AIR DATE: October 31, 2013 at 7PM ETFEATURED EXPERT: Jill CiciarelliFEATURED TOPIC: "All Things Fermented (Fermentation 101)"
With the increased interest and popularity of the Paleo lifestyle in recent years, so many people with chronic health and weight issues are discovering the power of an ancestral nutrition and fitness program. But many of these Paleo newbies are neglecting a key aspect of Paleo that is critical in light of all the emerging science we are seeing on having a robust and healthy gut microbiota. This is something holistic health coach Jill Ciciarelli from "First Comes Health" has noticed as well and is seeking to educate others about the vital importance of fermenting food for health. Our modern-day culture makes the idea of fermented foods seem strange (ever tried to ferment a Dorito or Twinkie?), but this is something that has been done by traditional cultures around the world for centuries to add more flavor and abundant nutrition to the foods being consumed. Jill's August 2013 book release Fermented: A Four Season Approach to Paleo Probiotic Foods shares all the basics of fermenting, finding foods locally in your area to ferment, and to begin perhaps for the first time in your life to add in this aspect of the Paleo lifestyle that has been missing. That's what we will take on this week in Episode 52 of "Ask The Low-Carb Experts" with the timely and very relevant topic of "All Things Fermented (Fermentation 101)."
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Here are some of the questions we address in this episode:
BOB ASKS: Is there any way to improve the Vitamin K2 content of fermented vegetables? I know natto has the highest amount of Vitamin K2, but I would like to maximize it in the veggies that I personally ferment, such as cabbage, peppers and more. Do I need to use a specific starter culture to make this happen or is there some other way to do it naturally?
JANE ASKS: Is there a sure-fire way of getting my cucumber pickles, when fermented, to remain crisp? I'm a moderately experienced fermenter and have tried making pickles three times. Unfortunately, they come out so soft I just had to throw them away. Adding grape leaves to the batch hasn’t helped a bit. What am I doing wrong?
FREDA ASKS: Can you address the controversy over bacteria from open fermentation using ball jars vs. PickleIt Jars that are completely anaerobic. The PickleIt Jar supporters suggest that the bacteria created in open fermentation creates bacteria that is not good for the gut and can actually be detrimental. What say you?
LENI ASKS: How is the probiotic content of sauerkraut (and other fermented foods) affected by heating? What is the temperature range that supports the survival of probiotics?
DEB ASKS: It it possible to make a "milk kombucha" as opposed to milk kefir? Is there enough sugar in milk to feed a SCOBY (Symbiotic Colony Of Bacteria and Beast)? If so, then does the milk need to be pasteurized to avoid bugs battling bugs? I’ve heard you're not supposed to use raw honey for the same reason.
ANNE FROM AUSTRALIA ASKS: I was wondering if you can tell me about the Vitamin K2 content of fermented foods, especially kefir?
JOANNA ASKS: I’m wondering about the amount of Vitamin K2 in non-dairy fermented foods. Grass-fed cheese has been my go-to source for K2, but I’ve realized that I really have to limit dairy in order to lose weight and I suspect that dairy is an inflammatory food for me. Do non-dairy fermented foods provide a rich enough source of K2 so that I won’t have to supplement? And what quantity of fermented foods per day do you think would be necessary?
TAMMY ASKS: Is it possible to safely ferment using only a mason jar? And what about using a layer of olive oil to seal it? I tried to do a quick ferment of pickles over a week recently and apart from being too salty, the olive oil layer turned green and really weird-looking after refrigeration. It makes me nervous to try using that method again.
LOUISE FROM NEW ZEALAND: The Inuit eat fermented fish. How do you ferment fish and is there a way to do it safely? What does fermented fish taste like?
HARRY ASKS: I know salami is fermented and I enjoy this aspect of it. But is commercially-made salami beneficial or are you best to make your own?
MECHELLE ASKS: A group of us get together regularly to make some fermented foods. Most recently, we juiced pears and made hard pear cider using the apple cider recipe from Jill's beautiful book. We invited our entire neighborhood over to drink it, and it was such a yummy hit! Thanks Jill! I’m curious, do you know of any research looking at the blood sugar impact of fermented foods? And are fermented beverages more likely to raise blood sugar than fermented foods?
JULIA ASKS: Do you have any favorite brands of fermented foods, especially kombucha, that you recommend? Or is pretty much anything in the refrigerated section of a health food store probably a good bet? Are any of the non-refrigerated fermented foods on store shelves any good?
SAM ASKS: I love the taste of kombucha, and my neighbor has SCOBY for me to start making my own. To be honest, I still feel confused about kombucha because of noted integrated health and wellness expert Dr. Andrew Weil's stance. Here’s what he has to say about it:
“I am...concerned about the possibility of contamination in home-brewed kombucha. Some batches contain aspergillus, a toxin-producing fungus. This would be a significant risk for individuals with compromised immune systems, such as those with AIDS or in chemotherapy for cancer.”
He also notes that he knows of “no health benefits to be gained by drinking kombucha tea.” This is the same man who makes his own sauerkraut and regularly talks about the health benefits and delicious taste of fermented foods! What are your comments about Dr. Weil's concerns?
AIR DATE: October 24, 2013 at 7PM ETFEATURED EXPERT: Dr. David PerlmutterFEATURED TOPIC: "Grain Brain & Ketones"
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The biggest breakthrough health book of 2013 contains a simple, yet profound message--the carbohydrates we are eating in our diet are directly leading us down the inevitable pathway to dementia, Alzheimer's disease and other neurodegenerative brain health ailments. It's the #1 New York Times bestselling book Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar--Your Brain's Silent Killers (read Jimmy's book review) by a Naples, FL-based neurologist named Dr. David Perlmutter (listen to Jimmy's interview with him in Episode 725 of "The Livin' La Vida Low-Carb Show"). Dr. Perlmutter identifies in his book the key role that ketone bodies play in various aspects of our health, especially brain health. And that some of the most common foods consumed in our diet--namely whole grains, sugar, starch and other culprit carbohydrates--are the very things that are robbing our bodies of adequate ketone production to thrive as our bodies were intended. That's what we'll be addressing in Episode 51 of "Ask The Low-Carb Experts" this week when we take on the topic "Grain Brain & Ketones."
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Here are some of the questions we address in this episode:
LENI ASKS: What is the impact of a ketogenic diet on bone health? There’s a lot of information on the web that seems to indicate that a ketogenic diet creates an acid environment that leeches calcium and other minerals from the bones. Is this true?
ADAM ASKS: What has been your response to the emerging idea that saturated fat is the root cause of Alzheimer’s disease? And I’m curious about what would bring on Alzheimer’s faster: a high-carb, high fat diet or a high-carb, low-fat diet?
MARY ASKS: After reading Dr. Perlmutter's eye-opening book where he mentions fasting blood sugar levels are closely associated with cognitive function. Would that be the best thing for me to track or would it be more useful to track post-prandial blood sugar and/or blood ketone levels?
REBECCA ASKS: If a person already has moderate to severe Alzheimer's or signs of dementia, is it too late to reverse the damage by eating low-carb, high fat? Can there be any reversal in symptoms?
LINDA ASKS: In 1997, I underwent surgery for a benign, but fairly large brain tumor. The dietitian put me on the Food Pyramid diet and I ate that way until I read Dr. William Davis’ Wheat Belly in 2011. We don’t touch wheat and gluten anymore and happily eat low-carb. I wonder what effect grains have on the development of brain tumors. As a 63-year old, is it too late for me to achieve optimal brain health after a lifetime of eating grains?
SANDRA ASKS: Should my husband be worried that his cholesterol has risen from 208 to 267? He eats what I eat—a low-carb, moderate protein, high-fat diet. His doctor will undoubtedly want to put him on a statin and my hubby is kinda freaking out about all of this. Any words of comfort you can give us?
LISA ASKS: I loved Grain Brain and have already implemented many of your suggestions. I've heard it argued by people in the low-carb and Paleo community that it's the processed foods doing most of the metabolic damage to our health in modern society. However, the unifying factor in many of the world’s traditional cultures is that they're all eating real, whole foods. But Dr. Perlmutter seems to be saying that even real, whole food carbohydrate-based foods like fruits and tubers are poison. Does this apply to everyone, or just those who are metabolically challenged in some way? I think many will find it hard to swallow the "all carbs are poison for everyone" theory when there seem to be so many people eating real-food carbs while maintaining excellent health.
HILARY ASKS: If carbs are so bad for our health, then how do people like Michael Phelps and Dr. Oz perform so well for so long eating pasta, pitas and pancakes? And why don't football players drink olive oil and eat sticks of butter on the sidelines rather than a solution of sugar and electrolytes?
MARGARET ASKS: When I hit my early 40’s I started having occasional memory issues—it’s both annoying and embarrassing. I've been eating low-carb, high-fat with no grains or sugars and copious amounts of coconut oil for the past two years. I am an avid exerciser and at a normal weight, but I’m still insulin resistant. While my memory hasn’t gotten any worse, it hasn’t gotten any better either. Can I ever hope to see improvement if I continue with what I’m doing or are there other things I can do to help with this?
KIM ASKS: I am a 53-year old female who has been on a ketogenic diet for about a year. I am reading your book and now know that many of my problems are a direct result of inflammation. I have lost 90 pounds so far, but I still have a lot of belly fat and inflammation. My low-carb friendly doctor recommends that I stay on a 1,000-calorie-a-day fat fast for a while to see what impact that will have. What effect will all this have on my brain? And what can I do about my belly fat and inflammation since I now know it shrinks the brain?
WENDY ASKS: Can you explain why switching from a grain-brain to a ketone-brain is so important in light of menopause? All the books about this subject say to eat soy and flax, load up on the carbs, exercise them off doing cardio exercise, and somehow avoid stress—yeah right! Obviously these people have never had hot flashes! When I started eating ketogenic after reading a book by your fellow neurologist Dr. Larry McCleary called The Brain Trust Program, I noticed my hot flashes disappeared for a while, but then they came back. Why aren't medical professionals from various fields willing to offer any meaningful enlightenment on this issue? Is this something that neurologists like yourself will need to lead the charge on?
DELILAH ASKS: For an 80+ year old woman already showing signs of dementia, how helpful will a ketogenic protocol be at this point? Is there any expectation of improvements and/or reversals in neurodegeneration at this point?
TRISH ASKS: I inherited the ApoE 4 genotype from a relative who developed dementia at an early age. In light of this, is a low-carb, high-fat diet the best one for me to be consuming to support my brain health? Or should I consider cutting back on my intake of dietary fat as has been recommended for ApoE 4’s?
MEREDITH ASKS: I'm confused about your statement in your book and on “The Dr. Oz Show” that it's okay to eat certain grains such as rice. What is it about the non-gluten grains on your "eat in moderation list" that makes them acceptable? Thanks for clarifying. Loved your book!
ERIC ASKS: Are you aware of any animal or human studies on the effect of ketogenic diets on Alzheimer’s disease?
AMBERLY ASKS: When I have been pregnant, my doctors have told me that being in a ketogenic state is not healthy for a developing fetus, specifically for their brain development. What research is there to support or refute this position? If ketones are good for an adult's brain, why wouldn't they be good for a growing baby's brain?
DAVID ASKS: I've been reading your book and talking to my sister about it. She made the point that it wasn’t until grains were introduced into the human diet that there were great intellectual and artistic advances in our civilization. She can't think of one non-grain based population that has produced any great philosophers, artists, etc. She argues that a grain-based diet is what fueled all the great intellectual achievements in human history and thus will do the same for her. How do I respond to this assertion?
DAMON ASKS: I have struggled for a long time trying to increase my blood ketone levels to an adequate level and it has never happened while eating ~200g fat, ~60g protein, and less than 30g carbs daily for that past six weeks. Is it possible to do so much damage from consuming carbohydrates in the past that becoming ketogenic is now impossible?
KURT ASKS: I've eaten mostly the SAD diet for the 54 years I’ve been alive. I probably already have a huge backlog of AGE's to now overcome. At my age, can a ketogenic diet reverse and even repair the damage that’s been done from a lifetime of high-carb eating?
ANN ASKS: If I remove gluten and grains from my diet at 50 years old, am I able to prevent the onset of Alzheimer’s disease? Or has the proverbial damage already been done?
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AIR DATE: October 17, 2013 at 7PM ETFEATURED EXPERT: Dr. Bill LagakosFEATURED TOPIC: "All Things Calories (Calories 201)"
The concept of calories is one of the most controversial and highly misunderstood concepts in the discussion of nutrition and healthy living. Most conventional health experts put forth the notion that weight and health management simply comes down to basic math--eat less calories in your diet and burn off more calories. In their world, it's all about food quantity. But for many of us in the low-carb and Paleo community, choosing food quality is so much more important as a means for controlling the hormonal and metabolic impact of those calories over how much of that food we are consuming. This is a concept that this week's guest expert knows a thing or two about. He is nutritional biochemist Dr. Bill Lagakos from the "Calories Proper" blog (listen to Jimmy's interview with him in Episode 708 of "The Livin' La Vida Low-Carb Show" podcast) and the author of a book entitled The Poor, Misunderstood Calorie. He'll took on the topic "All Things Calories (Calories 201)" in this fabulous podcast. You might recall we had Mat "The Kraken" Lalonde on the show back in Episode 9 for a Calories 101 discussion. Listen in as we dig a little deeper into this topic to clear up any lingering misconceptions you may have about the subject of calories.
