Tag Archives for " ketogenic diet "

March 28, 2024

Using food to improve your mental health with Dr. Georgia Ede

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On episode 635 of the 40+ Fitness Podcast, we meet Dr. Georgia Ede and discuss her book, Change Your Diet, Change Your Mind and how food can be used to help with mental health issues. 


Let's Say Hello

Rachel Discussion


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Post show with Rachel.

Music by Dave Gerhart


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Another episode you may enjoy


December 13, 2022

Is keto good for brain health? | Dr. Mary Newport

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When Dr. Mary Newport's husband was diagnosed with early-onset Alzheimer's disease, she began looking for answers. Her research brought her to ketosis as a possible nutritional protocol and the results were amazing. On episode 568 of the 40+ Fitness Podcast, we discuss her book, Clearly Keto.


Let's Say Hello

[00:01:48.790] – Allan

Hey, Ras.

[00:01:49.720] – Rachel

Hey, Allan. How are you today?

[00:01:51.420] – Allan

I'm doing all right. Kind of dealing with a stomach bugs. So I've kind of laid low the last few days and done most of my things from here at Lula's in our apartment. As you can see from the video, I'm in my studio, my fitness studio here at Lula's. And so I'm staying here because I don't want to be more than maybe 10ft away from the bathroom. So just trying to stay hydrated, taking some and things like that. Kind of get myself to a point where I can get through this thing with this little bug, but it's the thing.

[00:02:28.010] – Rachel

Well, I hope you feel better soon.

[00:02:29.770] – Allan

Thank you, but everything's great.

[00:02:31.510] – Rachel


[00:02:32.740] – Allan

How are things with you?

[00:02:34.410] – Rachel


[00:02:35.320] – Rachel

I just wanted to update you and our listeners real quick. I've shared that Mike, my husband Mike, has been battling kidney cancer, and our surgery is slated. It should be in another week or so. And they're going to remove his whole kidney and the nearby lymph nodes and adrenal gland and his pre surgery EKG and blood work. He had one more Cat scan which showed the tumor shrunk, which is great. Everything is looking good. And so I hope to have some good reports in about a week or so. But I wanted to share real quick, too, that we were talking to the oncologist and of course, all surgeries are high risk and it's always scary to go under the knife, but our doctor assured Mike that he was a pretty healthy patient. He's of good weight. His blood pressure is controlled. He is in good shape for surgery. And so it was really nice to hear that reassurance from the doctor that all that we do with our running and our dietary choices and everything has made him healthy enough to be able to manage a pretty big surgery like this coming up. So it was just nice to hear that reassurance.

[00:03:47.410] – Rachel

So if the oncologist feels good, then we feel good. So, good news.

[00:03:52.260] – Allan

Good. So, Mike's fit, trim, ready to go?

[00:03:55.770] – Rachel

We are.

[00:03:56.980] – Allan

Big takes scar.

[00:03:57.930] – Rachel

That's right. Yup. So we're very optimistic.

[00:04:02.430] – Allan

That's good to hear. So you're ready to talk to Dr. Newport?

[00:04:06.640] – Rachel



[00:05:08.140] – Allan

Dr. Newport. Welcome to 40+ Fitness.

[00:05:11.040] – Dr. Newport

Oh, hi, Allan. Thank you so much for having me on your program.

[00:05:14.170] – Allan

So the book we're going to talk about today is called Clearly Keto: For Healthy Brain Aging and Alzheimer's Prevention. And the one thing I would say is I think cancer scares everybody to some extent, as it should. But the numbers that we see for Alzheimer's cases, and particularly the forward-looking statistics on what that's going to look like in 40 years, 30 years is terrifying.

[00:05:42.850] – Dr. Newport

It is terrifying. I think everybody knows somebody or has a family member that has been dealing with Alzheimer's.

[00:05:50.810] – Allan

Yes. I come from kind of a long life family. So on my father's side, my grandfather lived into his mid 90s. Not well, but he did live yeah, my grandmother lived into her late 80s. But towards the end, I think she was also starting to suffer from some dementia issues. In fact, the last time I saw her, I don't think she recognized me. I think she thought I was my father because just the way she was carrying on and talking and things like that, I think she had confused me. So this is just one of those topics that I'm like, okay, if I can figure this out, I'm going to feel a lot better about getting old, growing old and together. You might not be together.

[00:06:35.190] – Dr. Newport

Right. You might not be together. That's what happened with me and my husband, right?

[00:06:40.690] – Allan

Yeah. Can we talk a bit about Steve's case and what happened there?

[00:06:44.980] – Dr. Newport

Yeah. So you probably mentioned already with my biography that I'm a physician. I practiced newborn intensive care for 30 years, and Steve was an accountant, and it worked out perfectly for our family because he stayed home with our children. He could work from home. He was the original Mr. Mom, and he was a perfectionist. He was in the kayaking. He read novels. But when he was 51, he started having memory issues, and I thought, maybe it's just a midlife crisis. He would miss appointments. He started shuffling around. His accounting work, like quarterly tax return was fairly simple for our practice. It should have taken him 20 minutes, and it would take him several days, and he would shuffle everything around and procrastinate, and it was becoming worrisome. And then he started forgetting if he'd been to the bank, in the post office, and he would misplace mail. And that was bad because it was, you know, checks that people were sending in for payments that he would misplace. So he saw a neuropsychiatrist who evaluated him and said this could be dementia, but more likely it's depression. And Steve was depressed, but retrospectively, most likely he was depressed because he knew he was not functioning well and that's something was wrong.

[00:08:03.480] – Dr. Newport

He was put on an antidepressant. We continued to get worse over the next few years. Driving, getting terrible, couldn't follow a map, was losing his accounting skills. Slowly but surely. They always say, use it or lose it. He was using it. He still lost it. I mean, that's how Alzheimer's is. And he was diagnosed with Alzheimer's, early onset Alzheimer's. At this point, when he first started having symptoms, he was 51. He was diagnosed at age 54 already. So that's early onset. Younger than 65 is considered early onset, and it's maybe 1% to 2% of people with Alzheimer's or early onset. So this was, as you were saying, you hope to live out into old age with your partner. And as I'm researching Alzheimer's at the time, I'm finding out the average lifespan is about seven years after diagnosis. And I thought, well, we're not even going to get to retire together. So that was just put a very big damper on our future. And so constantly looking for clinical trials or anything, we were always told by the Alzheimer's Association that we were within five years of a cure. We heard this over and over every year.

[00:09:20.620] – Dr. Newport

We're within five years of a cure, donate the research. But we were always watching for clinical trials, and they were kind of few and far between in our area. We lived north of Tampa and Florida, but he continued to progress. By age 56, he had lost all of his accounting skills. He had worked on the computer all day, every day, and they play on it when he wasn't working on it. Always had to have the fastest computer, but at age 56, he couldn't even figure out how to turn it on or use, much less use a mouse or do any accounting work. He also had to quit driving that same year. It's hard to think after diagnosis, someone with Alzheimer's still driving, but people do until they can, and, I mean, it's a very slow process. There's an awful lot you can do for a long time. A lot of people socially don't realize that you have a problem, and it changes how people look at you once you tell them. So we were not aggressively telling family and friends that he had this diagnosis right away, but at age 57, so about six years into symptoms, he stopped being able to make meals for himself.

[00:10:39.990] – Dr. Newport

He would just not eat when I was working. So our younger daughter, Joanna, ended up moving back in with us, and she would be with him in the daytime when I was working and make sure that he ate and that type of thing. But in 2008, when he was 58, it just felt like he was spiraling downwards, you know, I was pretty much giving up hope that we were going to come across that cure. And we had already, a couple of years before that, switched to a Mediterranean diet, mediterranean style diet. I had read some research that the people who ate the most Mediterranean like diet that had Alzheimer's lived on average, four years longer than people who ate the least Mediterranean like diet. I said, okay, well, maybe this will buy us some time. And that was the first I had even considered that nutrition might have anything to do with Alzheimer's. So then I was keeping my eyes doing, like, wider searches, thinking of nutrition and other factors that we might be able to address that possibly help him. But so when he was 58, this is May of 2008, two clinical trials became available in our area.

[00:11:51.060] – Dr. Newport

And we're like, oh, my gosh, maybe he'll qualify. Like in previous studies, you would be disqualified if you had a history of depression. If you were an early onset Alzheimer's and you knew it, wouldn't you be depressed? Who wouldn't be depressed? But these two did not disqualify you if you'd had depression. These were the first studies that came along in our area that had those criteria. And so he was scheduled for two days in a row to try out to be tested, to get into these clinical trials. Two different centers, two different cities. And the night before, I thought, I'm going to look up these two drugs and look at the risks and the benefits, because we might get a choice. If he qualifies for both studies, we'd have to choose. So I came upon a press release for a medical food that was going to come out in about a year from then. And they had done a pilot study in which nearly half of the people who had taken it had improved memory and cognition after one dose. And this was something you never hear improved with any drugs for Alzheimer's, that it improves memory or cognition.

[00:13:08.070] – Dr. Newport

It might slow the disease down for six months or so. So it didn't say what it was or what it did, how it worked. So I was able to find a patent application, and I read through that, and I learned a whole lot about Alzheimer's as the type of diabetes of the brain, which I think we'll talk about in a few minutes, and that ketones are an alternative fuel for the brain. And that one of the things that happens in Alzheimer's, is that there's decreased glucose uptake into certain areas of the brain. And glucose is a fuel. It's the basic fuel. If we're eating a typical higher carb American diet, we're running off glucose most of the time, and our brain in particular is running off glucose. But if you have a problem getting glucose into cells, the cell can be surrounded by glucose, but it can be starving, because the glucose just literally cannot get into the cell and provide the fuel that the cell needs to produce energy. This energy molecule called ATP. But it was discovered in the 1960s that when you starve or fast, that you use up the glucose that stored in your body fairly quickly within 36 or 48 hours.

[00:14:22.390] – Dr. Newport

And when that runs out, then you start breaking down fat, and you break down some muscle, too, possibly to make glucose. But since we have fat, we can break down fat. And some of that fat is converted to ketones, which are taken up very well by the brain and can provide fuel to the brain. So this was really a neat idea. This is cool. And where the medical food came in, it turned out it was MCT oil, medium chain triglyceride oil. It was a very specific medium chain fatty acid. And what happens they also found this out in the 1960s. When you consume MCT oil, your liver converts part of it to ketones. So it's kind of a neat trick to bypass that problem of glucose uptake in the brain. And I thought, oh, my God, this is brilliant, brilliant idea. And I remembered this thing about ketones and starvation and MCT oil converted to ketones. That kind of refreshed my memory. From medical school, I had heard about this. So in a patent application, I learned that MCT oil is actually extracted from coconut oil, which is the richest natural source of it. And so I thought, okay, I knew MCT Oil.

[00:15:34.620] – Dr. Newport

I thought it might be available in hospitals. I wasn't sure if I could even get it. But I knew I could get coconut oil because I had seen it in health food stores. So at this point I'm reading about all of this and it's about 01:00 A.m.. And he's set up to screen at 09:00 A.m. That same day. And so I didn't have time to do anything about it. We went to the screening. It was in Tampa, Florida. No, actually, I'm sorry. It was in St. Petersburg, Florida. And he did terrible there was a mini mental status exam. He needed to get 16 out of 30 points correct to qualify. They were looking for people with mild to moderate Alzheimer's. He scored only 14. So he did not get accepted into the trial. And the doctor asked him to draw a clock. And that's a very specific test for Alzheimer's. And I have it here, and I know you're not going to be showing the video on the book, but what he drew, so you can see it a few little random circles and a few numbers, four numbers. It was very disorganized. And the doctor said he's on the verge of severe Alzheimer's.

[00:16:40.710] – Dr. Newport

And I kind of knew it, but that really hit home. And I thought, what do we have to lose? I'm going to go get some coconut oil. And so we bought that on the way home. And then I kind of refreshed my freshman biochemistry with our medium chain fatty acids. And I found a fatty acid composition of coconut oil. And I learned that it was 60% medium chain triglycerides. And I figured out how much coconut oil I would need to give him to equal what he would get with that medical food that wouldn't be out for a year. And so the next day, he was scheduled again for a testing for a different clinical trial, a different location. And we tried, we went over what is the season, what is the day of the week. He couldn't remember any of that on the way there. The testing was about 3 hours. Well, I put a little over two tablespoons is what it added up to, an oatmeal in the morning. He had that for breakfast. And then about 3 hours later, he was tested. And he actually gained four points from the day before, which was really surprising.

[00:17:46.060] – Dr. Newport

And he qualified for the study. And I thought, okay, well, either we just got really lucky or maybe this actually did something, this coconut oil, and I'm going to just keep it going. And so the next day and every day after that, I would give them a little over two tablespoons of coconut oil. But I thought, why would you only use one dose of in the patent application? The peak level of ketones was about 90 minutes after taking the MCT oil, and it was down at 3 hours. So I thought, well, what does your brain do the other 21 hours? Your brain needs fuel 24/7. Even when you're sleeping, your brain is extremely active and uses a lot of calories, a lot of energy. So I just started cooking with it throughout the day. I got, like, every recipe I could get my hands on, and he was getting it basically at every meal from that point on. And just over the next few days, he had several symptoms that improved pretty dramatically. And, I mean, he himself said that the day he started coconut oil, that it was like a light switch came back on in his brain.

[00:18:53.260] – Dr. Newport

And before the coconut oil, he would be very sluggish in the morning, and his gait had become abnormal. He would pick up a seat kind of higher than normal and walk very slow. He couldn't run anymore, even though he looked physically fit. He had tremors. His jaw would tremor when he tried to talk. His hand would tremor when he tried to eat, had trouble finishing sentences he couldn't figure out. Like, he'd go to the drawer to get a spoon, and he come back with a knife over and over and over. He'd do that six times before he finally got the right utensil. And after the coconut oil, he just had more energy. He was more talkative. He started whistling again. He was a great whistler. He was all these great medleys making jokes, and he could get the utensil. And by about the fourth or fifth day, we're like, you know, something has changed. Something has changed for the better. This might actually be working. And so I was, in the meantime, researching everything I could about ketones. And I called Dr. Richard Veech, who was a world renowned ketone expert. Sadly, he passed away in early 2020 at age 84, still working at the NIH.

[00:20:06.700] – Dr. Newport

But he was considered the world expert on ketones. He had been studying them for decades, and he had been working on a ketone ester that could greatly increase ketone levels much more than coconut oil or MCT oil. He sent me all kinds of hypothesis papers that he and others had written. He had some of his associates who had written papers who were interested in ketone research call me. It was really kind of amazing when I told him what happened with Steve. And, well, at two weeks after that clock, so about two weeks after he started the coconut oil, he drew another clock. And this time it had the full round circle. All the numbers were there. They were in the right order. It was really messy. There were a lot of hands of the clock, but it was so much more organized. And Dr. Veech, I faxed in the first and second clocks, and he said, this is unexpected. He thought it would take much, much higher ketone levels for anybody with alzheimer's to improve. And then Steve just kind of progressed after that. I probably should let you get a word in edgewise.

[00:21:14.590] – Allan

No, the interesting thing here, and this is kind of my takeaway, is sometimes we're faced with tragedy, right? And then we have to make a choice and I just appreciate that your choice was to help anyone else that you can by sharing information about Steve and his story. And then again, some of the stuff that's happened since probably would have never happened if you hadn't done what you did and then reached out. So it's just not just, oh, I found something that works for my husband and we're good, that was, okay, I'm going to share this with the people who are doing these studies, with people who know people that are doing these studies. So there's some proposed studies that are actually going to give us good information because it's so hard to get a food study funded.

[00:22:04.780] – Dr. Newport

It is.

[00:22:05.890] – Allan

And the people that were going to do it, I'm assuming maybe they got their product released at some level, but they did it because they had a product. They did it because they were going to sell something.

[00:22:16.090] – Dr. Newport


[00:22:16.590] – Allan

And you just did this because you saw it was helping Steve and you're helping people yourself now. So I just want to thank you for that and say that we lost Steve at some point here, but I know that you made his life as good as it possibly could have been, particularly in those last years with this treatment. So I want to take a step back because we've talked about a few things and I've said this a few times on the show, because I've read it, that Alzheimer's is sort of like is sort of like diabetes type three, if we wanted to, some people call it that. But it's basically an issue with the brain getting energy. So with us having difficulty getting energy to the cells in the brain, we call a glucose uptake. Can we talk about a little bit more detail of, okay, what's going on in there? Because I know there's the tau strands and there's the amyloid structures and all those things, but those are the outward symbols of what's going on. The inward chemical stuff is where the real magic is because you just got to find a way to fuel those brain cells.

[00:23:23.680] – Allan

Can you talk about a little bit about how that happens? Because you talked a little bit about ATP, but we really didn't get into I've always known of it as the Krebs cycle, but you use the…

[00:23:34.320] – Dr. Newport

Cycle is another word. Cycle is another yeah. So basically well, I think a lot of people know that insulin is very important. Insulin has to do with getting glucose into cells in the brain. It's somewhat more indirect, it's indirectly involved, but it's still involved in some insulin does cross the blood brain barrier. It used to be thought that insulin was not made in the brain. It didn't cross into the brain. It had nothing to do with the brain. But it turns out it has everything to do with the brain. It actually does cross the blood brain barrier. It's just much lower levels than what are present in our blood. But in Alzheimer's, there's a problem that seems to be related to insulin resistance and insulin deficiency. There are some researchers that have found evidence that insulin is made in the brain. They don't know exactly where in the brain yet, but with Alzheimer's, ten to 20 years before you begin to have symptoms, there's already this problem of glucose uptake in the brain being defective. And part of it is glucose actually getting into the brain itself is depressed, and that seems to be related to insulin in some way.

[00:24:55.180] – Dr. Newport

And then glucose getting into cells, there are glucose transporters. So these are molecules that are kind of openings, I guess, in the cell membrane that allows glucose to enter a cell. And the ones that are involved in glucose getting across the blood brain barrier into the brain and into brain cells are deficient. In Alzheimer's. There's another problem. There's a complex called PDH complex, one that is right at the level of mitochondria, which are factories where ATP is made. We have like anywhere from 100 to 1000 or so of these mitochondria in a cell in which energy is produced, but also, like, thousands of proteins are produced in these mitochondria as well. And the PDH complex is required for glucose to actually be it's converted there's like six steps, and then it has to be converted to pyruvate to enter into that TCA cycle, which is located in the mitochondria. And this complex is deficient as well. And there's a thing called mitochondrial dysfunction. That's one area of study that hasn't gotten as much attention as these plaques and tangles that you mentioned. But basically there seems to be a problem with insulin resistance and insulin deficiency that affects glucose getting into the brain, getting into these mitochondria where ATP is made.

[00:26:28.350] – Dr. Newport

And Dr. Steven Cunnane in Canada has done incredible amount of work. He's at Sherwood University and he and his associates have been studying this very intensively, and they have been using ketone and glucose Pet scans. They've studied over 300 adults of all ages, including many healthy adults, healthy older adults, people with mild cognitive impairment, which precedes Alzheimer's and people with Alzheimer's. And they have found that there is what he calls a brain energy gap. So there's a gap between how much energy the brain needs and how much it actually gets. And this is present even in people who test normal in their 70s, cognitively normal, there's a gap of about seven to 9% between how much energy the brain needs and how much it actually gets. And in people with mild cognitive impairment, that widens to ten or 12%. In people with Alzheimer's at the earliest stages, it's 20%, a 20% gap between how much energy the brain needs and how much it gets. And it just continues to get worse as Alzheimer's progresses. So that's a very interesting finding. And then along with that, he has found that ketones are taken up normally in the same areas of the brain that are affected by Alzheimer's.

[00:27:43.860] – Dr. Newport

And it supports this idea that Dr. Veech had back in the 1990s, that ketones could possibly help someone with Alzheimer's. And he has tested MCT Oil, which is the medical food that I read about in that press release. And he has found that MCTL does contribute to increased fuel uptake and energy production from ketones, and it also improves cognitive performance in people with mild cognitive impairment. He did a six monthly study. They received two tablespoons a day of MCT Oil. After the study, he told me that he felt like three tablespoons a day would have been even better, that they might have gotten even better results. But they did all five cognitive domains that they studied. There were improvements in these people, and the level of ketones they produced from the MCT Oil was sustained throughout the six months. It wasn't that their body adjusted, and they weren't making ketones anywhere they were. They actually were making the same amount as at the beginning of the study. So basically, insulin resistance is a big part of the problem. It's something that happens with aging. But many, many people develop prediabetes and diabetes. By age 75, about three quarters of people have either diabetes or prediabetes.

[00:29:07.320] – Dr. Newport

So it's very prevalent. It doesn't always affect all organs in the body. So somebody might not have type one or type two diabetes, but they can still have diabetes of the brain. So the insulin resistance can affect the brain directly. And this seems to be a really big part of the problem. So it's insulin resistance not allowing glucose into cells, and then the brain needing some kind of fuel to fill in the gap from glucose, and ketones can fill that in. So it's kind of a neat idea. Using ketogenic strategies, so to speak, that will increase ketones could help overcome both of those problems, the insulin resistance and filling in the brain energy gap.

[00:29:54.190] – Sponsor

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[00:31:31.330] – Allan

If someone wanted to address this aging, particularly healthy aging of the brain, marrying ketosis with the Mediterranean diet is sort of your prescription. Can you talk a little bit about why those would be so protective?

[00:31:46.240] – Dr. Newport

Yeah. There have been hundreds of studies of the Mediterranean diet and cognition. I think I found over 500 when I did a search on PubMed. And basically the standard American diet has gone in the junk food route. Ultra processed foods, a lot of fructose, which is very harmful, very inflammatory, and cells in many cells of tissues, just not getting the right nutrients, not getting the right forms of vitamins. And with a Mediterranean diet, a whole food diet, basically a whole food Mediterranean diet, you're eating whole grains, legumes. It emphasizes fish, more so than red meat. It doesn't completely eliminate red meat, necessarily, but just suggest limiting that moderate amount of dairy and full fat dairy. This is not a fat free, low fat diet and emphasizes olive oil, healthy fats like olive oil and monounsaturated fats, which are in olive oil, nuts and seeds are very rich in them. Avocados, a lot of foods like that that you can eat. The interesting thing about dairy fat, while human breast milk has medium chain triglycerides in it, the newborn goes into ketosis. Within hours, a newborn that is strictly breastfed goes into ketosis. They break down their fat, which helps get through the first few days while the milk is trying to come in.

[00:33:18.190] – Dr. Newport

And the breast milk does have medium chain triglycerides. So the newborn, it gets quite a lot of its energy from ketones and ketones. Dr. Cunnane, again, he was studying newborns before he switched and started studying Alzheimer's. They found that fatty acids are broken down into ketones. And ketones are the building blocks for lipids in the brain, and the brain is about 60 or 70% lipids, including cholesterol, and ketones are the building blocks for all of that. So very important in the newborn. So back to the diet anyway. Dairy fat, cow milk, goat milk. It also has medium chain triglycerides in it. And I think these days, even there's been this idea around for several decades, I think about 50 years now, american Heart Association. We should eat a low fat diet, avoid saturated fats. And even now, like USDA, what they prescribed for children, the Women the Wick program, women's, Infants, and Children Feeding program for underprivileged people, it emphasizes lowfat dairy, even for little children that are just coming off breast milk. And breast milk is about 50% fat, and more than half of it is saturated fat. And now we're supposed to eat a low fat, fat free diet.

