What is the Keto Diet and is it Right for Me Part 1


Why did you want to become a Naturalpathic Doctor?

My whole goal right from the university and all that was coming into naturopathic medicine. So at the same time, while I was doing my Undergrad, I started working full time at the hospital. So I was an assistant in the lab where we type people for heart transplants, kidney transplants, any type of tissue transplant. So I would volunteer, I would work there full time and then I volunteered on the other side of that. So I got to see behind the scenes how everything worked. And then I’ll ask, I got to see the patients and their families as to what is involved in the kidney transplant. And also working very closely with the doctors and the staff. And I think I became disenchanted with the whole system because it was very, the quality of what people, the quality of life for the doctors wasn’t what I thought it was.

That’s what really what I was going for was quality of life, which I continue through to this day with, for myself, but also for my patients’ quality of life is paramount. So if you don’t have the quality of life, is it, is it worth driving yourself into the ground floor? So it was van. So at that point I still didn’t know what else I would do. And then a family friend said, have you ever thought about naturopathic medicine? And I think my reply to that level, that’s all Hokey, you know? No, there’s no evidence to that. Like there’s no research. But, I went down the research route and found that, okay, there’s a good number of evidence for, some things is lacking and others. But that was something that I became interested in and went and did another four years of, naturpathic training and came home and created Cornerstone.

Why do you think the Ketogenic Diet is so popular?

I would say the biggest reason why it’s so popular is because it’s a highly effective at helping people drop weight. Weight loss gets hyped up and, and unfortunately with that can come people making, trying to make as much money off, off something like this.

Is there any other benefits to doing the Ketogenic Diet?

Absolutely. I mean, the original research on a ketogenic diet, was actually in children with epilepsy before we had really good meds to help with seizures. So a ketogenetic diet was found to be anti-seizure. So kids that didn’t respond to therapy were put on ketogenic diets and their seizures dropped roughly around day three to day five. So there’s many reasons and now as we look at that now ketones, ketones are ketogenic diets are being studied and other seizures and extreme atmospheres with NASA, with navy seal divers and people that are in extreme environments. That research hasn’t happened yet, but there’s a lot of preliminary animal research coming out. Research always takes five to 10 years to come out. So we’re getting there, but if you look at the amount of research over the past 10 years coming out on pop med, you’re getting about 40 new research papers a month, which is before it used to be five. So it’s actually pretty awesome.

Do you promote the ketogenic diet when patients are looking to lose weight?

Uh, for the right patient? So it’s very specific. It’s not for everyone. And well I think we’re going to cover some of those if you’re missing a gallbladder or things like that. And it depends also what’s going on in your life. It depends on your own individual background and how comfortable you are in the kitchen and all those things cause you get into hype terms like a dirty Keto and things like that. But uh, yeah, it’s something I use a lot, I’ve been using out of an impact is for eight years and I’ve definitely used it with all of our thousands of patients successfully.

Walk me though what an assessment would look like for a client that is interested in a keto plan?

So the first thing right off the bat is that this needs to be, you really should be losing weight by a lifestyle because diets, I agree, it’s one letter away from Die. Diet is very short term and this is the whole thing with the diet world, so to speak at everything. Everyone’s looking for that quick fix. Whereas lifestyle, if you focus on eating properly and exercising and everything in a balanced way, the weight will come off as a side effect of just being healthy overall. So that’s where I first go. That’s what we preach is lifestyle being paramount to that. Provided we learned to cook, we learn proper meal planning and we learn what a portion looks like. We learned how to fill your plate and we learn all of those along the way so that by the time you get to the end of Keto in your way, you are, you don’t just revert back to your old ways, which is what we see all the time.

What would a typical keto meal plan look like? And can you combine it with intermittent fasting?

So intermittent fasting we would skip breakfast and the first meal they would actually, it will be lunch and that keto meal could look like a big huge salad with, olive oil and vinegar, salt, peppers, herbs and spices and getting off the dressings and things like that. On top of that for protein, they could be doing salmon or haddock, they could be doing chicken, chicken thighs. If they need snack food, coconut, dried coconut, coconut smiles, which you can get at Costco are awesome. Hmm. I’m trying to limit the dairy depending on the individual. So trying not to do too much cheese or things like that. Another thing which absolutely has to be involved are fat bombs, which are, because this is the thing we need to discuss about keto, is that most people don’t get enough fat. So fat bombs throughout the day and then they’re going to get home and they’re going to have a really nice supper with proteins and vegetables and again, more oils. Read intermittent fasting 101: How to Drop Fat and Build Muscle

How do you know if your in ketosis?