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Here are some of the questions we address in this episode:
KAREN ASKS: What role do hormones play when it comes to the amount of calories consumed as it relates to weight loss?
GERARD ASKS: What does Dr. Lagakos think of Lyle McDonald's energy balance formula? Does it line up with his findings about calories?
DEBRA ASKS: I just don't trust calories anymore. All I need from them is to do their job. How did the whole calories in/calories out concept gain such a stranglehold on our culture? Aren't our bodies so much more complex than energy consumed and energy expended?
AMY ASKS: Does Dr. Lagakos think the average person would be better off if we'd never heard the word "calorie" as it applies to food? I'm saddened when I think of all the human potential and creativity that are lost as a direct result of the obsessive behavior of calorie counting, watching the calorie meters on cardio equipment at gyms, and the complex math equation people think they need to perform in order to "balance their calories." That’s just way too much wasted brain power and emotional energy spent on a numbers games rather than focusing on nourishing our bodies the same way our healthy, lean, robust ancestors did for generations before anyone had ever heard of a calorie.
JAMES ASKS: There have been isocaloric studies conducted where the major difference was the macronutrient composition, but the outcomes tend to differ regarding fat loss and lean body mass retention. Then why do the "experts" still insist that 400 calories of a rib-eye steak is no different from 400 calories of Pop-Tarts? Does Dr. Lagakos think we will ever reach a scientific consensus that embraces the notion that calories from fat, protein, and carbohydrates have different biochemical effects and can't possibly be lumped together based on their calories?
KARL ASKS: I understand what the strict definition of a calorie is and that is refers to turning potential energy into kinetic energy. But I also know that our bodies don't utilize calories, but rather ATP. So given a basic understanding of how ATP is generated in the mitochondria, I don't see how to equate calories with the generation of ATP. Could you explain how the body utilizes energy?
HELEN ASKS: Is there any scientific evidence supporting the timing of when the calories are consumed. For example, if someone eats 2500 calories per day, does it matter if those calories are spread out over 4-5 meals or if they are all consumed in 1-2 large meals as part of an intermittent fasting protocol?
GARY ASKS: There is a common belief in our culture that states when you don't eat enough calories your body will go into "starvation mode" and accumulate stored body fat. Is there any science behind this, and if so, what exactly is going on inside the body to make this happen?
Speaking of common beliefs on calories, doesn’t the idea that all calories are the same actually violate Newton’s Second Law of Thermodynamics?
KURT ASKS: For years on the SAD diet I weighed 210 and regularly exercised by jogging, biking and lifting weights. Since going 90% Paleo/primal and wheat-free (but not ketogenic) 8 months ago I’ve lost 21 pounds and feel great. I exercise the same as always but I’ve plateaued at this weight for 4 months now. As near as I can tell, at 10% less weight, I seem to need 30% fewer calories than I did on the SAD diet. Have I become more efficient at using calories or are the calories I’m now eating somehow more efficient? This has been driving me nuts lately because I’d like to lose another 15 pounds without losing muscle. I look forward to your insights.
CHRISTA ASKS: I have a question about calorie consumption during pregnancy. The current advice is to eat about 300 more calories per day while pregnant. I want to support my baby's growth and am eating the most nutrient dense foods I can find. But I also don't want to gain an unhealthy amount of weight in the process. Do you have any thoughts on how a woman can determine the proper amount of calories that should be consumed when pregnant?
AIR DATE: October 10, 2013 at 7PM ETFEATURED EXPERT: Donald "Dr. Rock" SchnellFEATURED TOPIC: "All Things Aging (Aging 101)"
Father Time has a sneaky way of catching up to us all at some point, doesn't he? But what if you could hold off the effects of aging for many more years than you think simply by making some basic shifts in your diet, fitness, supplements and lifestyle choices. That's the heartbeat of the work of this week's guest expert named Dr. Donald "Rock" Schnell from "Young For Life" (check him out on Twitter and Facebook). He is an anti-aging specialist and co-author with Marilyn Diamond of the book Young for Life: The No-Diet, No-Sweat Plan to Look and Feel 10 Years Younger. Dr. Rock was once a staunch vegan advocate and noticed how it greatly accelerated his aging which is what motivates him to help people over 40 discover the easy and intuitive methods for increasing vitality, sexuality, and youthfulness through whole food nutrition, convenience exercise and correcting micronutrient deficiencies. That's what we'll address in Episode 49 of "Ask The Low-Carb Experts" taking on the topic "All Things Aging (Aging 101)."
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Here are some of the questions we address in this episode:
HILARY ASKS: I'm 48 years old and menopausal. I've had lupus-like symptoms ever since I was a kid and my health has been improved beyond my wildest dreams by avoiding wheat, plus adding in healthy fats and a pile of supplements that I cycle into my routine when I feel I need them. I'm curious about DHEA and I'm trying the NOW brand of 7-Keto DHEA. Every once in a while when I feel like I need an anabolic boost, I sprinkle around 5-10 mg into my Bulletproof coffee. It really is helping my tendons, muscle tone, mood and energy. Do you think this protocol I am doing is helping me fight aging? Is this the best form of DHEA for reducing the masculinizing effect?
JAMIE ASKS: We often hear insulin referred to as the “fat-storage hormone” but is it accurate to also call it the aging hormone? Do some medications accelerate aging? And are there any anti-aging supplements?
JENNY ASKS: I am 41 years old and not in peri-menopause yet. I’d like to retain my present feelings of vibrant youth and know that fertility is a marker of being young and full of health. What do you think of using bio-identical hormones to continue to menstruate through and after menopause? How exactly does doing something like this work?
ERIK ASKS: Would Dr. Schnell consider using exogenous testosterone as we get older to stave off the effects from aging? If so, then does he have a preference regarding the modes of administering it?
MARK ASKS: Is mimicking the internal chemical environment of a young body the best way to defy aging? If so, then how do "turn off" late-acting deleterious or lethal genes?
ANN ASKS: How do refined carbohydrates affect the skin as we age? Is this a direct reflection of what is happening in our organs long before it reaches the surface?
KATHIE ASKS: Which vitamins are most beneficial in warding off the effects of aging in conjunction with my low-carb, high-fat lifestyle?
LIZ ASKS: I work outdoors in a place where we have sun all year round. What are the best ways to keep my skin from prematurely aging? I use sunscreen (which I know has terrible ingredients in it) and cover up as much as possible. Many people I’ve seen who have worked outdoors doing what I do look 30 years older than they really are. I don't want to end up like that!
KURT ASKS: I’m 54 years old and enjoy running, biking and weight lifting. There is conflicting advice between doing steady cardio vs. intense interval training. What do you feel works best for men as they begin aging after 50?
NICK ASKS: Is eating low-carb to limit insulin and moderating protein down to limit MToR the best way to slow aging and increase longevity?
AIR DATE: October 3, 2013 at 7PM ETFEATURED EXPERT: James ClearFEATURED TOPIC: "All Things Intermittent Fasting (IF 101)"
Just mention the word "fasting" to the man on the street and the reaction you'll get from most of them would probably fall somewhere between completely scoffing at the idea to the sheer terror at the realization of going without food for more than a few hours. This concept of fasting even on an intermittent basis, as has become popularized in the Paleo community in recent years, is certainly a highly controversial and misunderstood strategy that could very well be the last piece of the puzzle in optimizing your weight and health issues. Is intermittent fasting (aka IF) the right way to go for everyone, especially for women who seem to have more difficulty with this? Is there anyone who absolutely shouldn't IF or even those who must do it for therapeutic purposes? And how long and how often should these fasting periods be done to get the most benefit out of them? These are just some of the questions we're going to explore further with a nutritional habits expert named James Clear (listen to Jimmy's "Livin' La Vida Low-Carb Show" podcast with him in Episode 705) in Episode 48 of "Ask The Low-Carb Experts" where we'll take YOUR questions on "All Things Intermittent Fasting (IF 101)."
Here's your chance to speak directly with the expert to ask YOUR questions. Start getting me your questions on this topic NOW by e-mailing them to AskTheLowCarbExperts@gmail.com no later than 3PM ET this Thursday. You can also ask your question LIVE on my show by calling (712) 432-0900 or Skype the show for FREE by calling the username freeconferencing.7124320900. Whether you call or Skype, be sure to use the access code 848908. Listen LIVE and leave us a review at iTunes if you like what you hear. This is golden opportunity to interact with the best nutritional health experts in the world, so don't be bashful. We look forward to sharing this brand new episode of "Ask The Low-Carb Experts" with you later this week.
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Here are some of the questions we address in this episode:
RENEE ASKS: I have long heard that women in general don't have great results from intermittent fasting. I'm wondering whether you agree with this, why it happens, and if this applies to post-menopausal women? I am a post-menopausal female and naturally IF more days than not. What effect does IF have on women's and men's hormones?
KARL ASKS: I have been doing Intermittent Fasting for the past few weeks eating meals between 12-8pm. Do you have any suggestions about how I can make sure I get enough food in my body during that 8-hour window? I feel like I’m eating way too few calories.
I do have a cup of coffee with about two teaspoons of heavy cream in the mornings. Does that coffee and/or cream make any difference in the effects of an intermittent fast? Should I add a tablespoon of coconut oil or MCT oil to make it better? Or should I be going that entire 16 hours without any calories consumed to technically do an IF?
JENNY ASKS: I've been eating low-carb, high-fat for 3 months now and incorporated a 24-hour fast, two days a week for the last month. I also try to mini-fast for 17 hours between my meals everyday. When does the timer begin for fasting: as soon as I put my fork down or about 3 hours later when I've digested my last meal?
One issue I am having is that I want to take my vitamins everyday, especially on fasting days, but I can't keep them down on an empty stomach. Is there any type of food that I can eat to stay in a fasted state but is substantial enough to let me take my vitamins? I tried almond butter and was able to keep the pills down but it was not the best option for me. Would a pure fast be even more beneficial than a multivitamin?
DAMON ASKS: Assuming proper caloric load and macronutrient breakdown compliance, what could be the reasons for not getting results as far as fat loss goes when engaging in regular periods of intermittent fasting?
Are there any disadvantages to doing resistance training in a fasted state in the morning if you don’t eat until later in the day?
DEB ASKS: I’m a 48-year old woman and changed my exercise to mainly weight-training and short bouts of high intensity interval training with lots of walking, but was eating low-calorie/low-carb/Paleo for part of the time and doing IF for most of that time frame. I check my muscle progress by doing hydrostatic weighing and I was told I’m losing muscle because I train in a fasted state. Does the kind of exercise matter when doing it fasted? What should I be doing and what should I avoid if I exercise in a fasted state?
JASON ASKS: How important is it to eat as soon as possible after a fasted workout? I enjoy my post-workout fat/protein shake but I could just as easily go without it as I am rarely hungry after a workout. Am I harming recovery and/or muscle growth if I just wait until lunch to eat after my morning workout?
Is there a known physiological benefit to forcing a 24 hour fast? What are the health reasons to do periodic fasts during the week?
JANIE ASKS: I skip breakfast just about every single day as I'm just not hungry in the mornings. Sometimes I'll have decaffeinated coffee with a tablespoon of heavy cream but I wonder if that officially breaks my fast. I see people in the Paleo community having multiple tablespoons of fat in their coffee yet they say that they are still fasting! I am pretty sure a 900-calorie cup of coffee is NOT fasting, right? Is there a calorie level that I can consume in my coffee that keeps my intermittent fasting going?
GEZ ASKS: I’m a 44-year old man and have lost 70 pounds following a low-carb, moderate protein, high-fat diet. Intermittent fasting 16-18 hours daily and high intensity eccentric exercise for 30 minutes once a week helped me shed the final 14 pounds. My question is I’m finding it difficult to lose the remaining fat around my waist and lower back. Should I change the length of my intermittent fast to longer periods of time between meals? I’ve also considered adding in a high-carb day once a week in the vein of Keifer’s Carb Nite Solution ketogenic cycling system. Any thoughts?
MICKEY ASKS: I have been fasting quite regularly and eat one meal in the evening around 1500-2000 calories a day. I don't really get hungry at all during the day. My concern is whether or not I am prone to losing too much muscle mass doing this? Is it possible to overdo it when you are fasting?