[00:34:41.490] – Dr. Newport

Even the dairy in a tiny growing child whose brain is actively growing and lipids are accumulating very quickly in this brain. So, you know, basically, you know, the Mediterranean diet is a it emphasizes healthy fats. It's not a low fat diet, but you can get most of the vitamins and other nutrients that you need for healthy brain aging by eating a Mediterranean diet. So I like the idea. And there are so many diets that can be adapted to a keto kind of a diet. So basically, when you do a Mediterranean keto diet, you're using the principles of the Mediterranean diet, but eating more fat and less carbohydrate. So basically eating smaller portions. I still remember the food pyramid from 1992, my god, the base of the period was General Mills of the pyramid. Yeah, it was.

[00:35:43.480] – Allan

It was General Mills.

[00:35:45.100] – Dr. Newport

Six to eleven servings of breads, pasta, cereals, all of that a day. And I mean, at the time I was overjoyed because, you know, I was buying into this low fat, hooked line and sinker. But, you know, I developed a really serious weight problem and I was eating skim milk. I was eating these that I thought were healthy cereals with a lot of fiber and this kind of thing. But it was a real struggle to not keep gaining weight, counting every calorie. And yet the low fat diet, it's a nuisance because you crave it's high carb. If you eat low fat, you're going to make up the calories with carbohydrates. And when you eat so much carbohydrate, it spikes your insulin level. And then when the insulin level comes back down, you get hungry again, and you're constantly craving thinking about your next meal and craving those sweets. And that's kind of where I was at for a lot of years until we switched to a Mediterranean diet. And within about three days, I stopped craving, constantly thinking about what my next meal was going to be and craving sweets. It was really kind of amazing.

[00:36:50.210] – Dr. Newport

But basically, you just tweak. What I tell people is when you look at the starchy foods, bread, rice, pasta, cereals, that type of thing, a lot of people don't want to give that up completely. And I think that's I'm an older person now, so I'll say, okay, older people, you get a little bit fixed and what your diet is like, and it's hard to completely give that up, and you might not have to. So I encourage people to reduce the carbohydrates, but kind of start with cutting portions in half of, like, bread, rice, pasta, and when you're used to that, cut it in half again. So basically eating smaller portions, eating more healthy fats. And for me, coconut oil is a healthy fat. I've studied it quite a lot, and there are a lot of myths out there about coconut oil being artery clogging fat and all of that. It just isn't. So it was made up. It was a competitor with Cisco and other shortenings that look very similar and had a long shelf life. So they kind of put out these myths there that have been perpetuated. But olive oil staying away from certain fats like oils that are reheated over and over.

[00:38:08.920] – Dr. Newport

A lot of fast food restaurants, they'll keep the same oil in their fryers for a week.

[00:38:14.910] – Allan

Yeah, I can testify to that. I work fast food when I was in college, and it's one of those things where there's a standard for how often you're supposed to change it, and that's even too long. But most managers will sit there and say, look, we're spending too much money on oil. So one more day, scrape out and filter it. You get all the stuff out of it and take it for one more day, right?

[00:38:41.510] – Dr. Newport

Yeah. And it's heated to a very hot temperature. You think about throwing French fries in there and how quickly they have to be, or whatever you're frying in it, and it creates a lot of toxic lipids that are very harmful for a long time, until very, very recently, they were loaded with hydrogenated fats, trans fats. And this could have played very well into this Alzheimer's epidemic that we were seeing, these trans fats. Every cell membrane is made up of lipids, and it should be very fluid, the cell membrane. But when you add trans fats and they get into the cell membrane, which they do, makes the cell membrane stiff, and the cell doesn't live as long, it affects what's transported in and out of the cell. So a lot of problems, and fortunately, they've almost been banned from the US. They were kind of phased out between 2013 and 2018, and they're still allowed to have up to a half gram of trans fat per serving. So some manufacturers adjusted their serving size downward so that they can still use some trans fat. And now they're exploring these fats where they remove they still make them hydrogenated fats, but they're removing the trans fats.

[00:39:53.670] – Dr. Newport

So it's still not really a normal fat. And some of these foods that they're experimenting with. So just so many reasons to go with a whole food like Mediterranean style diet, just many vitamins, minerals, other things like choline is a good example. Most people may not have ever heard of choline, but they might have heard of DHA, omega three fatty acids. But the omega three DHA attaches to choline, phosphatol choline. And it's a really important part of the cell membrane of the brain. Choline is also part of acetylcholine, which is a neurotransmitter that's involved with learning and memory. It's deficient in Alzheimer's disease. So you wanted to get plenty of choline, and that's something you can get with the Mediterranean diet. It's in certain nuts, it's in animal meats, fish, that type of thing. Eggs are really rich.

[00:40:55.310] – Allan

The yolk.

[00:40:55.310] – Dr. Newport

The yolk of the eggs, right? You don't throw away the yolk in the Mediterranean diet. You eat the yolk. It's just so many good nutrients. And it increases HDL cholesterol. Some people still believe it increases your cholesterol. It increases HDL cholesterol primarily. And eating this type of diet will help overcome insulin resistance if you reduce the carbohydrate in the diet.

[00:41:20.350] – Dr. Newport

And I kind of suggest trying to stay under 60 grams a day, a lot of people might still want some carbohydrates. They might want more than that, maybe limiting to 130 grams a day and then including enough healthy fats in the diet. But under 60 grams, there's a good chance that you will be in ketosis most of the time, stay in ketosis. And then adding coconut and MCT oil can help sustain, like, a constant level of mild ketosis. They call it mild nutritional ketosis. And there are supplements out there, too. Ketone, salsa, ketone ester that Dr. Veech was developing in the 1990s that's been out on the market, really marketed to athletes. But a lot of people with neurological diseases are trying it so that out there, ketone salts are out there, there's other ketone, all kinds of ketone products coming along. We didn't have access to any of that, but I knew about it as these things were being developed. And I think of those kind of supplements as like a way to further boost your ketone levels. It usually will sustain for three or 4 hours, and then it's kind of back to baseline again.

[00:42:29.670] – Dr. Newport

When you take a supplement, I think of using MCT and coconut oil as part of the food to help sustain at least a baseline level of ketosis. And then for people that want to supplement, they'll get a temporary boost in between.

[00:42:45.640] – Allan

Now we call ketosis. When you get your blood ketone level to .5, to basically around 5. And most professionals out there, experts on, say you don't really want to spend too much time above 5. But for someone who feels like they're having some cognitive issues and wants to have family history of this happening around them, and so I just want to be careful, where would you say that they should sort of keep their ketone levels for the most part of the day?

[00:43:17.910] – Dr. Newport

I'd say between .5 and 1, maybe 1.5. A lot of people are having really good success, and people with Alzheimer's and Parkinson's disease with mild nutritional ketosis. The higher range seems to be most effective for people that are dealing with epilepsy, drugresistant epilepsy, people with cancer. You mentioned cancer at the beginning of this, and there are quite a few studies going on, several dozen studies of using ketogenic diet as an adjunct to standard of care treatment for various types of cancers. It was researched first for glioblastoma, which is severe brain cancer. Most people don't survive more than six months from diagnosis. And it's really kind of amazing how the ketogenic diet seems to be able to slow down the growth of the cancer and even shrink tumors, obliterate how to get rid of metastases when it spreads to other parts of the body. And I have met some people at conferences who have glioblastoma, and they've been on a ketogenic diet for years now and have managed to survive so far. And they do also get other treatments, most people with cancer, but it kind of supports it. It seems to be effective for certain types of cancer and even possibly taking ketone ester.

[00:44:41.310] – Dr. Newport

There are some animal research suggesting that ketone ester could help before getting radiation, for example. And it can help shrink a tumor, make it smaller, which makes it more amenable to surgical removal. If you can get a smaller tumor, like in the brain or whatever it's being studied for breast cancer, colon cancer, prostate cancer, many different types of cancer. There are clinical trials going on now. Couldn't even say that a few years ago. But these things are happening now, and the ketone esther, Dr. Veech even though he worked for the NIH, he was competing with thousands of other researchers for research dollars related to Alzheimer's disease, and he could not get funding for a clinical trial for Alzheimer's with his ketone ester. But now, finally, the National Institute of Aging does have a study that's in progress. It's supposed to finish in 2023. And they're studying 150 people. They're looking at all the different blood, spinal fluid, imaging, biomarkers related to cognitive impairments. And it's people that have metabolic syndrome, which is pre-diabetes. And they're studying older people. I think they're between 50 and 70 years old and following them over time and with the ketone ester, and they're taking pretty hefty doses of it.

[00:46:02.380] – Dr. Newport

My husband Steve was actually the first person with Alzheimer's to use the ketone ester in a clinical trial. It was a pilot study of one person. And Dr. Veech picked Steve. I'm a doctor. I can monitor him. He felt very confident, and he literally sent us the this was in 2010, about two years after he started the coconut oil, and he sent us the raw material. It tasted horrible, just horrible. And he told me, figure out what to do with this. And I tried all kinds of flavorings and everything, and Steve shuddered every time he took it, but he took it willingly, had Alzheimer's. He knew all about the ketones ester. He was at a point where he had had some setback, and it turned him around again very quickly, and he was very stable for another 20 months after that. And thanks to Dr. Veech, I felt like we got nearly four extra better quality years than the year before he started the coconut oil. And what happened with Steve was that I had a lady that stayed with him when I went to work. And he hugged and kissed me goodbye, said he loved me.

[00:47:14.290] – Dr. Newport

Five minutes later, she called me and she said he had fallen straight back, had a seizure. It lasted 20 minutes. He stopped breathing. He turned blue by the time I got home. I got there before emergency services got there, and he was still blue. He wasn't breathing very well. He had another seizure on the way to the hospital. And I guess with his brain already so fragile from Alzheimer's, the head injury and the seizure, lack of oxygen, he became completely dependent after that. And he would have a seizure periodically, even though he was on anti-seizure medication and that kind of thing. And he continued to get the ketone ester in coconut oil. He lived another two and a half years. I really didn't dream he would live that much longer. And I think perhaps the ketogenic, these things we were doing helped sustain him. And he remained very healthy weight. A lot of people with Alzheimer's, they become almost emaciated as time goes on. And he ate very well up until a couple of weeks before he passed away. And then he just went unresponsive just fairly suddenly. And then we lost him a couple of weeks later.

[00:48:29.220] – Dr. Newport

So he actually did die from Alzheimer's disease, and many people die with it, but from something else, a lot of elderly people.

[00:48:38.440] – Allan

So Steve was not in a condition where he could really exercise to enhance his program all that well. But for someone who is able to do some exercise, how does that help this process?

[00:48:51.190] – Dr. Newport

Yeah, so exercise is very interesting. The Alzheimer's Association, now, they have speakers listen to their conference every year, and they say that somewhere between 30 or 40% of Alzheimer's may be preventable by modifiable life, by changing your lifestyle. Top being diet, eating a healthier diet. Exercise is the second is number two. Getting enough sleep is another one. Controlling blood pressure, if you have high blood pressure. But exercise, an interesting thing about it is that it stimulates ketone production. That's just one of the benefits that we know about. And if you, like, walk vigorously or elliptical, something like that, for 30 to 40 minutes, it will stimulate ketone production. This was actually discovered around the 1930s, and it was studied very intensively for about 20 or 30 years. There were quite a few studies, and they called it post exercise ketosis. And basically the ketone level would increase kind of into that mild range as we get with the MCT and coconut oil, and it would be sustained for eight or 9 hours, which is quite interesting. So exercise is another strategy. Some people, as much as they try, they can't tolerate coconut and MCT oil. But exercise is a way to stimulate ketones.

[00:50:16.840] – Dr. Newport

Overnight fasting is another great way to do that. And basically, if you fast overnight, you don't eat any solid food. You can still drink clear liquids without, you know, calories about ten to 12 hours after that you deplete the glucose that's stored in the liver and then you start breaking down fat and you start making some ketones. So you'll go into mild ketosis and the longer you extend the fast, the higher the ketone level will become. And some people kind of, some people call it bulletproof coffee, I guess that's one version of it. But you put coconut oil or MCT oil in your coffee or tea in the morning, it's only fat. And it actually increases further increases your ketones. And it will support you can do that while you're on fast and it will just kind of enhance your ketosis at that point. But there are a lot of people now that are doing a twelve to 16 hours overnight fast. They're basically skipping breakfast, maybe having the coconut or institute on their coffee and then having their first meal around twelve or one in the afternoon. They also call it time restricted eating, where you limit your eating to between a six and ten hour window.

[00:51:33.110] – Dr. Newport

For me, I kind of am around a seven or eight hour window. I've been doing this for quite a long time and I used to wake up hungry, want breakfast right away. And you just get used to it. You get used to it. It's a way to kind of keep your brain healthy by providing ketones to your brain.

[00:51:55.120] – Allan

Yeah, I usually have dinner around 07:00 6:30 7 o'clock, but I'm through eating before seven and then I won't eat until somewhere between twelve and two the next day and it's breakfast. I'm still making eggs and doing my thing, but it's just become kind of my normal structure. I want to first get up, I do other things. I don't necessarily eat straight away. I'm not really hungry. And I think that's the other thing. When you really get to a point where you're using ketosis appropriately, those hunger cues are a lot easier to pick up on. And you don't just eat because it's the habit of, oh well, it's breakfast, I just woke up, I have to eat something.

[00:52:33.190] – Dr. Newport


[00:52:33.810] – Allan

It actually gets a little easier when your body's burning fat for energy because I got plenty, right?

[00:52:40.770] – Dr. Newport

Yeah, you and me both.

[00:52:44.960] – Allan

So you wrap this all up. The book is excellent, by the way, and you wrapped it up with plan called the Clearly Keto Whole Food, Mediterranean Style Diet. Love every word of that.

[00:52:57.660] – Dr. Newport

Thank you.

[00:52:58.240] – Allan

I love every word of that. It's a really good, clear, easy thing to do. You also have recipes in the book, so you've pretty much souped to nuts made it to where someone that wants to work on their brain health using ketosis and the Mediterranean diet, it's there. So the book is called Clearly Keto. If someone wanted to learn more about you, Dr. Newport or the book, where would you like for me to send them?

[00:53:24.560] – Dr. Newport

I have a website. It's coconutketones.com. And that's C-O-C-O-N-U-T-K-E-T-O-N-E-S. There's no Y in ketones.com. And you can see links to my books. There's all kinds of information. I've had this website since late 2008 and I've just been slowly accumulating all kinds of information. I have a page of scientific articles. There are many studies now with MCT oil, but mostly smaller to medium studies. Larger studies are in progress. A lot of information, scientific reports about ketone esters and salts and ketones in general. Dr. Cunnane's research is on there. I've written some articles about how to use things like coconut and MCT oil and ketone salt, ketone esters. But basically there's a whole lot of information that people can find there. And my books are available. My publisher is Turner Publishing. The last I looked, they had a pretty good price, pretty comparable or maybe even a little less than Amazon for ordering my book. But Amazon, all the major book sites are carrying the book to pre order right now. And I do have other books before that, three other books that I've written. This one is kind of more back to Alzheimer's again. And it goes beyond I would say the first half of the book is all about ketogenic strategies, mediterranean diet, keto, but there's a whole lot of other things other things to do and other things to avoid that are not necessarily related to ketones.

[00:55:04.900] – Dr. Newport

A lot of certain foods and not overdoing certain supplements that could be harmful. And then the last chapter took me ten months to write. It was the first chapter I wrote, but I thought if I put this first in the book, nobody will ever get to the rest of the book. It's very science-y. It's all about what goes wrong in the Alzheimer's brain, all the different pathologies. So many of them are connected to insulin. Insulin resistance. I was really kind of astounded myself how much of this is related to insulin and lack thereof. Like those plaques and tangles, insulin resistance seems to promote formation of plaques and tangles, but the plaques and tangles themselves seem to promote more insulin resistance. It's like vicious cycles. And it kind of, to me, explains why Alzheimer's is progressive. You have this constant vicious cycles of related to insulin and insulin resistance, and it's just a downhill path from there. Just gets worse and worse over time. So that's for readers who are really interested in the science as well. I think it was a bonus chapter.

[00:56:17.360] – Allan

I geeked out. So, yeah, I enjoyed it. Yeah, you can go to 40plusfitnesspodcast.com/568 and I'll be sure to have the links there. Dr. Newport, thank you for being a part of 40 Plus Fitness.

[00:56:30.630] – Dr. Newport

Oh, you are very welcome. And thank you so much for inviting me to be on your program. Again, allan, this has been wonderful. Thank you for this discussion.

[00:56:37.750] – Allan

Thank you.

Post Show/Recap

[00:56:48.260] – Allan

Welcome back, Ras.

[00:56:49.920] – Rachel

Hey, Allan. This was a really amazing interview. A couple of things just hit me right off the bat. It's quite tragic that her husband was only 51 when he started to experience some Alzheimer dementia symptoms, which kind of hit me hard cause I'm 51, but it was hard to see him progress. And it's so true, you know, like cancer. I think we all have someone in our lives that might be touched with Alzheimer's or dementia, which we are. I've been watching my aunt decline, and it's a tragic disease to watch it unfold, but there is some things that we can do about it, isn't there?

[00:57:29.370] – Allan

Yeah, well, the base point I want to bring up is that she brought that he had early, what they call early onset. Okay. And that's important. That's an important delineation in this because it used to be that you really didn't see a lot of people with Alzheimer's until they were well into their 70s and 80s. And so it was a very uncommon disease to see when we were younger, like 51. And the same thing happened with type two diabetes, okay? So they used to have type one diabetes, which is where your body kind of your beta cells start to die out and then you don't create insulin. So you have to start taking insulin because your pancreas just can't create enough or actually stops creating it at all. And so that's type one diabetes. Type two diabetes used to be called adult onset diabetes, but they stopped calling it that when kids started getting diabetes. Okay? So it is definitely a lifestyle related issue where we're looking at diet and people who are eating excess sugar and excess refined carbs are getting these diseases earlier. Now, I'm not saying that's what Dr. Newport's husband did, but there's definitely a problem with our food and our lifestyles.

[00:58:45.880] – Allan

And a lot of these things are shifting and they're happening earlier and earlier. And it could be just anything. It could have been toxins he was associated with at one point, another outside his control, could have been some things that were within his control. We'll just never really know.

[00:59:02.460] – Rachel


[00:59:02.820] – Allan

But like you said with Mike, if we're doing the things we need to do to take care of ourselves, we're limiting our risk. And that's really all we can do in this whole math of getting older and avoiding disease, is to just do things that lower our risks. And I can tell you a whole food clean diet that's giving you all the nutrients your body needs. Exercising regularly, sleeping well, having great relationships, all the self care stuff, managing stress, all those are really, really important aspects of health. That if you're just doing what you can in each of those areas, you're going to not just feel and perform better. But you're giving your body more resilience to be able to keep these things from happening, or at least happening early. Because that's the other side of it. We don't know. But why is early onset happening? And I haven't really heard any good answers. But obviously, from what you've heard in this episode, by switching to a ketogenic diet, he was able to extend the length and quality of his life, which, again, I'm not going to say this is a scientific study, but there are more studies happening.

[01:00:20.110] – Allan

Because Mary, Dr. Newport shared his story and scientists became very interested in what was going on there. There'd be more studies to say, could this have actually prevented Alzheimer's from ever occurring? So those are some things to think about. It's not that the keto diet is the best diet. Don't get me wrong. Ketosis is a tool.

[01:00:43.140] – Rachel


[01:00:43.720] – Allan

But really, I believe, and we've had some different conversations in the last several months about metabolic flexibility and then again, just avoiding junk.

[01:00:54.330] – Rachel


[01:00:55.140] – Allan

Those two things are really the keys to health care.

[01:00:58.650] – Rachel

Well, like she said, better diet, better exercise, better sleep, it's better. Like, make better choices. Do you have to be perfect 100% of the time? No. I mean, we've got Thanksgiving, Christmas, holidays around the corner. There's time to celebrate, there's time to enjoy your home cooked foods and family traditions, but just make better choices most of the time. And absolutely, there's nothing good with sugar. There's nothing. No nutrients and refined flours. Just do what you can, when you can. It doesn't have to be perfect.

[01:01:33.060] – Allan

I agree.

[01:01:34.080] – Rachel

Yeah. Great interview.

[01:01:35.910] – Allan

All right, well, thanks. I'll talk to you all next week.

[01:01:38.980] – Rachel

Take care.

[01:01:39.810] – Allan

Okay, bye.

[01:01:40.770] – Rachel



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Another episode you may enjoy


January 18, 2021

The case for keto with Gary Taubes

Apple Google Spotify Overcast Youtube

Few people put in the amount of research journalist Gary Taubes does when he's writing a book. In his new book, The Case for Keto, Gary really dives deep into the nutrition science to walk us point-by-point through determining if the ketogenic diet is the right way to eat.


Let's Say Hello

[00:01:48.020] – Allan
Raz, how are things going?

[00:01:50.540] – Rachel
Good, how are you today, Allan?

[00:01:52.340] – Allan
I'm doing okay. Working on getting the gym open. We got some space next door, so we've been able to spread the equipment out a little bit more, which should help when we go to the health department. And my goal is before the end of this month to have the gym open and now it's just some final cleanups and put together and things like that to get it all ready. And then I've got a crew scheduled to come in and help me do some deep cleaning. So we're going to get everything set up. And I had to pull everything apart and clean it all up and then put it all back in.

[00:02:24.830] – Rachel

Yeah, it's a lot of work. I've done it a few times myself over the years. And one of the things that I've come to understand is that you can't go 11 months without significant training. You know, I'm doing some training, but it's not like I was before. My strength has dropped. I'm not as strong. So I actually had to hire some people to help me move a piece of equipment today.

[00:02:49.940] – Rachel
Oh, boy.

[00:02:52.160] – Allan
I moved it all over the gym before, but it is really, really heavy. It probably weighs about 400 pounds. So it's not a light piece of equipment. But I used to be able to just drag it all over the gym. Not a problem that wasn't happening for me today. I gave it a tug. It moved about four inches. And I'm like, okay, I really have to move this about 20 feet. So, little four inch increments. That was a lot of polling. So I went out and I asked a couple of local guys that work at the water taxi across the street, and I said, you guys wanna help me out? And I said, I think I will need about two of you. And two of them came in. One of them came in and he's like, he was going to get underneath and lift it up. And I'm like, it's kind of heavy. He says “I'm really strong.” I said, “I am, too.”

[00:03:33.470] – Allan
And he went to make the tug and it didn't move at all. And his friends laughed at him. And then they went and got another guy in there to help us as three guys and myself. We got it. We got it moved.

