you’re eating keto, a lot of the stuff that you’re eating is going to be high fat, and when it’s high fat, it means it’s high calories. So, you might have some almonds in the palm of your hand – it might be 5 to 10 almonds – you’re looking at about 200 calories there. So when you start writing these things down and understanding where the holes are, you can really plug the dike.

Allan (14:24): One almond is basically 16 calories, so if you’re off by one almond, that could be potentially 10 pounds of weight gain in a year. It’s not that you have to be exact, because calories are not really ever exact, or their estimates anyway, but you go three weeks and track what you’ve eaten, the volumes you’ve eaten, and you really pay attention to those numbers – you’re going to get to a point where you understand 2,000 calories is maybe a little too much, or maybe you need 2,500 because you’re losing weight a little too fast. So, taking the time to write those things down, and even to go further than just the data collection is, how do you feel when you wake up? What’s your energy level throughout the day? Do you find yourself needing to take a nap at 2:00 in the afternoon? How much coffee are you drinking now? Are you getting your electrolytes? Are you getting enough salt and enough water? There’s so much that a journal will allow you to collect and understand about yourself, to include your mood and your stress. I press it on with my clients all the time, that I do think a journal is a great tool for anyone that’s looking to make a change or at least understand why they are where they are.

Thom King (15:39): Absolutely. I don’t just use my journal for tracking macros and my behavior, but I also use my journal to set the stage for my day. I do write down what are the things that I’m most grateful for today, and what am I going to do today to make this day great and excellent? And then I just end it with an affirmation of, “With every breath I take in, I attract and create abundance and health and wellness in my life. And with each exhale I lovingly release any and all self-limiting beliefs that no longer serve me.” Combining that with breathing exercises, I found that journaling is something that I must do every day.

Allan (16:32): Yes, and I’m doing it. I wish I were better at doing it all the time, but that’s one of those practices that I really struggle with. But when I’m doing it, I feel so much better organized, I feel so much more complete and like I have everything together with my relationships, my food, my sleep, with all of it. So I do think it’s a great practice to understand what’s going on, to have a path forward and to be always affecting change. So if you’re someone that’s in the continuous improvement model with your life, a journal is a must have.

Thom King (17:14): Absolutely. It’s a daily event for me.

Allan (17:19): We talked a little bit about calories, and for a lot of folks, they’ll say, “They’re telling me I’ve got to cut the sugars and I’ve got to cut calories.” But as we call it down in the South – they love their Coke, which down here “Coke” just means any soda. So you come down here and you want to order a soft drink, you just ask for a Coke, and then they’ll ask you what flavor. You have to repeat yourself and say, “Coke, just a regular Coke.” And you’ll wonder why you had to repeat yourself – because “Coke” is just our word for soda, or a soft drink, or pop or whatever you want to call it. So they’ll say, “That’s one of the easy cuts. Immediately I’m going to give up my pop, my soda, my Coke, and I’m going to move over to this diet soda, because the diet soda has zero calories. So it’s the perfect drink because it tastes almost like the regular thing. And once I get used to it it’ll be fine. And it has no calories.” So they go into this mindset of, “This is the diet drink. This is what I need.” And they’ll say “diet” or “light” – “This is what I need to drink.” Can you tell us why that’s not necessarily the best path to health?

Thom King (18:30): I do a lot of experiments on myself. I would consider myself a bit of a biohacker. So, I was drinking a lot of Diet Coke and Diet Pepsi, thinking that it’s going to help me maintain good blood sugar levels, it’ll keep me in ketosis. But what I found is that if I was drinking diet soda at night, when I wake up the next morning, my blood sugar level would be elevated, and I was having a hard time getting myself into deep nutritional ketosis. So, I just conducted a little bit of an experiment and I also talked to a couple of PhDs about what’s potentially going on with diet soda. I’ve tested blood sugar before, blood sugar after, same with ketones. And I found that diet soda that contains aspartame or sucralose, which is Diet Coke and Diet Pepsi – that those will actually elevate my blood sugar levels and they will slightly decrease the amount of ketone bodies. And when I talked to a couple of doctors about it, what came up for them is that your body doesn’t recognize these manmade chemicals. It recognizes that it’s sweet, but it doesn’t recognize them because we don’t have the receptors for them. With Stevia or monk fruit, with natural high intensity sweeteners, our body recognizes it because we’ve got the receptors to recognize it, so it says, “This is Stevia, or this is monk fruit. This tastes sweet, but it’s not impacting blood sugar levels at all. This is how we’ll metabolize it.” But with aspartame and sucralose, your brain doesn’t recognize it. We don’t have receptors for it, which means that your body is basically going to function like you just had sugar, and the only benefit that you could get from chemically-sweetened soft drinks is the calorie abatement, but you’re still going to get a rise in your blood sugar level and you’re still going to get your ketone levels to drop, because your body doesn’t know what it is.

Allan (20:46): So, even though it’s not sugar and even though it’s zero calorie, it’s doing a sugar-like thing to you. Or maybe not exactly like sugar, but it’s changing your metabolism by causing your insulin and sugar responses to kind of go out of whack.

Thom King (21:05): Absolutely. And I’ve done this experiment several times. Occasionally, I’ll indulge myself with a Diet Coke – I love Diet Coke – but I do so with the knowledge that it is going to probably take me out of ketosis and it is probably going to raise my blood sugar levels a little bit. The fact that it doesn’t have any calories is a plus, but when you’re leading a ketogenic lifestyle, the goal is to keep yourself above, say, 0.6 to 1.5 millimoles of ketone bodies. So, there’s going to be a cost to it. But there are plenty of good replacements out there, like Zevia. Zevia is a soft drink that’s made with Stevia and it’s actually really good. If I’m going to indulge with a diet soft drink, I will certainly go with something that’s naturally sweetened over something that’s artificially sweetened.

Allan (22:09): When I moved away from Diet Coke, I was definitely an addict. Getting away from it was painful. So it’s not easy, but I did replace that with the green teas and coffee and things like that. There are now some products that are Stevia-based that are really good, if you want to continue the Cola route. There’s also tea and coffee, or good old water.

Thom King (22:37): When you’re on a ketogenic diet, drinking plenty of water is really important. You want to keep your body definitely hydrated, so your kidneys aren’t working overtime.

Allan (22:50): That is a big, big thing that a lot of folks struggle with ketosis. They get what they think is hunger, and the reality of it is either they’re not getting enough water or they’re not getting enough electrolytes. Once they figure that out for themselves, they’re so much better off and they have so much more energy.

Thom King (23:10): Absolutely, and that is key. I do keep little packets of electrolytes, and I have an app on my phone that reminds me to drink water every hour.

Allan (23:20): And then there is your journal, so full circle.

Thom King (23:24): It’s true. I hold myself accountable.

Allan (23:27): Good deal. Thom, if someone wanted to get to know you, get to know more about Guy Gone Keto and all the other things you’re doing, because you’ve got a lot going on – where would you like for me to send them?

Thom King (23:43): You can find me on any and all socials under Guy Gone Keto. You could also find me personally on all of the socials, and that’s Thom King PDX, as in Portland. My personal website is ThomKing.com. And my company is Steviva Brands, and you can go to Steviva.com. Yeah, any of the socials, and feel free to reach out, direct message me. I’m available to answer anybody’s questions.

Allan (24:25): I will have all of those links and all those social media outputs available in the show notes. You can go to 40PlusFitnessPodcast.com/328 and find all of those links there. Thom, thank you so much for being a part of 40+ Fitness.

Thom King (24:41): Allan, it was an absolute pleasure. It was an honor to be on your podcast.

Allan (24:47): Thank you.

I hope you enjoyed that conversation with Thom. I know I did. The similarities in some of our storylines and the things that we went through were very, very interesting. And it’s also interesting that both of us found keto as a way to address our issues. It turns out July for me is becoming this month of book editing. It’s not fun; I don’t really enjoy the process of doing the editing of something that I wrote or said. And as I go through it, it’s a struggle, but I’m seeing the book come to life and that’s really, really exciting. I’m calling the book The Wellness Roadmap. I’m going to start putting together a page for that real soon. It’ll probably be at WellnessRoadmap.net. If you go out there right now, you probably won’t find too much, but I am putting that together and it’s just really exciting to see a book come together. We’re working through cover art and we’re talking about layout, and we’re, of course, dealing with pages and pages of text.

But it got me to thinking, there are certain things that are true in life. If you want something, it’s not always a direct path. You can’t necessarily be a better human, can’t do the things you always want to do just by doing them. I like playing volleyball, but I know that I’m not going to be as good a volleyball player if I don’t put in the time to do other things – some of the things that we don’t like, like sweating or lifting weights or when the weather doesn’t let us get outside, doing our runs on a treadmill. There are going to be those times when there are things that we don’t enjoy, that we should still do to improve our health.

One of the caveats out there, “What’s the best exercise?”, and the answer that’s typically given is, “The one you’ll do.” I completely, wholeheartedly agree with that. When we were looking at cover art, there was one with the couple being relatively athletic on the page, I said that people might not like that. They might not like that you have to do workouts to get the things you want. And you don’t “have to”, but if you want optimal health, if you want true wellness, then sometimes you are going to probably have to do a few things that you don’t enjoy. I want you to think about those things from the perspective of why you’re trying to get where you’re trying to get, and it does make those things just a little more tolerable. So, do the things you don’t want to do when it’s getting you to a place where you want to be – that’s the short story of all that. So, I’m going to be spending a lot of time editing a book, even though it’s not the funnest thing for me. I am very excited about what it’s going to do when I’m done.

Also, this week I’m getting on a plane to New London, Connecticut. Actually flying into Boston, and I think it’s about a 2.5-hour drive from there. Then I’m going to go to New London, Connecticut – 20th to the 22nd I’ll be there. If you’re in the area, you can email me at allan@40plusfitnesspodcast.com, and I’ll be glad to catch a coffee or a drink with you. Let’s have a good time, let’s get to know each other. I really like talking to people that have heard the podcast and get your advice on some things that I can do better as a podcaster and as a coach.