AIR DATE: September 26, 2013 at 7PM ETFEATURED EXPERT: Dr. William CurtisFEATURED TOPIC: "Nutrition-Based Diabetic Therapy"According to the latest statistics from the American Diabetes Association, 26 million Americans currently have diabetes (mostly Type 2) with a whopping 79 million more who are what's known as prediabetic where they are insulin impaired to the degree that if nothing changes they will become a full-blown diabetic in the coming years. The sad reality of these statistics is they are getting worse, not better, with an additional 2 million+ new cases of diabetes being added annually. What's going on here to explain the explosion in the rates of Type 2 diabetes and even the more rare Type 1?That's precisely what we cover in this podcast featuring a former ER physician and family doctor from Corpus Christi, Texas named Dr. William Curtis from the multi-specialty clinic "Future Focus Family Medicine" who has become passionate about how healthcare must shift the way they treat patients away from disease management and more towards wellness and prevention care. His clinical experience has shown him firsthand that health does not come from the medicine bottle for the vast majority of patients but from the very foods they are putting in their mouths as well as fitness and lifestyle changes.When it comes to the subject of diabetes, that statement is magnified many times over with the need for the right kind of nutrition and lifestyle treatment modalities as the FIRST line of defense in an overall wellness plan. Dr. Curtis doesn't believe we should be convincing everyone they are sick and in need of a prescription medication to get better again. He contends that a whole foods-based, low-carb lifestyle that he teaches through his NRG Tribe Diet & Lifestyle Compass will provide diabetic patients with REAL encouragement and invaluable information to help them defeat this chronic health issue. That's the topic we'll take on directly in Episode 47 of "Ask The Low-Carb Experts" taking YOUR questions on "Nutrition-Based Diabetic Therapy."LOWER YOUR BLOOD SUGAR LEVELS NATURALLY:USE PROMO CODE "THANKYOU" FOR 10% OFFNOTICE OF DISCLOSURE: http://cmp.ly/3LOW-CARB CHOCOLATE CHIP COOKIE DOUGH QUEST BARSNOTICE OF DISCLOSURE: http://cmp.ly/3Here are some of the questions we address in this episode:ANDREW ASKS: It may just be a semantic argument, but I am wondering why the typical medical establishment position is that Type 2 diabetes is incurable. Conventional wisdom says that once you have a consistently elevated fasting blood glucose level, the “diabetic” label seems to stick for life. My doctor bestowed me with that distinction although he never even once checked my A1c, which I later discovered was low. But now my medical records show me as having Type 2 diabetes although I’ve never taken a single drug to treat it. This is such a scarlet letter on my health history that I’m wondering if I am plagued with this label for the rest of my life. What is the difference between "reversed" and "cured" in the context of diabetes? And is the term "managed" the best label one can hope for in the context of our current medical nomenclature?DEB ASKS: I am a 48-year old female who has eaten low-ish carb for the last year and a half (~75-130g per day) and my fasting blood glucose was always nice and low (100 units per day) who adopt a low-carb lifestyle? Do you see problems in this type of patient particularly in achieving the blood sugar lowering you’d hope for and do you attribute that to glucagon dysfunction and hepatic insulin resistance? What other factors should be considered when low-carb just isn’t enough on its own?
AIR DATE: September 19, 2013 at 7PM ETFEATURED EXPERT: Dr. Jacob EgbertFEATURED TOPIC: "Functional Fitness Medicine"
One of the major flaws in the way traditional medicine is practiced these days is this over-obsession on treating symptoms and lab panels rather than getting to the heart of what is causing chronic disease in the first place. Rather than seeking out preventative modalities that include nutrition, fitness and lifestyle changes, many doctors are opting for pharmaceutical and surgical answers first without ever giving a second thought to alternative treatment options. Thankfully, there are an ever-growing number of medical professionals who are bucking that system by zeroing in on what just plain works for their patients.
That's exactly what this week's guest expert has done and the lives of his patients are being changed on a daily basis as a result. He is a Utah-based Physical Medicine and Rehabilitation specialist named Dr. Jacob Egbert, DO from "PrimalRx" and the "Primal Mountain Strength and Conditioning" gym. Dr. Egbert has seen firsthand how debilitating physical weakness is for most people and is committed to improving their functional fitness level to coincide with a rock-solid Paleo nutritional plan. That's what we'll address in Episode 46 of "Ask The Low-Carb Experts" taking YOUR questions on the topic "Functional Fitness Medicine."
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Here are a few of the questions we addressed in this podcast:
ANN ASKS: I have been following a high-fat, moderate protein, low-carb diet for the past 5 months. It has been life-changing for me to say the least and I have lost 40 pounds with no exercise. But now I would like to become stronger and more flexible but unfortunately can't afford to join a gym. Do you have some suggestions to help me accomplish this goal in my home?
JAMIE FROM AUSTRALIA ASKS: A medical term we don't hear enough about is “sarcopenia,” that is the loss of skeletal muscle mass and strength. This is typically attributed to aging, but a lack of physical activity, dieting and illness are the primary forces behind why it happens. Of course our skeletal muscles are the body's sink for glucose and are important for metabolic health. So here’s my question: What is the best way for a doctor to monitor muscle mass and strength changes? Why don't they pay any attention to muscle status? Is there a role for a certified personal trainer in the health care system to monitor strength as a simple predictor of muscle health? Is there a process or prescription/referral pad for a doctor to prescribe exercise or refer a patient to a certified trainer?
AIR DATE: September 12, 2013 at 7PM ETFEATURED EXPERT: John Kiefer & Dr. Rocky PatelFEATURED TOPIC: "Cyclical Ketogenic Diets For Health And Performance"
At the recent 2013 Ancestral Health Symposium in Atlanta, Georgia last month, Jimmy Moore was the moderator of a fantastic panel of experts addressing the topic "Ketogenic Diets & Exercise Performance" featuring a star-studded line-up of Paleo fitness studs that included Robb Wolf, Mark Sisson, Ben Greenfield and Jamie Scott. The general consensus by most of these top names regarding the future use of the ketogenic approach for exercise and general health is the idea of regularly cycling in and out of ketosis to experience the maximum benefits. This is something that our expert guests this week know just a thing or two about. They are an exercise scientist, nutrition expert, and the author of The Carb-Nite Solution as well as Carb Back-Loading 1.0 named John Kiefer and a board-certified family physician from Gilbert, Arizona named Dr. Rocky Patel. These two knowledgeable men were here in Episode 45 of "Ask The Low-Carb Experts" addressing the issue "Cyclical Ketogenic Diets For Health And Performance."
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Here are some of the questions we address in this episode:
PEGGY ASKS: I see no reason why I should "cycle" in and out of ketosis. That seems a bit ridiculous to me, actually, when my performance is so fabulous remaining in ketosis virtually all the time. It's been truly miraculous for me. What added benefits will I get from going out of ketosis on occasion rather than simply staying in a constant state of ketosis for my exercise performance?
ALAN ASKS: Dr. Peter Attia on his “Eating Academy” web site (http://eatingacademy.com/nutrition/ketosis-advantaged-or-misunderstood-state-part-i) says that research shows "someone in nutritional ketosis – even if eating zero carbohydrates – still has about 50-70% of a normal glycogen level, as demonstrated by muscle biopsies in such subjects." I have been on a ketogenic diet myself since May 2013. And as a recreational athlete, I like to do long endurance runs of 13+ miles at a time. Sometimes my runs are great, but other times the performance is poor and I bonk near the end. It feels like I have depleted my muscle glycogen stores at this point. What strategies would you recommend that I do to boost the muscle glycogen prior to going on a long run while on a ketogenic diet?
ADAM ASKS: Is there such a thing as bulking up on a ketogenic diet? If you can’t bulk up in the traditional sense, then can you at least build muscle or see body recomp changes using a ketogenic approach?
JERIS ASKS: I do a lot of Bikram Yoga and I've been on a low-carb, high fat ketogenic diet for several months. I noticed at first I was getting that ammonia smell and bonking near the end of the 90 minutes. I tried loading up on different carbs and experimented with this on several occasions. A bunch a fruit right before, sweet potatoes the night before--nothing worked.
Finally, I heard Ben Greenfield talking about MCT oil and I was already putting that in my coffee in the morning. So I tried putting it in my water for the yoga and amazingly I could do the whole class with no carbs and without bonking or getting the ammonia smell. Maybe I just wasn't getting enough calories of any kind or I was eating too much protein.
My question is this: Is it okay to use MCT oil daily in order to stay in ketosis? I guess cycling in and out would mean back-loading with a sweet potato or some other "safe starch" once or twice a week. I'm not doing that right now, I'm just eating a bunch of veggies and a little bit of berries for carbs, so I THINK I'm staying in ketosis. If you stay in ketosis, then won't you become fat adapted more quickly?
DENNIS ASKS: If someone is engaging in a 24-hour intermittent fast a couple of times a week, then should they break the fast with starches?
LINDA ASKS: I am a 50-year old female runner who has been running for nearly three decades. I’ve always eaten carbs and low-fat protein 5-6 meals a day up until a year and a half ago when I started to lower the carbs and up the fat. I am at a healthy weight, but found that adding the fat made me feel so much better. I’ve been eating mostly Paleo with a little bit of dairy. I’ve really enjoyed listening to the ketogenic success stories of athletes like Ben Greenfield, Vinnie Tortorich, and of course Jeff Volek and Dr. Steve Phinney. My question is how is this working for the ladies? Even all the male podcasters have female co-hosts that seem to whisper in the background that they need more carbs, especially when they race or train at high intensity. I will admit, when I posted to Ben about how many carbs to eat when training for a half marathon, he said at least 100g on high volume days and scale back on rest days. I know eating for leanness and eating for performance are two different goals, but I would like to hear more about low-carb performance for women, especially at you get older.
DAMON ASKS: If someone ate a cyclical ketogenic diet but never got blood ketone levels to a significant level, then it seems to me that they would be in no man’s land where they have no ketones for energy but are also carbohydrate depleted. How can someone with this issue of low ketones and depleted carbohydrate stores figure out how to increase ketones to improve their health and performance?
LAWRENCE ASKS: Keifer says that staying on a ketogenic diet for too long can lower your testosterone levels. But low-carb researchers like Dr. Steve Phinney and Dr. Jeff Volek never mention this as a long-term problem for people in a constant state of nutritional ketosis. On what basis does Keifer make this claim?
JASON ASKS: Is a cyclical carb strategy REALLY necessary for everyone or is it more dependent on the specific kind of activity you are engaging in? I stay in a constant state of ketosis and run 20 hour/week as well as hit the gym twice weekly. I never feel low on energy and actually feel great pretty much all the time. In fact I do NOT like the feeling I get when I am kicked out of ketosis. In light of this, is there some unknown performance reason why I should be cycling in carbohydrates into my diet? And if I do decide to add in some carbohydrates, how do you determine the correct quantity so you don’t prevent keto-adaptation from taking place?
MINDY ASKS: I’m a 47-year old female who weighs ~175 pounds and I want to lose body fat. I’ve been on a Paleo/low-carb plan for about 3 years and I swing kettle bells a few times a week for exercise. I am currently attempting to do my own version of Kiefer’s CarbNite plan with a very low-carb, higher fat program for six days followed by a smaller carby snack, carby dinner, and ice cream on day 7. I’ve had blowout CarbNites before and then end up spending the next 6 days just losing what I gained from that event which is why I'm scaling back on them. Also, I initially did your high protein protocol and started gaining weight. I have found that much lower protein and higher fat just works and feels better for me. What, if anything, would you advise I change about the way I’m implementing a cyclical ketogenic diet?
DAMON ASKS: What is the maximum amount of time that you suggest being low-carb before beginning to cycle in and out of ketosis? Other than diabetes, are there any other conditions that may prevent someone from getting into ketogenesis if they are eating low-carb, high-fat?
MARK ASKS: What is the relationship between ketogenic cycling frequency, the amount of workload during exercise, and lowering body fat percentage if your goal is continual fat loss?
GREG ASKS: Does Kiefer or Dr. Patel promote using tools like blood glucometers or blood ketone meters along with the carb back loading protocol? I am particularly interested in the context of someone like myself who is around 15% body fat while doing heavy lifts like back squats, deadlifts, bench presses, and military presses a few times per week. Is there a particularly good way someone could use these meters to optimize and individualize things like carbohydrate intake post workout?
PAUL ASKS: On The CarbNite Solution, is it possible to kick start things by lowering your protein intake down to the bare minimum needs perhaps around 30-40g a day? If so, is this something you’d do for 6 of the seven days or just a few of them?
DEBBY ASKS: I'm currently using the CarbNite Solution protocol and an avid baker using coconut oil and coconut milk predominantly in my baking. I live a primal/Paleo lifestyle and limit my carbs to rice, sweet potatoes, and other real food starchy carb sources. I have heard that combining MCT oil with carbs, like sweet potatoes, raises insulin levels. If this is true, then would using coconut oil with other clean carbs such as the ones I listed above do the same? And if so, is there a limit to how much coconut oil to consume with our carbohydrate on a CarbNite plan?
JULIE ASKS: I am a 34-year old female currently following the CarbNite Solution program. I had gestational diabetes with both of my kids 2 and 3 years ago. At my heaviest weight I was 260 pounds and my fasting blood sugar level was about 104. I gradually reduced carbs and finally discover CarbNite Solution that helped me get down to 185 pounds with an 84 fasting blood sugar in the morning and 5.4 A1c level. However, my blood sugar sometimes goes up to 97-104 on other mornings. Is this something to be concerned with? Should I consume less carbs on my CarbNite until my readings return to normal the next morning? Or am I just overthinking this?
JOS ASKS: I'm a 34-year old female and just started weight training about almost a year ago. I am 5’5” and weigh 110-112 pounds with about 19% body fat. My goal is to increase muscles while minimizing fat gain. My current workout program mainly focuses on basic lifts such as a glute bridge, squats, deadlift, push and pull. I've been on CarbNite Solution for almost a year and have lost a good amount fat and gained a bit more muscle. I used to be that skinny fat Asian girl.
Recently I've just started to increase my training intensity by going a bit heavier in weights. I heard that once you increase the workout intensity that we need to increase our carb re-feeds during the week, as opposed only having it once a week. What do you consider “working out with intensity” and why can't we just increase the amount of carbs in our once a week carb re-feed CarbNite instead of eating more carbs during the week? Or do you think I should start switching to your other protocol, Carb Back Loading?