[00:03:41.930] – Rachel
Oh, how wonderful. Gosh, how crazy!

[00:03:47.420] – Allan
It is. But it was fun. It was fun. And I'm getting things in. It's lining up. And so I'm hopeful we can get the health department here in Bocas to see it as a good place for people to be and exercise. We'll have a clean up plan, have everything going. So a lot of moving and shaking there. And then, of course, started kind of launching a twelve-week program for my for my online trainee's and, you know, for people over 40.

[00:04:13.070] – Allan
And it's. Yeah. That's going really well. I'm super excited about the folks that are coming in. They're energized. You know, our private Facebook group is there where we're checking and everybody's everybody's getting really excited and doing some things here. So, you know, and even just the first couple check ins of folks coming through, I'm like, wow, you guys are just you're just flooringme. I've got some awesome people in there and it just everyday seems to be getting better and better.

[00:04:39.410] – Rachel
Isn't that exciting? I love to see when people get excited about trying something new, a new training program or something and really taking the reins on what they want out of their health and fitness. I love that.

[00:04:51.950] – Allan
Yeah, well, of course. Me too. That's why I'm doing this.

[00:04:54.800] – Rachel
For sure.

[00:04:56.070] – Allan
So what have you been up to?

[00:04:58.130] – Rachel
Actually, something similar myself. I love resolutions. I love making plans at the beginning of the year. I, I love the idea of settling in on a goal and I have some big running goals for myself this year. But in order to reach those goals, I know I need to branch out and do some other things besides running. So I've been putting together a body weight routine that I call the runner's workout. I'm putting the final touches on it and I hope to have it ready to share pretty soon.

[00:05:30.170] – Rachel
Cool. I'm looking forward to seeing that's going to be really good. That's really good. All right. So today our guest is Gary Taubes. And Gary, Gary is one of my favorite people because he thinks like a journalist, but he also understands health really, really well. And so he gets into these concepts of keto. So the book is called The Case for Keto. And I've had him on before The Case Against Sugar. And he sold me on that one for sure, because now, you know, I'm as against sugar as ever.

[00:06:06.200] – Allan
But his book The Case for Keto is really, really good. I was really excited to have him on the podcast again. So I guess let's go ahead and have that conversation with Gary.


[00:06:36.920] – Allan
Gary, welcome to 40+ Fitness.

[00:06:39.860] – Gary
Thank you for having me.

[00:06:42.080] – Allan
This is the second time you've been on the show. We had you on for The Case Against Sugar, which was episode 224, that was 245 episodes ago, and I still recommend people go read the book The Case Against Sugar. It's as relevant, if not more relevant today than it was then in 2017. And the book we're going to talk about today is called The Case for Keto: Rethinking Weight Control and the Science of Low-Carb High-Fat Eating.

[00:07:11.570] – Allan
And the thing I like, Gary, about the way that you approach these topics is that you put together a case which is what you're doing, and you're thinking in terms of how do I build up a body of evidence that really proves this. And it's not just you're going to go across and say, well, everybody knows and then stop and just use that as your anchor. You have no anchors. But the fact that you've done more research then probably anyone else in the field of nutrition, which is actually kind of sad considering you're a journalist and not a scientist, but you've done you've done more work in the nutrition field to understand why we think the way we do, why we do the things we do and why things work the way they do inside our bodies than maybe any any other human being on Earth. And it's just fascinating to read your stuff.

[00:08:07.470] – Gary
Thank you. You know, it's funny, as a journalist, you just keep asking questions until, well, I would like to say until there are no questions to be asked, but basically eventually you will reach a point of diminishing returns where your mathematicians are saying you're asymptotically approaching the endpoint. And yeah, I when I started this 20, almost 25 years ago, I had no biases. I was believe what we all believed about a low fat diet and then red meat being deadly.

[00:08:49.180] – Gary
And and then I but I was an investigative journalist with a science background. So I stumbled into this field. I wanted to know what the truth was. I just kept asking questions. I also hate writing. So research is a great procrastination tool as long as you keep doing research, you don't actually have to sit down and do the hard work of synthesizing it, making it reasonable.

[00:09:12.730] – Allan
Well, you did. And thank you for that, because you went through an entire history. And that's another thing. I mean, as we're talking about why we are where we are. We have to kind of understand some of the history, it's not if we try to put that anchor point in, this is the ultimate truth and we don't go back and at least understand where that truth came from and question that truth, which you as a journalist do, then there's a lot of things that can go wrong.

[00:09:48.320] – Allan
In a way, I kind of think about this is in terms of geometry. You know, you work as a kid, you work in the geometry problem and they make you show you work. And so you sit down, you prove that first thing and then therefore you can prove the second thing and therefore you can prove the third thing. And you have to do all three of those in that order or it doesn't work. And a lot of the science we have right now skipped through the first two proofs and now we're at the third proof.

[00:10:16.010] – Allan
This book doesn't do that. Why are we where we are? And what happened? What went wrong?

[00:10:22.460] – Gary
So this is what's happened to me. So my obsession has always been good science and bad science, more so than nutrition. It's just, the themes and bad science play out so well in nutrition and so continuously and obesity and diabetes research also. But one of the things that fascinated me is I grew up in the physics world and in physics. You learn the science, the history attached. Right. In part because as the history as you move forward in time, the science gets more complicated to start with, like Newton's laws. And you learn about Newton and you learn about the laws. And every law has a name attached to it. Every discovery has someone's name attached or whether it's, the variables, the units being teslas and gauses and ohms are people's names to learn who did the work, what they did, what they saw, what the alternative hypotheses were. You get to Einstein's theory of relativity. It's only when you get to quantum physics in the twentieth century that we tend to start using the name, leaving the names behind.

[00:11:28.250] – Gary
But any student of physics knows who did the work and what they did and what experiments were done to test it and what those experiments on. And I don't know, in medicine, you don't do that. The textbooks don't talk about the history. There's too much to learn. There's too much you have to digest in order to the theory goes to diagnose and treat patients. So maybe the ideas don't have time to learn it.

[00:11:52.830] – Gary
So as a journalist, when I got into this, I wanted to learn the evidence-based first behind the idea that salt causes high blood pressure. And that led me to the evidence behind dietary fat and heart disease, and that led me to the obesity story. So as a journalist, you start going back in time because we've accepted certain facts, dogma or consensus. So you go back in time to find out when they were still up for grabs, when there was still a controversy and no consensus formed over what we believe and see what the evidence was and what forged the controversy? Was it compelling evidence or was it political or sociological forces? And in nutrition, obesity was always the latter.

[00:12:44.460] – Gary
Go all the way back to the early 20th century for obesity and again, when we think of the obesity research community today, we think of hundreds, thousands of research around the world studying animals. Back then, obesity research constituted oh, I don't know, a dozen positions around the world, the German and Austrian clinicians with their schools of thinking and they had institutes with research physician, researcher in them. And these dozen people would write articles about obesity every few years.And in those articles, they might speculate as to what the cause was.

[00:13:21.910] – Gary
And there were two ideas of what the cause of obesity was. One is people eat too much: The gluttony idea. Sloth wasn't that much of an explanation back then, but you had Falstaff. A big, heavy set guy with a zest for living, sitting in a bar and he's got a leg of lamb with one hand and the tankard of ale in the other. And the reason he's fat is good. He's a glutton. And that was sort of the general thinking.

[00:13:49.950] – Gary
And then the other hypothesis was that obesity is a hormonal disorder that some people just put on weight no matter how little they eat. Okay? So some of us are predisposed to get fat, others aren't. The Germans and Austrians tend to embrace this hormonal predisposition idea, even though they didn't know how hormones regulated fat accumulation.

[00:14:13.110] – Gary
And in 1930, an American researcher named Lewis Newberg comes along the University of Michigan and he claims for the first time ever to have actually tested these two hypotheses experimentally. No one has ever done that before. And he claimed that the overrating hypothesis won, based on basically what he did, is he put some lean people on a semi-starvation diet and some obese people on a semi-starvation diet. And he said they kind of lost weight equally. It didn't matter whether they were obese. Therefore, the obese people didn't have some hormonal predisposition to make them trap fat. And nobody had ever done this so Newberg and the United States particularly has kind of embraced as getting it right.

[00:14:59.860] – Gary
And it fit preconceptions, right? Because lean physicians, because if you're lean it's easy to think fat people get fat because they too much. The Europeans, the Germans and Austrians kind of made fun of this energy balance idea, didn't explain anything. So if you want to explain like for instance, whether or not someone's obese or not, but why men and women fat differently, men put on fat above the waist, women tend to put on fat below the waist. So clearly hormones are involved, like why are there certain areas in our bodies we accumulate fat and other areas we don't? Why? There are things like lipomas, fatty tumors. All of these are independent of energy balance.

[00:15:44.500] – Gary
And you want a theory of obesity should be a theory of fat accumulation. So all of that is argued out in a few papers that go back and forth, the Austrian clinical investigator named Julius Bauer, the one of the leading figures in the field of endocrinology, says the energy balance thing is nonsense. The overeating hypothesis doesn't tell you anything. Newberg responds that the hormonal hypothesis doesn't tell you anything. World War II comes along. The European, German, Austrian schools evaporate. And post-World War Two, Newberg's overeating energy balance hypothesis is just embrace this fact.

[00:16:31.430] – Gary
Clearly fat people overeat and then for whatever reason, people start invoking the laws of thermodynamics as somehow relevant to this. And by the 1960s, you've got obesity research dominated by psychologists and psychiatrists who are trying to get fat people eat less.

[00:16:53.640] – Gary
And at the same time, you've got beginning in the 1930s, through the mid 1960s, a series of metabolism researchers, physiologists, PHds mostly rather than MDs to actually work out in the lab what regulates fat accumulation and the role different hormones play in regulating fat accumulation. And by the mid 1960s, it's clear that insulin dominates fat storage. The hormone insulin, it orchestrates partitioning in the body. When we burn fuels versus when we store them, use them for repair and regeneration. But it's the hormone that puts fat tissue and keeps it there. And so by the mid 1960s, you should have a hypothesis that obesity is a hormonal regulatory disorder, just like the Germans and Austrians had always said, where insulin dominates the length of diet.

[00:17:50.040] – Gary
And so all of this was just ignored, just ignored, because the obesity community has decided that fat people eat too much. Even when you look at the research in the field, they're not trying to explain fat accumulation. If you look at, for instance, the discovery of leptin, which is seen as a satiety hormone. The researchers are trying to explain appetite and hunger and why fat people might eat too much rather than why fat people might accumulate too much fat, which is an entirely different question.

[00:18:26.130] – Gary
So the latter is answered pretty much by elevated insulin and keep it elevated as it is in insulin resistance, and you're going to accumulate too much fat. But that's not even what we've been studying. And then the dietary implications, of course, are a disaster for 80 years, 90 years. Physicians tell their patients to eat less and exercise more because they think they're eating too much. And that's why they're getting fat.

[00:18:56.850] – Allan
When I was in high school, I thought I was going to be an NFL football player and offensive lineman, thought I was going to be this big, huge dude. I stopped growing in the 10th grade and couldn't put on any weight. I could eat and eat and eat and eat and in fact, really strongly believe that it was those eating habits that I developed when I was a teenager that set me up for having metabolic problems later because it was the type of food I was drinking a lot of milk, like a gallon of milk a day. I was eating loaves of bread because those were the things that put some weight on me. And so when I was younger, I was one of those folks that you would call just naturally lean. He can eat anything and everything and stay naturally.

That changed drastically after I turned 30, which again, is about the same time that certain hormones like testosterone. I was obviously I was working in corporate so my cortisol levels. I wasn't the carefree teenager anymore. My cortisol levels were obviously a lot higher. So I moved into that category in the book that you call fat and easily. And I think people who see this and they know this intrinsically. I'll have male clients and female clients and the male clients, if they really start working on the right things and do the things that are improving their overall health, they bounce back and they start losing weight a lot faster than females do. So a woman moves into menopause. And because her hormones change the structure of how and where she stores fat changes. So to sit there and completely poo poo hormones as having any involvement in this. I don't quite get it.

[00:20:49.010] – Gary
And this is what's so fascinating. On one hand, I mean, it's an interesting dynamic where. So Newberg did this. Because he had to answer questions after he said, as always, eating too much obesity always caused by eating too much. And so people said, what about menopause? You know, if you look at and I did and even into the literature on animal literature in the 1920s, you can find and endocrinologies saying, well, you know, animals get when you remove the ovaries and a female animal, that animal got fatter. And so clearly what we're doing is removing it's not secreting estrogen anymore and estrogen inhibiting fat accumulation.

[00:21:26.100] – Gary
And I think it was in the case against sugar. I had a reference from 1927 making that point. And I mean endocrinology as the term has barely even been coined by that time. They're still calling glands ductless glands and the researchers studying animals know that female animals will get fat or if you remove their ovaries. But still what's happening in humans in Newberg's says, well it's got nothing to do with hormones, even in women going through menopause.

[00:21:56.790] – Gary
They're saying what happens is they their kids are grown, they're out there, they're bored with their husbands. I'm an incredibly sexist discussions going on and they don't really care how they look anymore. And they're playing bridge with their lady friends all day long and eating bonbons. So it's still overeating. And they said, well, what about children of obese parents? Because he, you know, Julius Bauer had done some of the first research showing that, you know, we had 500 obese patients and 400 of them had at least one obese parent. I forget the exact number. So clearly it's genetic. And why wouldn't you expect it to be genetics? No, it's not genetic. And, you know, children with obesity learn to overeat from their parents with obesity. The groaning board, they called it, they just put too much food out on the table and they don't learn to control their appetites.

[00:22:50.010] – Gary
So they had an argument that everything. Nothing could be hormonal, and when Bauer attacks Newberg and you see this today with bloggers and everywhere and politicians, rather than ease off the argument a little, Newberg hardened it. Nothing can be hormonal because of anything, could be hormonal. Perhaps it could all be hormonal.

[00:23:17.630] – Gary
And then the idea of hormones were easily accepted as an excuse when that's what fat people was trying to understand. The AtMe movement or even the Black Lives Matter movement, because as a older white male, I'm being told that I can fundamentally cannot understand their perspective. And they're right. Okay, they're just right. I can't. And then it struck me that what we've got is lean people who are giving us diet advice, right?

[00:23:47.140] – Gary
The idea is if it's eating too much, the difference between if you take two 18-year-olds, say. A good example, my brother and I, when we graduated from high school, he was two years older. But his senior year, he played football. He was six feet tall and 190 pounds, six foot five and 190. And I was six foot two and 190 or 195. We both played football. We were both pretty good. He never got over 195 pounds and I went up to 240.

[00:24:17.450] – Gary
He couldn't. And he had more than I did. We would both accept that the difference was the idea the reason I went to 240 is I ate too much. And the reason he never went over 195 is he didn't, even though he ate far more than I did. So you've got these lean people giving this advice and they don't know what it means. They don't understand what it's like to slowly get fatter year in and year out no matter what you do. Right?

[00:24:48.680] – Gary
So we've all been through this. You restrict what you eat, you give up sweets, you do your calorie counting and no matter what you do and this is why I use that phrase fat and easily. It's like 1950s diet book terminology, but some of us fatten easily. And if you're not one of us, you can't understand what that's like. And you can't just say, well, you got to eat less, dude, or get out and run around the track, because that doesn't stop our bodies from wanting to fatten easily.

[00:25:21.610] – Gary
And we have to understand why our bodies are doing that. You're lucky your body doesn't do that. Just like somebody who wants to play basketball is lucky if they grow to six foot eight rather than six feet tall. And we know that's hormonal.

[00:25:35.960] – Allan

[00:25:36.380] – Gary

[00:25:38.480] – Allan
Because they too much.

[00:25:39.890] – Gary
Not because they eat more than the six foot guy. And it's funny. That's what the first guy, a German, Gustaf von Burgmann, who sort of wrote up this hormonal idea and made fun of this eating balance/energy balance idea said you know, a growing child is hungry all the time. That's not why it's growing. And you would never tell the child, look, if you would just eat less, you won't get so tall because we know they're not related.

[00:26:12.260] – Gary
And yet they turn this into obesity. They're growing outward instead of upward. And suddenly you flip all the causality in telling them to eat less is somehow a solution. And it's just not.

[00:26:24.770] – Allan
You said something in the book that just kind of resonated with me, probably something I should just actually just have posted somewhere for people to read whenever we're talking, particularly when they're dealing with hunger, is that you indicated in the book hunger is a response, not a cause.

[00:26:45.380] – Gary
Right. If you look at any biological system other than obesity, hunger is a response to a calorie deficit. Basically, you burn more calories, you're growing. You're going to be hungry because your body needs is building is in positive energy balance. It's building bones and muscles and connective tissue. And it needs the energy to do that and it needs the resources to create that that new growth and the response is you're hungrier than you are if your body isn't growing.

[00:27:18.170] – Gary
The examples I used and why we get fat. My second book was, you know, an elephant eats more than an armadillo because it's and it eats and several orders of magnitude more food because it's several orders of magnitude bigger. We never have a system where the amount consumed drives the growth of the system. It's always the growth process that determines the amount consumed. And what's fascinating is in nutrition. So remember, we've got these lean people. Newburg, by the way, was pencil thin. We've got them saying, look, fat people get fat because they eat too much, so they should eat less. And if they eat less, they'll lose the weight and everything will be fine, but we actually had an experiment to look at what happens when lean people eat less. And that was his famous experiment, Ancel Keyes, who in the early 1940s was a relatively young, ambitious nutrition researcher at the University of Minnesota.

[00:28:20.830] – Gary
This was before his dietary fat work. And he did an experiment, a famous experiment on starvation. And he published two books, two volumes of the biology of human semi-starvation. And this was a it was a semi-starvation experiment. So we got thirty two or thirty four conscientious objectors. And the idea was to understand the physical and psychological consequences of semi-starvation because when we won the war in Europe, the assumption was we would be confronted with famine conditions and particularly Eastern Europe, and we would have to know how to treat these people. We'd have to understand medically what they're going through.

[00:29:08.200] – Gary
So the diet that Keyes fed these conscientious objectors was similar to what they expected they would see in Eastern Europe. So it's tubulars like potatoes and turnips and little green vegetables and some very lean, small portions of meat. So it's a low-fat, low calories, about 1600 calories a day, even though it's referred to as a semi-starvation diet. That's what men are told to eat if they want to lose weight at the rate of a pound or two a week. So 1600 calories a day of a low fat, mostly plant diet, a very healthy diet by today's standards and the obvious consequence of this diet, not surprisingly, if you feed someone a semi-starvation diet, they get exceedingly hungry because they're only eating half the calories that they need.

They thought about food constantly. They obsessed about food. They wrote about food in their diaries. Tf they had gum, they chew gum constantly. They dreamt about food at night. They weren't allowed out of the lab to walk around town without a buddy system because they couldn't be trusted not to cheat if they were allowed out of the confined area where the study was going on. Several of the subjects suffered what Keyes and his colleagues called, I think they call it semi-starvation neurosis or psychosis, they had mental breakdowns. One of them tried to mutilate himself, actually successfully cut off several fingers with an axe, claiming that an accident so he could get out of the study.

[00:30:57.540] – Gary
The assumption is a lean person can tell a person who suffers from obesity to eat less and maybe 1600 calories a day, and that person won't be able to just lose weight, that's all. The fat tissue will get about the excess calories and they'll be fine. But the reality is, we know that if a lean person were to eat 1600 calories a day, they'd be starving and unable to sustain it.

[00:31:21.810] – Gary
By the way, the other thing that happened at the end of this trial, they lost 15 pounds in the first three months and then weight loss slowed down and sort of ground to a halt. So eventually their weight loss was not all that meaningful. They didn't have a lot of extra fat to lose. Then they start refeeding them. Okay, so now you're feeding semi-starved individuals and they're voraciously hungry and they had to slow down the feeding so they wouldn't get sick, but they still could eat like 10000 calories a day and they ended up all putting on more fat than they lost, which Keyes and company called post-starvation obesity.

[00:32:05.100] – Gary
The comment in the book, because we've all been there, right? We've all tried to starve ourselves, lose the weight, and then eventually you end up with binge behavior because you can't sustain it and you end up fatter than you started. All of this had been documented in lean people, and yet that's still the advice. And then lean people, conceivably the most famous nutrition experiment in history. And yet the lean people who tell us to eat less don't pay attention to that, because if they did, they would have to figure out something else to tell us.

[00:32:38.730] – Allan
When I was in the army, in the infantry, and so we're training and the way they would work is they had these meals ready to eat, MREs. That they would give us. And each one was 1000 calories and we were allotted three of them in a day. So, you know, I'm a young, healthy male, too, you know, 20 years old, 21, 22, and they're giving me three thousand calories a day and I'm losing a pound a day, so if I went out for two weeks, I'd lose 14 pounds and I didn't really have that much extra body fat to lose at that point in time, because I was at the time, I was about 185 pounds, maybe one 195 relatively lean.

[00:33:22.830] – Allan
But I would lose a pound a day if I was out and I was doing everything I could to find calories. So there were people who liked coffee at the time. I wasn't interested in coffee. I would trade my coffees for their cocoas. I would say, are you eating your creamer and your sugar? And if they weren't going to use their creamer and sugar, I would barter for that and I would take those to make little sugar cookies.

[00:33:47.880] – Allan
And so I was learning all of these little tricks on how I could get more food. And in fact, we were going in an exercise and this other group came in and our job was just to disrupt them. And when they came in and drop their packs off, we ran them off with their packs. When we came back through, we realized they had food in their packs, so we stole all their food.

[00:34:11.070] – Gary
This is a funny thing because you were lean, right? It's not funny. It's tragic because you were lean. Nobody judged you.

[00:34:19.170] – Allan

[00:34:19.830] – Gary
As though you are a glutton or a sloth or you lacked willpower or anything like that. You were just hungry and you were doing what you needed to do to get the food you wanted. But had you been overweight or obese and someone had seen you stealing that food, they blame your lack of willpower for being overweight or obese. I had a conversation with excuse me, the nutritionist at NYU recently through email has been arguing for decades that it's all about calories and she told me that her father had been obese and he definitely had a voracious appetite. And I said, but look I've eaten dinner with her over the years. I once took her out to a wonderful, amazing Italian restaurant in Greenwich Village to thank her for being a source for one of my very first article on dietary fat. And I said, you've seen me eat right. I am twice your size. I eat more than twice the amount of food you eat and I will leave the table hungry. But you don't judge it because I'm not obese, right?

[00:35:33.390] – Gary
The reason they twice as much as you do is because I'm twice as big as you are. It's that simple. And if my body was trying to get bigger still by putting on fat, I'd be hungrier still. And she may have actually gotten that. Again, in this world, people very common phenomena, when you can when you try to get people to shift paradigms literally from this energy balance, thinking and gluttony and sloth to hormonal regulatory thinking and insulin and carbohydrates. You can get them to shift momentarily, but inevitably they snap back to the way they always believed.

