Tip #1 How Doctors Have Been Using The Keto Diet

In this episode of ‘How the Diet Turns,” we discuss the different ways doctors have been using the Keto Diet plan and how it may of benefit to you. Although the Keto diet was originally used in the 1920s to treat seizures its use in the medical field has changed dramatically over the last 30 years.  Here we will discuss what it means to be on a keto diet and how it may be a valuable tool against certain chronic diseases and as a preventative strategy to support health.

What Is A Ketogenic Diet Anyway?

Check out my prior post to get the scoop on what it is and how it works.

In a nutshell, a ketogenic diet is very high in fat, moderate in protein, and very low in carbohydrates. The idea here is to keep your fat-accumulating hormone, insulin, low by keeping your blood sugar low.  When you keep insulin low you are able to turn on fat-burning genes that allow your body to use fat for fuel.

How many carbs are allowed on a ketogenic diet?

Most ketogenic diets require less than 50 grams of carbs a day.  For some individuals, they will not be able to get into “ketosis” aka the metabolic state of burning fat for fuel, unless they drop their carbs to fewer than 20-30 grams a day.  To give you an idea of how low this is, consider that one apple is about 25 to 30 grams of carbs. I don’t even count that as food much less my portion of carbs for the day!  

How is this different than low carb?

If you have done low carb diets before, you know that it can be quite effective for weight loss.  But the problem is that most of the time, low carb dieters are hungry all the time and can’t maintain that kind of eating habit.  The difference between low carb and keto is in the fat content. Eating a high-fat diet—about 70 percent dietary fat or higher—means you aren’t getting enough glucose for fuel, and will need to then start using fat for energy.  It’s all in the FAT. Most low carb diets are low carb, high protein and low fat, which is quite different than keto. 

How do you know if you’re in a state of ketosis?

Signs you’re in ketosis include weight loss, a feeling of euphoria with improved thinking and cognition, better energy, mental alertness, and better moods.  This occurs once you’re keto-adapted, which might take days or weeks. The best way to tell if you are in ketosis is by checking your urine for ketone bodies.  This is available on amazon but beware that the ketone bodies tested on these strips are only around in in the begining stages of ketosis. This test cannot register the ketone bodies your body starts to produce when you have been in ketosis for a few weeks.

What are the pros of the ketogenic diet?

• It makes you feel fuller compared to low fat/low carb diets.  Eating higher fat will reduce ghrelin levels (your hunger hormone) and help you feel satisfied longer.  
• It reduces inflammation. A healthy keto diet cuts out unhealthy processed, high sugar containing foods.
• It can help support a healthy gut.  By focusing on healthy, non-starchy plant foods that feed your beneficial gut bacteria, the keto is a great way to heal your gut.
• It can improve energy and clarity. Once you are in fat-burning mode, people report feeling better, having greater energy levels and improved cognitive performance.
• It is great for weight loss.  When done correctly, the shift in fat metabolism can break the plateau you may experience when going low carb, low fat.

What are the cons of doing the keto diet?

• It can be boring.  You’d think eating a lot of fat would be fun.  Guess again…
• It can contain too much fat for some. Not everyone can handle the amount of fat required to get into ketosis.
• Being social on a keto diet is tough.  Most foods are just not keto friendly. Alcohol being one!!
• You may experience the keto “flu.” As you transition into using ketones for fuel you can often experience electrolyte deficiencies that can lead to the keto “flu”.  Symptoms of keto flu include: Fatigue.Headache.Irritability. Difficulty focusing (“brain fog”) Lack of motivation. Dizziness. Sugar cravings. Nausea.
• You might GAIN weight gain if you are eating too many calories for your metabolic level.  

Which health issues can be improved on the keto diet?

Medical practitioners have been using the ketogenic diet to treat a variety of conditions.  Here I will review the medical evidence supporting it use.

Strong evidence:

• Weight loss — it is a very effective weight loss tool.  It reduces appetite, reduces fat production and increases fat breakdown.
• Cardiovascular disease — the majority of studies show the reduced carbohydrate intake to the level that will induce ketosis can improve lipid profiles, reduce triglyceride levels and improve cholesterol profiles.
• Type 2 diabetes and metabolic syndrome — results are astonishing regarding the improvements of all hallmarks of these 2 diseases.
• Epilepsy — the keto diet is an effective tool in the treatment of severe childhood epilepsy but interest waned following the introduction of anti-convulsant drug therapy.