AIR DATE: September 5, 2013 at 7PM ETFEATURED EXPERT: Dr. Paul RalstonFEATURED TOPIC: "Low-Carb Diets & Spinal Pain"
Have you ever suffered from back pain in your life? If you're like most people, the answer is an emphatic YES! Spinal pain is the #1 cause of disability worldwide and lower back pain is the #2 cause of missed days at work (behind sunny days!). What's at the root cause of all of this chronic pain that people are dealing with? And what can a low-carb and/or Paleo nutrition and lifestyle plan do to help alleviate the aches associated with our backs? That's what a Milwaukee, WI-based chiropractor named Dr. Paul Ralston will be exploring with us in this week's show. Dr. Ralston presented a lecture entitled "The Effect of Diet on Chronic Spinal Pain Disorders" at the recent 2013 Ancestral Health Symposium in Atlanta, Georgia last month and he is a big fan of CrossFit, Paleo and low-carb diets. In other words, he knows just a thing or two on this subject we've got for you in Episode 43 of "Ask The Low-Carb Experts" addressing the issue "Low-Carb Diets & Spinal Pain."
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Here are some of the questions we address in this episode:
MARGIEANNE FROM NEW ZEALAND ASKS:I’m a 75-year old woman and have had Bells Palsy since February 2012. I am working hard to stay in a state of nutritional ketosis. Recently I twisted my back while re-learning to ride a bike again. My chiropractor is doing wonders so I have great hope of feeling better than I did before the accident. I think I'm doing okay with my diet except I seem to be stuck about 44 pounds heavier than I’d like. I have about 30g of coconut oil daily and 10-15 mL of cod liver fish oil. Since I'm not losing weight, I've been tweaking things until I find what works again, including setting for myself a goal of getting in 10,000 steps/day several times a week. Is there anything else I can do to optimize my health based on what you’ve heard from my story?
KIM ASKS:I suffer from a lot of back pain mostly due to spinal fusion, scoliosis, degenerative discs, and fibromyalgia. The pain has gotten a lot better since I started eating low-carb. Why does low-carb help with back pain? I know I would have less back pain if I could lose some belly fat, but low-carb alone is not getting rid of it. I currently take oxycodone for the pain and wondered if taking pain medications interferes with weight loss. Do you have any natural remedies that can help me with my persistent back pain?
J.D. ASKS:I used to get severe pain in my lower back whenever I ran. Over the years, it began showing up when I walked, too. Among my many pre-low-carb attempts to fix my health, I tried a calisthenics routine for a few months that involved back extensions and that improved things considerably extending the distance I could walk. When I started eating low-carb, it had progressed to the point that I couldn't walk more than half-a-mile without pain. In fact, two weeks after starting low-carb, it was gone, entirely, and has never come back again! I spent the day at the State Fair, last weekend, walking for more than ten hours, carrying a backpack, and I had soreness in my joints, and in my shoulders and back, and was generally worn out--but I never experienced that back pain. And here's the thing: it disappeared over the space of two weeks, during which I did no exercise and lost about five pounds. So what changed?
I have to think that the problem involved fuel partitioning. My hypothesis is that because I was severely insulin resistant, and thus hyperinsulinemic, when I walked the muscles in my back were mostly burning carbs, and that the pain I felt was just ordinary lactic acid build-up. After I went low-carb and got my insulin levels under control, I regained the ability to burn fat. Of course, I may be entirely off-base, but whatever happened, it couldn't have been a response to weight loss or exercise, because it happened before any significant amount of either had occurred. Does Dr. Ralston have any thoughts about my situation?
AIR DATE: August 29, 2013 at 7PM ETFEATURED EXPERTS: Jimmy Moore & Dr. Eric WestmanFEATURED TOPIC: "Cholesterol Clarity Q&A"
With the much-anticipated release of the book Cholesterol Clarity: What The HDL Is Wrong With My Numbers? by Jimmy Moore and Dr. Eric Westman, both of the coauthors joined us on "Ask The Low-Carb Experts" this week for a Q&A session answering listener questions about this critically important new book about the subject of cholesterol. This book was written to fill a major void in the marketplace of an easy-to-understand manual on cholesterol, why it's not the evil substance we've been led to believe, what really matters the most on your cholesterol panel, and which levels are optimal if you are going to pay attention to cholesterol. Here's your exclusive chance to hear directly from both Jimmy and Dr. Westman answering listener questions about the book. That's what we've got for you in Episode 43 of "Ask The Low-Carb Experts" in this Cholesterol Clarity Q&A.
Get Cholesterol Clarity: What The HDL Is Wrong With My Numbers?(or download the Kindle e-book) from Amazon.com:
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Here are some of the questions we address in this episode:
ROXANNE ASKS:I have read and enjoyed books by both of you and am very much looking forward to reading Cholesterol Clarity! I am a 53-year old diabetic female who had heart bypass surgery 6 months ago. There is a history of cardiovascular issues on both sides of my family. I've read that statins can have some rather serious side effects. What, if anything, can you say to me and my doctor to convince us that it would be safe for me to stop taking the 10mg Lipitor I am now taking?
JAMES ASKS:So what's the deal with plant sterols? I see it for sale as a supplement to "lower your cholesterol" and I see people taking it. Is there any benefit to it? What about the harm in taking it? I follow a low-carb, high-fat lifestyle, so I get plenty of dietary cholesterol from animals.
TRAVIS ASKS:I have a one word question: Eggs. I eat at least three eggs a day everyday for breakfast along with some cheese and bacon. I feel this kind of large low-carb breakfast really gets me through the day. However, I can't find any consensus about eggs. Are they good, good in moderation, bad long-term, or will eating 21 eggs a week kill me?
KEVIN ASKS:I've read that higher serum cholesterol could be a clue that something else is going on in the body—for example, tissue damage that needs repair, or a decreased ability for cholesterol to be delivered into cells. Could you please talk about the role of LDL in particular, and what an increased level might indicate about other health factors?
KEN ASKS:The homeostatic model for serum cholesterol appears to be well worked out for a standard high-carb diet. Do you think that the correct model is substantially different for a ketogenic low-carb, high-fat diet, and that this might be the reason for the large number of "hypercholesterolemic" responses on this diet? Might the small intestine, instead of liver, be the dominant source of endogenous cholesterol on this diet?
DENNIS ASKS:My question is about the effect of fructose, sugar alcohols, and alcoholic beverages on your triglycerides. Would the fact my triglycerides are crazy high at 260 while everything else is fine mean that I should limit these things in my diet?
JULIE ASKS:I have been diagnosed with a number of health issues including diverticulitis and Type 2 diabetes. Since then, I have been doing Paleo and cut out all gluten, sugar and high carb foods in my diet. I discovered that going ketogenic was right for me. Before I went keto, I had blood work run with the following results:
Total cholesterol — 265HDL — 64LDL — 176Triglycerides — 158A1c — 5.8
The next time I had blood work done was 6 months later. I asked for a VAP test and, although my doc doesn't understand how to read this test, she ordered it for me on my insistence. I moved towards a higher-fat diet and lost 40 pounds over that time since my last cholesterol panel. Here are the numbers:
Total cholesterol — 313 (my doctor was pushing statins)HDL — 108LDL — 187Triglycerides — 77
To tell you the truth, my doctor had no idea how to interpret the more advanced numbers on my VAP test and I don't understand it either. I didn't accept the idea that I needed to go on a statin drug but I am greatly concerned with this very high 300+ total cholesterol level. So how do I interpret these cholesterol tests and what should I be doing differently in my diet to work on any weakness in these results? What exactly should I be looking for to track my progress?
MARYANN ASKS:The only guidelines I repeatedly see for the ApoE genotype 3/4 and 4/4 people are this: exercise, avoid smoking, abstain from alcohol and cut your saturated fat intake. Do you agree with these recommendations, especially the mandate to cut down on saturated fat? If so, how do you advise you patients who are eating low-carb, high-fat to reconcile this mandate to basically limit or avoid saturated fat with all that we know about the life-saving benefits of eating this way? What do people with this ApoE genotype gain by avoiding saturated fat?
PATHOLOGIST DR. SMALL:I’m 59 years old and went low-carb about a year ago and my HDL rose from 50 to 77 and my triglycerides dropped from 92 down to 38. My cardiologist was stunned and asked me how I got such an outstanding triglycerides/HDL ratio with an outstanding CRP level of .4 and an carotid artery scan that show I have the arteries of an 18-year old. But he was not impressed with my LDL being above 130, my ApoB rising to 102, and my LDL-P coming in at 1500. How do you prioritize the favorable readings against the somewhat unfavorable ones? Do Heart Calcium Scores from a CT scan really tell the tale of where you stand with actual disease taking place in your coronary arteries?
HOLLI ASKS:I'm wondering how I can raise my LDL cholesterol levels since they seem to be too low. I haven't tested recently, but my previous test showed my total cholesterol is 142, HDL is 78, LDL is 71, and triglycerides are 50. I've been working on correcting a leaky gut and eating a Paleo/GAPS diet for the past year. My energy is very low, I’m always tired and my hormone levels are all on the low end of normal. I'm wondering if my too-low cholesterol could be part of the problem and if so, what can I do to raise it? I am not taking any cholesterol-lowering medications.
DAVE ASKS:I went to my doctor and he says I am in the "dangerously high LDL range" and I should stop eating my low-carb high-fat diet and reduce my egg consumption to no more than 3 per week. My last lab results were the following:
Total cholesterol – 254LDL – 186HDL – 52Triglycerides – 82Blood glucose – 79
Over the last three years, my triglycerides have decreased, HDL increased, LDL increased, blood sugar decreased and weight decreased. I used to take a statin drug, but I will never take it again. I realize I probably shouldn’t worry about it, but my doctor went crazy about my numbers. Is the increase in my LDL cholesterol something I can choose to ignore or should I modify my diet to reverse the upward trend?
JW ASKS:Is it possible that the rise in either total cholesterol or LDL-P that some people report while on a ketogenic diet is due to the fat leaving the adipose tissue as they lose weight? Are there any studies that show if it persists or goes away once weight stabilizes? And if your HDL is higher than your triglycerides while your fasting blood glucose level is under 100, do you care what total cholesterol or LDL-P is assuming there is no familial hypercholesterolemia?
AIR DATE: July 11, 2013 at 7PM ETFEATURED EXPERT: Dr. Nannette YountFEATURED TOPIC: "Ketones & Brain Health"
NOTE: Audio for this episode will be posted on Friday afternoon
Since you listen to this podcast, you probably are already well aware of the tremendous benefits of low-carb, high-fat living on your overall health and longevity. But did you know that eating this way can actually make you smarter? Old-school thinking regarding the brain tells us that glucose is the sole source of fuel it can use. However, we are now learning through the very latest in nutritional health research that the brain can not only be fueled well by the ketone bodies produced by eating a low-carb, high-fat ketogenic diet, but these ketones may actually be a better fuel for the brain than glucose. That's the primary focus of the work our guest expert this week has been exploring.
Nutritional scientist Dr. Nannette Yount from the University of California at Harbor-UCLA has become intricately involved in investigating the role of ketogenic diets on brain health ever since she stumbled across the cognition-enhancing properties of ketones when she personally started consuming a ketogenic diet. What she has discovered in her research is how ketones may prevent the neurocognitive deficits such as memory loss and dementia typically chalked up to the aging process, the therapeutic effects of ketones on patients with neurodegenerative diseases like Alzheimer's and Parkinson's and how elevated blood sugars levels are quite possibly contributing to a significant cognitive decline leading to neurodegeneration. Dr. Yount theorizes that human beings are meant to run most effectively on a ketogenic diet and that our hunter-gather ancestors millions of years ago not only survived but thrived in this keto-adapted state. That's what we'll be exploring further in Episode 41 of "Ask The Low-Carb Experts" addressing the topic "Ketones & Brain Health."
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Here are just a few of the questions addressed in this podcast:
LAWRENCE ASKS:Does the brain need glucose?
STEVE ASKS:I have worked as a caregiver in an assisted living facility taking care of Alzheimer's patients for several years. So I have seen the devastating toll Alzheimer’s disease has taken on so many precious senior citizens. The diet they feed these people is absolutely horrendous—low-fat, low salt, high-carb and low-protein. It’s so tragic. I understand that brain cells may die if they are glucose dependent and also insulin resistant and that ketone bodies can fuel the brain in the absence of glucose by preventing more brain cells from dying. Would ketone bodies rejuvenate brain cells that were close to death and create new ones that would then improve the symptoms of Alzheimer's? In other words, given enough time, can someone completely or nearly completely recover from advanced stage Alzheimer's disease with the therapeutic use of ketones?
FRANZISKA THE RD ASKS:What level of ketosis is required to achieve improvements in memory and prevent cognitive decline as we age? Does a person gain further benefit from being in a deeper state of ketosis due to significant carbohydrate restriction (ie
Why is there so much variability regarding the need for protein restriction to enter into and remain in ketosis? I've heard of people needing to reduce their protein intake significantly in order to achieve ketonemia or ketonuria, while others eat very large amounts of protein yet manage to stay in ketosis.