And I’ll talk about coaching. I mentioned this last week – I’m looking for clients, I want to help you do this. If you’re looking for a coach, you think you might get some value from a coach – let’s talk about it. I know a lot of this is you go online, you see a forum, you see a page. I’m not a pressure salesman. I’m not going to say, “Do this or else.” I see a lot of that. I see a lot of, “Lose 20 pounds in three weeks and…” And that’s great – you can lose 20 pounds in three weeks. It’s completely possible. It’s not healthy and it’s not going to make you well. It’s going to make you thinner, but it’s not necessarily going to make you well.

I, as a coach, try to empower my clients. I try to teach my clients and I help my clients, and as a result they get well. And that’s what I want for you. So if you’re on the fence, you think this is something that might be good for you, you can go to 40PlusFitnessPodcast.com – I’ve got some information there. I can tell you about all the programs I have if you want to know. You can go to 40PlusFitnessPodcast.com/Talk, and that’s going to take you to a calendar link, where you can actually book a 15-minute block of time and we can just talk. We can talk through whatever issues you’re dealing with, whatever your health concerns are, whatever your fitness goals are. We can talk through what they are and make a decision if coaching is right for you. It’s not right for everybody, but I can tell you having someone there to keep you accountable, someone there coaching you, teaching you, empowering you to take your fitness journey, your health journey, your wellness journey to the next level – I think there’s a lot of value there that you might be missing out on. So I’d encourage you to go to 40PlusFitnessPodcast.com/Talk and learn more today. Thank you. Next time on the 40+ Fitness podcast, we meet Dr. Joel Kahn and discuss his book, The Plant-Based Solution. Until then, have a happy and healthy week.

 

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The diabetes code with Megan Ramos

Today we meet Megan Ramos and discuss Dr Jason Fung’s book, the Diabetes Code. She co-founded the intensive dietary management clinic with Dr Fung and she's also a co-host with him on the Obesity Code Podcast. They talk about keto, obesity, diabetes, and fasting. It’s really fascinating things they're doing with their patients. I know you're gonna enjoy this. I heard her speak at Keto Fest last year. She's an active speaker and author.

Allan (3:45): Megan, welcome to 40+ Fitness.

Megan Ramos (3:47): Hi, thanks for having me today.

Allan (3:49): I'm really excited to have you here. It's funny, my Internet went down over the weekend and I haven't quite gotten it up, so I'm just putting this through my phone. So I'm hopeful that we can get everything in. This book we're talking about today is The Diabetes Code by Dr. Fung, and you work with Dr. Fung in his clinic so you see this stuff every day. I was driving down the road the other day and I saw this business, and it was a renal care facility where they basically do the dialysis. And I was thinking, how can that be a standalone business? But in some of the stats that were in the book, it's really amazing how many people are affected by diabetes and then go on to have kidney issues.

Megan Ramos (4:38): Almost all of them. I've worked with Jason for 20 years and we co-founded this clinic, the Dietary Management Clinic. It's within our nephrology practice. And over 80% of our patients that come in for intensive dietary management have a diabetic-related kidney disease. It might not be full blown, but they have the early onset of diabetic-related kidney disease. The number every year of people that come into the clinic with diabetic-kidney disease is incredible. When I first started doing research there 20 years ago, diabetic-kidney disease was not as common. The other causes of kidney disease were much more prevalent, but nowadays over 80% of these kidney patients have kidney disease because of their diabetes. This is the most disheartening thing to both Jason and I, was that as diabetes got worse, the kidneys totally failed. And there is nothing as people in the field of nephrology or as kidney specialists we could do for these people.

As the diabetes became more out of control, the kidneys declined and declined and declined, and we couldn't help these people. We were essentially watching them die, or watching their kidneys fail and just telling them they need to prep emotionally for dialysis, and helping guide them through dialysis education and emotional support and connecting them with other people on dialysis. Because that was all we could do for these people. We couldn't help them out. Probably until about five years ago, we had nothing that we could do to help these people. As long as the diabetes got worse, they were going to end up with complete kidney failure.

Allan (6:33): I guess that's what's shocking, because I looked it up – there are about 6,500 of these dialysis centers around the world, and growing. It's a growing industry. But this is mostly a preventable disease. I guess the doctors had always thought this is just a progressive thing that happens. But the subtitle of the book is Prevent and Reverse. So, if someone does have prediabetes or diabetes, there are some things that they can do to deal with those. And that's what you guys are getting into as part of what this book is about. We'll talk about in a minute, but I want to take a couple of little divergences, because there were things in this book that I found fascinating, and they're not topics that people talk about a lot. One of those was the TOFIs, which I know basically means that they look thin, they look healthy, but they have diabetes effectively, or they're close to having diabetes because of their visceral fat. Can you talk about TOFIs in particular, because I think a lot of people think, “If I lose weight or I'm thin, then I'm healthy.”? And that's not entirely true.

Megan Ramos (7:45): No, we spend a tremendous amount of time trying to explain body composition to our patients. Actually, I had a patient in clinic the other week. She was 98 pounds, but her liver was so fat and her pancreas was so fat. She was diabetic. As a result, even though she was 98 pounds, her body fat percentage was way over 40%. So she's clinically morbidly obese, even though she weighs 98 pounds and she's about five foot three. She looks very slender, she's a size zero, maybe a size two on a bloated day. But we spend a lot of time talking about body composition. A lot of the people who follow the standard North American diet have more fat than lean mass. They don't have a whole lot of muscle mass. We’re a very sedentary society here in North America, so we're not as active, we don't have as much lean mass, and our dietary choices too, especially in women, have led to destruction of our bone mass density. And now we're seeing osteoporosis more and more often in men too. So bad food choices, things like phosphoric acid being extremely abundant in a lot of the processed foods that we're eating, are really taking a toll on our bone mass density. So this woman is very petite, but she's just a little sack of fat. It's fine if you’re a certain weight, but the majority of your body is strong bone and good muscle mass that’s going protect your joints and your body and your organs in general as you age. So we try to talk to our patients about how the scale doesn't really matter. Of course you don't want to weigh 500 pounds, you don't want to weigh 600 pounds. But myself, I've been 90 pounds and I've been morbidly obese, and I've been 120 pounds and extremely healthy. So it's really about body composition.

Diabetes originates in the liver, and certain kinds of foods that we eat can make us more prone to developing a fatty liver, and that kickstarts diabetes. We have a lot of these patients come into the clinic, they're very slender and they have an extreme fatty liver and as a result they have diabetes. And they go on to tell me about how they've never really eaten that badly and they don't understand how they had a fatty liver, because they don't drink alcohol very often or not at all. And I say, “You're diabetic because you drink too much soda. You're diabetic because you drink too much fruit juice.” The fructose and the excessive sugar diet cause this fatty liver disease. As a result, you might not have a beer gut with your belly hanging over the edge of your pants, but your liver is much larger than it needs to be, and your liver has a beer gut in itself. So we have to eliminate the organ fat.

There are a lot of people out there that are digitally obese and that are in much healthier shape than the skinny people who have a lot of this organ fat. When you have so much organ fat, that fat's going to prevent your organ from functioning well. We see fatty liver, fatty pancreas, fatty spleen. When you have a fatty liver and it gets so fatty, you start to develop liver cirrhosis, hardening of the liver. Then the liver can't do its job at detoxifying the body, then you have fatty pancreas. We see this all the time now because we have these type 2 diabetics and we see that their liver is so fatty that they can no longer produce adequate insulin to be able to regulate their blood glucose levels. So they end up with very high blood glucose levels and they end up on insulin as a result.

Allan (11:45): Yeah. There was another thing. Like I said, I love these little tangents. Sometimes I get into a book because I think that's where I really learn some things that help me be better at talking with people. And one of them is the Randle cycle. The Randle cycle makes sense to me in a lot of ways because so many people will say, “I want to lose fat”, and then they're eating a low fat diet. But based on what the Randle cycle says a cell can only use sugar or it can use fat, but it really can't use both simultaneously. I think that's a really important fact to put out there, because if someone wants to burn body fat and they're eating a predominantly sugar-laden or carbohydrate-laden diet, they're making it that much harder for themselves, aren't they?

Megan Ramos (12:38): Absolutely. You can't be a sugar burner and a fat burner simultaneously. The hormones that are produced when you eat excessive carbohydrates block fat loss. So you can't be eating a diet that's producing hormones that are blocking fat loss, and actually expect to lose body fat. That's just not how it works.

Allan (13:03): I think a lot of people think, “If I eat less calories total…” There are more calories in fat than there are in carbs. When they want to do the calories in, calories out, it seems to make more sense from a math perspective. But our bodies don't actually work that way.

Megan Ramos (13:21): That's correct.

Allan (13:23): There’s a drug I know that a lot of people will get on when they're prediabetic or diabetic, because they go in, and the symptom and how we know someone is diabetic is effectively blood glucose. They get up to a certain level of blood glucose and they’re said they're prediabetic. And then if they get up to another level, at that point they're called diabetic. A drug that's very commonly prescribed is called metformin. Could you talk about metformin, when it is appropriate to have metformin and when it's not?

Megan Ramos (13:58): Usually we’re not necessarily opposed to metformin in our clinic. It's a relatively benign medication and it does have some benefits that other medications don't have. The risk factor for taking metformin is much lower than a lot of the other medications on the market. But usually at our clinic, if someone is being proactive with their lifestyle and their diet, we usually don't put them on anything. We wouldn't start them on metformin until the sugars went over 10 or 180, or their hemoglobin A1c was over 9. If someone's being proactive with their diet and their lifestyle, so they've gone low carb, they increase the fats in their diet, they're not snacking, they're following a restricted eating protocol – we usually leave them off of metformin.

And we don't actually find it helps a lot with weight loss. A lot of our patients come into the clinic with lower hemoglobin A1c of 6.4, 7.1, and their doctors have told them that metformin will help them lose weight. I've never in 20 years have seen metformin help a patient actually lose weight, and the research out there on that is not very compelling. It's not really great quality research studies to go by. So when someone's blood sugar levels are excessively high… For us there's a certain range that we like to cap our patients under when they're being proactive with their lifestyle, because we do see their blood sugar levels drop really quickly. Cut out the carbs, stop snacking, stop eating late at night, skip breakfast. We see people's blood sugar levels drop by anywhere from 25% to 50% within two weeks, so we really don't engage in metformin until someone's blood sugar level’s over 180 or until their hemoglobin A1c is over 9 in our clinic.

