Lose 20 Pounds on a Keto Diet – But You’re Probably Not Going to Like This Post – Part 2

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Note: for those of you that didn’t read part 1, read part 1 – ‘k?

Sorry for the cliffhanger. I’m nearing 10 weeks in ketosis and have written 84 pages journaling my experience. Dumping that on you would be a bit much – but trying to summarize has been a bear. This is my second shot at it.

I’ve been doing (at least trying) to do a low carb / keto diet since 2003. In this go-round I have done a number of things radically different than in the past.

I made health – not weight loss – my goal. I have spent 15 years reading and researching this diet. I truly believe it to be the best diet for me. As I am focused on the health aspects, the moving of the scale is a nice perk – not the main goal. If the scale doesn’t move it might frustrate me – but it is not a failure. Eating off-plan is the failure.

I immersed myself in everything I could about the ketogenic diet. There are way more books, audiobooks, and podcasts with new information. Keto has become a ‘craze’ again and there’s a lot of new and interesting information and many people in Facebook groups discussing it. I personally don’t completely agree with *any* of the approaches I have seen, but have borrowed things from many of the approaches to forge my own version. I did a lot of experimenting and learning – and while I have been in ketosis for nearly 10 weeks now, how I stayed there has radically changed from the way I did it in 2003 – and the way I did it in April 2018.

I have started taking supplements again. When I looked I back to 2003 and asked myself what was different from when I first lost 80 pounds and now,  one big difference was I didn’t take supplements anymore. Back in the day I had taken a plastic film canister’s worth each day. I became disillusioned with vitamins (read ‘Do You Believe in Magic?‘ like I did to understand why) and had cut back to just a multivitamin – and only a few days a week. I began taking it every day and began to try to figure out what other supplements might improve health and am building up a ‘stack’ of supplements to see what impact it might have. I’m still experimenting here but will discuss this further below.

I fast 16 hours per day. I do what’s called a 16:8 intermittent fast daily. I skip breakfast – only having black coffee. This used to bother my stomach but I’ve apparently healed whatever the reason was for that and now it’s not a problem. I then have my lunch around 1pm and my dinner between 8-9pm. I don’t have hunger issues nor do I have food fantasies. Being in ketosis this long simply removes constant hunger from the equation.

I don’t snack. Here’s a really interesting notion I am experimenting with. While removing carbs reduces blood glucose, it’s not really blood glucose that is at the heart of the problem – it’s insulin resistance. Insulin is an energy storage hormone. When you eat carbs, your pancreas squirts out insulin to get the excess glucose out of your system, driving it into your fat stores mostly. After decades of abusing this system, your cells no longer respond to insulin and your pancreas has to squirt out more and more to get the same effect. So you can check your blood glucose levels and everything looks fine – but your insulin is through the roof.

So you give up carbs and your blood glucose goes down. That’s great, but you still have this insulin floating around. Know why? Because protein also stimulates an insulin response, you are STILL promoting insulin resistance.

So here’s an idea that seems to make sense: what if you were able to give your body an ‘insulin holiday’ – would being able to allow your body to not have insulin constantly in your bloodstream give your cells a rest and allow them to increase their insulin sensitivity?

Some people think it does, so I’ve decided to experiment with this. I’ve read that an insulin response can last up to 8 hours after a meal. This would mean that doing a 16 hour fast – with no calories coming in – gives me at least 8 hours per day where there is no insulin in my system.

The notion of snacking means you NEVER stop producing insulin. So the notion of a ‘snack’ is not part of my life.

There’s a second part to this which I will go into next.

I make sure my meals contain enough protein. What I read was that a particular amino acid – leucene – in adequate amounts – produces ‘Muscle Protein Synthesis’ or MPS. From what I read you need at least 3 grams of leucene in a meal to produce this effect – and leucene is approximately 10% of the amino acids in a piece of meat. From what I’ve read this will prevent muscle loss during weight loss even is you sit on your ass. A 16:8 fasting schedule provides me with 2 doses of this effect per day and maximizes the efficiency of the protein I take in per day. Remember that a properly formulated ketogenic diet is supposed to be an ‘adequate protein’ diet. If I have between 40-50 grams per meal I am well within the ‘adequate range’ but making every ounce of protein count.