[00:36:15.860] – Allan
There's a little bit of data there and, when you're when you get into a study where they'll do a well, they'll do a low-carb versus a high-carb switch but typically when they do that, they're really not going low-carb. They're they're going more of a moderate-carb kind of thing. And what they typically will show is for the first six weeks or so, these individuals that are on a low-carb diet lose more weight, but then they'll say six months later everything's pretty much even.

[00:36:47.420] – Allan
And I'm like, well, most of them weren't trained. That's how they were supposed to keep eating. So they went back to their old way of eating. And basically all you did was really. Yeah. Gave them a short term thing. And then you didn't pay attention to the fact that if they'd continue doing that thing for six months, it probably would have made quite a bit of difference.

[00:37:07.940] – Gary
The nutrition community has all kinds of excuses for why they can do bad experiments. So when they do those experiments, they don't test, for instance, whether a ketogenic diet leads to more weight loss than a low-fat or mostly plant diet. When the diets are sustained, they test the intervention. So they say, well, we've told people eat a low-fat diet and we told people to eat the ketogenic diet. And we gave them, you know, Atkins' book and Ornish's book or something like that. And then, you know, we just had them come in. We wanted to they they won't write it up like this. So they'll assume that they'll write it up as other people stayed on the diets. And then if you criticize and say, well, clearly from the data that people and stay on the diet and they say, then we know the diet to unsustainable. I co-founded a not for profit to try and improve the quality of nutrition science. We did some interesting experiments, but we did not succeed at improving the quality of nutrition science.

[00:38:18.690] – Allan
I guess the point I'm trying to get to is we're responsible for ourselves. And if we really want to get to the bottom of rather than most of us, I think we're listening to this and thinking we need to lose some weight. We probably fatten easily. We're probably not naturally lean. So we need to do something different than what is there, something different than what we've done? And if you've been concerned about the keto diet, just try and experiment.

[00:38:47.460] – Allan
And the experiment is to work with your hormones, looking at your carbs and your protein and your fat. And so, Gary, if someone was going to sit down and say, okay, I'm going to do an experiment, the subject is one. So my N=q and I'm going to do this experiment, how should they structure their experiment?

[00:39:06.720] – Gary
OK, so and this is why I wrote the book, by the way, among other things. So people know that they can do this. It's not going to kill them. Twenty years ago, you would have when I first did this as an experiment, I kept waiting for my heart attack. And then they have to understand how to do a right. Like any experiment, you have to get the methodology correct. So what we're doing with a low-carb, high-fat ketogenic diet. So remember, we broach this idea, the hormone insulin regulates fat accumulation. Insulin goes up, we store fat, insulin comes down, you start to mobilize and oxidize it. What's often not discussed is when insulin comes down, there's a threshold effect. So when I interviewed the researchers who studied fat metabolism, a phrase they often used was that fat cells are exquisitely sensitive to insulin. So if you're secreting even a little bit of insulin, your fat cells are detecting that. And that insulin is inhibiting what's called lipolisis, which is mobilization of fat from the fat cells.

[00:40:11.090] – Gary
So when you want to do if you're overweight or obese, you want to get fat out of your fat cell. So the fat cells, lipolisize fat, it's stored so it can come out and then you want to burn it for fuel. And what to do that you have to minimize your insulin levels, probably.

[00:40:29.310] – Gary
So ketogenic diet minimizes insulin. That's what it does. And it does that by replacing the carbohydrates, you consume all the carbohydrate rich foods. So everything other than green leafy vegetables and so on. It's a high-fat diet. So you're not eating grains, sweets, starches, legumes, because they're all carb, relatively carb rich. You're eating green leafy vegetables, eggs, meat, fish, fowl, butter. Animal sources of fat. In practice, it's actually very easy to do, it sounds complicated, but breakfast, if you eat breakfast and most of us in this world are many of us are now doing the intermittent fasting as well as our time-restricted eating. We just don't eat breakfast anymore. But if you do, instead of your usual carbs sources, toast, cereal, juice, skim milk, fruit, you're eating eggs and bacon.

[00:41:34.680] – Gary
It's the hardest thing to get over is the belief that eggs and bacon are going to kill you or eggs and sausage or kippers and sour cream, trout, leftover food from dinner. And then your lunches. I don't know. I lived in New York when I first came to L.A. when I first did this as an experiment. And I was a writer and I was unmarrieds. You tend to eat out every meal and inexpensive restaurants. And so I'd go out and instead of getting half a roast chicken with French fries and broccoli, I would order that roast chicken, say, hold the fries, give me a double or broccoli or, you know, hold the fries or the baked potato, give me an extra order of salad. And so you end up eating more green leafy vegetables than you ever did. Some vitamin deficiencies are not an issue.

[00:42:28.450] – Gary
Same for dinner. Dinner was instead of steak and potatoes and broccoli, it was steak and broccoli. You're just not eating the starches, the grains and the sugar, basically. and most people who do this and do it right. So the idea I remember is also so insulin dominates fat accumulation, carbohydrates dominate insulin regulation. So the simplest way to think of this is carbohydrates are fattening. That's what our parents generation grew up believing anyway. And so if carbohydrates are fattening and you don't eat them. Because at any time and what you eat them, they will work to make you fat or and if you try to prevent yourself from getting fat, it just make you hungry.

[00:43:21.640] – Gary
So you abstain from carbs. You replace it with fatty sources of food. You don't worry about the fat content as long as it's coming from sort of naturally occurring foods and people get healthier, they just they do. In the book, I describe this sort of cognitive dissonance between two conflicting definitions of a healthy diet. One is what we're told to eat fruits, vegetables, whole grains, legumes, lean meat in moderation.

[00:43:57.610] – Gary
And the other is what actually makes people like you and me healthier, which is green, leafy vegetables and meat, fish and pound dairy and eggs.

[00:44:09.370] – Allan
Yeah, it was interesting because someone posted on my Facebook group. They were looking they were struggling with keto. They had some struggles with keto diet and they wanted a balanced diet. And then, of course, there was another person that responded. Isn't that an oxymoron? And I had to respond and say, absolutely not. I mean, I probably eat. I would say ounce for ounce more vegetables because they're leafy green than I do eat meat when it's all said and done.

[00:44:40.390] – Allan
And yeah, there's some fat in there to make it actually taste delicious. But, you know, is just because everybody wants to nitpick and, you know, they're like, oh, it's the bacon diet. I'm like, well, they have a little bit of bacon. It's condiment. It's it's an aside, you know, it's like that's not their main protein. We're not all sitting around running around eating pounds and pounds of bacon. Now, yes, there are some people that are doing that, but in a general sense, you can have a balanced, fully nutritious diet. You have to have the understandings of what your body needs with regards to vitamins, minerals and particularly electrolytes. If we're going to go into ketosis because we're going to flush some water and just understanding those basic things is just a function of knowing how your body responds to food and eating appropriately.

[00:45:30.880] – Gary
And that's it. It's unlearning a lot of the simplistic crap we were taught. And then basing thinking about your diet in terms of human physiology instead of some, you know, like we're thermodynamic experiments. My favorite part, so part of what I did in this book, I interviewed over 120 odd physicians who had converted to this way of thinking. I estimate there are tens of thousands now worldwide at least to do this, but who now eat this way themselves and prescribe it to their patients. And by interviewing all these physicians, I could understand the challenges to them and to their patients and how they overcame those challenges. And at the end of the book, I give advice based on and ways to both think about this and do this, so that the eating a low-carb, high-fat ketogenic regime is something they can do for a lifetime.

[00:46:31.800] – Gary
But my I think my favorite chapter is. I start with the quote from a woman named Doctor named Carrie Doulos, who's a spine surgeon in Ohio. And Carrie comes from a family with a history of obesity and says without understanding her diet, she'd be 300 pounds. She's also a type one, has type one diabetes now, and she's a vegan. And she used to be a ketogenic diet. And she does so because she can tolerate animal products. So she would have she always had some ethical issues with them and she grew up ethically opposed to eating them. But she would do it if her body tolerated.

[00:47:13.260] – Gary
It just doesn't seem to do it. And she said it's it's not a religion. It's just about the way I feel, about how I feel. And to me, ultimately, that's kind of what we're doing here. And I play Carrie Doulos off against Georgia Edes, who's a psychologist, psychiatrist in western Massachusetts whose body doesn't seem to tolerate plant foods. And so Georgia is now a carnivore. All she eats exclusively is meat. And that's what makes her feel healthy and able to achieve a healthy weight. And as long as you know that you don't have any vitamin and mineral deficiencies and that you know your lipids are not insane, whatever that means is.

[00:47:58.220] – Gary
Of self-experiments until you found dumping crap food on us. And so we didn't really have to think about what we ate anymore. So you could give your kids sugary crap for breakfast and they'll eat it because it's full of sugar. And then you can give them take them to McDonald's or fast food restaurants and buy them a Coca-Cola and get them crap for lunch. And they'll eat that because the food industry did such a good job of making it palatable and the same for dinner and nobody had to think about it anymore. But there are people who think about it all the time or that the vegetarians and vegans have to think deeply about what they're eating and daily about making a healthy diet.

[00:48:38.210] – Gary
And anyone who is a foodie does it naturally and there's nothing more important to us. That's the fascinating thing. It's at least tied for being the single most important thing we can do in our lives, which is eat healthy. And it just requires some thought and practice to do it right? Nobody gets good at anything with that practice. The longer you do it, the easier it becomes. And meanwhile, we've been getting these messages from the nutrition community, don't even think about doing it. If you abstain from a if you don't eat the entire food group, that's an eating disorder. If it's unsustainable, don't try it anyway. Nobody can eat this way.

Even though it'll make you healthier, we're not going to tell you to do it because we don't believe you'll sustain it. I mean, sort of insane logic from the nutrition community. Whereas what they should be saying is being healthy takes work, you know, and so eat a diet that's designed physiologically to make you healthy, which this is, and then work at it so it gets easier. And now, of course, the food industry has settled. And so there are sort of you know, you can go on Amazon and buy a gazillion, you know, keto-friendly snacks and drink and God knows what they're doing for us.

[00:49:59.270] – Gary
But there they are. I was confronted yesterday with keto macaroons, I was always a big macaroon fan, I said I'm staring at the Amazon and blowing up the nutrition profile so I could see it going, wait a minute, wait a minute. They say it's keto-friendly. It's still like 14 grams of carbs.

[00:50:21.330] – Allan
You could probably tolerate two, maybe three of those.

[00:50:27.660] – Gary
You know, I mean, I could probably be very happy eating them, but I'm also very happy without eating them.

[00:50:32.740] – Allan
Yeah. Yeah.

[00:50:34.050] – Gary
And so ultimately, I passed.

[00:50:37.200] – Allan
Good for you, Gary. I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and stay well?

[00:50:47.340] – Gary
OK, well, I'm a big fan of telling people what not to eat, okay? I know other people don't like negative messages, but don't eat sugar, starches, and grains.

[00:50:58.860] – Gary
Wear a mask.

[00:51:01.410] – Gary
And, you know, I don't know if I got a third. I'm a writer. We're tortured. Right. So telling people how to be happy, I feel like I'm not sure I'm certified to do that. But, get outside.

[00:51:17.340] – Gary
And one of the things that we used to be so part of the logic of the nutrition world is do you tell people to exercise? Because if you exercise, maybe they'll burn off calories. And I think of this as like a greyhound, the greyhounds of the world figuring if they can just get the bastard hounds to run around the track enough, they could turn the basset hounds into greyhounds. And what they end up doing is torturing the basset hound. And you end up with emaciated, starving, exhausted basset hounds.

[00:51:43.980] – Gary
But if you can make those basset hounds healthy with the right diet, if that diet sort of reregulates their fat metabolism such that they're mobilizing fat from their fat tissue and burning it rather than storing it to excess, they'll have energy. And if they have energy, they want to exercise and they want to burn that energy off, which lean people do naturally. And then they'll want to go for walks and go for hikes and go to the gym and all those great things and get outside because of the energy to do it.

[00:52:15.850] – Gary
And so you don't exercise or get physically active to lose weight, if you fix your fat accumulation problem, you will want to be physically active. So do the former and then enjoy the latter.

[00:52:32.350] – Allan
Excellent. Gary, if someone wanted to learn more about you and or the book The Case for Keto, where would you like for me to send them?

[00:52:41.080] – Gary
OK, my website is garytaubes.com. I don't keep up with blogging, but it's there. Twitter is @garytaubes. The book is available. If you have an independent bookstore in your neighborhood that's still open, please buy it there. If not, Amazon will deliver.

[00:53:00.460] – Allan
Absolutely. Well, Gary, thank you so much for being a part of 40+ Fitness.

[00:53:04.750] – Gary
Allan, thank you for having me.

Post Show/Recap

[00:53:11.150] – Allan
Rachel, welcome back.

[00:53:13.010] – Rachel
Hey, Allan, wow, that was a really fascinating interview. There's so much to talk about.

[00:53:17.990] – Allan
Yeah, like I said, I really like Gary and I like his approach in his books predominantly because he doesn't take anything as fact. At first, you know, it's not like he's going to follow and say, okay here's here's our belief system. So I'm going to rest all of my argument on that thing. And a lot of people will do that. They'll say you don't need to do keto because it'll raise your cholesterol.

[00:53:41.630] – Allan
Some people get on keto and it lowers their cholesterol. Keto definitely lowers the triglycerides. It does a lot of other things that are really, really good for you. But it's not for everybody as Gary mentioned in the podcast. But, you know, if you're thinking about going to your doctor and you're thinking about doing keto or you're doing keto and you go to your doctor, your doctor says, oh, my God, get off that, you're going to die.

[00:54:03.410] – Allan
just realize that doctors are not infallible. And I don't mean for you to completely question your doctor, but realize at one point doctors were recommending cigarettes. You had advertisements, nine out of 10 doctors prefer a particular brand of cigarette.

[00:54:19.700] – Allan
Now, they didn't know they were not told in medical school that the tobacco was bad for them. And in fact, the tobacco companies went out of their way to make sure that that information was not available to your doctor. So doctors were recommending cigarettes. Now they're recommending different things. But some of our doctors went to medical school 15, 20, 25, 30 years ago. And a lot of them are still relying on the same things they were taught then, or they're relying on the things that they get at their conferences.

[00:54:52.370] – Allan
They have to do their continuing education. I don't know what they call it. You know, we call it CEUs use in a personal training space. We used to call it CPE when I was an accountant. But they have to get they have to go back and get education. Now, these educations are typically conferences and these conferences are typically sponsored and run by drug companies. So most of the science, most of the things they're hearing are not food can make you healthy. It's you need this medicine to be healthy and we don't have a deficiency of medicine. We have a problem with our food and Gary does an excellent job of kind of walking us through step by step, the Case for Keto. And so if your doctor is saying maybe you shouldn't be on that on that diet, highlight his objections, highlight them in your book, take the book to your doctor and have him read that section. You know, you need to do some stuff.

[00:55:49.620] – Allan
I remember when I was going through my first divorce. It sounds terrible, doesn't it. I was going through the process of the settlement and everything that happens. And, you know, she was going to get half of my 401k. And so it happened at that point in time to be reading a lot of things about divorce and about, 401ks and all that other stuff. And it said, you need this document called a QDRO, it's qualified something, something, something. Basically, it's where you're redeeming your 401k, but you're not taking the cash. So you do the form. And that way for your taxes, you don't have to pay taxes on the money you withdrew. Otherwise you do. And then the story was about a doctor who took a million dollars out of his 401k and basically had to pay five hundred thousand dollars in taxes because he didn't do this one document. So I went to my attorney and I said, well, have you drawn up a QDRO?

[00:56:46.200] – Allan
And he's like, What's that? So I showed him my research and I went to another law firm, a friend at another law firm, and requested a boilerplate for one and gave it to my attorney and he charged me my hourly rate for his time to read my research and do the form, which I thought was really, really not cool. But at least I saved myself a ton in taxes because I was aware of the situation. And I was a part of my own legal team.

[00:57:17.340] – Allan
I didn't just depend on the opinions and requirements that are put forward by my attorney. I made sure I understood the process as well as I could. So that I could be a part of the team and you really kind of have to do the same thing with your medical, because doctors are not infallible. They're human beings just like us. They're very intelligent human beings and they're fairly diligent because they did go through medical school. But at the same time, they're not doing the research specific to you every single day. You have to do that research.

[00:57:51.340] – Rachel
That's right. And you need to take your own reins of your own nutritional choices. And it's good to ask questions. It's good to question the doctor and help them or they can help you better once they know what you're trying to find out. But yeah nutritional guidance has changed so much. But the problem is that it hasn't been reflected in our country for anyway, in our guidelines, the food pyramid, as as we knew it growing up, was like that for probably 15 years and know that there were changes in the food pyramid. If it wasn't, last year was the year before, and it had been literally ten years in between. Any additional changes to what we know and it's only one dietary example to live by and it's not the right dietary example for everybody.

[00:58:42.610] – Allan
Yeah, well, one of the things is realized, that's a very politicized environment, Nina Teicholz wrote, The Big Fat Surpise, I believe, is the book she wrote. And she's been an activist on this thing the whole time. And the reality of it is when they get the people together in the room, the scientists, they're supposed to go through these studies. They sit down and they look at all the studies and then they start throwing some of them out as irrelevant or not valid. And all of the high-fat, low-carb diets, every single one of them was excluded from the study. And so, she's part of an organization that's out there trying to fight this, but they're moving forward with nutrition guidance.

[00:59:27.700] – Allan
And, basically probably for a generally healthy person that doesn't need that doesn't have metabolic problems, is not obese or overweight, those guidelines might work just fine. But for a lot of us that are I guess what I was with was is easily fat, I think was one of the terms I heard recently in an interview that that interview is coming up, guys, but easily fattened us easily fat and people. We can't eat that way. We can't feel that way. And unfortunately, that's not going to be a part of the guidelines. I was talking to a nutritionist out of Canada and she'll be on the show soon. And it was kind of the same thing. We were talking about the nutrition guidelines. She says, yeah, Canada has changed their guidelines. They don't have all of the grains and all that stuff anymore. They've lowered that down and they've got it a little bit more balance.

[01:00:16.450] – Allan
And I said United States is still charging forward with 11 servings of grain. She's like she's like, that's insane. And like, it's politics. And so, again, your doctor doing the best he can with his standard of care and his education. So just recognize you have to be a part of these decisions. You know, if you know that you need to go in for surgery and they're going to put a magic marker mark on the leg they're supposed to operate on, you check that mark.

[01:00:46.700] – Rachel

[01:00:47.470] – Allan
Don't just assume that they marked the right leg, you know, and when it was maybe it was supposed to be the left leg. Make sure that they marked the right leg. Make sure that the information your doctors giving you now, you do need your doctor to be involved. And here's one of the core reasons. If you're on metformin, some other blood sugar lowering medication or you're on insulin, your medication is very likely going to change if you change what you eat.

[01:01:14.860] – Rachel
That's true.

[01:01:16.150] – Allan
So a significant change in your diet is something you do need to talk to your doctor about. Like I said, he or she may object on the grounds that they don't believe that's a healthy, sustainable way of eating. But if you went in there and said, I'm going to go vegan or vegetarian. They'll be like okay, that's great. And it's like and keto.

[01:01:41.950] – Rachel

[01:01:42.230] – Allan
Yeah, crickets, but it's possible. And we've had we've had them on, too. So, you know, I think I think the key of this is of this whole thing is if you really want some support, when you're talking to family members, you want some support when you're talking to doctors. The only thing that I wish Gary was a doctor, he's a journalist, but he did take the time to get to the root cause he did go take the time to put together the history, to put together the case. And so to me, this book is is like gold. If you're trying to explain to someone why you're doing what you're doing.

[01:02:20.590] – Rachel
I think it's worth reading and experimenting. After listening to your podcast for a couple of years, you talked about keto for quite a bit, and I wasn't ready to accept that keto was a healthy diet to follow or lifestyle to follow. I had a hard time unlearning all of the things that I knew for a fact that that was bad for you. I mean, really, I had to really come off of all of those things that I had just tooken for a true science.

[01:02:50.410] – Rachel
But so much has changed. And and but I knew that if I didn't do something different, that I wasn't going to get where I wanted to be. And so I just like Gary had mentioned, like, I just did an experiment and I I told Mike,my husband I said, okay,I'm going to try this and see how it works. If it doesn't work, I'll try something else. But two years, almost three years later, I'm still basically following the keto lifestyle because it is working for me. Everybody needs to try that. Something different.

[01:03:23.140] – Allan
Yes. If what you're doing is not working, you've got to do something different if you expect a different outcome.

[01:03:29.630] – Rachel
Yep. And I know some people can be vegan or vegetarian. I know, like Gary had mentioned, he's got a friend who is a vegan, keto, and another friend who's Carnivore. It really is such an individual thing. And I respect anybody who can be vegan just as much as I respect anybody that can be keto. The fact is, is that they found something that works with the way that their body works and that's exciting.

So in the show notes, I'm going to make a point to I've had a carnivore on me, I've had a vegan keto on and I've had Dr. Will Cole on where he was pretty much somewhere in the lines between vegan and pescatarian. And so I'm going to link to those. So those are ways of eating that you're wanting to do. And then you're also want to consider trying keto or at least a low-carb version of those diets. I'll put the links in there for you to check those out, because there's a lot of good information in those episodes to just kind of give you an idea of what's possible.

[01:04:32.290] – Rachel
Perfect, I think that be so helpful.

[01:04:35.230] – Allan
All right, Rachel, I'll talk to you next week.

[01:04:37.840] – Rachel
Great. Take care.


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Another episode you may enjoy


How to use seasonal ketosis in an ancestral-based healthy lifestyle

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Over the past eight years, I've followed a ketogenic diet (low carb diet) for much of the year in a way of eating I call, Seasonal Ketosis. It is a part of my ancestral-based lifestyle to promote health, fitness, longevity, and joy. Seasonal Ketosis is a form of cyclic ketogenic diet based on seasons, where I'll have a season of feasting and a season of famine each year.


This episode of the 40+ Fitness podcast is sponsored by Let's Get Checked. Let's Get Checked makes it easy for anyone to get professional testing and consultation from the comfort of their home. Go to 40plusfitnesspodcast.com/LGC and use the code Allan20 to get 20% off.


[00:02:48.920] – Allan
Ras, how are you doing.

[00:02:50.130] – Ras
Great Allan. How are you today?

[00:02:52.570] – Allan
A little frustrated. The Panamanian government reneged on giving us our Saturdays back. So now it's the last time I thought I was going to get a Saturday off. And it appears that they decided that Bocas del Toro doesn't. And part of it is, you know, at least at this point, they're thinking in terms of states or provinces as we are. And we just happen to be associated with Bocas del Toro province, which includes the mainland. And so they are having some major outbreaks in on the mainland. But last we heard, there was less than twelve cases here on the island.

So, you know, it's under control here. But we, you know, living under more stringent rules. So they didn't open our curfew and they didn't give us the Saturday back. So,

[00:03:38.880] – Ras
Wow, it's so sorry to hear that. That's awful.

[00:03:41.850] – Allan
Well, it is what it is. It's just, you know, this, too, will pass.