Allan (16:01): Okay. And that's because at those levels now, this is dangerous to the brain and its function, because it needs the blood sugars in a fairly tight range and you're well outside that range at this point. So, a drastic measure like a medication actually does make some sense. And when they make the lifestyle changes, I'm guessing they start to come off the metformin as well.

Megan Ramos (16:23): Very much so. Usually most people who are just on metformin when they start can be off of it within a couple of months of being very proactive and consistent with their dietary changes. When the blood is so concentrated with sugar… Sugar is very pointy, it's spiky, it's like a little ball of spikes. And as it goes through your circulatory system, it has the potential to really scrape and scratch the sides of your blood vessels. When you lose integrity in your blood vessels, you prevent them from being able to expand and contract when they needed to, to allow more blood flow at certain times. So they can no longer expand, and this is where you run into a lot of difficulties. It's okay to have some spiky little balls of sugar go around in your circulatory system, but when you have so much and the blood is so concentrated with it, you can guarantee that your blood vessels are being scratched to heck. At that point when they can no longer expand the way they need to, then you're going to run into a lot of problems and have blockages and put yourself at high risk for stroke.

Allan (17:40): Yeah. Everybody loves simple rules. You can say something like calories in, calories out, step on the scale. It's a very easy number for us to use, and I think people love those simple things. But what I found is a lot of the times simple doesn't actually answer the whole thing. One of the cool things is you've taken the time to write basically three rules, and then there’s a fourth add-on to it, that are fairly simple. They're simple on the outside, but when you actually start drilling into them, it’s very important. In fact, for many of us it’s a huge life change to do some of these things. But I liked the idea that they're simple enough for you to know what the rule is, and then you can start applying it. The first rule that you have in here, and this is for reversing type 2 diabetes, is to avoid fructose.

Megan Ramos (18:39): Absolutely. So fructose doesn't go into your bloodstream. When you check your blood glucose levels, you're checking your blood glucose levels. You're not checking your blood fructose levels. So when you break out your glucometer, you're not measuring fructose. Fructose gets directly imported to your liver. If you give your liver a little bit of fructose, your liver can handle it, and it will process it and utilize it for energy. But when you dump a massive amount of fructose in your liver, it gets overwhelmed by it. And how it copes with that onslaught of fructose is to pump it out as fat and convert it to fat instantaneously. And when it gets so overwhelmed, that fat gets stuck in the liver, because the liver can't process it as effectively as it needs to. So that is the number one cause for fatty liver disease, is excessive fructose.

I was diagnosed at the age of 12 with fatty liver disease and I can tell you that was from excessive apple juice consumption during the first 12 years of my life on this planet. And I was a skinny kid. I was underweight until I was 26, and then I went from skinny fat to just plain out fat at 26. But it's just fructose; it really doesn't reflect in your bloodstream. This is why when you look at the glucose index, you'll see something like a popular mainstream chocolate bar is considered to be moderate, and that's because the sugar that we use is half fructose and have glucose. So if you look at the glucose index, you'll see something like a popular chocolate bar being considered moderately okay. Where something like a slice of bread is one of the top things, being the food most likely to raise your blood glucose levels. The sugar in bread is all glucose, but that in fruits and things like chocolate bars – those are all half fructose and half glucose, so you're only actually seeing half of the sugar that you're consuming with those items when you're checking your blood glucose levels. So fructose goes straight to your liver, it overwhelms your liver, it becomes fat instantaneously, and if it becomes so overwhelmed with fructose, you start to develop fat in the liver as well.

Allan (21:06): We're getting most of this fructose now from soft drinks, and it's a food additive now because it’s very cheap to get from corn, so they have the high fructose corn syrup that they use to sweeten just about everything that's processed. That's where we're getting a lot of this, and from the fruit juices, as you mentioned. This isn't to cry against fruit; there's a lot of nutritional benefits to having some fruit in your diet, but you shouldn't drink those calories as a form of juice, because then you're not getting the fiber and the other things you would be getting from that fruit. Rule number two is to reduce refined carbohydrates and enjoy natural fats. And I like that term, “natural fats” a lot, because I think that's been the struggle. We say “good fats” and “bad fats”, people want to try to define those in different ways. But I like the term “natural fats” because at that point it's very clear what it is. This is from a plant or an animal product and it's something that's naturally occurring. It's not something that you have to squeeze or process to make this thing happen. It’s just there. Can you talk a little bit about how eliminating refined carbohydrates and focusing on natural fats is going to help us?

Megan Ramos (22:25): Absolutely. When you consume carbohydrates, your body has to produce insulin to help you utilize the energy from those carbohydrates. Carbohydrates are large bunches of sugar molecules, primarily glucose. When we can consume a carbohydrate from our mouth, and then continuing down into our small intestine the carbohydrate is broken down into its individual sugar molecules, or glucose molecules, and they're released into the blood. In order for those glucose molecules to get into our cells, they need to be guided there by insulin. You need to have insulin latch onto the glucose and take it to the cell because the insulin molecule knows which cells need the glucose, and the insulin molecules have the key to enable the glucose to get into the cell, so the cell can gobble it up and utilize it for energy.

Our bodies only need so much energy, Allan. We don't need to be eating and constantly refilling our fuel tank, and this is what we do in society. We eat multiple times throughout the day, we're eating refined carbs, we're trying to bombard and completely overwhelm ourselves with energy, and our cells don't utilize this energy. So we have all this insulin and all this glucose hanging around, and then the insulin essentially packages the excess glucose that your cell doesn't need and stores it as body fat to be utilized later. So insulin is a fat-trapping hormone in a sense. Its purpose is to trap this excess sugar and store it for us to utilize later when our cells need it. We’re constantly feeding our bodies nowadays, so we're constantly storing excess sugar energy with insulin’s help, rather than going back and burning what's already been stored and saved to be utilized later on.

When you consume dietary fat though, you get very little insulin secretion. So a fat molecule is a bunch of fatty acids attached to a glycerol backbone. When you consume fat and you're digesting fat, your body doesn't actually need to produce any insulin or any fat-trapping hormones to help your body break down the fatty acids to be able to utilize those for fuel in the body. You do require a little bit of insulin to metabolize that backbone of the fatty acid molecule, but you don't need a whole lot of insulin to be able to get rid of that glycerol backbone. So it's negligible. When you consume fat, you produce zero fat-trapping hormones. There are other fat-trapping hormones – estrogen and cortisol. You don't produce those when you consume fat.

Another thing about fat is that it's absolutely the most satiating macronutrient that we have. When you consume fat, it sends a powerful and rapid response to your brain that you're being fed all this energy. You can actually get satiated off of eating fat before your belly starts to expand. Whereas when you eat carbohydrates, the message that's being sent from the stomach to the brain is very slow. When you eat carbohydrates, you have to wait until your belly is fully expanded, and once that expansion has occurred, that's when your brain starts to receive faster messages saying that you're full. So you get quite bloated and you end up overeating when you eat carbohydrates, because you have to wait for that belly expansion to occur before your brain gets the message that you need to stop eating. You don't need that for fat, so people actually end up eating only what they need when they're eating primarily natural fats. So you don't end up bloated, you finish eating and you're quite satiated before you have to undo that belt notch and undo the button on your pants. That's one of the other great things about eating fat. We tend to just eat the fat that our bodies actually need at the time for energy. We tend not to overeat it because of that rapid messaging that occurs when we consume fat, to our brain, telling us to turn off our hunger.

Allan (27:02): I think another thing when you are eating high fat, low carb, is that you're not as hungry as often, whereas with carbohydrates and sugar, if you have a high carbohydrate breakfast, they now have a term called “second breakfast” that's become very popular. The fast food restaurants are latching onto that by serving breakfast foods later in the day, because they're high carb and it gets people eating another breakfast fairly soon after they ate the one they just ate. It’s insane, but it is what it is. I can't blame McDonald's for wanting to make that money if people are going to take them up on it. The third rule of these three rules and the plus, is actually my favorite, and it's because it's a very simple thing that I think if people wrap their heads around, they're like, “Yeah, that actually does make a lot of sense.” And it is, just eat real food.

Megan Ramos (28:00): Absolutely. A lot of our patients live on government assistance. They're in bad shape. They're given $700 a month to live off of. I can't imagine that, because of the cost of living in Toronto. That’s what I pay to rent two parking spaces a month downtown Toronto. So the fact that they have to pay for all of their expenses with that, it’s astounding to me that they can live off of that. So sometimes buying all these fancier food items that are labeled “ketogenic friendly” or have different stamps of approval on them from for low carb, aren't possible. But eating real food is the most important thing. If you can only afford to eat legumes and lentils because they're more economical, at least they're real food. So really trying to utilize this real food to keep away from the refined carbohydrates, preventing your blood from having this rush of glucose and this insulin surge and really damaging the connection between insulin and your cells in the body.

Allan (29:14): It's one of the strangest things, when I really started getting into food and understanding the foods that I should be eating versus not eating – I go to the farmer's market and I buy a stake. And it's a one-pound steak, which is normally what I would have eaten. That would be my dinner, a one-pound steak. But I get this grass-fed beef and I find that I only need about a quarter of it and then I’m full, because my body's getting the nutrition it needs, it's getting high quality fat, natural fat. So I feel satiated with actually less food, because it's a higher quality product. I know it can seem expensive when you start pricing out what these are, but there are two things that are going to happen here if you can do this, and do this more often than not.

One is, you're going to find that you get satiated by whole food, real food, much faster because you're getting the nutrition your body needs, and then two, if we're out there buying this stuff, the supermarkets are going to start trying to carry it more and more. And you're seeing that now – you can go into the Walmart supermarkets here and you can find higher quality meats, grass-fed meats and local meats in some cases, because they're trying to cater to what the demand is. So just adding one or two of these high quality meals and trying to stay away from the processed stuff I think is going to mean a world of difference.