JOHN FROM THE UK ASKS:My 78-year old father has been diagnosed with Parkinson's Disease and his family has witnessed a very rapid mental decline over the past 3-4 years. He has no symptoms of shaking at all, but seems to suffer from muscle wastage and dementia. I personally think that his symptoms match those precisely of dementia with Lewy bodies. From the research you have come across, do you think a ketogenic diet could help him at all or is he too far gone?
RICHELLE FROM AUSTRALIA ASKS:What does Dr. Yount know about Huntington’s disease and the ketogenic diet? Everyone always refers to Parkinson’s and Alzheimer’s as the key neurodegenerative diseases. But Huntington’s is a genetic condition with a huge variation in the age of onset and disease severity indicating epigenetic and environmental factors at play. I am a 46-year old female and I have Huntington’s (CAG mutation of 42). I have been using a ketogenic diet for 10 years off and on. The research I have found relates to Alzheimer’s, Parkinson’s, multiple sclerosis, epilepsy and brain cancer--but nothing for Huntington’s. Are you aware of any? I am sure I am on the right track but it would be good to read scientific studies that are specific to my problem.
JEAN ASKS:In addition to the effects on brain health you report for a ketogenic diet, do you detect a key component involved due to the addition of coconut oil, particularly with regard to Alzheimer's Disease?
ROBIN ASKS:I sometimes feel a little foggy or lightheaded while eating a low-carb, high-fat diet. My carbohydrate intake is generally 20g or less daily. I’ve been doing this for a couple of months now and even restricting my protein intake to around 60g daily. I am 54 years old and currently weigh 170 pounds. In the two months I’ve been doing this, I have not lost any weight yet but I'm seeing that my fasting blood sugar levels have come down to around 100 or less while my blood ketones today readings are 2.5 millimolar. Is it normal to have brain fog with numbers like these?
RENEE ASKS:It’s my understanding that MCT oil is good for the brain, especially for patients with Alzheimer's disease. But what about MCT oil for people who don’t have Alzheimer's? I’ve done some research and discovered that there are two types of MCT oil--C8 and C10. Unfortunately, there’s nothing about this on the bottle. Is there any benefit to choose specific type or brand of MCT oil over another?
KARL ASKS:Is the amount of ketones in your blood proportional to the benefits received by the brain? In other words, is having 3 millimolar of blood ketones better than having 1 millimolar? I have tried hard to stay in a 2+ millimolar level of blood ketones. But even when restricting carbs well under 50g, keeping protein low and eating quality fats I have a very hard time maintaining anything over 1 millimolar. Is my brain receiving the full benefits of being in ketosis? And how long do the ketones stay in your blood? I am considering trying to cycle carbs so I would do something like 5-7 days of a ketogenic diet, 3 days of higher carbs, 3 days moderate carbs then repeat. Assuming I only consumed nutrient dense carbs (not pizza and ice cream), would I keep enough ketones in my system to experience the brain health benefits?
CHRISTINE ASKS:With the brain consisting of large quantities of fat, how does the process of breaking down fats into ketone bodies affect the brain or does it have an impact at all? So if the body breaks down fats from other areas to create ketones for fuel, then would it convert any unused ketones back into fat that could then be used to bolster the brain, build it up and recover from damage?
PAUL IN AUSTRALIA ASKS:My mother was recently diagnosed with progressive supranuclear palsy. She is falling frequently and I am concerned that she will soon need to be confined to a wheelchair. It is unlikely that I can get her to make significant changes to her diet (she’s just too old and too stubborn) but I was wondering if coconut oil, MCT oil or any supplements can help her at this stage. Any suggestions you can make regarding food or would be appreciated.
I suffer with depression and attention problems and in desperation started taking 40 ml of flaxseed oil daily after reading a post about it on the Internet. After two days I experienced a strange little emotion I’d completely forgotten about: joy. The following morning while getting dressed I was in the middle of putting on my jeans when I stopped, one leg on the ground and one leg in the air–I was balanced and didn’t need to touch the airborne leg down to avoid falling over. This felt odd to me. A while ago I noticed I couldn’t put my socks on without having one foot up on the bed or by leaning up against the wall. So I tried putting on my socks “stork style” and did so with ease, even putting on my shoes in the same manner. It felt great to have my balance back. I have cut back on the flaxseed oil because of concerns over blood clotting with a daily aspirin regimen. I’ve tried adding fish oil and coconut oil but can’t seem to get as much benefit as I was getting from 40ml of flaxseed oil. Can you please explain what might be going on with the flaxseed oil to improve my balance?
ANDREW ASKS:Can you cause harm to the brain if you don't consume enough calories on a ketogenic diet? One of the problems I have eating this way is that I'm not really hungry very often so I forget to eat. When I go too long without food I start to get a dull ache sort of like pressure in my skull. I try to consume lots of calories from quality fats when I do remember to eat along with moderate protein and minimal carbohydrates. I like being ketogenic but I can’t help but wonder what impact this is having on my brain health.
JEN FROM AUSTRALIA ASKS:I am brand new to low-carb and already feel much more energetic and thinking clearly--I must say I am loving how this feels! I’d like to hear what Dr. Yount says is an optimal day of eating for maximizing ketones to keep my cognitive function and physical health in the best shape possible. I’m an older mother who will be working into my late 60’s and need to be looking to the coming years of raising my child now at the age of 53.
GREG FROM NEW ZEALAND ASKS:I am a 50-year old male and have been on low-carb, high-fat diet for the past seven months. Early on I was getting ketone levels around 1-2.2 in the evening. But lately they have dropped back down to barely 0.5, although I still have steady energy levels and fast intermittently for 16-20 hours at a time. In other words, I believe I am still keto-adapted. One significant aspect of my personal lifestyle is circadian dysrhythmia from long-haul flying and missing out on sleep. I also take the occasional sleeping pill (Triazolam) to help with the time zone changes at hotels. Does the brain function better with more ketones or is it fully satisfied at some particular level? Is the brain’s choice of energy source influenced by circadian dysrhythmia? And finally, do you have an opinion on raspberry ketone products for raising blood ketone levels?
HEIDI ASKS:According to the book The Brain Trust Program by neurosurgeon Dr. Larry McCleary, ketones are the secret to remedying hot flashes, Alzheimer's, and a whole host of other brain illnesses. But I don’t think there's near enough information out there as to how to TRULY fight the effects of menopause--conventional wisdom says to eat your soy, take hormone replacements, and hope for the best. I've been taking the advice out of Dr. McCleary’s book, and along with coconut oil and the recommended supplements, have kept hot flashes at bay for months now. Hot flashes themselves are the brain's cry for more glucose, but the glucose can't get there any more, because the lack of estrogen to coat the glucose means it can no longer pass through the blood-brain barrier. So in order to feed the brain what it needs without using glucose it instead relies on ketones--and boy DO THEY WORK! Does Dr. Yount have any corroborating experience with using ketones for menopausal issues?
AIR DATE: June 27, 2013 at 7PM ETFEATURED EXPERT: Dr. Bill WilsonFEATURED TOPIC: "Anxiety, Bipolar & The CARB Syndrome"
NOTE: The audio will be published by midday on Friday
Think about the tremendous load of stress we are putting on ourselves in modern society and the impact that is having on our mental health and well-being. Here are some sobering statistics: The Centers For Disease Control estimates 1 in 10 Americans are clinically depressed, The Anxiety And Depression Association Of America notes that 40 million American adults have an anxiety disorder and The National Institute Of Mental Health says that another 5.7 million Americans are impacted with bipolar disorder annually. This is something our guest expert this week has seen up close and personal in his Northern Minnesota family practice. A few years back, Dr. Bill Wilson couldn't help but notice that his patients were getting fatter and sicker than ever before and the indelible effect this was having on brain health was alarming to him. That's when he sought to find answers and developed what he refers to as "The CARB Syndrome" which identifies the metabolic component involved in the health of your brain that can manifest itself in a myriad of ways. In Episode 41 of "Ask The Low-Carb Experts," we had Dr. Wilson zoom in specifically at answering YOUR questions about "Depression, Anxiety, Bipolar & The CARB Syndrome" solution.
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Here are a few of the questions we addressed in this episode:
CODY ASKS: My 13-year old daughter wakes up every night and cannot get back to sleep for over an hour. This has been an issue as long as we can remember. She has always been very temperamental as well and is prone to quite a bit of anxiety. She is a super picky eater and attempting to change her diet in any way, shape, form or fashion causes EXCESSIVE trauma. She also doesn't like meat. She does love cheese (Kraft Extra Sharp Cheddar and Cheeseheads String Cheese are the specific brands she’ll eat) and a lot of fruits (she’s very aware of textures and doesn't like apples that are too crunchy, even the hint of a grape seed, etc.). But other than those two things, her go to foods are junk, such as Cheetos, crackers, Pringles, candy, pizza and peanut butter & jelly sandwiches. She has asthma and eczema as well. She's seen 5 different psychiatrists and has received 5 different diagnoses. She's been on a handful of medications, all of which were either ineffective or made her worse. She is now off of all the meds and I supplement with a daily multivitamin, Vitamin D, Vitamin K2, B vitamins, magnesium and selenium. Do you have any suggestions on how we can help her?
DR. VAN DERVEER ASKS: Hi Dr. Wilson, I'm a psychiatrist in Boulder, Colorado. I'm seeing big improvements in my patients with anxiety and mood disorders by recommending the elimination of grains from their diets. Can you please share your insights on where we are currently with the science of a brain-gut inflammation connection?
NANCY ASKS: I just had lunch with an elementary school teacher today. She was telling me how the numbers for autism have skyrocketed and of course mainstreaming autistic kids into the schools. We talked about the effect this was having on the classroom environment and the fact that the parents of these children seem to be in denial about what their child is going through. Would our sugar and carbohydrate-laden diets have anything to do with this increase that has been happening?
MICHAEL FROM AUSTRALIA ASKS: At the age of 42 I had my first panic attack and I remember the exact time and day it happened. It has been relentless every single day for the last 22 years. I went down the conventional health path with various general practitioners, shrinks and psychologists—all to no avail! My shrink put me on Xanax and I think I have tried every SSRI known to man with no success. When I attempted to wean myself off of Xanax, my generalized anxiety disorder returned with a vengeance. It’s a miserable place to be in. I discovered the low-carb, high-fat way of eating over decade ago thanks to people like Dr. Mike Eades and Gary Taubes. Their advice had marvelous affects on all my physical health markers, including my lipids, BMI and blood sugars. However, it has not helped me with my anxiety at all. At this stage I am not optimistic of a cure, but do you have anything that can give me some hope for the future?
PHIL FROM THE UK ASKS: I currently eat a low-carb diet that consists of less than 30g of net carbs per day. I had a Vitamin D test and it came back as "insufficient." So I began supplementing with 4000 IU daily for a month and fixed that. I also take an EPA supplement that is extracted from fish oil. Is there any science around which if any omega-3 fish oil supplement is most effective for depression and anxiety issues? Does DHA in some way negate EPA if they are taken together?
RICK ASKS: How common is magnesium deficiency in those people dealing with anxiety problems? Also, considering your medical practice is in northern Minnesota, how often does you see people that are deficient in Vitamin D and do you use it in treating patients dealing with depression and anxiety issues? If so, what is the ideal blood level you are shooting for in your patients? Finally, have you used probiotics in treating depression?
AIR DATE: June 20, 2013 at 7PM ETFEATURED EXPERT: Dr. William GrahamFEATURED TOPIC: "What Are 'Normal' Lab Values?"
Have you ever gotten back test results from your doctor and were relieved to see that you were in the "normal" range with your lab values? Did you ever stop to ask yourself how they came up with these numbers? What if you are in the normal range on a particular test, but you still have symptoms in your health that make it obvious you are still not well? These are just a few of the questions we addressed in this week's episode of "Ask The Low-Carb Experts" with a low-carb/Paleo-friendly family physician named Dr. William Graham from King, North Carolina. He has a special interest in measuring fasting insulin and ketone levels as well as testing his patients for vitamin deficiencies. As you will quickly see, Dr. Graham is quite opinionated and more than willing to stretch the boundaries of "traditional white coat medicine." That made him the perfect choice to answer YOUR questions about the topic What Are 'Normal' Lab Values? on this week's show.
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Here are just a few of the questions addressed in this podcast:
KELLY ASKS: I’ve read that the "normal" ranges on most lab tests are actually averages of all the tests results that the lab has conducted. Why this is so frightening to me is because most of the people who are having tests run have something WRONG with their health. This means the supposedly "normal" values are really clouded with a lot of sick people’s numbers and the more tests run on sicker people the more "normal" sick actually becomes. Is this actually how it works or do I have it all wrong?
LESLIE ASKS: As with modern infant growth charts, I often wonder what's considered normal these days. My family doctor has joked with me that according to her charts I should be dead with blood pressure of 110/60 and a resting heart rate of 54 as a woman in my late 50s.
SIMON ASKS: I’m a lean, fairly healthy 26-year old man and I've been following a low-carb ketogenic diet since the beginning of April 2013 because I didn’t like feeling constantly hungry on a high-carb diet. I had a blood test done at the end of May and my uric acid levels were out of the normal range measuring 7.2 mg/dl. The normal range specified is 3.6-7.0 mg/dl. Should this be cause for concern? Are my kidneys perhaps still adapting to the presence of ketones? By the way, my total cholesterol is 223 mg/dl and my triglycerides are 139 mg/dl.