Emerging evidence for the following conditions

• Acne — several studies have been published suggesting that certain foods can result in acne, particularly foods with a high sugar load and milk products.  
• Cancer — there is evidence that high insulin and sugar levels can promote cancer cell expression and stimulate cell proliferation.  Since cancer cells rely on sugar as their fuel source and can’t use ketone bodies effectively, a ketogenic diet creates an environment that keeps cancer cells under control.
• PCOS or polycystic ovarian syndrome is closely related to type 2 diabetes and metabolic syndrome and therefore would likely see the same benefits as seen in those 2 conditions.
• Neurologic disorders (Parkinson’s, Alzheimer’s, ALS, traumatic brain injury) — it appears that ketone bodies (the fuel source that is produced as a result of a ketogenic diet) have certain neuroprotective effects.   Caloric restriction and ketosis can improve energy production in the brain, which is often damaged in these neurologic conditions.   The human brain operates at its most efficient when in ketosis.
• Schizophrenia and bipolar disorder – some studies have shown improvement in mood symptoms while using a ketogenic diet.
• Narcolepsy — in the 2004 issue of the medical journal Neurology 9 patients with narcolepsy placed on a ketogenic diet experienced less sleepiness during the day and had fewer attacks.  

So the research is just emerging, but stay tuned on more reasons why a keto diet may be a helpful adjunct to your current treatment regimen for chronic illness or as a great way to lose weight and feel great. Your mileage may vary……it’s not for everyone.  

 Tip #2 My experiment going on a keto diet 

I like to experiment on myself before subjecting patients to therapeutic escapades, dietary or otherwise.  I often do things that I tell my patients to do. I try out supplements and vitamin powders. I try out meditation apps. I’ve attempted to obtain my own pap smear……The point is, you learn a lot when you yourself try things out.    And FYI, do NOT attempt obtaining your own pap smear.  

How I did the keto diet……

I’ll summarize my three steps outlining how I went about doing the keto diet for 2 weeks.  I might have continued beyond those 2 weeks but I had to leave to go skiing in Utah and someone had to eat all the carbs that Utah had to offer. To be clear, I don’t technically ski. I go straight  to the apres ski portion of the program.https://app.carbmanager.com/

Step One:  Read extensively and do exhaustive research about your new diet plan

Like anyone with advanced medical training, a research background, and extensive nutrition knowledge, I looked long and hard for the right information→ that’s right, I found an app!  It’s called Carb Manager.

• You plug in your weight, height, the amount of carbs you want to eat in a day, your activity level and how much weight you want to lose or gain or maintain.  
• I put in that I wanted to lose ½ a pound a week.  I also tried to put in that I wanted to be 4 inches taller and never have to shave my armpits again, but they didn’t have that feature.  
• I entered my carb limit of 30 grams  a day.  To put this in perspective, I practically eat 30 grams of carbs a day just by brushing my teeth.  Seriously, that’s like one measly apple. Here’s an example of how much fat, protein and carb I was supposed to eat in a day according to Carb Manager:
  • 120 grams of fat
  • 100 grams of protein because I “may” have entered that I’m a body builder for my exercise
  • 30 grams of carbs (for keto purposes you need to go 20 to 50 grams a day at most)
• At the close of Day One I was fully depressed and dejected.
• PS: if you just wanted a keto calculator to determine your carb, protein and fat intake based on your age, weight, activity, height and weight loss or gain desires, just got to the Keto Calculator link here.

Step Two: Do your Research

While on line at Whole Foods I happened upon a magazine called Keto Digest, or Keto Lifestyle or something with Keto in the title.  And I thought, HA! This will be cheaper than a cookbook and the recipes looked fabulous. Assuming I also hired a chef to cook them because I can’t cook. I was on my way to kicking keto butt!!   

Note to self: check the price of magazines before purchase. This one was $29.99. OUCH!!!

I also researched keto recipes online, which was a wealth of information.  I made my shopping list and was ready to go.

Step Three:  Go Shopping

There were things on the list I don’t normally eat (like dairy) and quantities of things I normally wouldn’t eat either.  

• BAGS of nuts, the highest fat varieties like macadamia and walnuts.
• Grass fed organic butter and ghee
• Coconut oil, avocado oil, olive oil
• Avocados and olives
• Lots of greens
• Pastured eggs
• Organic Bacon
• Salmon and Lox
• Cottage Cheese
• Parmesan crips
• Organic Salami
• Broccoli and Riced Cauliflower
• Shredded cabbage
• Chicken legs and thighs
• Cacao fat nibs….ew
• Pork rinds
• You get the idea…..

Here is what I ate on Day One:

The first day’s feed totaled

• 37 grams of carbs (so I went over my allotted amount)
• only 100 grams of my required 126 grams of fat
• only 81 grams of my 100 grams of protein.
• Only 1400 calories of my 1600 I was supposed to eat.