Megan Ramos (30:46): I agree. The more of us that do it are going to put a lot of pressure on these big corporate organizations to be able to charge this at an affordable price. In Canada, we're a little bit slow on this. Costco every now and then is a bit better, but I've noticed a huge improvement in the States. My husband's American and every year we go down to Florida for a few weeks at some point to visit with his family. It's amazing how in some of the supermarkets down there like Publix, they actually have pretty affordable grass-fed beef and hormone-free, antibiotic-free free range chicken. It's cool to me now that you can see that even at regular chain supermarkets within the United States. It's really neat.

Allan (31:34): Yeah, and that's what I'm saying, I think they're getting on board and realizing there's a demand for this. As we create that demand, we're going to drive these stores to start carrying that type of food. Invariably they compete with the other stores. There's, like you said, Publix here, there's Winn-Dixie and there's the Walmart market. They're all within two miles of each other, so they've got to push for your business and that's going to drive the price down. So again, just eat real food. These three rules will work for the vast majority of us that have walked into your doctor and the doctor's like, “Your A1c, you're prediabetic”, and you're like, “Okay, what do I do?” These three rules are going to work for quite a few of us. But you get patients because of it being a kidney issue – they're typically a good bit further down the line of this, so some of the strategies, some of the things that you have to do go above and beyond these three rules. That's where we get to talking about fasting, both intermittent and in some cases extended fasting. Can you talk a little bit about fasting as a protocol? How someone should go about this and what they should look for, as far as how to do it and the benefits they're going to get from fasting?

Megan Ramos (32:51): In terms of how to do it, it's always very important to have physician supervision or have a nurse practitioner watching over you while you do this, because like I said earlier, we see really rapid reductions in blood glucose levels. We also see very rapid improvement with blood pressure too, even in our kidney patients. Kidneys control blood pressure, so usually when there's so much kidney damage, we can't do anything about blood pressure. But we even see huge improvements with our patients as they start to lose weight, as their blood sugar levels start to come down, with their blood pressure, and so patients will feel very dizzy and unwell. So always have physician supervision, have someone monitoring your meds, go to your doctor if you don't feel well, stop fasting if you don't feel well. You can always start again once your medications have been adjusted. But the best thing to do is just to start off slowly.

So if I have a patient who comes into the clinic who's quite nervous about fasting but has done some research and does understand that there are benefits to fasting, such as weight loss and blood sugar reduction, blood pressure reduction, less medications across the board, improved lipid panels. They want to do it, but they're frightened to do it or they're just someone who's always eaten. When I was diagnosed with diabetes, I probably ate every two hours that I was awake for about 27 years. So the idea of not eating for an entire day… It was just habitual, constantly eating. I ate 30 cups of popcorn every night for probably a good 25 years to satiate myself after dinner time. And it's just habit. You go to make it whether or not you actually feel like you need it. So there are habits that need to be adjusted too, and those definitely take a lot of time.

The first step that we have a patient do is we encourage them to eat real meals. Eat a proper sized breakfast, eat until you feel satiated. Eat a proper sized lunch; again, eat until you feel satiated. We really encourage our patients to start fasting between meals. Sometimes going from breakfast to lunch and lunch to dinner, and then from dinner to breakfast the next morning – that's a huge change for them. Women in particular are terrified of feeling full, because we have chronically followed these low calorie diets that are very low fat and very high carb and if we ever ate to satiation, that meant that we overate and that we didn't lose weight, and that we rather gained weight. A lot of women in particular have been conditioned to think that when they feel satiated, that's counterproductive.

I was one of those women. It took me years and actually seeing that in other patients to realize that was a big part of my own struggle too, was that if you ate a proper meal and you ate until you're satiated, that you had failed because you were going to gain weight. And in the past on a high carb, low fat diet, that's absolutely true. That’s not the case on a low carb, high fat diet. It's quite different in how your body produces these hormones when you consume these macronutrients. When you eat back to satiation, you don't overeat, you don't produce fat-stimulating or fat-trapping hormones – you're in the clear, you're perfectly safe. You’re just going to give your body the adequate amount of fuel that it needs. That's really difficult for women.

So first thing we do is try to teach our patients how to eat proper meals and eat until they're full, and just cut out all snacking. Sometimes that's still really hard for them, so we'll first work on cutting out evening snacking. And that's the biggest vice for everyone we work with, is that evening snacking, sitting around the television with your family or going on the computer and surfing the Internet and having your bag of snacks or your bowl of snacks with you. So the first thing to do is to cut out snacking. Then the next thing that we recommend is that people try cutting out one meal and going down to two meals a day. We usually encourage people to cut out breakfast first, because diabetics will know that no matter what they do, their morning blood sugar levels are always the highest, unless they take a lot of long-acting insulin at night time or a medication such as Diamicron or Glyburide in the evening time, which stimulates a lot of insulin to be produced and secreted by the pancreas throughout the night.

But otherwise, if we're not taking these medications in the evening, our blood sugar levels are high regardless of what we eat in the evening before. So we encourage our patients initially to try cutting out breakfast. At breakfast time our blood sugar levels are high, as a result our insulin levels are high and this is because your liver tries to dump out extra sugar and tries to get you to burn it in the morning time. It's a survival mechanism. You've got excess sugar in you, your body needs to burn it. It will dump it out in the morning time, because historically we never ate in the morning time. In cavemen days they didn't have cavemen cupboards or cavemen refrigerators.

Allan (38:16): Or microwaves.

Megan Ramos (38:18): Exactly. We've evolved to have this process where our body self-fuels in the morning time anyways. When your liver dumps out the sugar in the morning, your pancreas automatically secretes insulin first thing to help your body metabolize and utilizes glucose to fuel you. So your glucose is already higher, insulin is already high, so burn it out, use that fuel. If my car has a completely full tank of gas in the morning, I’m not going to go to the gas station and try to squeeze in more fuel. My gas tank doesn't need any more fuel; it's completely full. It's better that I drive to work in the morning time and do my errands, and then later on in the day when my fuel tank is no longer full to add some fuel to it.

So that's what we encourage patients to do next, once they've sort of mastered the eliminating snacking and eating proper meals, is just to cut out one meal and then see how they're feeling, see how their bodies respond. Usually by this point we can gauge whether or not they're going to be a quick case or a more challenging case. It's hard to predict because there are some people with very stubborn insulin resistance who were only diagnosed with diabetes a few months ago, and there are some people who are actually quite quick to respond to therapeutic fasting, even though they were diagnosed with diabetes before I was even born. So we gauge this. We use the 16/8 diet, which is where you just eat lunch and dinner, we gauge how well a patient will respond. From there we would either recommend an intermittent fasting regimen or a prolonged period of fasting. Of course that depends on the patients, how they're feeling about fasting – if they've decided to develop a good relationship with it, if they're willing to try to do a little bit more.

If someone looks like they're going to respond quite well to fasting and they're going to be able to come off their medications quite quickly and see a good reduction in weight loss in a short period of time, we would have them do an intermittent fasting regimen anywhere from three 24-hour fasts a week to three 42-hour fasts a week. So, the therapeutic intermittent fasting regimens we recommend are 24 hours, 36 hours or 42 hours. And the frequency at which we like our patients to do them is three times a week. We've experimented; three times a week gives us the best overall results. Sometimes twice a week is just not enough to give us consistent results or give the patients enough results that really motivates them to continue fasting. But three times a week seems to compensate for any blemishes they might have in their diets on the weekends or when they eat out on Friday nights. So we have stuck to this three-time-a-week rule for the last five years and we've had a lot of success with it. So we start someone out with 24 hours with the goal of working them up to doing a 42-hour fast three times a week if they're suitable to do so. We'll keep them there until they start to hit normal blood sugar ranges, normal fasting insulin levels and normal A1c. Then we start to bring them down into more of a maintenance range.

If someone looks like they're going to be more of a stubborn case in terms of losing body fat or reducing their blood glucose levels, we’ll try to work on more prolonged periods of fasting with them. This could be anywhere from doing two 48-hour fasts a week or a 72-hour fast a week to sometimes doing five to seven days. We usually cap patients at 14 days within our clinic. The odd time we have a patient that will surpass 14 days. Usually at that point we're checking their bloodwork once or twice a week, we're seeing them in clinic twice a week. So we get to know them pretty well in a short period of time. We just had one gentleman, I saw him last Thursday and he was on day 26 of a fast. And his A1c had come down from 13 to about 11, and his blood sugar levels in millimoles per liter were 14 when he started and he had finally broken the double digit barrier. So after 26 days of fasting his sugars dropped to 9. That's just a little bit below 180, I believe. So sugars were still that high and he was actually taking a little bit of insulin still. I joke with him and I say he's the sweetest man I've ever worked with, because his body is just full of sugar. And he's quite slender; it's all in his organs. It's all visceral fat.

Allan (43:15): I think there's a couple of key things here. One, this is not a protocol that you just up and do yourself. You work with your physician, because if you're on certain medications, those medications will very likely have to be adjusted at some point in there and you don't want to be in a situation where you've done something and your physician's not available to know that you're doing that, to guide you through that process. So, it is important to involve your physician. Then the other question I had was, as you're putting them into these fasting protocols, is this just them drinking water, are they taking any kind of electrolytes? I know some folks have used bone broth while they're on a fast. What is the protocol you're using most with your clients?

Megan Ramos (44:01): For people who are just looking to lose weight and for those who are trying to combat metabolic syndrome, diabetes and obesity – we do permit them to utilize bone broth – not unlimited quantities of it. If they're doing a 24-hour fast or even less, like 16 or 18 hours of fasting, we usually ask them to try to do the fast with just water, if they can. Usually bone broth we would recommend to someone who's doing 36 hours of fasting or longer, and no more than about one or two cups a day at most. We definitely recommend bone broth once a day for our patients who are doing longer than three days of fasting. That's sort of a guideline. Sometimes our patients choose to ignore us, but we make them sign a form saying they're ignoring us. The purpose for that is to prevent refeeding syndrome and to make sure that they are getting in phosphorus and magnesium and calcium when they're fasting.