EDWARD ASKS: I was wondering if the lab standards for blood pressure are somehow biased. I'm an American born citizen of Asian descent and lived on a diet of rice for many years. It never bothered me that my blood pressure was considered Stage One Hypertension as I personally felt fine. However, with the medications I'm taking, I now feel tired and sluggish simply with the goal of lowering my blood pressure because it’s not in the right range. Can you help me understand this?
LISA ASKS: I had a regular CBC done recently and my BUN level came back as 23. The lab test states that normal is between 7-18. The doctor hasn't recommended anything for me to do about this. I follow a lower-carb diet compared to the SAD diet and I don't eat a lot of sugar. Should I be concerned about my BUN levels being so high?
TONY ASKS: Other than the typical blood test markers physicians run to gauge the general health of their patients, what are the top 5 blood markers people should be paying most attention to after the age 40? Are they different for males vs. females?
ARI ASKS: What do you think about the seemingly high prevalence of low-carbers, including Jimmy, who have very high LDL-P numbers but no other signs of imminent heart disease risks? I realize there is very little research on this right now, but would love to hear Dr. Graham’s personal experience on this subject working with patients eating a low-carb diet.
KEN ASKS: Between the standard lipid panel, NMR Lipoprofile test, CMP panel, and CBC panel, which 3-4 numbers should folks be most concerned about to determine their cardiovascular and overall health risks?
RICHELLE FROM AUSTRALIA ASKS: What is the significance of lactate in the blood particularly in the context of mitochondrial function? What other blood markers are good to keep an eye on to monitor mitochondrial function? Also, what are the best tests to monitor nutrient requirements in the body?
AIR DATE: June 13, 2013 at 7PM ETFEATURED EXPERT: Dr. Michael RuscioFEATURED TOPIC: "All Things Thyroid (Thyroid 201)"
The thyroid gland serves one of the most under-appreciated and yet totally misunderstood functions within the human body. If someone is dealing with excessive weight on their body, you might hear them say something along the lines of it being due to having a bad thyroid. But there's got to be more to it than that, right? What is at the root cause of why your thyroid might not be functioning at optimal levels? And what steps can be taken to fix these thyroid issues without resorting to taking potentially harmful prescription medications? That's what we'll be exploring with a Walnut Creek, CA-based functional medicine physician named Dr. Michael Ruscio (listen to my interview with him in Episode 407 of "The Livin' La Vida Low-Carb Show").
Dr. Ruscio specializes in the subject of thyroid health (and has quite the personal story to tell) which is why he will being joining us to talk about "All Things Thyroid (Thyroid 201)." You might recall we had the great Chris Kresser on to talk about this subject back in Episode 10 to give a Thyroid 101 introduction to the topic. But Dr. Ruscio will help us dig even deeper into answering YOUR most pressing questions about thyroid health and how it relates to your healthy low-carb, Paleo lifestyle. If you want to get a taste for what his teaching style is like, then be sure to check out his YouTube channel for lots of informative videos on this subject and more. Dr. Ruscio joined us in Episode 39 of "Ask The Low-Carb Experts" to keep the conversation going on the vital importance of attaining and maintaining good thyroid health.
Here are just a few of the questions we addressed in this podcast:
DANIELLA ASKS: I'm a 36-year old mother who recently started eating a low-carb Paleo lifestyle. I consume 1500-1600 calories most days and take in about 50-60g of carbohydrates daily. My energy is great and I look and feel the best I have ever felt in my life. Sleep and athletic performance are incredible as well and my muscle definition at 5’3” tall and 110 pounds has never been better. My only concern is that I take 60mg Armour thyroid daily and I am concerned that my low-carb diet may interfere with thyroid function. I feel like I eat adequate calories most of the time, but should I be concerned? My last labs showed everything to be good: TSH 0.6, Free T3 at 2.2, free T4 at .8.
KATHERINE ASKS: I'm 39 years old and I've been on a low-carb diet (40-70g carb per day) for 22 months in response to pre-diabetic blood sugar levels. Since changing my diet, my T3 has dropped and is now borderline low. Initial thyroid tests 22 months ago were all normal. I've done some casual reading in recent months that a low-carb diet can suppress thyroid function. In other places I've read it can help it. Can you please help clear up this confusing issue?
NANCY ASKS: I have actually been struggling with the low-carb concept out of fear of ruining my thyroid. There is so much conflicting information out there with regards to low-carb being bad or good for thyroid. I’ve heard that women should not be on a low-carb diet for too long or at all because of the risks to their thyroid function. I am already obese at 5'1" and 184 pounds and I feel lost and not sure which nutritional path to take.
KEN ASKS: I've been eating Paleo over the last year and recently had an NMR test. My LDL particle count was very high at 1403 with my small LDL coming in at 492. HDL is 62 and triglycerides are 50. I was wondering if you could further explain the role the thyroid plays in the particle count levels and whether those of us eating a low-carb Paleo diet should be worried. It seems many of us eating this way, including Jimmy, have high LDL-P and I’m curious if our way of eating is making this happen.
JUNE ASKS: Do you have a preference between Armour vs. Nature Thyroid?
RICK ASKS: What are your thoughts on treating thyroid disease with high levels of iodine supplementation?
WENDY ASKS: I have been taking 30 mg of Armour Thyroid and have been Paleo/Primal since Jan 2011. I eat fish 2x per week. I avoid raw cruciferous veggies and take a drop or two of a concentrated iodine supplement weekly as I don't want to overdo it. I recently started adding kelp sprinkles daily to my food and would like to stop having to take thyroid medications if at all possible. Is this doable?
JACKIE ASKS: I had thyroid cancer in 2008 and had a total thyroidectomy. I'm currently taking 200 mcg of Synthroid daily. Since the thyroid controls metabolism, how do I increase my metabolism to lose weight? I’m 57 years old, 5'2" tall and weigh 260 pounds.
DEANNA ASKS: I did the HCG diet over 2 years ago and lost nearly 40 pounds. Since then I have slowly gained almost all of it back. I am having hypothyroid symptoms (hair loss, brittle nails, cold hands and feet) the main one being a total inability to lose weight no matter how hard I try. I eat mostly Paleo. What are your thoughts about the HCG diet and its effect on thyroid function? I have read that it could affect reverse T3 but there are a lot of functional medicine doctors advocating it.
PAUL ASKS: What are Dr. Ruscio’s thoughts on the Endocrine Society's updated clinical practice guidelines for the management of thyroid health in pregnancy? They seem to be quite controversial.
LINDA ASKS: I read that eating one Brazil nut a day is enough to bring up a low thyroid to normal levels. Is that true? What other foods can help with this?
JASON ASKS: Is the excessive fluoride typically added to the drinking water in local municipalities something to be worried about because of iodine absorption issues and by extension be a contributor to hypothyroidism?
INGE FROM MELBOURNE, AUSTRALIA ASKS: I lost weight after my sister died in 1993 and at the age of 40 I developed a taste for alcohol that killed my thyroid. For 10 years the specialist put me on Thyroxin until my blood pressure became very high due to a lack of T3 stimulation. She then put me on 7 grains of thyroid extract and I started losing weight again. I’m now seeing an integrative doctor who is not happy about this high dosage of thyroid extract. He told me to back off of it and now I’m gaining weight again putting on 8 kg, I sleep 10 hours a night, I retain fluid, I can no longer exercise because I’m so exhausted all the time and I have severe brain fog. Do you have any suggestions for me?
MELANIE ASKS: I just got diagnosed with Adrenal Fatigue that according to my doctor is causing Functional Hypothyroidism. So my Free T3 and T4 were in the normal range, but at the lower end. I need to fix the adrenal fatigue issue but I also need to be supporting my thyroid so that it doesn’t get any worse. I'm pretty familiar with ways to support the thyroid, but wanted to ask the opinion on taking animal glandulars. I wonder if Dr. Ruscio is familiar with the Xymogen T-150 thyroid support product (a freeze-dried, BSE-free, bovine, multi-glandular, mineral and herbal formula to support healthy thyroid function). Do you have an opinion on it? My doctor wants me taking it.
ROGER ASKS: Before I went low-carb Paleo, I knew my thyroid wasn’t functioning well. My Free T3 and T4 levels were horrible and I was feeling sluggish. Is a short-term supplementation of pregnenolone a good way to boost thyroid health and balance other hormones?
CATHY ASKS: I started Synthroid for hypothyroidism in January and quickly developed a bad case of acne. Is this just a coincidence or did the medication cause this?
AMBERLY ASKS: The thyroid tests done by my doctor were all normal, but then I started going to another doctor who specializes in bio-identical hormone replacement. He said that one of them was low, maybe the Free T3. He put me on Armour thyroid to treat it. When I asked him if this could have any negative effects, he said that it could shut my thyroid down, but that since my thyroid wasn't functioning as well as it needed to on its own. Thus, he convinced me it would make sense to go ahead and start the Armour since it wasn't going to get any better on its own anyway. My Free T3 is now slightly too high. Do you agree with this doctor’s aggressive approach?
AIR DATE: June 6, 2013 at 7PM ETFEATURED EXPERT: Diane SanfilippoFEATURED TOPIC: "All Things Digestion (Gut Health 101)"
The more we learn about diet and health, it seems that as our gut health goes so goes our overall health. And perhaps you have shifted your diet over from the Standard American Diet to more of a low-carb or Paleo lifestyle and you're still experiencing issues with your digestion that have you flummoxed. It can be frustrating when you start eating a real foods-based lifestyle and still dealing with things like bloating, IBS, constipation, low stomach acid and more. But Diane Sanfilippo from the "Balanced Bites" blog and podcast and the author of the New York Times bestselling Victory Belt book Practical Paleo: A Customized Approach to Health and a Whole-Foods Lifestyle has some real solutions to these most common problems associated with digestive health issues. Diane is joining us in Episode 38 of "Ask The Low-Carb Experts" to answer all of YOUR questions on digestion and gut health.
ENJOY CARB-FREE PASTABILITIES FROM QUEST NUTRITIONNOTICE OF DISCLOSURE: http://cmp.ly/3LOWER YOUR BLOOD SUGAR LEVELS NATURALLY:NOTICE OF DISCLOSURE: http://cmp.ly/3
Here are a few of the questions we addressed in this episode:
PAM ASKS: I have been on a Paleo diet for several months now and I eat generous servings of vegetables three meals a day. Despite that I have less frequent bowel movements than I would like--less than once daily. I have accepted the fact that I probably have to take a fiber supplement. I currently use a formula that contains psyllium seed husks, non-GMO soy fiber, oat bran, acacia gum, and apple pectin extract. I chose this brand because of its reasonable price and high fiber content per serving, however I am concerned about the soy and the oat bran. Do you have any product recommendations that would not contain these concerning ingredients? Most of what I find in the stores seems to have too few grams of fiber per serving to bother with, or have other even more questionable ingredients in them.
ALLY ASKS: So for the last year and a half, my digestion has been utterly icky. I’ve had severe bloating, gas, diarrhea and more. I eat a very strict low-carb Paleo plan and was diagnosed with Candida requiring me to eat this way. However, it only made me worse. For the last month and a half, I've been following a whole-food based approach similar to Matt Stone's Diet Recovery, eating more carbs (rice, sweet potatoes, white potatoes, sugar), and my digestion is now AMAZING. It improved almost immediately and I've been doing great. The only problem now is I can't seem to lose weight. What's up with that? Why was my digestion so poor when I ate low-carb Paleo (which I LOVE), but it improves when I eat foods that I honestly would prefer not to? How do I navigate around this tricky situation?
KRISTIN ASKS: I'll keep it simple: Should my poop float?
JAMES ASKS: My 27-year old brother is suffering from some problems with digestion. For most his life he was eating the Standard American Diet, basically carbage. I have been low-carb and following a generic ancestral eating template for a year and a half now and he has adopted some of the LC/Paleo principles. However he still snacks on chips and candy occasionally. His GI tract seems to want to hold on to the food as long as possible. This results in feeling full and bloated with constipation. Without being too graphic, he has examined his stool and sees undigested food. This occurs more often with tougher cuts of meat such as brisket. He has tried more chewing and more vegetables to increase his fiber intake but it doesn’t seem to help. He does not appear to be malnourished but it does make life difficult and interrupt his day-to-day activities. What should he be doing next? Get a gastroenterology exam? Stool exam? My amateur guess is that his gut bacteria may be off, but I have no idea where to begin. Any pointers would be great.
JENN ASKS: What are the signs and symptoms of intolerance to FODMAPs? To be blunt, fruit causes me to be rather gassy and I'm trying to figure out if it is a FODMAP issue or a gut bacterial growth issue. Do you have any suggestions on how I can figure this one out?
DANIELLE ASKS: Low carb + FODMAPs = better digestion because...?
RACHAEL ASKS: Sometimes if I have too much fat I have an immediate and urgent digestive issue to contend with and at other times I'm totally fine! Are there certain fats that can cause more issues or are there any food combinations that I should avoid? I’m a huge, huge fan of Diane!
GEZ FROM THE UK ASKS: I follow a high-fat, moderate protein, low-carb diet. Does it matter if some meals are mainly protein and fat while others are primarily vegetables and fat in regards to digestion? Or should I strive to make sure the macronutrients are balanced in each meal?