Blood work and urine tests will work. But the cheapest way is to get keto sticks, which you can pick up at a pharmacy and we use them with our patients as well. So after day three of being in Keto or starting a ketogenic diet, we generally have people pee on a stick and it mildly purple. We want people in moderate ketosis. That’s the fastest way when we taught a Keto adapted or fat adapted that could take up to three to six weeks depending on their digestion because a lot of people have to adapt to that amount of oil in their diet.

In terms of the Keto stick, is there different ketones that the stick looks at versus blood work ?

What it comes down to though is it’s just not necessary. Like if you’re doing research and things like that, absolutely. Like if you really want to be by the numbers, by the 0.1 millimole of ketones in your blood, you’re going to need to do a finger prick bloodwork. But for the sake of being successful on a ketogenic diet, the urine sticks are, are more than enough.

Can both Type 1 and Type II diabetics go on a ketogenic diet?

Absolutely. But you have to be careful. Normally I only recommend this being done under medical guidance if they’re using insulin or medications.

Can Ketoacidosis happen for diabetics?

Yes, definitely, that is something that has to be watched for sure. And that’s why if you have an underlying condition that is serious like that and you’re on medication for it, you really should be doing this under the guidance of a medical professional.

Should we be more concerns about the quality of the fat or make sure we fat the proper ratios of macronutrients?

The ratio is extremely, really important and unfortunately it’s a numbers game. Oh wow, I need 135 grams of fat a day. We train people how to calculate net carbohydrates and, and just to get the right amount of protein. The biggest mistake I see people make on Keto is that they are eating way too much protein, hundreds of grams a day, which is hard on the kidneys. Yeah, hard on the body in gives you bad breath. It’s hard on your teeth. I mean there’s so many things about protein. So, we always just do that education. So no, really you have to look at the macros. And then after that we have to discuss quality of the fat, quality of the protein. Let’s get your grass fed beef and let’s do fish. Let’s do things like that.

What can you tell me about exogenous keto supplements that I keep hearing about? Do you recommend them?

First, I want to see the research. Show me the research and I’ll totally get behind your product. But when you look at the research papers that are cited, they’re all actually studied on endogenous ketones or someone who has been in a ketogenic state. I think the big gray area we have is what are you defining Ketosis as? Because if you are going to measure ketones in the bloodstream, you’re in Ketosis, then they’re not lying. Because if you do a finger prick after drinking, exogenous ketone, he’ll have a small, very slight bump in ketones in your bloodstream for about an hour. Okay. But after that, it goes away and you go right back. So I think the definition there is, is needs be more clearly defined. Research needs to be done.

Dominic D’Agostino, owns the patent on Bhb, which is Beta hydroxy butyrate, which is a ketone salt. That is the main ingredient in these ketone supplements. But when you read his research, it’s done mostly on animal that’s looking at seizures. He does research for NASA. He does research on Navy Seals, on divers. So people that are in extreme environments, that’s where that is being studied. There has been no research on weight loss. Let’s also break it down to the biochemistry. Whenever I start looking at something, it’s like, well, let’s go back to the very basics. I can go back to physiology and biochemistry. How does the body actually work? So when the body is in Ketosis, your levers making endogenous ketones, meaning they’re being made within your body. If you have too many ketones, the ketones actually shut down the process called Lipolysis, which is the breakdown of fat. So when you’re in a ketogenic state, your body actually goes into a normal rhythm of if you have too many ketones, your body starts breaking down fat. So it’s not about getting more and more ketones into your blood stream because that in essence, if you’re doing it for weight loss, is actually stopping it. So it’s just when we look at the biochemistry, we just look at it that way and we look at the research and then the individual can make the decision from there.

Do you recommend supplements for a Ketogenic Diet?

Well, it depends on their level of activity. So at first generally you don’t need anything. But by week two we are finding that people need sodium. And, and I think this is because we think salt is bad. We’ve been hammered, you know, since the 1980s where the Dash Diet and blood pressure that we have too much salt. But when you’re in Ketosis, your body has very low levels of insulin, which has a direct effect on the kidneys where it loses salt. So you’re actually peeing out more salt, which is why you’ll see a lot of water retention in that first week. People go into Ketosis, they at least lost seven to 10 pounds. That is not fat. That is water you are holding onto before.