But for shorter fasts, it's not much of a concern. Most of us nowadays, especially us who are obese and who are combating diabetes – we're not malnourished. We have too much excess body fat, we’re too nourished – that's why we’re struggling. For most of our patients with metabolic syndrome, we do recommend a bit of bone broth. We do let our patients have about three to six cups of coffee a day if they don't experience a glucose spike from drinking coffee. Some of our patients do, even with decaffeinated coffee, it's very bizarre. But I'd say most of our patients can consume coffee. About 10%-20% of them have quite a large glucose spike, so we'll take them off of coffee. They're allowed to drink herbal tea and water – flat water, mineral water or carbonated water. So that's what we use for metabolic syndrome.

We do treat patients with various neurological conditions and some cancer patients, and for them we focus on shorter bursts of water-only fasts. We don't do longer fasts with these patients, because we're trying to induce autophagy in these patients to help kill cancer cells and repair their mitochondrial function. We need to have some nutrient deprivation in order to induce that. We don't know if too much autophagy, too much of the cellular regeneration is a bad thing, so we do these shorter bursts of water-only fasts. And another reason why we keep them short is to, again, prevent refeeding syndrome in cancer patients. A lot of these cancer patients have already lost a substantial amount of weight and they're not as hungry, and there's lots of nausea associated with chemotherapy treatments as well. We try to keep them short, so there's lots of refeeding in between each round of fasting, just to prevent any issues when they are fasting.

Allan (47:06): Okay. Again, the book is called The Diabetes Code. I learned so much, and I do every time I read one of Dr. Fung’s and your books. It's fascinating, the tidbits here. But I think if people do follow those three basic rules… And whether you have diabetes or not, they're still really important rules for you to function by, so that you keep from getting diabetes with our current food supply. Eating real food, avoiding the processed stuff and cutting out fructose, particularly in your drinks, like apple juice, like you said, and sodas. If someone wanted to learn more about you, learn more about the book, where would you like for me to send them?

Megan Ramos (47:50): People can check us out and learn more about Dr. Fung and myself and all the work that we're doing up here in Toronto on our website. Our website is IDMProgram.com. There's information about our podcast, our books (The Diabetes Code,  The Obesity Code, and The Complete Guide to Fasting, where you can get more information, what we're doing, clinic-recommended resources, as well as our program and how our program works, up on our website. And there's links to following both Dr. Fung and myself and the rest of our team on various social media platforms, like Facebook and Instagram and Twitter, up on IDMProgram.com as well.

Allan (48:29): Okay, cool. This is episode 321, so you can go to 40PlusFitnessPodcast.com/321, and I'll be sure to have a link there. Megan, thank you so much for being a part of 40+ Fitness.

Megan Ramos (48:42): Thanks for having me on, Allan. It's great to talk diabetes code with you.

Allan (48:46): Absolutely, thank you.

 

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Easy keto with Carolyn Ketchum

One of the biggest struggles people have with sticking with an eating plan is the effort it takes to cook meals.  In her book, Easy Keto Dinners, Carolyn Ketchum gives us some great tips and recipes to make eating ketogenic much easier.

Allan (03:42): Caroline, welcome to 40+ Fitness.

Carolyn (03:45): Thank you. Allan. How are you?

Allan (03:46): I'm doing very, very well. Your book is Easy Keto Dinners. This is going to be really cool because it's hard to be prepared. It's hard to always be cooking and even though we can do certain things like batch cooking, or just keep things very simple, like a steak and Broccoli. Some nights it is a struggle.  You've put together a cookbook that makes some of our favorite meals available to us in a fairly easy way.  Can you explain the concept of easy for us a little bit?

Carolyn (04:29): Yeah. It's interesting. A lot of people ask, does this mean everything's under 30 minutes and I can make it quickly? Well, yes and no. There are plenty of easy fast recipes in the book and then there are plenty of easy, slow recipes in the book because sometimes if you have a 30 minute meal, that means that you're staying ending. They're chopping and cooking and sorting and doing everything, you know, standing there for 30 minutes actually working. And then there's recipes where it takes you 10 minutes of prep time and you throw everything in a pot or a slow cooker and you walk away and you know, a couple, three or four hours or up to eight hours and then it's done, but you're not actually cooking the whole time. So my concept of easy is just, it's really the minimal prep time and the minimal work and the minimal sort of having to create everything yourself.

Allan (05:17): Yeah. Some of the recipes are so simple and they are very quick. Some of these you'll have done in almost no time. Others, you are going to spend a little time on the prep and then you're setting it free and you can go about your life. You're not right there. It's a good mix of both. Do you mind if we take a step back a little bit and talk about why you're writing keto cookbooks?

Carolyn (05:51): Well, yes. I have not ever had weight to lose. That's lucky me. A lot of people come to keto for weight loss. But I had gestational diabetes at ease with my third child and after she was born it seemed to go away. All my blood tests seem to be saying I was good to go. I kept testing every so often. I started to see the numbers creep back up and I got concerned. I went to my doctor and we agreed that I had prediabetes and needed to do something about it. I did my research. Very few people in the medical world are actually suggesting low carb, although it's becoming more and more common. Thank goodness.  I decided after doing some research and having known when I had gestational diabetes how much work it took to keep my blood sugar under control when I was on a standard American diet. I just knew something had to change. So I just started cooking and baking low carb.

Allan (06:58): Even though I eat keto most of the year. That's not something that I really try to push on anybody else because I don't want to be that guy. It's funny. Not Funny. It's actually kind of sad. My sister and I were having a conversation this morning about her having the same issue. She had gestational diabetes and then after her third child, she now has to be very careful. She'll notice her blood sugar going way, way up. I don't think she's as diligent at checking it and managing it and doing those things.  At least this week when I'm feeding her, she's gonna be eating low carb

Carolyn (07:40): Good. And maybe she'll see. I think the thing for me and the reason I write cookbooks and write a blog is I've fallen in love with this lifestyle, but it took awhile. When I decided I had to go low carb and gluten-free. I basically sat on my kitchen floor and cried because I'd always been a passionate baker and I thought that was over for me. I've discovered it's not, which is fabulous. I've discovered there are so many wonderful ways to cook and eat and be keto. I think people are very much afraid of it and I understand why. Because I'm going to have to give up all my favorites, but you're not going to have to. You're just going to have to make them in a very different way. And sometimes you do have to change your taste, but it does happen. And then you start to love it. Why would I ever do anything else?

Allan (08:27): My wife was getting into it. She was doing the shopping on Saturday. I took a picture of your cookbook, the ingredients list, and I told her to get these things. One of the recipes I sent her was for the cheesy biscuits that I planned to make for breakfast this morning. When I went up in the pantry, started looking around like, there's no coconut flour.  She didn't get it. She thought we had some.  No.  I said, and you don't get any cheesy biscuits. No cheesy biscuits for you. But I will probably go shopping this afternoon and buy some coconut flour so she can have cheesy biscuits tomorrow.

As you get into these things and you start learning more and more about the kind of recipes and stuff that's out there, you do realize there are adaptations. It's not as convenient as going to the grocery store. And the freezer section and there being a whole keto section. Paleo kind of took off and now there's that. They advertise that they're Paleo dishes and that's wonderful. There aren't that many low carb stuff convenience foods. There are diabetic sections and stuff where they'll have the candies and the other stuff. But now we're using real whole food and prepping it ourselves. This is really cool because you've, you've made it really easy.

Can you give us some tips? For me, it's always been batch cooking. That way you're getting a lot of value out of the amount of time you're investing. I could see taking some of these recipes, adapting them times four, times five and putting those away. Can you kind of give us some of your tips on how to have an efficient and effective kitchen?

Carolyn (10:31): Yeah, I have a lot of tips. One of the things is you say batch cooking and I'm just not good at that. I never have been. I know it's a great way to do things and if I'm making something like Carnitas or pulled pork or that kind of thing, it always ends up being a whole bunch and then we put some in the freezer. That's great. It's just never been my style. Part of the reason is that I like a lot of variety. I don't want to have to eat the same thing within two days of each other. There are not a lot of keto convenience foods out there, but it's growing. But I would say be careful there because a lot of people are calling things keto and they have a lot of junk in them.

Be careful if you purchase some of those things. But one of the things for me is these days grocery stores are making things really easy on us so you don't have to make all your own bone broth. Maybe it's not quite the same. Maybe it's not quite as nutritious. But buying, Pacific Foods bone broth or a Whole Foods brand bone broth is going to save you a lot of time and energy. Things like we were talking about cauliflower rice earlier. The grocery stores are now putting out rice cauliflower, whether it's in the fresh section or the freezer section. I make a lot of my own tomato sauce. But then there are times when I've blown through my stash from the summer.  I go to the store and I check the labels to find the lowest carb one that I can.

So one of the things that I did in this book was a resource guide for store-bought options. You don't have to reinvent the wheel and make everything yourself. I think that that saves you a lot of time. Try prepping ahead sometimes if you know you're going to be having a busy week prepping things ahead, like cutting things up or you were saying cauliflower, you do sometimes just sort of sit there in front of the TV and rice your cauliflower. Sure. Why not? That's a great idea. And one of my favorite tips though is rotisserie chicken. Almost every grocery store has a rotisserie chicken section. You grab one and you can make easily two to three meals out of that. Or you can just cook your own chicken ahead and have it shredded and in the freezer and then you pop it into a recipe.

Allan (13:01): When I say batch cooking, it's not always dishes. I'm going to grill, you know, a lot of chicken quarters because I'm out on the grill cooking steak and then I'll grill a bunch of chicken. I'm doubling up on my time. And then another, another thing is if I, if I know I'm going to be making a crockpot meal that day when I get back from the grocery store or the farmer's market, I've got all fresh vegetables and fresh meat and as I'm unpacking, I'm washing, cutting and putting it in a crockpot rather than putting it in the refrigerator. So, by the time I finish unpacking my groceries, I've already got the meal started.