LESLIE ASKS: About 6 months ago, I had a tooth pulled that entailed taking antibiotics for 10 days - amoxicillin and using nitrous oxide during the procedure. Right after that, 15 pounds crept up on me within about 2-3 weeks. I have NOT been able to make the scale budge no matter what I have tried--Whole 30, low-carb with 25g carbs max daily for 6 weeks, intermittent fasting, fat fast, fish and salad--nothing is working. I have always taken a probiotic and added even more right after the procedure. This didn't help, as far as I can tell. I eat plenty of cultured foods. What else could be going on?
JOEL ASKS: Is it possible to eat too much sauerkraut in a day to help with good gut flora? I'm a tall guy (6'4") with a big appetite, but I've leaned out to a normal weight now (207 lbs) after eating a low-carb diet for 8 months. In a meal I will eat around 350g of sauerkraut. Is there any harm in regularly eating this much sauerkraut 2-3 times a week? Are there any benefits to eating this much?
AIR DATE: January 31, 2013 at 7PM ETFEATURED EXPERT: Ben GreenfieldFEATURED TOPIC: “Ketogenic Diets And Exercise Performance”
Carbohydrate loading has become so deeply-ingrained (all pun intended!) in our culture for endurance athletics these days that hardly anyone questions whether it is the most effective means for fueling exercise performance or not. But ketogenic diet researchers like Dr. Stephen Phinney and self-experimenters like Dr. Peter Attia have discovered a new paradigm that could quite possibly be the future of fueling exercise activity–using ketones as an alternative and much more preferred energy source for fueling exercise. And we’re pleased to have a bona fide expert on this topic with a triathlete and sports scientist named Ben Greenfield (listen to my interviews with Ben in Episode 609 and Episode 457 of “The Livin’ La Vida Low-Carb Show” podcast) who is joining us in Episode 37 of “Ask The Low-Carb Experts” to share what he has learned about the role ketogenic diets can have in maximizing exercise performance.
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Here are just a few of the questions addressed in this podcast:
ALAN ASKS:Do you think a ketogenic nutrition plan is compatible with training at lactate threshold? And for races shorter than 5000 meters, is a ketogenic diet optimal or detrimental to maximum performance?
MIKKI ASKS:I’m interested in whether you’ve come across research or anecdotal evidence of the effects of a ketogenic diet on exercise performance in women? A lot of the research that has been conducted seems to be in men. I am an endurance runner and I am much better doing longer distances. When I had an RER test done in a fasted state (albeit on a cycle and not a treadmill), it showed I was a complete sugar burner. However, I have no problems training (and performing) for extended periods of time in a fasted state, or with the intake of minimal to no fuel.
As far as body composition goes, I’m very lean. Would this have any effect on the RER test results? My diet composition was at the time around evenly split between the three macronutrients. But since becoming interested in and converting to the low-carb, whole food diet approach thanks to Mark Sisson, Robb Wolf and other people in this field, my CHO sources now come from fruit, a small amount of kumara/potato, nuts and non starchy greens. I used to consume a lot of grains and sugary foods. I’ve dropped all artificial sweeteners and processed foods from my diet, upped my intake of fat and feel great.
Could the small amount of sugars along with the intake of artificial sweeteners in my diet have influenced my sugar burner result from the RER test? Does it even matter that the RER test suggested I wasn’t a fat burner if I am good at running over longer periods of time with little intake of fuel as aforementioned?
KEITH ASKS:If muscles draw energy from the sarcoplasm that stores glycogen for energy, then what positive effect could a low-carb diet possibly have on the sarcoplasm? I’m especially interested in bodybuilding where most studies show that sarcoplasmic hypertrophy is the key to developing larger muscles and differentiates the bodybuilder’s physiology from the power lifter.
SUE ASKS:I’m in my mid-50’s and started low-carb 2 years ago after suspecting my body wasn’t utilizing fat for energy. Twice, I did an ironman triathlon and twice, I got rhabdomyolysis. I would like to consider an endurance event again, but wonder if there’s a way to confirm my body is using stored body fat instead of protein? How can I be sure that it does? In the Fall 2012, I did a ketogenic diet for three months but wasn’t able to get my ketones higher than low 2′s.
CLAY ASKS:Can you please address a ketogenic diet in relation to endurance for people who are ectomorphs? What is different, if anything, about the details of a ketogenic regimen for people like myself? I’m 6’1″ and weigh 153 pounds and I run 3-4 times a week, do yoga and lift weights on the other days.
JONATHAN ASKS:I recently read a series of articles in which Robb Wolf makes it sound like ketosis isn’t something someone can do if they are involved in an MMA/Crossfit or other extreme intensity type work because they are too glycolytically demanding. I would love to hear your thoughts on.
NEERAJ ASKS:I do fasted long runs of 24 miles almost every week and eat what I think is a ketogenic diet. I DO include a lot of vegetables in my diet like kale, spinach, broccoli, string beans and the like. However, I’m not seeing any ketones in my urine Ketostix. Are these reliable? Could you talk about high-end athletic performance and the ketogenic diet. I run anywhere from 5Ks to 100Ks. Am I likely to see slower times in the shorter races and better times in the longer ones? And are you aware of any pro runners out there using ketogenic diets?
CHRIS ASKS:Would you recommend going into ketosis while training 20 hours a week for an ironman race?
GEZ FROM THE UK ASKS:Is it possible to exercise intensively with high performance on a ketogenic diet and at the same time maximize muscle gain and fat loss? Does it matter if the ketosis is from being low-carb or from intermittent fasting?
MECHELLE ASKS:I am a 45-year old mom who has been low-carbing since June 2012. I am working hard on getting into full-on nutritional ketosis with readings of 1.5 in the afternoon. My goal is to get above 2.0 millimolar in the morning! I am hoping a formal weight lifting program will help me get there. After reading Ben’s Get-Fit Guy’s Guide To Achieving Your Ideal Body Weight, I realized that I am a pure Mesomorph. Here is my question for Ben: In your book, you recommend lighter weights, with more repetitions for me; however, I am intrigued by Fred Hahn’s Slow Burn and his suggestion to use weights heavy enough for complete muscle fatigue with just a few reps. Is your suggestion for the lighter weights for cosmetic reasons? As a Mesomorph, can I actually get as strong and build as much bone density when lifting lighter weights, with more reps, as I can with lifting heavier weights in the manner Hahn suggests?
Filed Under: exercise, ketogenic, Low-Carb, Nutritional Ketosis
AIR DATE: January 24, 2013 at 7PM ETFEATURED EXPERT: Paul JaminetFEATURED TOPIC: "All Things Hunger (Satiety 101)"
If you ask a typical registered dietitian about the role of hunger in your diet, then you'll likely hear something like what I recently read in a SHAPE Magazine column by Cynthia Sass, RD entitled Why A Little Hunger Can Be Healthy. Sass wrote that "one of the most common missteps I see that keeps people from getting results is being afraid to get hungry...mild to moderate hunger is normal, and it's something you should be experiencing about four times a day." She went on to say that "if you’re never hungry you’re probably eating more than your body needs to reach and maintain your ideal weight." Interestingly, she went on to admit that if you eat a "balanced breakfast" of cooked oats with fresh fruit and nuts with a glass of fat-free or soy milk that should "feel a little stomach rumbling" in a few hours. What an admission by someone who is supposed to be an authority on what good nutrition is all about!
But the idea of getting hungry as a positive sign in your diet goes against what our expert guest this week believes is the sign of a healthy nutritional plan. Paul Jaminet (listen to my previous interviews with him in Episode 453 and Episode 526 of "The Livin' La Vida Low-Carb Show" podcast) is the author of the newly-revised version of his book called the Perfect Health Diet: Regain Health and Lose Weight by Eating the Way You Were Meant to Eat where he explains that hunger is actually a tell-tale sign of malnutrition that needs to be addressed and not something to be glorified or honored as something good for you as the RD above suggests. The nutritional content of your food and making sure you are getting all the key essential micronutrients in what you are eating is very closely associated with the level of satiety you will experience on your chosen diet plan. But far too many people still feel this strange connection to being hungry on a diet which is why Paul Jaminet is joining us in Episode 36 of "Ask The Low-Carb Experts" to look at the role of hunger and satiety on a weight loss diet.
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Here are just a few of the questions we addressed in this podcast:
RISA ASKS:I eat a ketogenic diet and have observed during the week of my period and the week after that I have very little need to eat. However, during the week of my PMS, I experience an increased hunger unlike anything I see at other times. I am feeding my hunger sensibly with fat and proteins and it still takes much less food in order to make me feel satisfied. Unfortunately, though, I just can’t lose weight during this time. Does Paul have any theories about the potential impact of the menstrual cycle on hunger and satiety in a ketogenic state for women?
DR. BRETT HILL FROM AUSTRALIA:Is there any research out there on the satiety per calorie of various foods? If not, then I am seriously considering doing some and writing a book about it. My main question has to do with the satiety of nuts vs. nut meals? I am curious about what happens to the satiating properties of consuming whole nuts when they are ground into a flour or meal that ostensibly makes them more easily digestible.
SCOTT ASKS:I work very hard to eat appropriately, monitoring the types of fats I eat, adequate amounts of proteins and restricting carbs to no sugar/starch/flour. I make my own breakfasts and lunches, but dinner is with my wife and kids who are not following this diet yet. Typically we consume a leaner protein and a vegetable or salad. Sometimes, though, after we’re finished eating and I’m cleaning the dishes, I have an almost insatiable desire to just KEEP EATING! This is just crazy to me. As you might imagine, when this hits is when I get into all of the wrong foods. Is this an emotional or physiological response?
MIKE ASKS:My wife and I have been eating a Paleo diet with dairy for a few years now. Thanks to Paul & Shou-Ching's work we have reintroduced "safe starches" into our diet and doing well overall. I eat within a 6-8 hour window, Tracey's window is more like 8-10 hours and we have been intermittent fasting for 2+ years. I very seldom get hungry and if I do it quickly passes. Tracey on the other hand is often hungry to the point that she can't stop thinking about food during her fasting time and very seldom does she feel satisfied even after eating quite a bit of food. I have seen a lot of blog posts lately related to the differences between males and females, but I find this concept interesting since it has been very easy for me. Does Paul have any thoughts or ideas about why Tracey may be having this hunger?
AIR DATE: January 17, 2013 at 7PM ETFEATURED EXPERT: Dr. Steven GundryFEATURED TOPIC: “High-Fat Diets: Good vs. Bad”
Depending on who you ask these days, a diet described as "high-fat" can either be a very good thing or a really bad thing for your health. For those of us who embrace a healthy low-carb lifestyle change, we understand the significant role that dietary fat plays in providing satiety, as an alternative fuel for our body in the absence of significant amounts of carbohydrates and other important health functions. But are all fats created equal? Absolutely not!
That's why we're so pleased to welcome a bona fide expert in this area who knows just a thing or two on differentiating between the outstanding good fats and the truly bad fats. His name is Dr. Steven Gundry and he is one of the top heart surgeons and researchers in the world. But his real passion is in helping people stay off of his operating room table through the healthy nutritional principles he shares in his book Dr. Gundry's Diet Evolution: Turn Off the Genes That Are Killing You and Your Waistline (listen to my two-part "Livin' La Vida Low-Carb Show" interview with Dr. Gundry about his book in Episode 179 and Episode 180). He's joining us in Episode 35 of "Ask The Low-Carb Experts" to learn more about what fats you should embrace and which ones you should run away from on your low-carb, high-fat diet.
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Here are a few of the questions we addressed in this podcast:
RENEE ASKS:My husband's family has a very strong family of heart disease. He is doing better with controlling his carbs. However, he is not low-carb and will not do low-carb. My question for Dr. Gundry is this: if my husband is eating a moderately high level of carbohydrates, is it dangerous to combine that with more saturated fat? I always buy good quality fats like Kerrygold butter, coconut oil and red palm oil. We only use extra virgin olive oil at room temperature poured liberally over steamed vegetables after they are cooked. I'm wondering if the combination of higher than optimal carbs with higher saturated fat is heart healthy or not. I believe that saturated fats are heart healthy if you eat moderately low-carb or even higher-carb. Or, should we lean more toward the monounsaturated fats like olive oil for him?
TYLER ASKS:I am a patient of Dr. Gundry and he's changed my life as well as several of my family members. I’d like to ask him to discuss the ApoE 3/4 or 4/4 genotype and why those who have it should be eating animal fats sparingly? It seems like many in the Paleo community seem to neglect this and Dr. G. has a different take on it.
DUSTIN ASKS:Is it possible to eat too many macadamia nuts?
TESS ASKS:Although Dr. Gundry is probably more interested in heart health than thyroid health, perhaps he can tell me more about what impact omega-6 fats have on thyroid function.
MICHELLE ASKS:I have been aiming for consuming the best quality nutrient-dense foods, including fat sources like Kerrygold butter, organic cream cheese, olive oil, lard from foraging pigs and coconut oil. I have been eating high-fat cheeses, pastured beef, wild caught fish and salmon, dark meat with the skin from pastured chickens, bone broth, eggs, seaweed, olives, avocados and spinach. My first question for Dr. Gundry is: In light of my food choices, what information can I offer to my very sweet and concerned mother-in-law (who follows a low-fat, “healthy whole grains” diet) when she tells me she is afraid I will have a heart attack because of all the fat I am eating? And what can you tell women of childbearing age about nutrient-dense high-fat diets during pregnancy?