So then if you get low sodium, you can, your head can start to feel funny, you can get tremors, your muscles started to feel funny, all kinds of things. So I often have to counsel people to put more salt into their diet and they think that’s very strange at first. But as you start researching keto, it’s an entirely opposite way of eating than what, you’ve been taught as a kid. Honestly, like when they’re cutting out refined foods and bread like that all have sodium in it cause that they’re going on like mostly protein, high fat and vegetable. Um, the sources like you have to get salt from a completely in my, in my own practice with all my patients, I use salt as a marker of how much processed food do you eat because really you can’t overdo salt unless you’re eating processed food.

Definitely. Sodium’s a big one, sometimes potassium and that’s let’s eat some Avocados. Let’s get some more foods that have potassium in your diet. And then the other one would be magnesium because you’ll see a lot of people get muscle cramps. They’ll start getting Charlie horses at night. There. I’ve started twitching and they don’t, they can’t stop it. Things like that. We generally see that with people who have high levels of activity.

What can you tell me about medium chain triglycerides?

Medium change. Triglycerides are a type of fat that is, the chemistry is different because they’re very short. They get absorbed in the stomach immediately. So genuinely if you were to take olive oil, for example, your gallbladder has to release bile to help digest that and it goes and it takes a while to get absorbed. Whereas MCTs can get absorbed in the stomach, they get shunted to the liver and they can be turned into fuel immediately. Most MCTs are derived from coconut, so you’ll see a lot coming from a coconut oil. You’ll see a lot in bulletproof coffees. You can add them to smoothies and things like that. It’s a great way to get that extra level of fat into your, into your diet when you’re doing Keto to do it properly.

Would you recommend MCT supplement for someone that has a hard time getting consuming fat?

Absolutely.

Can someone without a gallbladder go on the Ketogenic Diet?

Yes, but it has to be monitored. It takes a lot of preparation because you have an inability to properly digest fat. And because we need so much fat on a Ketogenic Diet, you can give yourself diarrhea because the fat’s just passing through. And really then if it’s passing through, you’re going to be tired. So genuinely, if someone doesn’t have a gallbladder and they truly need to do keto and we go through that with the patient, we actually work them up very slowly. So we’ll switch to Paleo fairly quickly. So no sugar, no grains, and we’ll actually measure the fat and then we’ll increase that weekly or biweekly up to a level where they’re not in ketosis yet, but they’re moving towards that. And eventually your body will just flip as we decrease the carbohydrates. And because the last thing you want to do is to create bile duct inflammation and think they’re going to get nausea, you’re going to get pain. And that’s not why we’re doing this. We’re doing it is to increase quality of life. I don’t recommend someone jumping into it that doesn’t have a gallbladder that’s not being monitored.

What do you do after when a client has successfully completed a keto protocol.

Awesome question. I wish more people ask that question. But yeah, so with females, the maximum amount of time I do keto is 12 weeks. And the reason for that is I started to see hypothyroid symptoms. The weight loss slows down and they start getting cold. And I’m not sure the exact research behind that or as to why it’s happening. There are a number of hypothesis. One is as you lose fat, there’s hormones that are stuffed away in that fat. So hormones can, you can get a hormone flux as you lose weight, especially if you lose weight too rapidly, your body has to create a new set point for your weight. So I think that’s why the thyroid gets involved in males. I haven’t seen that, but females for sure. We never do longer than 12 weeks of keto.

Do you personally follow a ketogenic diet and what are your favorite recipes?

Oh my goodness. So many recipes. I do follow a ketogenic diet. I will cycle it for 12 weeks, twice a year. And then the rest of the time I stick to a low carb, Paleo, unless I’m training and that starts to go up and then you have to increase the carbohydrates. Favorite recipes. There are so many. But last night we made a vegetable goulash with a little bit of ground lamb and bake to that and then garnish it with a little bit of fresh Parmigiano Reggiano. And that was one of my favorites. And then if you really need a treat, I like the keto cheesecake.

Listen to What is the Keto Diet and is it Right for Me Part II

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