[00:03:45.990] – Ras

[00:03:46.410] – Allan
It just means I'm going to get more miles in during my five days I can walk then.

[00:03:50.690] – Ras
That's true.

[00:03:51.390] – Allan
Than I normally would.

[00:03:52.880] – Ras
That's true.

[00:03:53.630] – Allan
So how's your week been.

[00:03:55.340] – Ras
Good. Good. Got a good run in this morning. Our weather's cooling off a little bit so running was great this morning and I've got a run club tonight so I'll be getting a few more miles with some friends tonight too. So that'll be fun.

[00:04:09.030] – Allan
Cool. Yeah. All right. So let's go ahead and get into today's episode. I'm going to be talking about seasonal ketosis, and it's a term that, I coined the phrase and I talked about a little bit in my book, and I recognized that I've mentioned it a few times on a few podcasts and I briefly describe it. But I wanted to go into a little bit more detail because I was talking to somebody about ketosis and they're like, oh, I could never eat like that year round.

[00:04:36.420] – Allan
You know, every once in a while I want some cake or bread or something like that. And so I said, well, you can have your cake and eat it too, with some stipulations. So let's go ahead and get into that episode.

Hello and thank you for being a part of 40+ Fitness Podcast, I'm really glad to have you here today. Today's show is going to be a little different. I have talked about seasonal ketosis as the way that I eat a few times on this show and on some other podcasts, but I've never really broken down how it works and why it works and what it is, specifically for me and how it fits within my overall ancestral based lifestyle.

Now, when I started this effort to go from a fat bastard to healthy and fit. I was introduced to Paleo by a dietitian and she brought up the paleo diet, explained what it was, what I could eat, what I couldn't eat, and I loved it. So I stepped away from my high carb diet and started just eating meat, fish and vegetables. I'd never heard of the ketogenic diet or the keto diet, as it's often called, but because I was on such a low carb version of the paleo diet, it actually put me into ketosis.

So I had to figure out what ketosis was because something different was happening to me and, you know, my breath and other things you hear about. But the weight loss was dramatic. So I enjoyed a lot of benefits out of the ketogenic diet. My blood sugar got steady, I had higher energy, I had less brain fog and it felt great.

Now, over the past eight years, I've continued to follow the ketogenic diet for most of the year, and I call that seasonal ketosis. Now, most people that adopt the ketogenic diet, they do it full time and they start eating low carb and they stay low carb and they try to keep their body in ketosis all the time and they see the benefits.

They would ask, why would I ever go off the keto diet if I enjoy how I feel when I'm on it? And to answer that question, for me, it's really about balance. I enjoy beer, I enjoy wine, I enjoy fruit, I enjoy yeast rolls. And occasionally I want to have a hamburger with a bun. So I pick a specific part of the year where I would allow myself to go off of ketosis. Now, I mentioned a few shows back that I had not started my famine season on time and really kind of blew it for a while. But I am back into my famine season and I've lost 25 pounds plus and still going.

But that's, that's not all this is really about. So I use seasonal ketosis as a way to stay generally healthy, to keep my health in good check, to keep my weight in a healthy body composition range. It improves my fitness, longevity, and the joy I have in my life. So I've developed an ancestral based lifestyle. And I'm not going to get into the argument about what our ancestors would or would not have eaten. I'm not going to get into the argument of, you know, how long they lived and all that. I'll talk a little bit about that. But that science doesn't interest me. I know that there were no fruits available to my ancestors in the northern part of Europe. I know that they would not have been able to transport food all around the world, so I would not have been eating nutrients from different continents all at one time.

I would not always have access to vegetables and fruits and all this other gobbledygook. I just wouldn't there'd be periods of time when I wouldn't. So but before I really get into seasonal ketosis, I do want to talk about a few key things just so we're all on the same base. When I'm talking about ancestral living, there's a few just core tenets that I'm going to throw out there. One is understanding what ketosis is now. Ketosis is when your body is burning fat.

So that can either be the fat that you're eating or it can be body fat. And in doing so, you create ketone bodies. Now, these ketone bodies are something that your brain and your body can use as fuel. Most of the time people are running on glucose. OK, there's glucose in your blood, there's glucose, you know, in the form of glycogen, in your muscles and liver. And we use that for energy most of the time.

At least that's how it's been for at least the last probably six to seven years here in the United States now. And we've also got a lot fatter. Ketones, on the other hand, can do all of that fueling. And in many cases it's more efficient and it's cleaner. It doesn't cause as many problems for us. So our bodies actually perform better, operate better and are in better health when we're in ketosis. So that's just ketosis. Now, the ketogenic diet is also called keto or the keto Diet.

It is a low carb, high fat diet that forces your body to go into nutritional ketosis. Now you can induce ketosis with exogenous ketone bodies or MCT oil, which is a medium-chain triglyceride. But that's not what I'm after here. We want healthy food. We want a healthy diet of real food that puts us into ketosis naturally. And it's not that hard to do. You just got to get the macros right and push through. Now with me, seasonal ketosis is a cyclical ketogenic diet. Now, instead of doing just a week, I do my cycles running over months, OK.

And in fact, seasons. So I'll have a season where I'll go into famine and then I'm in a strict ketogenic diet at that point. I stay in ketosis almost the whole time and then I'll have some feasting seasons when, you know, I'll go ahead and allow myself to eat what I want. I don't have any no, no's. Now I do tend to continue to eat a little bit high fat, low carb at that time, but the rules are gone. I just eat what I feel compelled to eat and enjoy the food that I have.

Now, my approach to health, a healthy ancestral lifestyle really is about health and longevity, even though we may never actually answer that question how long our ancestors would have lived. What we do know is that child mortality was much higher. We know that they didn't have the medical Know-How of modern times and they had less access to food. And we didn't have access to what, you know, most of the experts would call healthy Whole Foods. I mean, we had what was there that was all that was there. So what we didn't how we did. That's all we had.

There were no McDonald's. There was none of that stuff. And we did a lot more physical activity every day. So whatever the evidence says, you know, if people weren't living as long, it was probably for different reasons. OK, now, during those times, there would be periods, particularly in the north, where we would have feast and famine. When we would spend part of the year eating a ketogenic diet and even some periods of fasting. We didn't have food preservation. So we would have to wake up in the morning and maybe not have any food around. So we would have to go get it. We could be traveling and walking for hours and not find that.

But what we would do is if you think about it from a seasonal perspective, we would have access to more food in the spring, through the fall. So there would be fruits, there'd be vegetables, there'd be things like that. And so we would probably put on some weight between spring and fall. We'd just be a normal thing. And it was good because body fat helps protect us from the cold, keep us warmer, and it also gives us food. I mean, when we don't have food, it provides us the energy we need.

Okay, now as we go into the winter, weight loss would be the norm as we started using that fat on our bodies to keep us alive. So if we didn't have access to food, our bodies adapted to stay alive, our bodies adapted to be able to continue to do what we needed to do. I also believe that we were opportunistic eaters and we didn't have a McDonald's or a Tim Hortons or whatever it is that you have on every corner.

We didn't drink sweetened beverages. We just had water. We ate whole foods. When we killed an animal, we ate it hoof to nose. As hunter gatherers, we ate well as we could and we fasted when we had to. So we were on the land. And I think that's one of the core tenets of this is that we knew what we should eat, what we shouldn't eat, and we got that through the tribal knowledge. So, you know, I think it's really important to understand that the things that we call food today are not food. You know, groceries, as they are today, are not as nutritious as what we had been. And we've got to fix that as a people. That's got to be a priority somewhere along the lines.

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Now, another big tenant I want to talk about is fitness. Now, we were not sedentary. You cannot survive as a hunter gatherer if you're going to sit and not do anything, you just don't. So we would have to be fit. We wouldn't be able to go to a gym for cardio and strength training, but we would have regular exposure to three primary movement modalities that were really, really important for us. We would do low intensity, steady-state or LISS, as I like to call it where we had to migrate.

So, you know, food's not always where we want it to be. And the animals were moving with migration patterns. We would have to move with them if we want to be successful hunters. So this would require sometimes days of us to walk and travel, hiking, basically, and we'd have to carry our stuff with us. So if we had shelter and coats and in different clothing and blankets and all the different things, we needed tools and weapons, we would be carrying those with us. So we would go on these long, low intensity, steady state movements.

Now occasionally we would have high-intensity interval training. And you could think of that in terms of if we were hunting or we were fending off other tribes, it would require us to have some power and some skill. So working with weapons, moving for short periods of time, quickly resting, moving again, that would be normal regular activity for us. So, yes, more movement. And then finally a strength in mobility when we killed a large animal or we stumbled across a berry patch, we would feast.

Now, that would also require, in some cases, for us to lift parts of the animal and carry it back to camp, or we'd have to squat down to pick the berries that we were going to be eating. So, again, more movement. And so you can see through this, just the lifestyle of a hunter gatherer is filled with tons and tons of movement. Now, we also would have work life balance. We would be putting in long commutes. We wouldn't be doing a lot of the things we do now.

But while we're working to survive, we would also understand that we needed to rest. We would understand that, you know, we would need flow. And what I mean by flow is, you know, flow is kind of fitting in with what's there. You know, we would know that there's ways to hunt. There's ways to to move. There's there's times that we need to go. And so we would start following a natural pattern of days, months, seasons.

You watch some of the shows where they depict people and they live by the moon, the moon and the seasons give them the information they need to survive. Now, if they faced a threat and then they had a stressor, which, you know, basically what a threat would do is the stress response. It would be acute, immediate, it'd be life or death. So they would have that cortisol hit. They'd have, you know, that adrenal hit and then it would be gone. It wouldn't be this long, drawn out months and months and months of things that we do to ourselves now.

So we would have a very low stress life in a general sense, as long as we were able to successfully hunt and move and do the things we needed to do. Our stress levels were much lower. We also did risk management. And that sounds kind of weird talking about our ancestors.

But the way you stay alive, the way longevity happens, is understanding the risks associated with your life is a primal living being. We weren't worried about calories, blood sugar, vitamin C, processed meat, dietary fiber, or if we had a healthy microbiome, those concepts weren't even in our head. But what we did was we followed a path that was set by our ancestors.

My ancestors would go and they'd say, we know we go this direction. This is the way we have to go this month at the moon. And then we would go, but we would have to also understand what we're facing. If another tribe moved in to the area, we might have to change the plan, but we would do it. We had risk management. We were paying attention. So the biggest risks to us at that time was infant mortality and tribal warfare.

And the only biohacking that we would have done was just making sure that we were aware of the risks and then figuring out ways to avoid them or deal with them. And then relationship would be very important to us. We worked and moved as a tribe. And in a tribe, it works to our benefit because it helps everyone's survival. We hunted in packs and were hard coded in our DNA to be socially engaged. So that relationship, that closeness is really, really important to the nature of ancestral living.

And then finally within ancestral living. I want to talk about curiosity. You know, we did tend to follow the same basic patterns, seasonal patterns, year in and year out. But we were constantly engaged with what was going on. In the world around us, because our survival depended on it. You know, we couldn't go in and ask Google or Facebook what the weather was going to be like or if we were going to have an early summer or a late winter or whatever.

There was no groundhog to do it for us either. We looked to our elders to advise us and then the tribe had to learn and adapt, and that's how we would survive hard times. Now, I recently started a blog to dive into these issues in more detail. But full disclosure, I'm a terrible blogger. I can brag about this being episode 455 of the 40+ Fitness Podcast. But you know, I've done several blogs over the years and I don't think I've ever gotten more than maybe 15 blog posts in any one blog I've ever started.

So they blog fade pretty quickly. You know, I hope that doesn't happen with this blog. But what I plan to do with that blog is explore a lot of these topics that I've talked about so far. So if you're interested in any of those, you might want to check out the blog. I'll do the best I can, but. What's probably gonna end up happening is I'll probably end up bringing some of those topics here to the podcast, so check out the blog as I get going on it. Probably not anything else on there now. But check it out. And that's where a lot of these topics are going to be discussed in more detail. And if you have any questions, feel free to join us on the Facebook group at 40plusfitnesspodcast.com/Group. And just ask I'm there. I mean, I'm there to participate and help you in any way I can. So if you're interested in this topic, I would like to carry on that conversation.

So for today's discussion and then I'll be gone already for quite a while. But I really want to dive into seasonal ketosis and share why I do it and the reasons that it may or may not be right for you. The first question I kind of have in my mind when I'm thinking about this is seasonal ketosis. The same thing is cyclical keto diet? You know, and technically it is it's you know, you're cycling in and out of keto. So it is a cyclical keto diet. However, when you talk to most people about this cyclical keto diet, it's a six days on, one day off, and they call that a refeed day. And I'm metabolically capable of doing that kind of keto diet, but I'm not a really good moderation type person.

[00:22:02.340] – Allan
You know, I'm either all on or all off. So if I took a weekly cheat day, you know, or carb up day, I just don't know what that day after that might be like. And I might just go ahead and have a second cheat day. So when I start my famine season, you know, in my ketogenic diet, I start dropping weight relatively quickly and then I'll get to my set point and I'm good, you know.

I like seeing two to five pounds come off in a week. What I wouldn't be a fan of is seeing like four pounds down, then two pounds up. And I'm pretty sure that's how the cyclical keto diet would work for me. And I don't really like that. It's progress, don't get me wrong, it's progress. But that's just not me. I'm happy knowing that I can have a few more carbs on my high activity days without going out of ketosis.

So if I'm going to have more carbs, I'm just going to work out a hell of a lot harder that week to make sure that I can keep myself in ketosis and have the carbs too. So if I want some fruit, I got to earn it from a from a carb, blood sugar, muscle and liver glycogen model. Now, there are some positives to the cyclical keto over full time keto. In many cases, athletic performance can be better and muscle growth is better.

I'm not a bodybuilder and I perform fine without the refits. I can I can do as much as I want to do. I need to do so again, cyclical keto is just not for me. But if you're someone who's looking for a way to do keto and then have that kind of that refeed that break, you might want to check that out. Now, why does seasonal ketosis make sense to me from an ancestral perspective?

And I've gone into some of this already. You know, I when I started this and I was learning about the paleo diet, I came across Mark Sissons primal blueprint. And now Mark laid out a very reasoned case for how our ancestors lived and ate. I used to character I think he named Duroc. So rather, you believe in human evolution, creationism or intelligent design, I don't think you can argue that we we're not doing things right now.

We've got to change something. The standard American diet is killing us. You know, back then we didn't eat refined grains and we didn't have junk food. You know, we were hunters and gatherers. We were, like I said, opportunistic eaters. And we ate the nutrition that our body required, essential amino acids and essential fats. They came from animals, primarily red meat and fish. That's where we got our food. Most of our food was going to come in that form.

And then based on the seasons, you know, we had short periods of the year where it was either cold or dry. We were in ketosis because there just might not be any vegetables or fruits available to us during periods of time. And then, of course, because, you know, food availability and everything, we would spend a good bit of time fasting or intermittent fasting or maybe some extended fasting, depending on the nature of what's going on in the world.

You know, if if we got a good, cold, hard freeze and all the animals are moving and there's no, you know, no vegetation at all, we got to go with the animals. We got to catch up to them. And then we got to do the hunting. So just recognize that our diet would have been very keto for much of the year. OK, now I started doing this for weight loss. That was my my core reason. And I was very much drawn to the primal paleo diet because it made intuitive sense.

Mark did a really good job, because it was maybe the first article I read, that you can't eat what you don't have access to. So you wouldn't eat processed foods at all, ever. OK, everything we would have eaten. Would have been whole food. It would have been locally and sustainably sourced and the human body was designed to be a hunter. I mean, there's no doubt whatsoever when you look at our features, look at what we can do. We were designed to be hunters, but when there are fruits and vegetables available, we're probably going to eat those. But we would not have eaten a high carbohydrate diet year-round. It's just impossible for any of our ancestors short of just some very small areas, you know, in the tropical zones where people would have eaten primarily carbohydrate diets that just wouldn't have anyone from northern Europe, anyone pretty much if you're from Northern Europe or Europe at all, your ancestors probably didn't eat a lot of fruits and vegetables.

That's just that's just part of it. Now, you can look at the current chronic diseases, obesity, heart disease, stroke, type two diabetes, cancer, neurodegenerative diseases like Alzheimer's and Parkinson's. And the health problems are associated with our food. There's something seriously wrong. In our modern world, most people have insulin resistance or metabolic syndrome. And it's it's so epidemic that it's just weird to me that this has become politicized. That, you know, we have the food companies telling our government what to tell us what to eat is kind of crazy. It's not animal products and saturated fat that are making us sick as much as those food companies want the government to tell us that it is. It's just not true. It's the fast food. It's the processed foods.

It's high, refined carbs and sugar. We're eating too much sugar. We're eating too many refined carbs. We're not eating whole food. So if the government was in our favor doing the things that it was supposed to do, they'd be focused on food quality. They would not be telling us to eat cereal and grains and refined carbs. They would be telling us to eat meat, fruits and vegetables, Whole Foods.

Now, I've interviewed experts across all spectrums of nutrition. I've had vegans on I've had carnivores on paleo, keto, everywhere in between. The interesting thing is, is every single one of them will tell you that their way of eating is the best because it is based on high quality whole food. And they'll be able to pull out the studies that show people eating their diet. Whole Foods are crushing it. They're doing great. But what's hard is that they ignore Whole Food studies that say the exact same thing about a different type of diet, because it doesn't fit their world view, it doesn't fit their paradigm.

They have a cognitive bias. So, I just really struggle when someone tells me that the quality of your vegetable matters, but the quality of your meat doesn't. It's just all meat is bad. Or and people say the same thing you know, the other way. Is the quality of the meat matters, but all vegetables are bad. You know, that doesn't make sense to me. Our bodies were designed to eat both. Quality is what matters.

That's why the paleo diet makes sense to me. I think everybody should be trying to eat more whole food. You know, the debates out about whether we would have eaten potatoes or, you know, and I don't think we would have eaten much dairy, to be honest with you, because we didn't have cows. You know, we didn't have goats.

We hunted them or something similar to them. But we didn't we didn't have any animal product like that. We weren't domesticating the animals, so we weren't doing dairy. Beans, you know, those are a little weird because yeah, there are some issues there where we have to be careful with them. But, you know, I like the primal experience of having a big, juicy steak. I just do. I love having a cup of blueberries or blackberries and the sweetness and the tartness and just, I love that.

I'm not going to give up either one of them, I'm just not. My diet is comprised of meat, fish, vegetables and some fruit. I did try the Carnivore diet for a few weeks and I started missing vegetables. I tried the vegetarian diet and then I adapted it into the pescaterian and diet to try to get my protein. And I couldn't do it. I gained weight because I was eating too many fruits and vegetables and grains, so I just started putting on weight. So there's not something that I enjoy. And, you know, when I when I do these did these little experiments, you know, I was typically doing them during my my feasting season. So, you know, was not a period of time when I had to worry about being in ketosis. I just did what I did.

I think it's important for you to understand that whole food is the answer. However, you choose to put that in a way of eating is really about you. But I will say this. If you're going to try seasonal ketosis, you do need to think about a few things. OK, one, I don't. Have any insulin resistance or diabetes or, you know, I don't have any of the the diseases or any of the issues that that people would would be suffering from, that they might be using this as a protocol. So if you have insulin resistance or diabetes, you know, or you're using the ketogenic diet for cancer, Alzheimer's disease, PCOS, or an autoimmune auto immune issue, I wouldn't necessarily cycle off of the ketogenic diet.

Those protocols are specific about staying in keto the whole time. And so that's not something where you would want to cycle out because you're just setting yourself up. If you're way above a healthy body composition and you want to use keto to lose weight, seasonal ketosis is also probably not something for you because your weight is going to fluctuate. I fluctuate 10 to 15 pounds each year as I go through these cycles. So that is, and then, of course, if you're prone to eating disorders, you know, you need to find a way of eating that you're comfortable with.

If it's sustainable for you, the cycling in and out is probably not in your best interest, you know, except for this slip up. I had recently did a covid-19 I've been able to manage my seasons stably for the last eight years. You know, going into my feasting season in late August, early September, and then coming out of it right after the Super Bowl or my birthday at the first week of February. That's my feasting season.

And then my fasting season or famine season, as I call it, will run the rest of the year. And as I said I might put on 10 to 15 pounds during the feasting season, but I ditch that weight pretty quickly and spend my famine season at my lower, lower range of my set point. Now, I love the metabolic flexibility that I have to be able to spend part of the time in ketosis and part of the time having a little bit more carbs.

When I say more carbs, I'm talking about beer and some simple carbs. You know, it's like I'll have a hotdog, I'll have a hamburger. Someone offers me a piece of pie at a tailgate, I'll eat it. So that's kind of that thing. You know, to me, the weight loss is relatively easy. Once I'm in ketosis, my body just naturally says, OK, you don't you don't need this. And some of what I'm flushing out from a weight perspective is water.

But a lot of it is body fat and it goes pretty quickly. And I'm pretty happy with that. Now, if you're interested in diving deeper into this topic, there's two ways that you can do this. I talked about the group earlier, you know, 40+ Fitness Podcast, dotcom focus group, or you can go to the Web site – 40plusfitnesspodcast.com/455. And there's a comment section under this post.

I put a post with the transcripts each week and that's why I tell you the full show notes are there. If you go there, there's a comment section, you can leave a comment there. I'm pretty passionate about the benefits that I get and the flexibility I get and the freedom I get with seasonal ketosis and my style of ancestral living. So I love talking about it. If you want to go into more detail with this, I encourage you to go check out one of those two places and let's continue the conversation there.

[00:34:12.300] Allan
All right, Ras welcome back.

[00:34:15.510] Ras
This is great. A lot of good stuff in the episode.

[00:34:19.320] Allan
Yeah, you know, most people that will talk about ketosis, they talk about in terms of it being a permanent lifestyle. And it can be. But I think it's it's kind of easy for people to get roped into measurements or things and not necessarily doing it for the right reason. I knew that I was going to roll up on football season and want to go tailgating. You know, since I finished my Tough Mudder, I was like having a beer and I was out of ketosis that afternoon, that evening.

[00:34:50.880] Allan
So, you know, just for my life style perspective, it just didn't make sense. They're going to be periods of time that I was not. But I found a manageable way that I could spend some of the year in ketosis and get the benefits that I wanted to get, but at the same time, spent some time doing some things that I enjoy.

[00:35:11.220] Ras
That sounds great, I'm glad that you found this new way to work keto into your normal lifestyle. That sounds like it's flexible enough to work with the way that you like to live.

[00:35:23.000] Allan
It does. You know, of course, you know, this year I had a little bit of difficulty getting out of the beast mode just with everything that was going on. I did put on a good bit more weight than I normally would have. But I've dropped almost all of that now and I'm back down to near a low for the last five years, I've been running at about two hundred and seven pounds.

And I'm right about there right now. I think I'm going to push it down a little lower because my muscle mass is a little lower than it was five years ago. So I'm probably going to push my weight down below two hundred before I kind of level things out again. So I do see some fluctuations with my weight and I know that can be challenging for a lot of people.