WENDY ASKS:Is eating more fat from grass-fed and pastured animals than fat from expeller pressed organic oils good or bad for you while eating a low-carb diet? Are there any health concerns I should be aware of?
RAYMUND ASKS:I would like to ask what Dr. Gundry thinks is an optimal ratio of the various fat types while on a ketogenic diet. What are the proper amounts of monounsaturated, saturated and polyunsaturated fat (including both omega 6s and 3s) that should make up our daily intake?
MARY ASKS:In the optimal diet, where should I be getting most of my dietary fat from and how much fat is too much?
AMY ASKS:Is eating one whole avocado daily providing too many omega-6 fats? We take fish oil supplements but my understanding is that it does not necessarily cancel out the other foods we are consuming.
MIKE ASKS:I've heard a lot about the dangers of polyunsaturated fats but I don't really understand where to draw the line. My general understanding is that trans fats are evil, mono and saturated fats are awesome, and polyunsaturated fats are somewhere in between. How much polyunsaturated fat is too much? Eating grass-fed beef means I have a half-hour drive to Whole Foods, making my own mayo means I have high fat tuna fish or egg salad less often, avoiding processed foods at restaurants makes it nearly impossible to enjoy a guilt-free night out with friends. I feel as though all of these "rules" make it nearly impossible for anyone to succeed on what is supposed to be a relatively straightforward approach to eating. How do you personally decide when to compromise food and/or fat quality for your sanity's sake? Is it possible to drop that last bit of weight without complete and militant adherence to every rule under the sun?
SUSAN ASKS:Why are the fats found in eggs not bad for us? Can I eat half a dozen eggs a day without any health consequences? And does eating too much saturated fat in your diet lead to an increase your uric acid levels and give you gout?
GEZ FROM THE UK ASKS:Do you agree that a low-carb diet should also be moderate in protein and high in fat from a longevity and health perspective? And what are you thoughts on intermittent fasting which seems to happen naturally in people who eat enough quality dietary fats while limiting their carbohydrate intake?
VINCENT ASKS:Can you please explain what if any connection there is between a high-fat diet and blood glucose levels? I know there is something that fat does in the metabolic process that reduces or eliminates sugar spikes, but I would like to hear an explanation about this.
BETH ASKS:I would like to ask Dr. Gundry his thoughts on Organic Macadamia Nut Oil and grass-fed ghee, both of which I get online. I saw Dr. Gundry speak at a women's health expo in November and am hoping he could clarify his thoughts on American chickens and the estrogen levels: Did he mean ALL chickens, including organic? And why is the estrogen in them so bad for us?
JEAN ASKS:What do you think about using bacon fat in cooking?
LAURA ASKS:I have a friend who is on insulin who is doing low-fat, high protein diet. I’m worried about the low-fat part of her diet for long-term success and the high-protein for her kidneys. What does Dr. Gundry think about what my friend is doing?
MICHALEA ASKS:Are plant sources of fat good to consume although they may be higher in carbohydrates? What role does the fiber in these high-fat plant foods play?
AIR DATE: January 10, 2012 at 7PM ETFEATURED EXPERT: Dr. Jayson & Mira CaltonFEATURED TOPIC: “The Importance Of Food Quality On A Low-Carb Diet”
One of the biggest criticisms of the low-carb diet over the years is that it sacrifices choosing the best quality foods in favor of the simple process of cutting carbohydrates. But in 2013, that's not the reality of what most of us low-carbers are actually doing. The challenge that we face as carb-conscious consumers is in balancing our desire to control the amount of carbohydrates we consume with the need to obtain the most nutrition out of the foods we eat. That's where our guest experts Dr. Jayson and Mira Calton come into play.
In 2012, they shared about the critical importance of getting the proper amount of micronutrients in our diet with the release of their book Naked Calories. But in 2013, they're back with a brand new book releasing on February 26th entitled Rich Food Poor Food: The Ultimate Grocery Purchasing System (GPS) that serves as a virtual guide for how to go shopping without getting confused by slick marketing by food companies. Recognizing the importance of food quality on a low-carb diet is what we will be discussing in Episode 34 of "Ask The Low-Carb Experts."
Start getting me your questions NOW regarding the importance of food quality on a low-carb diet for me to ask Dr. Jayson and Mira Calton by e-mailing them to AskTheLowCarbExperts@gmail.com no later than 3PM ET on the day the podcast airs. You can also ask your question LIVE on my show by calling (712) 432-0900 or Skype the show for FREE by calling the username freeconferencing.7124320900. Whether you call or Skype, be sure to use the access code 848908. Listen LIVE and leave us a review at iTunes if you like what you hear. This is your chance to interact with the best nutritional health experts in the world, so don't be bashful. We're glad to be back and look forward to sharing a brand new episode of "Ask The Low-Carb Experts" with you this week.
AIR DATE: November 1, 2012 at 7PM ETFEATURED EXPERT: Dr. Peter AttiaFEATURED TOPIC: “Finding The Diet That's Right For You”
If you've been listening to my podcasts or read my blog for any length of time, then you've obviously heard me talk about one of the basic philosophies that I think is an important part of living a healthy lifestyle. Here it is: "Find a diet plan that is right for you, follow that plan exactly as prescribed by the author and then keep doing that plan for the rest of your life making appropriate tweaks along the way to keep it working." But how do you go about figuring out what the "right" diet and lifestyle plan is for you? That's what we'll be exploring further in Episode 33 of "Ask The Low-Carb Experts" with a highly-qualified guest expert named Dr. Peter Attia from the "Eating Academy" blog (listen to my March 2012 interview with Peter in Episode 560 of "The Livin' La Vida Low-Carb Show" podcast).
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Here are some of the questions we addressed in this podcast:
RENEE ASKS:I have been refining what I think is my perfect diet for about 3 years now. During that time my diet has drastically changed for the better. I eat a very strict Paleo autoimmune diet with no dairy, nuts or nightshades. This has worked very well for me and now I am experimenting with a few little things here and there to tweak my diet that help me go from feeling good to feeling great. I am wondering about the cross-reactivity of coffee with gluten. I have heard that this can be a problem for some people, but I dismissed it because I didn’t want to believe that it can be a problem for me. But now I’m thinking that it IS a problem for me because after quitting coffee I started losing weight with no other changes in my diet. And it's not just calories because I replaced the coffee with a coconut oil cocoa that would have equal calories since I made my coffee into a coconut oil latte anyway. I know that gut issues are the minority of manifestation of gluten intolerance, so this effortless weight loss might be showing some type of healing. I also heard that a study came out early this year confirming that a coffee/gluten cross reactivity is a significant problem. What are your thoughts on this issue?
MICHAEL ASKS:I'd like to hear Peter address hypercaloric feeding on a ketogenic diet in combination with weight training. Is it possible for someone who is already basically lean and healthy to overeat and train his way up in size? What is the likely practical limit to size gain and performance in weightlifting with insulin levels being kept very low?
MIKE ASKS:I have found success stabilizing my weight on a diet of 20-30g of carbs per day. However, I can't seem to lose those last stubborn pounds. I am a 5'8" male and currently weight 160 pounds with 19% body fat. My goal is to get down to 15% body fat. I started monitoring my ketones and after a month was able to lose another 4 pounds and 1% body fat, but it was very hard for me to maintain the high percentage of fat in my diet required to get my ketones high enough. Recently I started slow lifting and I really like that program. But when I increased my protein to aid muscle development I knocked myself out of ketosis and am right back to the 19% fat, 160-pound mark. I suspect a hormonal problem is contributing to the difficulties in losing but I’ve tested my testosterone twice and both times it’s near the high end of the "normal range." Recently my TSH also tested fine at 1.9, my Free T4 Direct was in the middle of the lab range at 1.32, and my TPOab was also in the middle at 12. My Free T3 was on the low end of the lab range at 2.2 (with the lowest reference range being 2.0). Given all of the above, are there variations I could try in my diet that could get me unstuck and help me reach my goal?
MARYANN ASKS:I’m a 76-year old woman with the H63D gene for hemochromatosis and have high ferritin. My latest test was 436 and it goes up and down with an all-time high of 625. My doctors says that a phlebotomy is unnecessary unless it goes over 1000. I also have paroxysmal atrial fibrillation which I understand eating the Paleo way is the best for this. My A fib discussion board members say my ferritin is way too high now. What diet would you say would be the best for me?
TINA ASKS:I am 42 years old and have been overweight since having children in my early 20s. I am 5'4" and weigh 199 pounds. My A1c was 5.8 when I check it a few months ago and my doctor advised me that I’m at risk for Type 2 diabetes and that I need to start exercising 30 minutes per day. I have been playing around with low-carb/Paleo and primal diets for the past few months but I can't decide which way to go. I have read tons of information and listen to many health podcasts like the ones from Jimmy Moore, Balanced Bites and Fat Burning Man. Where do I start? I crave sweets at least once a day and that continues to be my biggest downfall. How do I pick the diet that’s right for me?
PALEOZETA FROM AUSTRALIA ASKS:I would like Dr. Attia to talk about intermittent fasting and…well, diarrhea. Sorry. About 10 minutes after I eat again following an intermittent fast, which works very well for me in conjunction with my ketogenic diet, I tend to have one or two bouts of diarrhea. I was reading that it could be our body expelling the toxins in it, but I’m not so sure about that. I’ve heard other people who do IF having this same issue. Do you have any insights about this?
JAN ASKS:I'm a peri-menopausal woman, and I eat a low-carb, high-fat version of primal. My doctor is pushing statins on me strictly on the basis of my LDL-C which registered in at 142 using the Freidewald Equation. My HDL is 79 and my triglycerides are 71. Because of my insurer and financial situation, getting an NMR Lipoprofile test to measure my LDL-P is out of my reach to better assess my risk factors. I can't even get them to do a C-Reactive Protein test to assess whether there's inflammation. Is there any dietary tweak I can make to bring LDL-C lower without negatively impacting my excellent HDL and triglyceride readings?
ERIC ASKS:It seems very timely that Dr. Attia will be on your podcast, Jimmy, as your latest Apo B results showing 238 and an LDL-P score of 3451 would appear to be quite alarming based on his recent “The Straight Dope On Cholesterol” series. Since Dr. Attia is a huge fan of ketogenic diets AND has a lot of knowledge about the importance of lipid markers, I would imagine he would be in a fantastic position to help clarify what is going on here. He seems to believe that the Apo B number is one of the most important markers of cardiovascular health. By the way, what is Dr. Attia’s Apo B number?
JACK ASKS:Since cycling is a topic that is rarely addressed in Paleo/low-carb circles, does Peter have any tips for maximizing endurance athletic performance while on a ketogenic diet? Whenever I try to do cycling while in ketosis, I often feel fatigued and lose some of my power. Alternately, if I eat a lot of carbs and sugar-laden cycling food, I get stomachaches and feel bloated and grouchy most of the ride. Peter's blog has been the only thing I've ever seen talking about this topic and I’d appreciate hearing more from him about this.
ROGER ASKS:Does a ketogenic diet repair or re-regulate an underactive thyroid? I’ve been on this diet for a year and a half now, but my hypothyroid symptoms still exist although I feel much better. My latest blood tests suggest I have low T3. I’m athletically built, never been overweight and exercise moderately. I’m wondering if Dr. Attia is a proponent of doing any thyroid supplementation in conjunction with a ketogenic diet as a beneficial approach to treating these hypothyroid symptoms?
MICHELE ASKS:I heard you mention on your previous podcast with Jimmy that you use vegetables as a vehicle for consuming more fat. How important are vegetables in the diet if you’re eating a high-fat, low-carb diet? I always get confused because you hear how important it is to eat a lot of vegetables but I’m not particularly fond of a lot of them when trying to increase my ketones.
TOM ASKS:We often hear the phrase used in the low-carb community that “there’s no dietary requirement for carbohydrate.” I’ve always assumed this comment was directed at the usual suspects like breads, cereals, pastas, legumes, etc. However, I have to ask, are vegetables really necessary to consume? In my case, I’m referring to non-starchy vegetables, such as kale, Brussels sprouts, cauliflower, and so forth. While vegetables contain vitamins, nutrients, fiber, and phytochemicals, I’ve read that cruciferous vegetables are also potentially goitrogenic. Cooking these vegetables for long periods of time supposedly helps to mitigate any deleterious effects, but the suggested cooking time is a minimum of 30 minutes. So what’s the scoop on veggies?
DARREN ASKS:Over the past year and a half, I've been following a low-carb diet stopping short of nutritional ketosis. I'd put my daily carbohydrate input close to 100g out of a 2700- calorie diet. It has allowed me to accomplish and exceed the goals that I set out to do:
- Lowered my Triglycerides from ~330 to <70- Decreased my A1c from 5.8 to 4.7- Reduced my fasting blood glucose numbers- Shed over 35 pounds off my body
During that time, I've been reading as much information as I can about a low-carb lifestyle. Looking at the best low-carb diet studies that I have seen, most are centered on ketogenic diets and clearly show the benefits of that lifestyle. And yet it seems there are still many questions about nutrition that are either unanswered or do not have answers backed by solid science. Should I be concerned about any long-term health risks from my diet falling short of ketogenic levels? Will your NuSI project be focusing primarily on a strict ketogenic lifestyle or a variety of diet plans across the spectrum? And are there any specific tests that I need to run on myself before, during and after if I wanted to do an n=1 experiment of getting into nutritional ketosis?