Carolyn (13:56): I think that's fabulous. If you have an instant pot you can do some of that stuff too. That's always fun. I'm getting used to mine and trying to do more recipes with it. When you talk about going to the farmer's market or the grocery store, you have to have a stocked pantry. I mean if your cupboard's bare and you come home from work and there's nothing to make, then even my recipes won't help you. You have to pick a day of the week where you go and you have your list of what I might probably make this week. It can change a little as you go and you have to stock things. Keeping some proteins in your freezer like ground beef and chicken thighs. I'm, I'm a fan of chicken thighs rather than chicken breasts personally. I think they have more flavor.  Just having them on hand, and even if you forget to take them out of the freezer, there are ways to quick thaw them.  There is a section on that in the book with tips like that to save you some time.

Allan (14:57): Yeah. It's really about having it all stocked.  In the future,  I will have coconut flour on hand to make those cheesy biscuits. I didn't have it and like you said, if you're missing that one ingredient, then you're now looking for option number two, which is probably the same thing you ate yesterday, that the eggs and bacon or the eggs and sausage. But that's unsatisfying when you want to change things up a little bit. Um, and you said yourself, you, you don't like to eat the same thing, so you like to change things up.

One of the things I like about the Easy Keto Dinners cookbook it has a lot of variety in flavors. Some of them are very interesting flavors and others I know have particular health benefits. Can you talk a little bit about what spices you're using in here, some of the reasons why you're using them, either from a pairing of flavors or a health benefits?

Carolyn (16:03): Well, I have a lovely large spice drawer that I keep pretty much totally stocked at all times. Another question that I get from people is, do these recipes have five ingredients or less? And I'm like, well, maybe if you don't count the spices, because I think, again, people confuse easy with fewer things and if you have a good spice cabinet, you've got tons of things in there to help flavor your foods. I like spicy stuff.

One of my favorite recipes in the book is the one pot jerk chicken and rice because I really love those jerk flavors. I faked it in this one because a real jerk seasoning a has brown sugar. We're not going to do that. It also has scotch bonnet peppers, which are hard to find and at any time of year. So I made it spicy without the Scotch bonnets. It's a dry rub too, whereas a real jerk seasoning mix would be sort of a wet paste. You can fake flavors and get really close to the real thing.

There's tons of health benefits to so many spices. I know turmeric fights inflammation, but you have to eat a lot of it to do that. It's flavor that gives us a sense of safety. So along with the fat from the keto diet, we need flavor for us to be like, wow, now I'm full. I don't need anymore. And I think knowing when we're full is part is one of the benefits of the keto diet.  Knowing when we're satiated and stopping.

Allan (17:55): Yeah. And I think that's another thing cooking, is you can be proud. I don't mean this in a bad way, but if you can take pride in the fact that you prepared a really good dish, even if it was easy, the fact that it tastes good and you really are enjoying it, you're probably going to slow down. You're going to make eating a lot more mindful, right? Which is going to make everybody's life better.

Carolyn (18:22): I learned that early in college. I remember being in my dorm and the food was so bad that everybody would eat a meal but they wouldn't feel full or they wouldn't feel satiated and they'd head to the convenience store afterwards and get chips and chocolate bars. I remember doing that too. And feeling like, wow, you know, food needs to have an impact on your taste buds for you to feel satiated.

Allan (18:45): Yeah.  You've got things in here like the chicken Parmesan casserole, spicy pork and cabbage stir-fry. So there's, there's variety and you've organized it based on the protein source a throughout the book.  Then you have a little guide at the back that's really cool because if you're wanting to manager your prep time, which ones are fast, which ones are slow.  It has a food allergy and sensitivity guide as well. It is great to have this little guide where you broke down to make it even easier to know what you're doing.

Carolyn (19:19): I made sure that 50 percent, it's a little more than 50 percent of the book is dairy free or can be made dairy free. And there aren't a lot of recipes with nuts in them. So if you're a nut allergy person then you're good to go with most of these recipes. I think that that's important too because somebody needs to know at a glance whether something's going to have something that they're intolerant to

Allan: (19:44): And you flag those. So it's very easy for us to go through and know which ones would impact us.

Then the other thing is, because a lot of a lot of recipe books don't do this, you actually have the breakdown of the macros. I think is very important for someone when they're first coming on to keto. They're trying to get their fat intake up to a certain level and keep their carbs low. You've put that together in a way where I know this is going to put me in the right macro profile for the day. I'm maintaining my ketosis.

Carolyn (20:24): I think everybody needs that. I calculate them all myself on a program that I have downloaded on my computer. It's a paid program. So it's not like My Fitness Pal.  My Fitness Pal has tons of errors because it's user inputted data.  But even my paid software will have errors since it pulls from the USDA web database.  The problem is they are using averages. My chicken thighs weren't as big as the average chicken thigh. I get a lot of pasture raised chicken. My chicken thighs are not that big because they were not plumped up by all the grains. I had to do some hand calculating, which was exhausting.

Allan (21:11): I built a spreadsheet when I first started going keto.  When I would cook a Chili it would be without the beans. I would use about a third, maybe a half of the tomatoes I would have used otherwise to cut back a little bit. And I got a lot more meat in there and when I browned it I put all the fat back in there and even put some more fat in there. And so now based on everything I added, I'm like, I've got the calorie counts and they've got the macros of all of the ingredients.  I added them up and divided to make a serving around 500 calories.  How many servings does this make? And man, that spreadsheet was like the banking records for GE,

Carolyn (21:55): I kind of find the math a little fun. And sometimes I would go, whoa, that's way too much protein for this recipe. And I would have to dig and do some research and figure out. Because in my database it will also have, you know, five different chicken thighs in there, based on like whether the bone isn't it or whether the skin is still on or whether it was enhanced (the step where they shoot it up making them look plumper and juicier). I had to find the right one that was more like my chicken breasts. I feel obligated to say that all of those are provided as a courtesy. But if somebody is very, very specific, then they should probably be doing their own calculations because as, like I said, things are pulling from averages and it's very hard to do. And if you're very specific and you weigh everything. I know a lot of people when they first start keto, they're weighing everything they eat. Then they should probably try to calculate it a little bit themselves.

Allan (23:06): Yeah. Once you get comfortable with the way that you're preparing your dishes it actually gets easier and easier. The higher the quality of the food, That's again, that's another reason why I'm such a big proponent of cooking for yourself.  You know what you're putting in your body and your family's bodies.  The food we eat is health. If we're not doing food right, then we're not taking care of ourselves.

Carolyn (23:43): That's why I say to a lot of people, beware the keto products, because there have been several instances recently where companies have been accused of erroneous nutrition labels.  They overstate the amount of carbs.  And they'll call themselves keto.  I would have rather make that cookie myself than have bought your cookie and possibly put myself out of ketosis having done so. Even when the supermarket has the keto section, which they eventually will, because the tide is turning, I feel like you're going to have to read the label and be smart about it.

Allan (24:23): Yeah, absolutely. So the book is Easy Keto Dinners. If someone wanted to learn more about you, get to your blog or learn more about this book or your other books, where would you like for me to send them?

Carolyn (24:35): All Day I Dream About Food is my blog because I really do dream about food all day and I enjoy doing that. I also have a second cookbook, which is my first cookbook and the Everyday Ketogenic Kitchen, which is a more lengthy cookbook that covers everything from breakfast to dessert.  It also has sort of my story a little more and how keto works and things like that. That's a great resource and Easy Keto Dinners is almost like a companion guide. You're adding more dinner recipes to your repertoire.

Allan (25:07): Absolutely. This is going to be episode 318. You could go to 40plusfitnesspodcast.com/318, and I'll have the links there. Carolyn, thank you so much for being a part of 40 plus fitness.

Carolyn (25:20): Thank you. It was wonderful to talk to you.

Allan (25:29): If you're enjoying the 40+ Fitness Podcast, would you please go out to itunes and leave us a rating and review. Go to 40plusfitnesspodcast.com/review. That will take you the itunes page and you can leave us a rating and review right there. Thank you.

 

Another episode you may enjoy

Keto comfort foods with Maria Emmerich

Keto Cure with Dr. Adam Nally

Dr Adam Nally, aka Doc Muscles, collaborated with Jimmy Moore and Maria Emmerich to write the book KetoCure – A Low-Carb, High-Fat Dietary Solution to Heal Your Body & Optimize Your Health. This book takes Dr Nally's 18 years of medical experience and nearly 14 years living a keto lifestyle and presents a way for you to take control of your healthy using ketosis.

Sponsor:  This episode of the 40+ Fitness Podcast is sponsored by Fresh-Pressed Olive Oil.  They are offering you a $39 bottle of their high quality, fresh-pressed olive oil for only $1.   Go to 40plusfitnesspodcast.com/oliveoil to learn more.

Allan (06:53): Dr. Nally, welcome to 40+ fitness.

Dr Adam Nally (06:56): Thank you. It's a pleasure to be here.

Allan (06:58): They call you Doc Muscles and you have a story. I think they should call you the Keto Cowboy because a lot of your pictures are you with your horse and living out there in Arizona and all that. And it's like, yeah, I think of you more as the Keto Cowboy than Doc Muscles. But you kind of have both of them going on. Could you take just a moment and talk about the story of how you became Doc Muscles?

Dr Adam Nally (07:23): Well, you know, it's kind of funny. In medical school, the one way I blew off steam was lifting weights and so I was in the gym. They had a gym that was part of our medical school that we could go and use anytime we want it to and so I found myself in the gym lifting weights. It's a lot because that was just what I enjoy doing. The one on one day I was in there with a couple of friends and the trainer you turned to me and said, hey, if you keep doing it will be the doctor of muscles. And so one of my buddies who would rather golf then lift weights, he said, “We'll just call your Doc Muscles.” And so it was a stupid, little off-the-cuff comment.

A few days later we actually had to pick a Twitter name and that was right as Twitter had been released and we were communicating via social media. I couldn't think of a handle, so I just used Doc Muscles and that's the handle that I've had for Twitter and Facebook. It really wasn't intentional. Other than that, that's where it came from. I've always enjoyed weightlifting and always enjoyed the process of gaining muscle, being fit and my fitness has waxed and waned through that through the years as you go through schooling and training and various things, but I've always gone back to the fact that that weightlifting has been one of the big things I've enjoyed.