[00:36:11.350] Ras
Yeah. That's what I wanted to ask you about that. As you watch the scale go up and down, how does that impact mostly how you feel? Because to me a few extra pounds can feel kind of yucky and sluggish for me. But for you, how does that feel when you're in the fisting mode versus the famine mode?

[00:36:31.660] Allan
Yeah, well, first off, I'm but I'm about five foot 11, so I can I think I can carry 200 pounds pretty well and I can carry up to two fifteen I would say. I don't actually worry about the scale as much. I mean occasionally I'll step on it during my fisting mode just to kind of see where I am. I can usually just guess by looking at how my pants fit.

I before we move down here to Panama, I found a pair of cargo shorts that I liked. So I bought like four or five different pair and different colors of the same cargo shorts. And so they all fit me the same way. And so I can just pretty much tell when I put those cargo shorts on how I'm doing and where I am. And as I mentioned, I eat relatively low carb during my feasting season. So I'm not crazy on carbs.

It's just I don't really worry about it. If, you know, if I'm out with folks, we want to have some beers. I don't think about it. You know, if someone offers me something that I wouldn't normally eat like a hamburger with a bun, I'm going to eat it. I'm not going to worry too much about it, but I do pay attention to my size. You know, if I didn't start noticing that I'm getting bigger, then I'll I'll tap it down a little bit.

I won't I won't go as crazy. Well, except during COVID. But…

[00:37:54.320] Ras
Yes, totally different rules for covid.

[00:37:58.930] Allan
And so, you know, if you're someone that's really stuck on the scale and you just know there's this weight, your magical weight you're supposed to wear, your head tells you, this is my no, you're not going to like this. You know, the interesting thing is, like, you know, like I said, I'll put on ten, fifteen pounds in a swing. So from my feasting to that, I will put on up to fifteen pounds.

You have to recognize that about about five or seven of that is water weight. And I flush that the first week I go back into ketosis. Right. You know, so I'll literally sit there and say, OK, I'm going to go in ketosis, you know, drop five to seven pounds in a week or two. And then it then it tapers down and I'll lose a few pounds a week and then one pound a week and then my body will get to that homeostasis, its happy weight and I just go by how I feel.

Now I've mentioned this before on another episode I was talking about this a little bit. I don't feel as good during the feasting season, you know, because the foods I'm eating or not is healthy. You know, the beer is not a health food.

[00:39:11.260] Ras
That's true. Sadly, sadly true.

[00:39:13.260] Allan
As much as they'll try to tell you it's okay. It's really good. No, it's not actually really good for you at all. That's fake science. Someone wanted that to be true. They made the hypothesis and then they just said, well, it doesn't kill you, so it's got to be good for you.

[00:39:27.730] Ras
Great. Great science.

[00:39:29.450] Allan
Yeah. So, you know, don't if you're someone who's going to freak out about the scale, if you're someone who has issues with your eating, this is not that kind of thing. You know, find one way that works and stick with that would be my recommendation for that. If you really worried about the scale, stay in ketosis.

But I also want to preface it. You know, I notice I do feel better in ketosis. It's just a better state for me to be in. But I'm not all that tight end up being that way all the time. You know, I'm okay to have a couple bad, you know, days where my energy level is not as high or, you know, I feel a little frumpy. I'm cool with that. It's the price I pay for the detour I took, and I just accept that.

If you're someone who's doing it as a protocol for cancer, for diabetes, insulin resistance, any other metabolic issue, then it's something you're probably going to want to stay on. It's not something that I want to cycle through.

[00:40:31.030] Ras
That's a good point.

[00:40:31.030] Allan
You know, even the people that do cyclical, where they're taking one day off per week, I said that that would actually drive me bonkers because I would feel like I was making all this progress dropping, like I said, seven pounds in a week, only to pick four of them back up. Yeah, it would be like that's all I'm doing is flushing water. I'm not really losing any weight.

And so I would struggle with that kind of cycle. Whereas if I'm off, I'm off. If I'm on, I'm on. And that's another thing about my personality, you know, and I talk about in the wellness chips, you've got to know yourself. You got to be self-aware. And it's one of the things I know is I don't have a dimmer switch, the light switch, maybe I'm on or I'm off.

And so it's just easier for me to say, okay, flip the switch and I just do it.

[00:41:24.010] Ras
Yeah, it's a good point. I think that the cyclical, you know, one day a week where you can have a cheat day or cheat meal or whatever, it's a slippery slope because food can be a trigger. And if you have that one serving of chips, that might become the bag of chips and then it might be one more serving the next day, in the next day. And it is a slippery slope. And if you're not confident in your ability to put it away and get back to it, then that can be dangerous.

[00:41:52.180] Allan
Yeah. And, you know, one of the things that I would like to mention is that, you know, we're starting to get anecdotal evidence and maybe some studies where we're looking at performance of someone who's in complete ketosis versus someone who uses carbs as a fuel along with ketones versus someone who's just a sugar burner. And, you know, I'm not going to say one fueling mechanism is best for everybody, but I would put this out there for anyone that is trying to do in terms sport, the heavier you are, the more weight you have to carry for the miles that you're traveling, the more wear and tear you have on your body.

And if you're eating refined carbs specifically and sugar, you're going to have inflammation and that inflammation is going to cause problems in your joints. And so from a health perspective, I would I would be the one that would air on the side of using ketones for for energy.

If I were doing endurance athletics, an occasional carb up here and there before a race might help your performance. But, you know, I'm not sure how much additional glycogen your body is going to be able to carry for that particular event. And you're always going to want to practice what you're going to race. So you would be eating carbs as a regular probably thing each week to carb up for your long runs if you're following the standard training protocol. So you would still be eating a good bit of carbs as a part of that.

So I'm not saying one is better than the other from a performance perspective. I'm just thinking in terms of wear and tear on your body inflammation and you just weigh a little bit less, you know, in carrying less water. So, you know, yeah. All of that's going to probably, in the end, help your performance. But I don't they don't have enough evidence right now where I would say there's one superior fueling way.

[00:43:55.510] Ras
Yeah. And I think as an endurance athlete, that's what kind of attracted me to keto in the first place, was I needed to lose a few extra pounds that I was carrying around. Every time we've moved and and we've moved several times as a family, we set up the house. We have projects I can't get in the runs. I gained a few pounds and so I looked to keto for just something different, a way to just get those pounds off. And it actually worked for me.

The one or two times that I've actually ate something non kaido. It impacted me greatly. I was very sick so I can't really do too much cheating. I know I've got a limit. I probably can eat something that's bread or sugar, but not very much more than a bite of cake or something small because it will impact me. But as far as the endurance part of it, it has helped a lot in my running.

I'm not winning races or anything. I've never been fast either in the first place. But yeah, keto has been a real big help for me in the endurance field. But like we like you mentioned earlier and just a little while ago is that you really need to find what works for you as an individual and there's just a wide range of eating, I could give you a couple of names of some impressive vegan ultra runners. Scott Drake is probably one of the most famous vegan ultra runners.

And then to the exact opposite, Michael McKnight, just this summer or spring, actually ran a hundred miles and no calories, nothing, no food. One hundred miles. I want to say, he did it in 18 hours, if I remember right. But so he's he's definitely keto. But like you were mentioning, he is also carving up a little bit in the week leading up. So his body was fueled with carbs, but then he goes straight kitto so that his body is prepared with fat as well.

And I think that's probably how he survived it. But he's also a pretty famous keto ultra athlete.

[00:46:05.330] Allan
Yeah, I as over the years I found I can get into keto pretty easy. I don't really do the of flu thing anymore since I go in and out, you know, each year I don't really have a kid, I feel a little less energetic for a day or two, but the switch over for me is pretty quick. So that's one of the things I like about doing it the way I do it. But that said, not everybody would you might not have the same experience that I had.

So, you know, the what's that they say in the ad is the results you see might not be your results right into it. So I'm not going to say everybody would have as easy of a time going back and forth. I don't have any insulin resistance. I don't have any blood sugar issues. You know, my awarenesses always been fine. So for me to switch back and forth seems relatively easy, you know, but like I said, most of the year, I'm eating this way anyway.

The difference is just not paying attention to my carbs, are not being worried about the carbs. And so that's why it works. And the other side of it is I don't stress about rather on that point five or point to five as far as what my ketone levels are, as long as I'm in ketosis, I'm cool. But a lot of people are like, no, I want to see that. No, I want to be one point five or better.

And I bought a Keto Mojo not long ago to replace my other ketone meter that I lost. I guess I can't find it after I moved. I'll probably find it when I go get the rest of my stuff. But anyway, so I bought it and they introduced this new where they measure your glucose and you measure your ketones at the same time. And we do that. It gives you a different measure relative so ketones relative to glucose. And so it's an index that they've created.

[amazon box=”B08G5BZQVL”]

And so again, it's just one of those. But again, it's that competitiveness of seeing a higher number that it seems to be pushing toward. And I'm not a big fan of that. You're either in ketosis or you're not. You're not. You know, you can say you're more in ketosis. I mean, there's just more ketones circulating in your blood. So I don't think you're in more ketosis. You just can't be more perfect.

You can't be more pregnant as you are. There are the days you might feel more pregnant than you did the day before. But you know that you're not in you know, you're not in more ketosis. You're in ketosis, you're not. And so it's for me, it's a good protocol. But I'm a little bit different in that I don't have a health issue. I do it to thin out, to lean out a bit, because if I did the feasting all year round, if I ate that way out of control, I would blow up, you know, so I know I can't do that and I have to be very cognizant of it.

I wasn't this year. I went and I stayed with it and just kind of proved my point of once I broke that that that barrier that I had my set point for my body, it said, oh, good, we'll just throw in a lot more weight. We don't have a problem with that. You gave us the fat cells years ago. We know how to use them. Just keep feeding us. And it did. So, you know, you got to turn that around.

And for me, it's when I said no dimmer switch just flipped the switch and let's go.

[00:49:25.580] Ras
That's awesome. You must be very metabolically flexible then to be able to go on and off and in and out of ketosis. And your body doesn't give you the pain that a lot of people get with people it doesn't know, you know.

[00:49:38.780] Allan
I'm very fortunate. I know a lot of people are not like that. They struggle to get into ketosis. And once they're there, like, I love this, I'm never going back. And, you know, that's cool. But, you know, you eat something bad like you said, you don't maybe you don't even know it has sugar in it or as many carbs in it as it does. And you eat it and you fall out of ketosis.

Now, people do that all the time and go right back into ketosis and never even know they were out of ketosis. So it's not this magical state. Where you're going to have to go through keto flu every time you go in and out, because people are going in and in some levels, most people are in a mild state of ketosis almost every morning they wake up because you've gone, you know, eight or 12 hours without eating. So your body is starting to produce ketones.

Now, is it using them efficiently as a fuel? No, because you're immediately going to put some more glucose in the system. You know, if you're very active, like you do your endurance sport and you're burning down some glycogen in your muscles and your liver. So when you do have additional carbs, some additional carbs, your body's going to use this insulin to restore that. So if you need it in the liver, if you need it in the muscles, then insulin is going to do its thing to do that.

If you didn't do any work and you're already topped up with glycogen, then it's only got one other choice and it's going to start making fat. So if that's something you're trying to avoid, you want a better body composition. I can't think of a better way to do it than keto.

[00:51:09.910] Ras
Yeah, that sounds about right. That's what I've experienced as well.


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– Anne Lynch– John Somsky– Melissa Ball
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Thank you!

Another episode you may enjoy


March 9, 2020

High fiber keto with Naomi Whittel

One of the complaints about the ketogenic diet is that it lacks fiber. Naomi Whittel has solved that with her new book, High Fiber Keto.


Allan (01:05):
Naomi, welcome to 40+ Fitness.

Naomi (01:08):
I am so excited to be here with you. Thank you. Thank you.

Allan (01:11):
Your book High Fiber Keto. Okay. First, you know, fiber and keto in the same book title right next to each other. Actually getting along, uh, a 22 day science-based plan to fix your metabolism, lose weight, and balance your hormones. So when I heard this book was out there, and like I said, keto and fiber in the same title and right up to each other and they're not fighting, they're actually getting along in this book. So I don't want to give all of the plot away, but, uh, you know, I just thought that was a very interesting concept and I was really eager to dig into the book and I'm glad I did because I learned quite a bit.

Naomi (01:45):
I'm so glad to hear that. You know, it's, um, to me, first and foremost, keto is something that I've been passionate about personally for about two and a half years. So I've been in a ketogenic nutritional ketosis state for about two and a half years. I've come out of it a couple of times, but most of that time I've been there. But I was born in Switzerland. I was born on a biodynamic farm and so whole foods and, um, clean, nutritious vegetables, meats, dairy, fruits, all of the things. And I've eaten a lot of grain over my life. Um, all of it started with this premise of whole food. And I, I really appreciate the philosophy of the concept that look, not one size fits all and it also depends a lot of times on our age. So I'm 46 years old. Nutritional ketosis is perfect for my body because I'm like 75% of the U S population, which says that they are carb or experiences Carb intolerance may not recognize that that's really what's happening, but they're carb intolerant.

Naomi (02:59):
Growing up in Europe, my mother's French eating baguettes every single morning, having a carb centric diet. It took me many years to get to the place where my autoimmune system was like, okay, I'm done. I can't take any more of this abundance of glucose. You know, my insulin was all over the map. My blood sugar was all over the map. And look, I was eating healthy foods, but it was the time in my life. And so I'm excited to sort of bring what fundamentally I believe is important for all of us. And that's fiber and what fiber does in our body, like 90% of Americans are deficient in their fiber. And then when you take, you know, there's soluble and there's insoluble fiber, some of the fibers that are out there, the soluble fibers have different types of fibers, like things like inulin that literally create the prebiotics that feed your whole microbiome. So your probiotics in your body love certain foods. And those happen to be a lot of these amazing fibers that connect with the nutritional ketosis.

Allan (04:18):
And I want to jump ahead to that. I want to talk about fiber because I think you're right. It's one of the big arguments when you go in and say, okay, I'm going to do this keto diet. And they're like, Oh well you won't get any fiber in your diet and therefore that's bad. But I know, and they're right, there's a lot of science out there that tells you that fiber is beneficial to your heart, but you got to get it from the right sources. So in the book you had the five fiber facts, could you kind of go through those facts and kind of walk us through, because one, I think it's going to show us how important fiber is in our bodies and then two, it's going to kinda dispel some of the myths of why Keto and fiber are not really against each other and they can actually work together.

Naomi (05:01):
Yeah. You know, I'll just give you a little bit of background and then we'll get into the five facts around fiber. What I would say with the five fiber facts is that when you're getting into nutritional ketosis, when you getting into nutritional ketosis, what usually happens is your body naturally in trying to sort of meet the 65 to 75% of the fat needs that you have, your body naturally just gravitates towards what's almost like a little bit easier and more simple. And so over time, what I was finding for myself in my own body is while I had always consumed a ton of fiber, I wasn't getting enough fiber when I started keto. So the five fiber facts were really like where I fell and started hurting my own health because I wasn't getting fiber. And then recognizing, okay, how do I bring these carbohydrates into my body in a way that's not going to take me out of nutritional ketosis?

Naomi (06:07):
Because by the way, I feel amazing in nutritional ketosis. So I would say the very first thing that anyone needs to think about when it comes to these fiber facts is that if you're eating things like cruciferous vegetables, you and I are both really big fans of them. What are they? Things like a broccoli, things like, you know, the, the most delicious cauliflowers. I mean there's cabbages. Like there's so many different, uh, Brussels sprouts. I had a ton of Brussels sprouts last night. So this family of vegetables do more than just bring in the good fibers. They have so many health benefits. I mean, we could go through the sciences. It's completely mind blowing as we know it. They also activate autophagy in our body. And my first book, Glow 15 is all about the ways that we can naturally activate within our system what we have. And activating a autophagy is our natural detox system.

Naomi (07:12):
We know that the cruciferous vegetables help to naturally detoxify our body. And so in order to have this optimal health, we have to make sure that we're really bringing in the right amount of fiber. So most people need somewhere between 25 and 35 grams of fiber. But because fiber's a carbohydrate, and in my view of nutritional ketosis, I try to keep my carbohydrates to about 50 grams a day. I don't play with net carbs or I don't or you know, the, I just say 50 grams of carbohydrates. So then I'm looking at fiber as part of those carbohydrates. And fiber obviously is utilized in the body in a very different way than other carbohydrates, right? It's not going to spike the insulin, it's not going to create the blood sugar issues. So it's, it's pretty exciting to sort of think about how that can work in the body.

Naomi (08:13):
So fiber helps to balance our blood sugar and we know that this balancing act that fiber does is just one of the sort of benefits of fiber. And what I found when I brought the two together, Keto and fiber was that the ketogenic diet also helps to balance blood sugar. So you take the two and you have like a 10 X effect, so that's a really powerful thing. Again, next one. Satiety. Nutritional ketosis helps us to feel satisfied and for me one of the best benefits was being able to take control of my mind again. We have like 60,000 plus thoughts in an average day. How many of those thoughts do we spend craving some sort of sugar or some sort of food or whatever it may be. When you get into nutritional ketosis and your body's able to really use your own body fat as your fuel instead of using sugar glucose as a fuel, you become satiated, your mind is able to focus on many other things because you're not an on this hamster wheel.

Naomi (09:31):
Well, fiber also really helps us to say sheet, which again helps us to not have those cravings. So it becomes like this virtuous cycle of positivity for our health and our wellbeing. So it helps with satiety and it helps with cravings. And the beauty of fiber rich foods, you know I have artichokes on the front of my book is a fiber dense food is a nutrient dense food. The whole food aspect of fiber rich foods is so powerful. So you get like a pack of all of that, which I love very much. And you know the artichoke is a great source of fiber. It's got about, on average a mid sized artichoke has about 10 grams of fiber. It's also got all of the important electrolytes. So one of the big issues that we have when we are deficient in fiber, which again about 90% of Americans are deficient in fiber, is we also become deficient in magnesium.

Naomi (10:37):
And we know that magnesium is this core mineral that we need for recovery when we exercise. We need it for over 300 reactions in our body. And yet it's not only about it not being in the soil like it used to be, it's also because all of our crops are being sprayed heavily. So even if you're eating organic, you're still not getting the levels of magnesium that your body needs. And then you take it a step further. If you're not eating fiber when you're doing nutritional ketosis, it makes it even more difficult. And magnesium is so critically important for anyone who's doing keto. It doesn't matter what diet you're doing, it's going to be super critical. But the electrolytes that you need to take when you're doing nutritional ketosis are more so than if you're on more of a carb centric diet. So the last thing that I would just say sort of as, as the five areas of focus with fiber is the fiber helps with our digestion. It helps to improve our digestion, it helps to increase the amount of butyrate that we're producing. And butyrate, as we know, is how our ketones are produced. And ketones are the energy source. You know, Dr. Dominic D'Agostino considers them like the fourth macronutrient. Um, there's a lot of research that we're going to see around ketones and what ketones do for our brain, what they do for our different organs. But the beauty of fiber is it works synergistically, truly with nutritional ketosis and within our digestive system it also helps with the production of butyrate.

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Allan (12:18):
So some of the core things that came out of that, then I want to kind of just reiterate here is one, you're getting your fiber from whole foods. This is not something where they say, okay, here's a cereal that has all this high fiber stuff, but we're still talking about real food. The other thing is, you know, for most people you can get in and stay in nutritional ketosis with 50 grams of carbs per day, particularly if a large percentage of those is coming from fiber. So if you're targeting that 25 or 30 or 35 grams of fiber and you're measuring your ketones, what you'll find is that you'll be able to get into ketosis. There's other people that will just, they'll cut out carbs entirely. They'll get down well below 20, maybe down to zero or 10 or something like that.

Allan (13:03):
And they find themselves in ketosis pretty quickly. But then they're not getting their magnesium. They're not getting their sodium, they're not getting their potassium. So they're having to supplement with those things. Whereas if they're eating a nutritionally dense fiber rich diet, that is also ketogenic they're less likely to be deficient in those minerals are going to be getting the nutrition they need. And so it's kind of like you said, it's the best of both worlds because you're going to get to eat your Brussels sprouts too. And I love Brussels sprouts by the way. We just can't find them on this Island. And often enough, every time I see him, I snatch them up. Uh, I had my wife, my wife went to David, which is a town about five hours away from here. And I told her she asked what do you want?

Allan (13:45):
I'm like cauliflower, all the cauliflower you can buy. Cause we can get rice cauliflower. But they charge like for like 16 ounces of it, they charge like seven, eight bucks. And so I was like, buy some cauliflower. So it's, you know, for $3 you buy head, she'll buy me three heads of cauliflower for nine bucks. So I made a bunch of cauliflower rice. Yes. And so you know that's kind of the cool thing about all this is that when you're giving your body what it needs it starts operating better. Your thought clarity, everything else is going better. You had a concept in the book that I just thought was awesome because I tried to tell people, you know, don't, don't feel like you have to kill yourself on a treadmill every day to get weight loss and also realize that, you know, sitting around doing nothing is also probably not the answer as well. You want to get yourself into a good basic protocol of movement and everything else. So you're finding kind of an optimal space for lifestyle. You mean the term you used in the book for that was dream metabolic engine. Take a few minutes to get into that concept because I really liked this concept.

Naomi (14:52):
Yeah. I love this concept. I'm very excited to share it with all of you. So as a woman in her mid forties, I'm always looking for ways to optimize my health. My biology, I have four children. I'm a founder and entrepreneur, you know, and an author so my time is so limited. And I also, you know, I know, but it feels like we all know what it feels like to have a body that's like really working with us and for us. And so I'm always striving to give my body what it needs at this time. And it's not static, right? We talked about different diets for different people. And I am not a dogmatic person. I've never believed like right now for my body, nutritional ketosis is what keeps giving and it's been two and a half years. But it doesn't mean in a couple of years that I'll be in a place where I can transform what it is that I'm eating.

Naomi (15:57):
It's the same thing with exercise and it all comes to, and like mindset is, is another example of it and how we leap and how much regenerative sleep we need. Um, but it all comes back to this idea of our metabolism. So just like, I fell in love with understanding how all we needed to do was activate autophagy in our body auto meaning self phagy meaning to eat as like the Greek definition of autophagy self eating, and that we could activate autophagy through the cruciferous vegetables, through different types of exercise, through a nutritional ketosis, through intermittent fasting, through, you know, tapping into your circadian rhythm, so when you sleep, you're really regenerating. I fell in love with metabolism in that same way and it was after I had interviewed over 80 experts. I did this docu series called the Real Skinny on Fat and the real skinny on fat really looks at, you know, everything around what went wrong.

Naomi (17:07):
Why did we here in the United States go from in the 50s having a 10% obesity rate and having a high fat diet to really getting to a place where there were a couple of events that occurred. Um, Eisenhower had a big heart attack. The president had a heart attack. The conclusion from his medical experts was that saturated fat was an enemy. And, um, you know, in Panama how much coconut is enjoyed and how much saturated good fat is enjoyed there. And so our country in the United States went to a place where everything became low fat, no fat. And now if we look at what has resulted from that, about 60% of our country is overweight or obese. Childhood obesity is a thing. It didn't even exist, you know, 50 years ago. And so for me personally, when I learned all of this information and I tried to think of how can I most easily affect my health, where I can enjoy my life and not have to spend, you know, 20 hours a week just trying to put the pieces together from this book or that book or whatever it might be, I felt that our metabolism was really the answer.