I don’t add fat to my food. What kind of screwed up keto diet is it where you don’t add fat? Here the idea is that if you want your body to burn fat, you want it to burn your CURRENT BODY FAT – not the fat you ingest. I calculated my macros (carbs, protein, and fat using one of the many ‘keto calculators’ out there. This one at https://www.ruled.me/keto-calculator is adequate – and instead of aiming for an exact target I came up with my own ranges – these are mine:

Calories:     1200 – 1892
Carbs:        20
Protein:    94-124 (104 is ideal)
Fat:        77-155

This give me a wide latitude to play in and not have to worry about being so damned exact about things. I typically meet my minimums at lunch and have a larger meal in the evening. I tend to be at the low-end on fat – which comes from the meat. I very rarely add fats to my cooking – maybe olive oil to a salad though I don’t eat salad as often as maybe I should. And this leads to another interconnected point.

I have a very limited and simple diet. OK – this is where you stop reading. I get it. But if you are interested in how my relationship to food has changed, keep reading.

If you join the keto groups on Facebook, you will frequently be exposed to keto food porn on some of them. The inventiveness in these groups is boundless and you can find bread recipes, pizza, ‘fat bombs’, all sorts of snacks, and could happily avoid most carbs and still have your favorite indulgent foods. The problem is two-fold for me: these recipes take a lot of time to prep, and sometimes the calories are through the roof.

I don’t do this. I’ve stopped frequenting these groups that post the food porn. Instead, I’ve chosen to follow a very simple diet dominated by the following foods:

  • Chicken thighs
  • Chicken breasts
  • Grass-fed beef
  • Hot Italian sausages
  • Grass-fed, nitrate-free hot dogs
  • Nitrate-free bacon
  • Broccoli
  • Lettuce
  • Kimchi (Korean fermented cabbage)
  • Avocados
  • Arugula
  • Olive oil
  • Ghee (also called ‘clarified butter’)
  • Less than 4 oz. of cheese per day.
  • Salt
  • Trader Joe’s 21 Seasoning Salute

I’ve certainly had other keto-friendly foods (pickles, tomatoes, eggs, cauliflower, a little pasta sauce, salsa, among others), but the above list predominates.

You might be thinking: what a restrictive diet!

that is exactly what I thought as well – until I tried it.

I find it LIBERATING.

Nearly everything I cook is baked. I cook enough meat and veggies for 2-3 days. I measure out my portions into sandwich bags on a scale for lunch, then weigh out my dinner. Since I don’t snack, I have what I would call a natural and normal hunger response when I do eat – and I enjoy my food. I even find my portions to be almost too large at times – though my total calories for the day can sometimes be as low as 1200 calories. While you might think this is a rather bland set of flavors, my response to flavor has changed since I removed what I some call ‘hedonic’ foods with complex layering of flavors. I thought I never could wean myself off of my Orange-Tangerine artificial sweetener, but after a few miserable days, I didn’t miss it anymore. My palate has adjusted, I love my meals, shopping is a breeze, cooking is a breeze, lunch is a breeze – and now I know what it feels like to ‘eat to live’ rather than ‘live to eat’.

“I don’t eat that.” I’ve given up a lot of things – all grains, nuts (portion control problem), sweeteners, a lot of dairy (portion control problem), and so many other things I can’t count. I don’t have willpower nor do I believe in willpower as something that can be sustained over a lifetime against something as primal as hunger – and there is a bit of a mind trick I use to deal with this.

I have a lot of respect for ethical Vegans. They have made a decision that eating animal products is wrong and they do not eat them. They simply say: “I don’t eat that.”

there’s no negotiation here. Ethical Vegans don’t have a ‘cheat day’. It is black and white for them. I’ve decided to do this on my diet. I have foods I eat – and a very long list of foods I don’t. If offered, I say: “I don’t eat that for health reasons – and I can’t even have a taste.” If a further explanation is needed, I am eating this way to avoid getting full-blown diabetes and the best way for me to do that is not having the smallest cheat. As soon as you open the door to a small cheat, a larger one can easily creep in, and BAM! There goes all your hard work. This has happened to me too many times to count.