For me, weightlifting is cathartic. Plus now over being over 40 and understanding sarcopenia, now it's not just fun. It's actually important. It's critical. There's nothing to blow off stress better than just throwing around weights. Well, I have to say riding my horses is the other one that I enjoy. It's actually quite enjoyable and we're finding that weights play a huge role in insulin resistance, which I'm sure we'll talk about later. And it helps with testosterone.

Allan: I read this a study not too long ago by a Harvard scientist. They went through their hypothesis and they did their study and they basically found that the low-carb high-fat diet performed better than the standard way that they want you to lose weight (complex carbs and low fat). They acknowledged the low-carb high-fat diet but concluded that's too hard to comply with, so you should do it our way. He's not wrong to an extent. When you first try to get into Ketosis, it can be quite difficult and challenging once you're there. It's well worth the effort, but it's that kind of that first several days, where they use the term Keto flu. I prefer to call it carb withdraws as your body learns how to do different fueling systems. Can you talk a little bit about that keto-adaptation and then some of the hacks that you have that will help us get through that process a little bit more effectively?

Dr Adam Nally (10:30): That's a perfect question. You know, it's interesting. I've been doing a keto lifestyle for about 13 1/2, almost 14 years. In the first five or six years, it was more low-carb. What we realized though is that to be in Ketosis, you have to be very, very low carb. And that means in many cases is it's less than 20 grams a day of carbohydrate. And that's where a lot of the other researchers who I think were probably raised on bread and pasta, will say that's too hard and nobody can give up bread and pasta.

Allan (11:07): You find that when you think about eliminating that from your diet, it can be some challenge. But when you actually feel as good as you feel when you achieve a ketogenic state and you start to see a dramatic improvement in all of the inflammation and the other things that occur. You feel fantastic. You don't want to go back. When you do cheat and you go out of Ketosis, you feel so bad. You'll ask, “why did I ever live this way?” It is a very sustainable lifestyle.

If you look at the standard American diet, the average plate on the American eats and probably other countries as well, 85 percent of what's on there is starch of some sort of some form of starch or carbohydrate or sugar and that, so our body gets used to those fuel types and amazingly the epigenetics forms around eating a certain way. Our genetics are designed to help us eat. We downregulate fat absorbing receptors in the gut and also in every cell in the body. They're called mct receptors and we downregulate those well when we start eating more fat and we shift to a keto diet, where we're decreasing the carbohydrate or increase in fat. Our bodies don't usually have as many receptors is that needs to absorb that fuel. So number one, you're not gonna absorb the fat as fast and so it takes a little time to get the fuel in. Number two, it takes weeks and sometimes a couple of months to upregulate enough for those receptors both at the gut and also in the cells to absorb that fat into the system and have it available as fuel.

And third, there is a conversion process in the liver that takes a little time in helping your body adapt to being able to convert the ketones even faster and that can take a little time, too. So there's this transition period of a couple of weeks to some people, a couple months where you may feel a little more fatigued. You may not have the energy or sustainability, but if you're an athlete, a lot of athletes will say, well, I felt more tired during this first two months period of time. I couldn't hit my race pace that I normally hit or I couldn't lift as hard as I thought it was lifting. And that's just because there's a problem with fuel as you're shifting over. So that's actually pretty normal.

A lot of the keto flu symptoms or that people get are not related to the adaptation period. They're actually related to dehydration or an inadequate salt intake or something. I haven't done a number of patients that come in and they just are afraid to eat 70 percent fat. There was tremendous fear and so instead of eating red meat or pork, they cut their carbs out and they keep eating chicken and they limit the fat. I have a few of them are still using that I Can't Believe It's Not Butter stuff or whatever that is. We want you to add the fat back in. So sometimes it's just you're not eating enough fat to bring your percentages up to 70 or 80 percent. It may that you're not taking in enough salt and that will be sodium, potassium, magnesium and zinc.

Then, as you mentioned, there's often a period of time where there is carb withdrawal. I have some patients that are so carb addicted, they'll actually get migraine headaches that kick in over that first week because of that carb addiction is so powerful. The fructose is converted to an aldehyde form in the liver that acts similarly to the morphine and actually stimulates a similar receptor in the brain that morphine does causing this, “Woah. I love that” kind of a feeling. And you have withdrawal from that. So those are the pieces that fall into that Keto flu or that adaptation period. You get fatigue and feeling groggy and lack of energy we often refer to as Keto flu, the adaptation period, depending on what, how and what your body's used to may take anywhere from a couple of weeks to a couple of months.

Allan (14:36): Now it's funny, the folks that sit there and say, you can't live without pasta or bread. They haven't met Maria Emmerich who is one of the coauthors on here and has a lot of recipes in the book. I made her actually did her braised duck with lemon thyme. I substituted with chicken and man, you know, that that's worth the price of the book right there. Just that recipe. She's so, she's so awesome. Jimmy Moore was also a coauthor on the book and he puts a lot of flavor on this from the perspective of someone who's really, really struggled. He's learned a lot over the years. He does his podcasts and so he's kind of one of the preeminent experts, along with yourself, on ketosis.

One of the things Jimmy really deals with, it's really kind of a huge, huge struggle for him, is insulin resistance. As we look at what is happening, and you even say it in the book several times, one of the core elements of the lifestyle diseases we get is our insulin levels. But if you are insulin resistance, using ketosis as a therapy is going to help you improve your health. Can you talk a little bit about insulin resistance and how ketosis can help us reverse some of those problems?

Dr Adam Nally (16:03): I've been in medical practice about 18 years in total, including residency and training. And the interesting thing I saw was these patterns that started arising in the first few years of my practice. People that would come in and they would have a little bit of weight gain, their blood pressure would start to creep up a little bit, their cholesterol starts to rise, and then they'd have gout or they'd have a kidney stone. Some of them have a little bit of neuropathy that occurs and they wouldn't be all at one time. They would have one of these or they'd have a couple of these things arise. And then I would notice their fasting blood sugar was just slightly high, and then a few years down the road and we'd all have a sudden see that they gained a little more weight, their blood pressure is creeping up and we were adding a few more blood pressure pills, an extra statin, and drug here and there. Women were coming in to see me saying, I am gaining weight, my periods are irregular, I'm having trouble getting pregnant, or various things like that.

So there were these patterns that kept occurring over and over and over again. And if you look back in the literature, these things didn't really show up in the early 1900s and late 1800s. They weren't there, but they started in the early 40s and 50s and 60s and then became predominant through the 70s and 80s. As you're looking at these patterns, you see these things repetitively over and over as you go through door number one and door number two in my office. It got to be quite fascinating. So in trying to understand me, I was struggling the same thing. If you meet my clan, many of the Nally's are 300 – 400 pounds. My father was almost 400 pounds when he died. If you look at his labs and my labs, they're almost identical in the early thirties and I was really worried that my father progressed to type 2 diabetes and was eventually on 150 units of insulin, 32 pills and dialysis. He ended up having a heart attack. I was looking down the same road. That bothered me and it bothered me that I was seeing it and I was doing what I was taught to do in school.

Yet it wasn't changing and my patients were doing what I was asking them to do, but it wasn't changing and we kept adding pills every year. That was very bothersome. What I started to notice was his insulin level. I would check it periodically. It would creep up and I started noticing that his insulin load was higher and higher. One of the things that I was trying to identify as is there another marker that we can use to catch diabetes earlier. One of the things I saw was triglyceride levels jump. We know that insulin directly stimulates triglycerides. If your triglycerides start to rise, what that basically says this, your insulin load was high in the last 24 hours, and so I started looking at patterns of insulin. What we found and what I've found in the literature is that 10 to 15, sometimes 20 years before you ever become a type 2 diabetic, your insulin levels will start to be high and those high insulin levels will create one of six patterns:

1. Weight gain,
2. high cholesterol,
3. Elevated blood pressure,
4. Infertility issues in women,
5. Polycystic ovarian disease, and
6. Thyroid changes.

All of these are patterns of the way the body's handling this excessive insulin load.

We know that from the perspective of weight gain, there are over 32 hormones that drive weight gain itself, but insulin seems to be the master hormone. So if your insulin's off, it throws the rest of these hormones out of whack and your body may use different patterns to try to accommodate that. With a high insulin load and based on your genetics, insulin resistance starts to identify itself.

Insulin resistance is a problem with many of the, what I call diseases of civilization. So high blood pressure, diabetes, weight gain, Gout, and kidney stones. These are all diseases that we didn't see much of before the 1900s. And all of a sudden we do. I started noticing is that about 85 percent of the people that walk through my doors had high insulin levels 10 to 15 years before we ever diagnosed them as diabetics. They were overproducing insulin in response to the sugar, the starch they eat.

If you give me a piece of bread, theoretically I should produce a slight sort of insulin for that piece of bread. But if you check my insulin when I eat that piece of bread, I'll produce 10 times the insulin in response to that bread. And that insulin acts like a worn away key. It doesn't quite get the cell open very effectively. So the body produces more of it. You have now 10 times the insulin floating around your body doing the job that one key was supposed to do.  Those 10 keys also stimulate other processes in the body that shouldn't have been stimulated by that one piece of bread.

Allan (20:30): I really enjoyed that metaphor that you had in the book where you talked about a worn key and how much additional effort it has to go on to actually open the lock. You're turning that key and if it were the way it was supposed to be, one key goes in and just does it, but our body doesn't react that way if we have this propensity to have more insulin in our system.

Insulin is not a bad thing.  You even say that in a book. It's actually a good thing because it's there to protect our brain by keeping our blood sugar levels at the level they're supposed to be, but we're just a little out of whack if we're going to get these surges of blood sugar and whatnot.

So the standard American diet (SAD) way of eating a is literally going to continue to take you down that sick path. I appreciate that you, you mentioned a lot of those diseases PCOS, heart disease, type 2 diabetes, weight gain, all those different things. I want to talk about a couple of them that are going to really hit home.

This was the first time I'd ever really seen anyone tie hypertension to this whole situation and how ketosis could help hypertension. Could you talk about that a little bit?