Naomi (18:26):
So our heart has a metabolic rate, you know, our brain, we have a whole body metabolism just like there's whole food. And so getting your metabolism to really work with you in the same way that autophagy can is, is essentially the premise of this book. It's the passion behind this book. And so a metabolic engine that's the stream is based on a couple of different principles. It's based on the idea first and foremost that the number on the scale is not the number that you should be thinking about. Right? The number on the scale is just a number. What you really need to be thinking about is the ratio and the ratio between the amount of lean muscle that your body has and is producing and the amount of body fat. And so for any woman, like when you hear that throw away the scale, we're going to get in the gym or we're going to learn about NEAT, which is non exercise activity thermogenesis, or we're going to, you know, increase our cardiovascular activity, whatever it may be, we're going to focus on strengthening and building our muscles and that's going to improve our metabolism so that we can live our most beautiful and healthy life. It's like a very empowering thought. So that's one of the principles around metabolic health.

Allan (20:03):
Yeah. So kind of from that, what we're basically saying is when you get to a good metabolic state, you're going to be lean, you're going to have plenty of energy. And you know, you're basically going to be able to live a very good energetic cause, you know, obviously, and you've said this in the book, energy is life. When we talk about feeling really good, uh, and those days when, when just like everything's happening for us and it's like our energy levels up and where it all comes back to it. I woke up, I rested well, um, I was refreshed, I got good nutrition and my energy was great and I had a great workout and I'm ready to attack day. So I think that's what we're really getting to here is when that stuff starts for you more and more and more, that's you getting leaner. So yeah, the scale is going to probably go down for most of us that are overweight, but that's not the end number. That's a piece of data in all the other data that you can be looking at because there's also, you know, they'll look at BMI, they'll look at waist to hip ratios and there's, there's some value in each piece of that data. But that's just kind of an outlying symptom of the metabolism being primed for you to have the energy and just really feel good.

Naomi (21:17):
yeah. And, and there's other very simple ways to optimize your metabolism. I mean, if you are not doing nutritional ketosis, okay, but start your day. If you're not someone who's sensitive to carbohydrates, but you make sure that you start your day with fat first, carbs last, that's going to support your metabolism. If you want to do an intermittent fast until noon in the day and you stop eating at 8:00 PM, that's going to support your metabolism as well. And we know, you know, to your point, this sense of energy and how our metabolic health really energizes our entire wellbeing, all of our organs. It's pretty phenomenal. There are so many misconceptions about our metabolism. You know, we always think a fast metabolism is what we need. But it's really an optimized metabolism. There are times in our life when our metabolism will slow down and that's appropriate.

Naomi (22:19):
There are foods that we can eat that can help to optimize it. So in the first chapter of high-fiber keto, it's all about metabolism and really starting to understand it from a fundamental level. And we built this assessment that you can do. I built it with a metabolic world renowned expert, and it's about, I think it's about 50 questions, but at the end of it, it's going to tell you what the true age of your metabolism is today. So I'm 46 I want my metabolism to be younger than my chronological age. And if it happens to be older, that's okay too. You can learn the simple steps that you need to take. Like for example, for a woman in their forties you know, us thinking about balancing our hormones. Well, it's something we need to be thinking about all along. But once you get into your forties your progesterone has gone down.

Naomi (23:20):
You know, your estrogen is starting to go down. Your testosterone could be at a very low level. Like that's really the time period when you know these sex hormones are going down. Most women hit menopause by the time they're 51 so understanding how your metabolism is affected by your thyroid and balancing your hormones and eating right for your body at this point in your life is critical. And maybe, you know , I firmly believe in um, in, in taking bioidentical hormones and it's not just about this idea of, okay, I'm going to have more energy or my skin's going to be better. It's also for example, like let's just take testosterone when we're in our forties and for most women it's really going down significantly. It affects our joints, it affects the way our body feels, it affects our ability to make good decisions and to even make decisions. So balancing the hormones and understanding how metabolism can have such a big part of that through the different exercises is really just so key.

Allan (24:31):
Now, one of the concepts that you've got into the book that I think it was again, another great thing to have in this book. There's so many little things buried in there. So we're talking just about the surface of this. And so this book is something that you can go through and I think read five times and you're going to pull something good out of it each and every time. Cause there was all these little tidbits woven in there. But, um, you made a, I think from an advice perspective, a mistake that a lot of people make is they will step in and they'll say, okay, I'm going to go on this elimination diet. They call keto. I'm going to get rid of all my carbs. Uh, and then I'm going to go ahead and I'm going to quit coffee. I'm gonna quit smoking and I'm going to start running five miles a day.

Allan (25:11):
And, um, I'm gonna make sure I call my mom at least once a week. You know, they try to change so many things at one time. Uh, and in particular it's the diet and exercise. And I want to kind of specifically get into, because so many people will go, you know, when, when it was new year's Eve, it's like, okay, tomorrow I'm in the gym and I'm also going on this diet. Uh, and their bodies are really not equipped to deal with that much change. So you introduced a concept in the book, you called me time. Ah, and, and I think I really liked that. It's kind of this gentle understanding that movement is still key, but it's not that you have to go spend, you know, an hour on the elliptical Monday through Friday. Can you talk about me time?

Naomi (25:57):
Absolutely. So me time is all about what stands for sort of like the metabolic edge time. So again, it's giving your chance yourself a chance to optimize and not have to like grind. I'm a firm believer that what makes us happy will also make us healthy. And that's, you know, fundamental and philosophical in my world. And I also firmly believe that every day is a new day and it's a daily renewal. So when we wake up in the morning, it's a fresh day. And what we do today is going to impact the way the day is experienced. So from the nutrition that we take, the movement that we do, the foods that we eat, the mindset that we have, this is a daily renewal and we have to constantly be renewing. Um, and it's also a very positive thought and me time goes right into that. So what I did with high fiber keto is I started with those 80 interviews that I did for the Real Skinny on Fat for the docu series.

Naomi (27:01):
Then I myself got into nutritional ketosis and went through all of the challenges. And about a year and a half after I was in nutritional ketosis is what I said, I want to get this concept of metabolic health out there into the world. Like this whole body metabolism concept. And I know that people will benefit tremendously because metabolic syndrome is such a big issue and most people don't even fully understand what it is and that it's affecting their health or that they may have two of the five, you know, or three of the different five factors around metabolic syndrome. So I was really, really passionate about that. But what I wanted to do is I wanted to do a clinical study to prove out the concept of keto and fiber. And so I did a clinical study at Jacksonville University and I did it only on women, not because we didn't want it also to work for men.

Naomi (28:04):
But because there's so much of a lack of science on women right now, we need more science on women in order to understand, because we're different obviously than men and our hormones play a big part in the way that we live in the health that we have. And so we studied these 25 women and the professors, the experts, the PhDs that created this study with me, what they said is that when a body is getting into nutritional ketosis, it doesn't matter if it's an athlete, it doesn't matter if it's my great grandmother, it doesn't matter if it's my eight year old son who by the way does keto. Um, and he does it, you know, to prevent seizures and he's done it for quite some time. It doesn't matter who you are, when your body is adjusting from using sugar as your fuel source to becoming a body fat burner, you need to focus entirely on that.

Naomi (29:07):
So the program that we did was 22 days and every single participant benefited. And so I thought, okay, we're going to put together an exercise program, but I was absolutely mistaken and the professors told me we're going to put together a movement program. And this movement program is all about NEAT, which is a new area of science. Meat is an acronym for, as I mentioned before, non exercise activity thermogenesis. And this a way that we can just simply move around. I'm going to give you some examples every day and actually burn up to 500 calories. So right now as we're doing this podcast together, I'm standing up, my body is activated, my glutes are activated, my core is activated and I'm, I'm moving my hands around a lot because that's my nature. Anyone who likes to Twitch or tap their knee, keep up the good work, right?

Naomi (30:11):
If your mother said, don't do that, don't, you know, bang your fingers on the table or whatever. All of that is NEAT. All of that is activating your metabolism and it's, and it's helping to burn these calories and it's a form of movement that's really useful. So in the book we show you a very simple plan of adding up to 7,500 steps a day. So you're going to get to that place. You're going to never sit for more than 30 minutes at any point, right? Like I want you just to get up and move around. You're going to engage in, you know, tapping your fingers, shaking your hands, moving around, just this physical movement, wherever, whenever, if it's, you know, we always here park your car away from the grocery store, do more walking. Growing up in Europe, we didn't really use cars in the same way.

Naomi (31:04):
And you know, for you in Panama you have more of a luxury of being on your feet more than we do here in the U S you know, it's, it's more difficult, but there's lots and lots of ways. I mean, even simply using a manual toothbrush like a couple of times a week or just doing physical things and then trying to get outside as much as possible because movement outside is so beneficial to your overall wellbeing. And I consider all that really great. So I don't want you to be exercising when you start this program in the 22 days while you're allowing your body to get into nutritional ketosis. Instead, I want you to be doing this, you know, me time or this metabolic edge time to really activate thermogenesis naturally with movement.

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Allan (31:54):
Yeah. So this is not a time to start. If you're going to start a nutrition program, focus on that. You still need movement, your body needs movement. Even if it's just something as simple as like you said, walking around, standing when you were sitting for awhile, tapping hands, uh, doing a little dance while you're brushing your teeth, whatever it is. Um, enjoying that time of movement. Our bodies were designed to move. In fact, our lymphatic system, uh, which is responsible for moving toxins out of our body, which if you're burning body fat, there's toxins being released in your body right now is a really good time for your lymphatic system to be optimized and movement optimizes your lymphatic system. So this is really good. And so it's not the time to start an exercise program, but what's going to happen is once you get into ketosis and your energy level starts optimizing, you're almost naturally going to want to start moving more.

Allan (32:46):
And so it's going to kind of be this self-fulfilling prophecy. As your metabolism gets better, you want to move more. As you move more, your metabolism gets better. And it just, it just builds on itself. So just recognize the exercise will come, the exercise program will come because you'll just have so much energy. At some point you'd be like, I've got to do something with this. Um, so that's going to come. But another thing that I really liked to do, you said it was 22 days for your program, which was, you know, I think it's a really good opportunity for someone to see if something is going to work for them. Too many people quit keto in the first week and say, no, it's unsustainable. If you make it through these 22 days, which you make pretty simple because you tell us exactly what to eat, what to do each day, but you don't just start with day one. Its like, you know, go in and eat all the carbohydrates in my house and run in and start this thing. You kind of have this little prefix prep period to get ready to get started and then the 22 days. Could you kind of just walk us through the program that gives someone an idea of how this all works?

Naomi (33:43):
Yeah. You know, changing our mindset is like the most difficult thing ever, right? I've been doing this for two and a half years. I grew up enjoying whole fats. I never ate low fat or no fat and I still have to work on my mindset because you know, nutritional ketosis is only enjoyed by a very small fraction of the population. And look, there are parts of the world, like when I'm in Alaska, the Inuits have been doing it for a very, very long time. And when I sat down and spoke with a number of the women over there and I said, okay, tell me about your favorite foods. Where do you get your energy from? They were talking about things like blubber, like whale blubber and a lot of the foods that they eat from the ocean, um, and all of the fats. And they never look at coffee as an energy source for them.

Naomi (34:38):
They always look at fat as it, but, but for most of us, education and learning and hearing this counter to what you may be hearing in the media is a challenge in and of itself. So the setup before you get into this is first helping to work with the mindset because otherwise, you know, it's like you'll self sabotage and then you'll be frustrated and you won't get the kind of results that your body wants to give you. Um, so I go into this concept of, you know, making sure that what's in your home, the foods in your fridge and your pantry are the right ones. Getting the mindset going, understanding that the first pitfall that most people experience is from a lack of hydration or, or going from, you know, having all of the hydration that's found in a carbohydrate to the lesser hydration that's found in a fat.

Naomi (35:40):
And so many people get keto flu. And how do you prevent that? So how do you get enough of the, let's say the green gel waters from cucumbers and celery and a lot of the vegetables that can penetrate more deeply into the cells than just a glass of regular water. We talk a lot about hydration in that. In that early part, I speak a lot about obviously the electrolytes and how important they are because that that change is a really big deal early on and then we get into exactly what the participants did in the clinical study and I try very, very hard to make this the most simple step by step guide. We have over 80 delicious recipes. I went back to like comfort foods to make these recipes so that your mind wasn't like, Oh my gosh, I don't want to eat these odd things that I've never heard of.

Naomi (36:37):
No. Like we have peanut butter and jelly fat bombs, we have all this good stuff. So just trying to simplify it so that when you get into the 22 days, you're going to be like the participants, you're going to benefit. Every single one of them had benefits to their health. Like some people, they lost as much as 9.7 pounds of body fat, seven pounds of weight. Um, everybody improved their blood sugar levels. Everybody you know, made changes around their circumference of their waist. Not everybody in the 22 days got into nutritional ketosis. Only 60% of them did. But everybody benefited. So you may be like the other 40%, it may take you a bit more time and I show you exactly how to go there and how to do it naturally and easily.

Allan (37:29):
Yeah. And that's what, this is a very gentle program to get you there. It's not the drastic, drop yourself to know carbs and go through all this heck, if you will for the first seven days with the keto flu and then you come out the other side feeling great. This is more of a gentle, we're going to lower our carbs to a steady state, which for a lot of people, 50 grams is, it's still, it's still a move. And so the preficts kind of gets you in the right mindset, gets you moving, and then you start going and then 22 days you see the effects of what this can do for you. And yes, there are recipes, really eager to try that Gouda cheese sandwiches that you had in there. That's on the repertoire. As soon as I can find some almond flour, I might not have it shipped in. I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and stay well?

Naomi (38:24):
You're asking me my top three. I just, first of all, I love what you just said. Um, three strategies I think to stay well and to be happy. Number one is getting into understanding how much sleep and regenerative sleep you need every night. So learning what your sleep cycle is. That's a really important strategy. So once I discovered that my sleep cycle was 90 minutes, I knew that I needed five sleep cycles to feel my best. And so seven and a half hours was better than eight hours. And so that's my number one strategy. Another strategy, and it's, and it's here in the book, is all about hydration, right? I think most of us believe, okay, I have to drink eight glasses of water to be hydrated or whatever. We know that you need to be urinating six times a day in order to be flushing through and really being hydrated and what are the ways that we can get hydrated.

Naomi (39:25):
I spoke a little bit about gel water. I'm really passionate about deep hydration at a cellular level. Because when we don't have that and as we get into our forties and beyond our ceramides, you know, the lipid I layer that sort of protects our body. It's like the mortar between bricks, it starts to break down on our skin and so our skin starts to leak moisture, it starts to leak that hydration. And so I'm a really, really big fan of understanding all things hydration and I think that's a huge piece. And then of course understanding what's right for your body, what type of foods are going to energize you and make you happy and healthy and being able to be flexible enough so that you don't put yourself into a box and then four years later your doctor's like, I cannot believe you've been eating these foods because your blood levels show this. Then you're deficient in that. So it's really about flexibility and constantly customizing your life for you.

Allan (40:35):
Thank you for that. Naomi, if someone wanted to learn more about the book, it's called High Fiber Keto. Learn more about what you're doing. Where would you like for me to send them?

Naomi (40:45):
They can go to highfiberketo.com we have a website, Naomi Whittel. I have a YouTube channel and we've got tons of videos showing, you know the recipes and different activities within the book. All of my social platforms. And then our website is just naomiwhittel.com.

Allan (41:03):
You can go to 40plusfitnesspodcast.com/424 and I'll be sure to have the links there. Naomi, thank you so much for being a part of 40+ Fitness.

Naomi (41:13):
Allan, thank you so much for having me. I love being here with you.


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Another episode you may enjoy


The new keto-friendly south beach diet with Dr Arthur Agatston

Dr. Arthur Agatston inventer of the South Beach Diet, has added a new twist to the wildly successful diet making it even better. His keto-friendly version should help you drop the weight for good. We discuss his new book, The New Keto-Friendly South Beach Diet on this episode.


Allan: 01:00 Dr. Agatston, welcome to 40+ Fitness.

Dr. Agatston: 01:03 Great to be with you Allan.

Allan: 01:04 Your new book. It's called The New Keto-Friendly South Beach Diet and I want to say, okay. I knew about the South beach diet, but it came out at a time in my life when I didn't really have to think about what I was eating or what I was doing, so I was familiar with it being, you know, kind of a more of a whole food protein style diet. Not dissimilar from some of the other stuff that was out there like Atkins and whatnot, but still very effective. A lot of people that I knew that did the South beach Diet really got good effect.

Dr. Agatston: 01:33 Yes, and I must say you weren't that interested the I was not that interested in diet. I was always thin until I realized I was, well I didn't realize it then, but I was addicted to sugar and I was pre what I call pre pre-diabetic even though my blood sugar is, everything appeared normal. But I, once I got off the bad, carbohydrates and sugar, I lost weight and it was I guess in my early fourth reason. I know, I love your show that 40 plus fitness because things change as we age, we get more fat, less lean body mass, less muscle and bone and exercise. The proper diet becomes more and more important as we age. Although our youth today are in big trouble with their diets. So it starts early, but it is tougher, is tougher as as as we age.

Allan: 02:35 Yeah. And I definitely want to get into some of the warning flags and things that we can look to before we get there. Because again, yeah, the doctors are going to say, Oh, you're a A1C is fine. Keep eating the way you're eating. That's not necessarily the answer. Because historically, I mean if we look back and you think about it and you, you talked about bears hibernating, but you know, in a, in a sense, human beings, we went through feast and famine ourselves, you know, and we would get into that. We get into that same season when when the bears fattening himself up and we're finding the berries and the nuts and we're, we're just gorging on that stuff. So our, our bodies were kind of pre-wired to put us into, for lack of a better word, what you call it. You were doing it like bingeing like you would eat a part of a blueberry pie and then you'd go back and eat the rest of it. I think that's just natural for us to do.

Dr. Agatston: 03:28 Yes, I love the, I do love the grizzly bear analogy. We're always either storing food for either an overnight fast when we're going to sleep or you know, in our history it was more often for times of famine and it's all mammals, but it's really almost all living. Ever since we became multicell cellular organisms, we had a, have a way of storing energy to use when there was no energy available from the environment. And so the fat storage mode where when we eat, whether carbohydrates, sugar turns into fat, other than what we're burning for our immediate needs and it's stored as fat and to some degree has starch or glycogen in our liver and our muscle. And usually we needed that not only when we slept and more eating, but we never had the luxury of three meals a day.

In most of our history. We were in a sense doing intermittent fasting, which gave us time for our insulin levels to go down when we ate our insulin levels go up, we store, we store storage in fat, and when it goes down, we burn it for energy. And that important survival mechanism has been totally upside down. When we have only the feast, we don't have famine. And so we're storing fat indefinitely and really creating physiologic problems that we never had in our natural existence. And it's most recently it's the abuse of sugar, high fructose corn syrup, which is, has been important because when it was introduced, it was ubiquitous really in everything and often a hidden killer in a sense. And our intake of sugar went up tremendously, really starting in the 1980s at the beginning of our obesity epidemic.

And people didn't realize they were consuming all the sugar and it was turning into fat being stored for a famine that never comes. And that's what really messed up our physiology, caused all the modern diseases. Yeah. We think of obesity. We think of diabetes, we think of heart disease, but it's cancer, it's depression, it's Alzheimer's. And every time we bring our standard American diet called the sad diet to another country, whether it's Dubai, Mumbai, Beijing, Tokyo, they get all the Western diseases, not just diabetes and obesity, but increased rates of cancer, again in Alzheimer's, autoimmune disease, all our chronic diseases. And when, what we often see now is when people came from more traditional diets like Asians, the Japanese had been studied carefully when they moved from Tokyo to Hawaii, to San Francisco. The rest of the United States, they, we've known for years, they get increased heart attacks, but they also get increased cancer, particularly breast cancer has been very well studied in Japanese women from Tokyo to the to the Midwestern United States. And so the cancer goes up as well as the obesity, the diabetes, and the heart disease.

Allan: 07:25 Yeah, so one of the things that you got into in the book is, okay, so you had, you know, we had the South beach diet and for a lot of people that was very useful because they went through a phase where they kind of allowed their body to change its insulin mode and effectively. Then after that short phase, they could go on and start reintroducing some of the food, say before until they kind of found that balance of a whole food diet that was basically much more nutritious for them. But you've adapted that so that the new South beach, new keto friendly South beach diet is just a little different. Can you kind of compare and contrast those and and why you use the term keto friendly versus just making it a keto diet?

Dr. Agatston: 08:05 Yes. I'm one of the first things that in the original South beach by the first phase, which was the low almost Keto phase only went for two weeks and what we know now, once it did get rid of cravings, the other thing that happens when you're low, you're low carb, low sugar, low processed foods is when you run out of your starch, your glycogen stores in your, in your liver and your muscle. You then have to get fat adapted, which means you really turn on the hormones, the enzymes that break down fat and make it useful. One of the best examples is the traditional marathon lovers who get hydrate loading on the night before the marathon and the idea was to fill their livers in their muscle with as much starch glycogen, that's the storage form of sugar if they could, because within two to three hours running the marathon, they would run out of the sugar glycogen stores and they had to burn fat and they weren't good at it, so that was called hitting the wall and they ran out of energy.

Now long-distance runners have learned to be fat-adapted and that takes one to many months and it continues. And I've had that experience myself. So instead of just the first phase being two weeks, we'd go for one to many months of low processed carb, low sugar so that we can learn to use our fat for energy. And the first fat that goes is the belly fat. And today it's interesting the long endurance runners, the people doing triathlons and even more than marathons are going low carb and they don't hit the wall, they burn their fat very well. Now for the rest of us, you know, it takes 12 hours to a day. It's individual where you, you deplete your Icogenics stores and you begin to burn more, more fat and become fat adapted and allowing for that is very important.

When I first became really strict and good, it's when I realized I, I was truly addicted to sugar and I went cold Turkey once. Once, by the way, I understood that I was truly addicted to sugar, that when I cheated, it wasn't a lack of self-discipline. And what would happen to me is I could lose my cravings on the first phase of the South Beach Diet. But when I went to the second phase, I would invariably have a fruit or maybe even a whole grain bread, but I would, or a dessert and I wouldn't sop and now we know it's not a lack of self-discipline. It's truly and addiction and many Americans, especially overweight Americans are addicted. But once I got off that addiction and stayed on sort of the traditional phase one the South beach diet, I did my first, I was, I started the diet while on vacation and I came back and I returned to my, to my boxing, which I did regularly. And I still, I recall vividly, it was a Tuesday morning in late September, hot in south Florida. And normally I would take a round or two off when I did my boxing and all of a sudden I didn't have to take around off. I went continuously for eight rounds and now I can 12 rounds, three minute rounds with a minute and a half rest.