In terms of the timing of my meals, that’s my own thing. You can eat when you wish.  I’m not a morning eater.  I like doing Intermittent fasting so my first meal of the day is often really at lunchtime and depending on my schedule lunch is really dinnertime, or snack could be dinner or lunch.  But I usually eat 2 to 3 times a day.

Breakfast: around 12 pm

• Coffee with heavy cream
• ½ an avocado
• 3 cups mixed greens
• Mixed nuts ¼ cup
• 2 pouched eggs slathered in butter
• 3 slices of organic bacon cooked in avocado oil

Lunch around 5 pm

• 8 Green olives (olives have more carbs than you think)
• Parmesan crisps (baked parmesan cheese that resemble a cracker
• Riced cauliflower
• Ground turkey sauteed in butter with mushrooms
• Shredded cabbage and red onions slaw with a ton of olive oil, sea salt and lime juice

Snack — around 730pm when I got home from the office

• Decaf coffee with heavy cream
• Cacao butter nibs (literally a brick of solidified coconut oil or something, but it’s like 15 grams of fat in one chunk)
• Cottage cheese ½ cup
• Organic salami around a pad of butter
• A few handfuls of greens and celery

That was essentially what I did for the last 2 weeks.   I’d make chopped salads with tons of low carb greens and then add sardines or a can of salmon or chicken thighs since those are fattier. I was basically trying to eat fat like there was no tomorrow.  And notice the no fruit!! That was kind of hard. If I got hungry I ate fat.  Like a couple of tablespoons of almond or peanut butter.  Some fat bombs that I referenced in another post, or ate full fat cottage cheese or made some decaf coffee with butter and heavy cream.  It’s harder than it looks people.  

So what happened?

• After 2 weeks I lost 4 pounds.  I didn’t need to lose weight, but who doesn’t like THAT side benefit?
• I still had to shave my armpits.  THAT was a BIG disappointment.
• I didn’t experience any mental clarity or amazing energy like they say you should but then again I wasn’t checking to see if I was actually in ketosis (you need to technically measure this by doing urine ketone strips or checking your blood)
• I was more flexible in my yoga class.  So that’s a thing.
• I was pooping more frequently with all that fat in my diet
• Overall it was fine but hard to eat as much fat as they want you to.  
• Eating fat did work to curb my appetite — so when I wanted to snack, I’d reach for parmesan crisps or salami and butter or those coconut oil fat blobs.
• I wasn’t counting calories at all, I was just trying to make sure I didn’t exceed my daily rations of carbs (total carbs, not NET by the way) and was desperately trying to add fats, especially if I was hungry.  I’d eat butter, or salami, or something fatty.
• I also did make some of the fat bombs I wrote about in my Share the Health post and those were pretty great. 
• I experienced no keto flu at all.  
• I managed to still be social — On Friday nights when I was out with friends I did have a tequila with soda water and lime juice (the lowest carb option I could think of) but that was fine and not as many carbs as you think.  

How to do keto right…..

Overall I think it’s really a mind shift to get over eating fat since we’ve all been trained that fat makes you fat when really carbs and even protein make you fat.   You also have to be super conscientious about eating vegetables, the low starch kind and try to get a real variety so you don’t mess up your gut bacteria that rely on veggies and fiber to grow and do good things for you.  So if you want to do keto, check out my article for an extended version of my foray into eating keto, click the link here.  (And if there is no link it’s because my husband didn’t post my article on my website so talk to him.) But the summary is:

• Make sure to eat plenty of low-glycemic plant foods.
• Keep up your electrolytes and hydration.
• Choose high-quality animal meats and healthy fats.
• Remember that calories count.
• Skip the processed stuff.
• Be aware of any food sensitivities.
• Increase gut-healing foods. AKA don’t avoid plants.

Closing thoughts…..Keto isn’t right for everyone

If being in ketosis helps you feel better,  become mentally clear, helps avoid sugar crashes and helps you with your weight goals, great.  If you’re eating too many inflammatory foods you won’t lose weight, and you may get super bored with the lack of variety.   Some people “fail” keto because they are not checking to see if they get into ketosis.  In addition, some folks may not feel well eating in this way. Aside from the keto flu — a transition time that may temporarily make you feel yucky– if you feel unwell, the way you are doing this diet may not be right for you. It may be best to work with a practitioner regarding if this diet can benefit you and your wellness goals.  

Please Share the Health if you liked what you read.!!!  

For more information about my wellness programs and my practice, check out my website www.drsadaty.com.  Look! You are already here. Ready for the legal disclaimer? Information offered here is for educational purposes only and does not constitute medical advice. As with any health recommendation, please contact your doctor to be sure any changes you wish to consider are safe for you!