Dr Adam Nally (21:44): Well, it shocked me. I started applying the low-carb keto lifestyle and I noticed it helped me with my weight. So I said, well, let's try this with my patients and see what happens. We started measuring blood values and monitoring people's biometrics and seeing how they're doing. The amazing thing that I saw was that when people actually lowered their carbs got into ketosis within about two weeks, their blood pressure normalized. One of my patients was on three blood pressure medicines. All of a sudden he called me up and said, hey, I'm dizzy, I'm light-headed, what's going on? And so when we check their blood pressure and his medicines were actually too strong and we had the start are backing them off.

That puzzled me initially.  But the literature says, if you lose weight, you're going to see a drop in blood pressure. For every 10 pounds of weight you gain, your blood pressure goes up five points and vice versa,  It is the standard you're taught in school. But that was, I was seeing much more than that. I was seeing more dramatic drops in blood pressure and it didn't make sense. We started looking into the research that's there and we realized that this high insulin level actually stimulates the body to retain salt of sodium, potassium, and even magnesium. And so your body will hang onto these salts and water follows salt wherever it goes.

Water is kind of a boyfriend for salt. Salt goes here, the water follows.  Insulin is stimulating the kidneys to retain sodium and potassium salts. The blood pressure stays higher and it seemed like the more people followed high-carb low-fat diet their blood pressure crept up. And when I switched it around and we put them on a keto diet, their blood pressure would fall.  That correlated really well with the drop in their insulin loads. And the drop in their overall inflammatory markers. When we put a person in the ketogenic state, before they've lost even five pounds, I'll see 10 points in blood pressure drop, which didn't correlate with what you're taught in school.

So I thought this has to be hormonal. And so as you start looking, and that's what we talked about in the book, is there's a number of, of physiologic functions that insulin stimulates. When you have excess insulin present, you're going to see a dramatic rise in blood pressure. And when we returned that insulin level back to its baseline (normal) level, all of a sudden the pressure normalizes and it does so quite rapidly. It was an eye-opening process I was not expecting to see.

Allan: (24:04): Yeah, when I was first starting this journey and it's one of the things I did, I went to the doctor and he's like, you're prehypertensive. I asked what does that mean? He told me that I almost had high blood pressure. You're right on that line. So when you lose the weight, your blood pressure will go down. And my blood pressure did drop with the weight loss.  But ketosis is basically doing it faster.

I think that's a good thing to note is a, whenever you're going to change the way you eat, the way you move, the things you're doing, it's worth having a conversation with your doctor beforehand so they understand what you're about to do and at least can monitor your medications and things like that so you're not doing something that could potentially wreck yourself even though you're doing the right thing. You have to be aware that you know, if you start feeling a certain way, you need to talk to your doctor because you're actually improving your health, but your medication doesn't know that's what your intention is. So it's going to do what it's supposed to do and you want to. You want to make sure that you're working with your physician to do this.

Dr Adam Nally (25:08): Absolutely. I had a lady that called me up one day and just mad as a wet hen. She was upset that her husband got hospitalized because of the keto diet. And I said, well, who's your husband? She goes, well, he's not your patient. I said, well, did I put him on the Diet? She says, no, I did, but he's on four blood pressure medicines and he almost passed out and so she was really upset that her husband had to go to the hospital because he was so lightheaded. He had almost passed out.  His blood pressure dropped suddenly and he was overmedicated. So we talked to his doctor.

Allan (25:38): Talk to your doctor, please. They may not understand that the keto diet. They may not even agree with the keto lifestyle. Have the conversation with your doctor. You should share that information with your doctor and make good health decisions because the doctor is there to help you. They shouldn't be the decision maker. You should be the decision maker and the doctors there to facilitate you getting healthy, but if you have something you really believe is going to work, have that conversation, be armed, this book is a great way to arm yourself because you can just basically say, look, here's what I'm seeing, here's what I'm thinking.

Tell your doctor you want to give this a try and you need them to work with you and make this happen. And, and, and most doctors, once you kinda put it out there that way, they're like, okay, fine. If you have some problems with your blood pressure, give the of the office a call and we'll talk about lowering your medication or whatever. Don't put yourself in the hospital just trying something, work with your doc.

Now one that was very interesting and I knew there was a kind of a link and it's kind of almost a threeway linked – insulin, cortisol, and testosterone. There's this internal battle happening in your body that if any one of those things gets out of sync, they kind of mess with the other ones and I always knew that existed from the things that I've read, but you put it out there really, really clearly. Working on your insulin levels using the keto diet, you can actually improve your testosterone levels.

Can you talk a little bit about that?

Dr Adam Nally(27:18): Oh, absolutely. This is another shocker. You're applying these principles. All of a sudden people are getting better and you say, I didn't do anything to fix that. The patient didn't change anything. What happened?  Testosterone is a real complex hormone and the way it's produced and the way it responds. What we find is that because of a number of influences of this high insulin load the fat cells produce hormones. Our fat cells produce a plethora of hormones, at least eight of them specifically influencing the way blood sugars are handled and the way insulin responds.  They also affect the way the brain handles testosterone.  When you see this rise in insulin, what ends up occurring as you see changes in the way Leptin and some other hormones like kisspeptin and how those affect the pituitary gland, and then again go into effect the testicular production of testosterone.

It's very sensitive system. Minor things can influence it, and there's this dramatic effect.  About a third of men that come to my practice who are insulin resistant, will start to see their testosterone's drop.  I'm gaining weight. I have no energy. My Libido's gone and I just don't feel like I used to feel. They'll start to see a breast size enlargements and their wife is coming and going and doc, I gotta buy him a Bra. It gets to be a challenge and for many, it's very embarrassing.

The big challenge is that there's not a lot of great treatment for this other than giving testosterone and giving testosterone has some significant side effects. Just giving the testosterone itself didn't fix the problem. So as we started applying keto lifestyles and we started naturally lowering the big insulin response by just removing the starches and the sugars out of the Diet and giving people back fat that what that does is it allows number one, the insulin level to drop. And number two, when you're giving people back real fat that now the body can create testosterone from the fat.   Testosterone is a form of, a derivative of cholesterol, which is a platform of the fat.

And as your body now has the adequate fat present to make adequate testosterone. We this improvement in the overall function. So I'd see guys testosterone's jumped 150 points back up to normal just by making a dietary change within a couple months. And it was dramatic.  We're getting a better response with just this dietary change than I was with given them topical testosterone creams and things of that nature. So I'm very effective in a very brief way. The book actually goes into a lot more of the detail of how that works from a physiological level. But it was another one of those shockers for me to keep seeing this repetitively over and over again. Guys, testosterone's are getting better.

Allan (30:11): Yeah. I interviewed vegan on one of my episodes when I first started.  He had a good argument for the vegan lifestyle and how it works and people are healthy. And I'm like, I don't know that I could go completely Vegan, but I'm going to go pescatarian.  I'm going to eat fish because I live on the Gulf coast. I had a blood test. My lipids always run really high, which I'm not very concerned with because my, my HDL relative to my triglycerides are awesome. In fact, sometimes my HDL is higher than my triglycerides by a good bit.

I gave it a go and my LDL did drop a little. It didn't drop what I would call significant, but my HDL plummeted, my testosterone plummeted, I gained weight. I found this is unbelievable. I'm eating the way skinny people eat and I'm getting fat. It made no sense to me whatsoever except for the fact that get satiated because I wasn't eating enough fat. And so here I am eating some nuts but a lot of fruit and vegetables and fish.  But even though fish has a good fat, it's still generally lean.

I actually gained weight being a pescatarian. It's not what my body needed, so I eat a keto diet, but I eat it on a seasonal basis.  I think that makes it a little bit more sustainable for me because, well my brother is a brewmaster and I love beer and I occasionally enjoy a couple glasses of wine a and things like that and those will sometimes bring me out of Ketosis. I enjoy tailgating. I'm in the southeast, you know, I love football. Are you an Arizona or Arizona state fan? Before I go too far.

Dr Adam Nally (32:31): Oh, I, you know, I'm gonna I'm gonna upset somebody. If I tell you that I actually met my father-in-law, went to ASU. I've got another brother-in-law that went to U of A. So I kind of have to play the fan.  I didn't go to either. I actually went to Grand Canyon University. So I'm a Lopey. I see from that perspective there, but it depends on which family member room with his team on really for at the time. So yeah. when they're playing each other, I watch from home.

Allan (33:05): So during that season I just want to be able to go and kind of enjoy myself and I realized I'm not going to feel my best. I'm not going to operate and maintain my best, but you know, I'm basically going to take that time to enjoy my life. And then when it's over, then I'm going to go into my winter where now I've got to go and get back into ketosis. The way you know, my ancestors very likely spent a large portion of their life being from northern Europe.

Getting into the keto lifestyle is not hard if you have that determination to get there in the first place, but I see so many people wanting to hold on to some semblance of the way they used to eat and they typically do this through artificial and some natural sweeteners.

Can't I use the zero calorie sweeteners? And if I am going to use one, which one would be the best one for me to consider using? I'm not a scientist, I don't know all the science around all of it. I know that there's a lot of ill effects for quite a few of them and there are new ones popping up every day and it's just too much to keep up with. I feel that just eating whole food is the way.  At some point you're going to find that a carrot is actually probably too sweet for you when you actually try to just eat a carrot because your body's telling you there's a lot of sugar in this. A strawberry tastes delicious.

We used to put sugar on blackberries and I have no idea why I used to do that because now I eat them without. But I can't have more than three or four of these because they're just so sweet. You do change your palate. But that said, there just are some people who feel they need that bridge or something, that sweetener thing and to get them to the next level. Can you talk a little bit about these, some of the artificial and the natural sweeteners, and what is the right one for us to consider if we were going to do one?

Dr Adam Nally (35:16): Okay. I practice from a perspective of people. People have to live their lives. You know, you still have life. You're still going to show up at Aunt Matilda's house and she's going to want you to eat a cookie.  If you don't eat that cookie, she's gonna be really upset. You may be offended at Matilda for the rest of your life and then she writes you out of the will. Or she dies the next day and you just feel horrible, but you know, you never ate a cookie and she just was going to hit you for eternity. We have to understand that people h