Allan: 12:12 I do have to say this, if you haven't done boxing as a workout, three minutes is an eternity. I have some clients I do some boxing with and you know, we'll go for a minute. I've gotten one, I'm up to about a minute and a half and they're, they're done. You know, like I need a break. And so going, just even going a three minute round is saying something. But for you to have the endurance to be able to, you know, go round after round with what about a minute rest between rounds. That's, that's pretty impressive.

Dr. Agatston: 12:40 For my tender young age, I take an answer 30 seconds in between rounds.

Allan: 12:45 No, but still three, three minutes is a lot of time to keep moving.

Dr. Agatston: 12:49 Yes. And I couldn't in hot, difficult conditions, I would always take rounds off and since I'm fat adapted, I don't, I feel better physically and mentally and that much more than the cosmetics of losing my belly. And then remember I was a diet doctor. My wife used to say, Author, no more TV for you only radio. You get rid of that little belly and so, but it's much more the way I feel and since we've been, we've been more flexible with our patients. The results we see are incredible and besides the fat adption, the longer sort of phase one, the other idea is you don't have to be in full ketosis. Actually, when we're in the fat burning mode, we're often in ketosis. It's the levels we can't measure easily by current methods, but you can, you can lose the belly.

You get all the benefits without actually being in ketosis. The big advantage of ketosis, particularly for people who are diabetic, who really want to jump into something strict, is you can measure your ketosis and you can document compliance and that's, that's good for us often and our patients. But to make the diet a lifestyle, there still has to be more flexibility. We also encourage either time-restricted feeding or intermittent fasting. And we do suggest that with full keto, with fasting that you do it with a nutritionist, to health coach or your physician, your physician so that you can avoid problems such as what's called the keto flu. But so we are flexible in our approach depending on our patient, the needs, the desires and you can even be a vegetarian low carb as long as you're having whole foods and not having other process carbs. It's tougher but you can do it. And of course traditional societies that like the Asians with rice and not the Okinawans with with sweet potatoes, they were some of the, well particularly the Okinawans were some of the longest lived populations in the world, but they didn't eat snacks all day frequently. And now to the degree that sugar has shown its ugly face in all these societies, they are becoming overweight, diabetic and all the Western diseases that had been in the United States for decades.

Allan: 15:48 When you put this together, I mean cause like one of the things you said and I think that's really important is, well a couple of different things, but one that I thinks is really important is that we all are gonna have different needs. We're all going to be slightly different from a biology perspective of how we want to apply this. So there's, there is a lot of flexibility to this to say, I know, okay if I need to lose 30 pounds or I am diabetic, I'm probably gonna stay in phase one and be a little bit more strict and probably get to a point where I am in ketosis if not completely, at least most of the time I'm eating at that low of a low carb. But you have 12 rules for what you call keto friendly eating. Could you just kind of go through those rules with us? Cause I think that'll make a lot more sense to folks when they see, okay. It is really kind of flexible. It 12 rules sounds like a lot, but they're just the basics of if you're eating this way, you're going to be much more healthy.

Yes. And by the way, yeah, you got it exactly because the flexibility is we all come with different degrees of we call the thrifty gene and the tendency towards becoming diabetic ultimately. And so the rules are first minimize sugars is number one. And we might say no sugars, but you know, our parents and grandparents who had the sugar cube in their coffee was a lot different with the amount of sugar we're getting today. And so you can burn some sugar without having stored it. It's the volume that is totally off the charts today. And refined carbohydrates are absorbed more rapidly than whole grain or high fiber carbohydrates. And by being absorbed more rapidly, they, it's called the incorrect in effect, but they increase our insulin levels out of proportion to just the increase in blood sugar, blood sugar alone.

So if you give blood sugar a certain amount intravenously through the vein, the blood sugar goes up a little bit and the insulin goes up a little bit. But when you consume it, then you stimulate hormones. It's something called GIP, which causes an exaggerated increase in insulin. And that's, that's the problem with frequent feeding. And snacking, which we used to say, like everybody said, when you went to the South Beach Diet, have frequent snacks to stabilize your blood sugar, your insulin levels. That was just plain wrong. So the third rule is, is limit snacking. You want to give time for your insulin levels to drop and that's where having very low glycemic foods, whole foods or nothing for breakfast and lunch, that allows your insulin levels to go down. And that's when you can start burning fat. When your insulin levels are high, you block the burning of your fat stores.

So you can be once the, insulin levels stay high and you can't access your fat stores, you can be starving and you run to the fast-food restaurant or you have a coke that doesn't even suppress, doesn't even, doesn't even fill you up. So you want to give time for your insulin levels to drop by not snacking, having fewer larger meals, which is the next in the 12 rules or having foods that are absorbed further down in the intestine and don't increase your blood sugar and your insulin levels. We say maximize the healthy fats and one of the things is while some people I know don't like dairy cause they're sensitive to it, well saturated fat in meat, in dairy, we now know raises your large LDL bad cholesterol particles and they do not cause heart disease.

This is relatively recent knowledge but it's done. It's been repeated in several large studies. It's the small LDL particles that cause heart disease and they come from sugar and bad carbohydrates. And one other point that out the bad carbohydrates is again, it's volume. Because when you have a bad carbohydrate, you either burn it or if it's glucose, not sugar, you can store it as glycogen, as starch, but only so much about 700 calories. Then you then it turns into fat.

Allan: 20:50 Yeah. But that's part of the problem is these processed carbohydrates are process to basically make us eat more. That's what the food manufacturers are doing. If you don't eat, let's just say you're not going to eat one Pringle. You could eat one Pringle and maybe you'd love the taste of it and that would be all you needed. Your body could absorb that and you'd be fine, but invariably it's a long sleeve and you're not just going to eat one.

Yes, absolutely. And one of my favorite books by Dr. Robert Lustig from UC San Francisco, the Hacking of the American Mind, and he talks about how the food companies make us addicted. And yeah, I mean sugar. I seen another friend, Dr. David Ludwig, did a study where they gave Cokes to teenagers before they ran into a fast-food restaurant and they ate more, not less because fructose, the sugar in the cokes does not suppressed. There's not suppress your appetite. It actually increases. And again, those processed carbohydrates including sugar are absorbed at the beginning of your small intestine or you get that bad incretin effect where your insulin goes way up, and sugar is not turned into starch or glycogen in your liver. It's either burned or it's turned into fat right away. So a high sugar diet is a high-fat diet. And then we say, you know, limit the Omega six vegetable oils.

Of course, the original vegetable oils, and they're not made from vegetables. They're made from, from seeds. The first were made from cotton seeds now soybean and many other types. And they originally they were hydrogenated for shell finding and that was shown not to be healthy, to be very unhealthy. They were outlawed. But instead of going to just traditional saturated fats such as lard, butter, coconut oils or olive oils there going into nonhydrogenated vegetable oils. And Americans were never, humans, in general, were never exposed to naturally. We need small amounts of these or else they're called on your Omega six oils, which today are the vegetable oils and small amounts are fine, but when you process them and create the salad dressings, the cooking oils, we were never meant to have that many oils and it throws out our Omega six inflammatory measures to Omega three oils which are anti-inflammatory.

So where our ratio of omega six to omega three should be from one to four to five to one in most Americans its greater than 10 to one. And so you should be avoiding all vegetable oils as far as I'm concerned, it's proinflammatory but your vegetables and you know the nonstarchy vegetables, asparagus and brocolli, Brussels sprouts and green leafy vegetables, the spinach, those are all good. Yet when the problem is when we always talk about fruits and vegetables because a lot of fruits have a lot of fructose, particularly the tropical fruits, so fruits have anti oxidants that could be good for us when it's a whole fruit in the form of a Berry, but a lot of people think they're being healthy cause they're having a lot of fruits and they can overdo it because of the sugar and the fructose that makes the fruit sweet so we shouldn't be always loving vegetables and fruits and fruits together and then a wide variety of needs, poultry, seafood all very nutrient-rich and eat primarily whole foods.

The best example of this I think is the field cut truly whole grain oats versus instant oatmeal and with actually the same amount of fiber when you have the steel-cut oatmeal, the sugar or the or the starch core of the oat is surrounded by fiber. It takes a while to digest and releases the starch, the sugar into the blood stream slowly and you stimulate the enzymes further down the intestine that are good when you have processed instant oat meal. Even if you have the same amount of fiber, it's not surrounding the starch core and so it's absorbed much more rapidly. The enzymes, the hormones have direct access to the starch, it turns to sugar instantaneously and that increases your insulin levels rapidly and you're much hungrier. The studies have been done, you're much hungrier sooner than if you have the steel cut true oatmeal.

So, and that's true of eating whole foods and that means whole foods adding the fiber in separately. There's just a lot less evidence that that's helpful. And flexibility. It's more important not to be snacking and not to be eating frequently often than sometimes what you eat if you're eating in a relatively small window or during intermittent fasting. I hate to say, you can get away with more because you do increase your starch stores and your insulin, but then you have a long period of time to burn off that starch and the fat that's been consumed. So we prefer whole good foods all the time. But if you're going to be, if you're going to cheat, cheating in a short window is much better than if you're grazing and eating all day. That's disaster. There were snacking very well documented where we're eating many more times per day than we were in the 1970s and it's cause we're walking around hungry all day because our blood sugars are swinging around and our insulin levels are high and we don't have access to that big store of fat in our bellies.

Allan: 27:38 Well, and I think flexibility is important, but this is not, we're not talking about a license to just say, okay, I'm going to allow myself to have a piece of cake every night because I can, I'm only having, you know, two big meals a day and therefore I know I can have, and that's great. But if you're wanting weight loss, if you're diabetic or prediabetic or as we're going to get into in a minute pre pre-diabetic, then you have to understand, or you no you're addicted to sugar. You really have to think hard about how you can approach this and use this diet as a tool to get yourself healthy, to get yourself off that addiction because it's possible. But if you're going to start the game cheating, you probably not going to get there very fast.

And by the way, I mean that is the mistake that I frequently made without knowing. But even now, I mean, in the holiday season, if I'm acting in a fair, and this has happened and I, you know, and I eat the wrong food, the addiction comes back so quickly. And other than that, knowledge of I I can't do this or I can't keep doing this and I can get back on the wagon pretty quickly. But you're, you're, you're absolutely right. This is not a license to be cheating every night. I mean, the good thing if it's once a month or you know, somebody loves their pasta meal and there's a good amount of protein with it. And that's, that's again, depending on the individual, some people will immediately fall off the wagon and get into big trouble. Others, I always have patients who don't have the sweet tooth I have and they can have a bite or something and have a bite, you know. In Miami we have, we have Joe's stone crab and their key line pie. And I generally can that have just one bite. So I don't have it at all. And others can, including my wife. So that's knowing how each of us are as individuals.

Allan: 29:44 And that's one of the things I liked about your book was it took that into account and said, you know, because now you've dealt with thousands of patients and yourself and it's like we're all going to have to approach this slightly differently and we're going to figure out what works for us and we're just going to have to be self aware that you know, if we have this addiction, if we have this issue. One of the things you had in the book, which I thought was really, really important because by the time you go to the doctor and your A1C is over six and they're going to start now diagnosing you with diabetes, you're way down the road and you talk about some tests, some things we can look at before we even get to that point. And so these are tests I'm actually kind of interested in having done because my A1C is great. My blood sugar is great, but that doesn't mean I'm out of the woods. It just might mean that right now my body's creating a ton of insulin and it's able to shuttle all of that blood sugar away so I don't stay in a high blood sugar state. So one of them you call was, it was basically the insulin resistance test or you know, insulin. And then the other one was called the Atkinson calcium score.

Yes. The first, as far the points you've made about insulin are so, so important. So in fact, if we take in America healthy young, 20-year-olds, not overweight today versus the 1970s their hemoglobin A1C, maybe five are they're very normal. They're fasting. Blood sugars are absolutely, absolutely normal. They give a glucose tolerance test where you take a drink of 75 grams of sugar, glucose and wait two hours, their blood sugar comes down. But if you measure the insulin levels, it's taking four times normal insulin levels to keep their blood sugar normal. And that's already hacking fat into their liver, if you anybody, even teenagers, if you see a belly on anybody, a little protrusion, it means they have high insulin levels and they have excess fat in their liver. That's where it all, it all starts. So the test that we do, we call it the insulin secretion test, your insulin-resistant test.

It was actually developed by Dr. Joseph Kraft in the 1970s he died recently at age 94 and unfortunately, he did great work. Unfortunately, it was not recognized by the nutrition establishment, including the American diet. I thinks its an association. Partly, you can only measure insulin levels. In the 1960s the developers undercut the Nobel prize and hasn't been measured clinically until very recently. But he did the measurements when it was very expensive, but on 15,000 patients and he found that he called it diabetes insight too. I call it, it's kind of a medical term, I call it pre prediabetes because anybody with high insulin levels is having problems already, whether they know it or not. Including depression. There is an epidemic of colon cancer in young people, breast cancer, which are related to high levels of insulin. And so the real tests you need, which I'd like to give Kraft credit, called the Kraft test, is you take the insulin, the glucose drink, which was given in the traditional oral glucose tolerance test.

All pregnant women today get the oral glucose tolerance test, and instead of just measuring blood sugar, you measure insulin levels. And so, so many people who have bellies and some, are what do you call it? TOFI. There's thin on the outside and fat on the inside. If you look with a CT scan, cat scan of their belly, they have belly fat. Even though from the outside you would never realize it. And so you can really only tell, you could do it if you do a special MRI of the liver, but that's too expensive and not practical. The Kraft insulin secretion test, it's not expensive. The main thing is it's done over two hours. You do a fasting in some level, then you drink the glucose and then you repeat it at 30 minutes, 60 minutes, 90 minutes and two hours. And so we see patients who already have plaque in their coronary arteries, they have all kinds of chronic illness and their A1C is normal.

And so the fact is it takes years to develop. The fat is not only in your liver, it's also in your pancreas, and it's not till your pancreatic beta cells that make insulin, that synthesize insulin, become injured by the fat in the pancreas and you can't make enough insulin to keep your blood sugar normal. That's when your A1C, your fasting blood sugar goes up. And that's when we diagnose you have a problem pre diabetes or diabetes. But in fact, 10- 20 years before you can measure high insulin levels and people are suffering from again, skin problems to having cancer to heart disease when they're told your blood sugar is normal, don't worry about it. So that's, it's so important to understand. If you have a belly, you have high insulin levels, you're at risk of having heart disease, diabetes and cancer and Alzheimer's. Even though your doctor say your blood sugar is normal. So it's very important to get that word out right.

Allan: 35:43 And then the calcium score is basically going to tell us how much plaque is built up already.

Dr. Agatston: 35:50 So yeah, the calcium score I developed with my colleague Warren Janowitz. And if you're heading for a heart attack, if say you're 40 years old and you're heading for a heart attack when you're 50, 55, 60, you already have plaque in your coronary artery. And with the calcium score, it's inexpensive. In Miami, it's $99. At Johns Hopkins, it's $75 to have the test. You can,uand it's essentially no radiation. It's a cat scan that has some radiation, but you get more radiation when you, when you fly in distance. So the radiation is not an issue for cost is really not an issue. And even though your cholesterol might be normal, things can look normal.

But again, if you have a lot of small LDL particles and other problems that are hidden, you may be developing plaque and you can't tell with a cholesterol test, LDL test or any other tests. Here you're looking directly in the coronaries with a safe, inexpensive test and that tells you what your risk is of a future heart attack. But it also, it predicts all cause mortality because it indicates how the various risk factors for chronic disease are mixing in you as an individual. So the one thing that we see now is we see people whose hemoglobin A1C, their blood sugars are normal, but they have high insulin levels. They may have some other genetic markers that we look for cause you're my practices is cardiac prevention. But those tests are not so difficult to get either. But the main thing is that with the high insulin levels, the sugar and bad carbs they're consuming is turning into fat in the liver and they're overloading the liver with fat.

That causes a lot of problems. But one thing it does is it turns the normal LDL in to small dense LDL, small LDL particles that are not cleared by the, in the bloodstream easily. They don't fit into the usual receptors. They become oxidized and the oxidized LDL sticks to the vessel wall. It gets underneath the vessel wall, builds up the plaque and we again can see with the calcium score, you can see the build up of that plaque and the result of the high insulin levels years before you get chest pain or a heart attack and you can monitor it and then can prevent it.

Allan: 38:36 And I think that's huge. You know, so many of the tests and the things that we get diagnosed with, we're already sick and this is an opportunity for you to catch it much, much earlier, even if the other tests are coming out relatively clean these are really cool. I, I really appreciate this cause I was having, I mean I remember interviewing Dr. Fung and his, his book about the Obesity Code, and back then and he's like, you know, it didn't make any sense to measure insulin because you're doing it fast and you're doing it one time. But you know, here's some advancement where we're saying, well let's, let's go ahead and test the other side of this. The sugar is glucose equation. Basically using the same test, just looking at the actual insulin response, which I again, I think that's just brilliant.

Dr. Agatston: 39:17 And I yeah, I admire Dr. Fung a lot. And but you can't just measure the fasting insulin. We have people with normal fasting insulins and I'm particularly young people are at at 30 minutes after the glucose load their, I mean their insulin levels are in the hundreds, whereas their fasting glucose is normal. In older patients, you get more and more of the delay in the insulin, which indicates dysfunction of the beta cells in the pancreas that are making insulin. And that's because fat, we know that you get a fatty liver years again before you're diabetic or, or even pre-diabetic. And the fat is also going into your pancreas and interfering with the beta cells. And so you get a delay in the insulin secretion. So we can see both the degree of insulin resistance and the degree of what we call beta cell dysfunction, the pancreatic dysfunction that eventually is going to lead to the high blood sugars when you can no longer make enough insulin to keep the blood sugar normal.

And the other thing with this delay in the production of insulin is the insulin peeks hours after a meal and it stays high and that's that high insulin level that is locking in the fat after a meal. So when people get up in the middle of the night starving, even though they have all these fat stores in their belly, in their liver, in their muscle, the problem is they have sustained high insulin levels that blocks the enzymes that breaks down the fat and gives you the energy in the hibernating bear late in the fall. The bear is, they're eating the fruit that's become ripe. That's why fruit is seasonal and they are ravenous, depleting the forest of blueberries and other berries, even though the bear has already put on 400, 600 pounds of fat, but they don't have access to the fat because their insulin levels high. So they can continue to put on the fat for the winter hibernation.

Once they're hibernating and they're not consuming that fruit and the fructose in the fruit, then their insulin levels drop. Now they have access to the fat and that's how they hibernate the whole winter without eating because its that fat that is helping their brain, their kidneys, their heart to continue to function while they're asleep. So normally when we sleep every night we're not eating, so we're accessing our storage starch and fat. But what our insulin levels are high, we can't. So the blood sugar falls and we may wake up in the middle of the night starving and go to the refrigerator and have whatever sugar and carbs are there to bring our blood sugar back up. So it becomes a really vicious cycle.

Allan: 42:36 Yes it does. And so I think this is, you know, we're, we're into January here and I think, so this is kind of a great time to look at something like the Keto Friendly South Beach Diet because it's going to help you regulate your insulin. It's going to help you kind of go through a good period now where you can be thinking in terms of the bear or humans and what we would and wouldn't be eating. The rules are pretty simple. You do have meal plans in there and recipes so it's all put together very well. So again, I think this is an excellent opportunity to take something that worked. The South beach diet definitely was one of those things that people, when they follow it, it worked and you've improved it, which I think again is just wonderful.

Dr. Agatston: 43:16 Well thank you. Thank you so much. And Allan, I mean you obviously you really got it. And it's part of the book is certainly understanding the principles because even for me, who was the cardiologist diet doctor telling, putting my patients on diets for years, but I didn't understand the addiction aspect. Once I did it made such a difference for me and it is, it is for my patients. So this was not necessary eating differently. I mean it was the understanding that made me stick to principles that I already knew. So understanding the role of insulin and how it's different for all of us and understanding flexibility, understanding that America is not overweight because we all of a sudden lost our discipline or for that matter have stopped exercising. Exercise is very, very important. But what causes, what's caused the obesity and chronic disease epidemic is mainly, it's mainly the way we're eating.

Allan: 44:22 I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and sta well?

Dr. Agatston: 44:32 I would say understand insulin, keep it down, don't snack between meals, try some intermittent fasting and others is getting a good night's sleep and this enters in. Of course, if you're overweight and have sleep apnea, you may not be able to sleep proper, but we know a lack of sleep. Again, it stimulates enzymes and hormones that lead to high insulin levels and the other is regular exercise. And exercise is not going to be a solution from the calorie burning aspects. They prove that on the Biggest Loser for your, for your brain, for insulin sensitivity, for keeping up lean body mass. And you know I, you know, I love your podcast and the and being well over 40 plus that we have to keep our muscle and our bone. And you know, when we weigh ourselves, it's the weight, the BMI doesn't really mean anything because that includes, muscle, bone and fat under our skin, when we call the subcutaneous fat, it's only the fat in and around or origins.

That's the dangerous fat that we have that we have to worry about. And regular exercise, it improves our brain function, improves our sensitivity to insulin. So it decreases insulin resistance and it helps us age. We sustain lean body mass and on balance and so many things that's part of healthy aging. And I agree with you. Wellness, we use the term optimal health and it's, it's your vitality. And again, what's kept me on the changes in the diet that I made is I vitality, my ability to exercise, my ability to concentrate, get rid of the brain fog. And it's all those things. My belly was often hidden, people couldn't see it where I was wearing clothes but I knew it was there, but it's because I feel so much better with this and this type of lifestyle. So sleeping right, my exercising right and eating right.

And as you age you have to be more and more concerned about each of these elements. And so I really applaud for what you do with 40 plus as we age, we do become more insulin resistant and it becomes tougher and tougher and you have to get enough sleep, enough exercise and eat the right foods and not eat too often.

Allan: 47:18 Great. Thank you for that. So Dr. Agatston, if someone wanted to learn more about you or learn more about the book, The New Keto-Friendly South Beach Diet, where would you like for me to send them?

Dr. Agatston: 47:30 South beach diet website changed recently.

Allan: 47:36 Okay. That's good. Yeah. Just send me the link and I'll make the show notes so you can go to…

Dr. Agatston: 47:41 Agatstoncenter.Com is our office, our website. It has all of information too.

Allan: 47:48 Cool. Well you can go to 40plusfitnesspodcast.com/416 and I'll be sure to have those links there. So Doctor, thank you so much for being a part of 40+ Fitness.

Dr. Agatston: 47:58 Thank you Allan so much. It was really enjoyable.

It's that time of year. It's the time of year when everybody is thinking about health and fitness. Maybe you've set some resolutions, maybe this is the year that you want to get healthy and fit and if it is and you need a little bit of help, check it out at 40plusfitnesspodcast.com/coach you can come on as a group client and I can help you lose weight, get stronger and make 2020 something special. Go to 40plusfitnesspodcast.com/coach.


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Thank you!

Another episode you may enjoy


April 30, 2018

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