Like Vegans, people will think you’re odd – even odder than Vegans because their way of eating is better known. My diet is for health reasons first. I have my reasons for eating this particular way that most people won’t care about – and I won’t bore them.

I can easily sit and watch people eat all this stuff in front of me and I don’t care. My older daughter tried tempting me with bread at the steakhouse but my reaction to the bread was like a rabbit reacting to a slab of beef: utter indifference – because I don’t eat that. If I allowed cheats I would exhaust myself with the ‘how much can I have’? then having even a little taste will turn on cravings in the brain I don’t have anymore for 72 hours after the cheat, according to one doctor. So even one bite will at least make me miserable for 3 days – and at the worst, completely derail 10 weeks of hard work.

If I eat the way I do now, I don’t have diabetes. If I eat like a normie – I do.

I watch my salt, magnesium, and potassium. When you start a low carb / keto diet you lose a lot of water weight quickly as the carbs in your system bind to water molecules. No carbs and you lose that extra water – good – but as you lose the extra water you begin to mess with electrical pathways in your body and have the potential for problems if you don’t watch your electrolytes. This is how you get the ‘Atkins Flu’ as it was called years ago, or the ‘keto flu’. You get a headache, you get shaky, you get a head rush. This is your body’s electrolytes going screwy.

With salt, I make sure to salt all my food. Then I will have a glass of salted water if I feel weird – or just because I haven’t eaten in a while. I also take a magnesium supplement daily.

From what I’ve read, I am leery of taking potassium supplements. People on these keto Facebook groups usually use a product called ‘No-Salt’ – a salt substitute, but what these online groups don’t tell you is that some people – like me – are on ‘potassium – sparing’ blood pressure medications where is says on the damn label not to use this stuff. So I don’t. Potassium also seems to be the one that can also fuck you up the most – causing your heart to beat wrong. That’s something that can kill you and I am not going through all this trouble to die! I usually get my potassium through foods – an avocado is a great source.

Being this deep in ketosis also means heavy exercise or being out in high heat can mess you up way faster than normies walking around with excess water weight and electrolytes. I’ve heard people say they steal salt packets from restaurants and make sure they have a couple on hand – and some water – in case they feel weird during activities like these. This electrolyte issue also calls into question the bogus medical advice of drinking 8 glasses of water a day. For regular folk – so what – it gives them something to do other than eat, makes them feel full, and makes them feel good about themselves. Folk in heavy keto lose extra electrolytes like this. I will frequently drink a liter of seltzer on ice in the evening, or water during the day – but I really don’t count and do it because I’m thirsty.

I take ‘weight loss’ naps. Sleep is real important. I know a lot of people struggle with sleep – I don’t usually have a problem. One less thing for me to worry about as poor sleep can prevent weight loss – and is certainly not good for your health.

But here’s something I noticed in me by accident. Occasionally, on a weekend, I find the opportunity to take a nap. Lazy shit that I am – I take it. What I have found more often than not is if I weigh myself after the nap, I’ve lost a pound or two. It’s the damnedest thing. I’ve seen no one else mention this, but it does happen to me.

I measure my meals using Cronometer. None of the diet tracking apps are just right. Some can’t count net carbs. Some have nutrient values that are not based in reality. Some are just not designed very well. I’ve recently started using Cronometer and while the free version has annoying advertisements that can make you wait a few seconds before entering your values on certain screens, it is my current fave. I particularly like how you can set your own macros, clearly show net carbs, and view your micronutrient counts. There’s some things I don’t like – and some things that don’t work as expected, but here’s the thing: because I eat pretty simple, it’s pretty simple to enter my macros in a minute or two. Another app called Carb Manager is also good – I just prefer Cronometer.

I mess up at pretty much all of the above. Think of all of the above as the bullseye on a target for me. I aim for that center. Sometimes I don’t hit it – but that’s what I keep aiming for. Example: after a very good meal where I had two martinis (which I should not have had!), when putting away the food I ended up having some of my kid’s leftover mashed potatoes. While this didn’t cause me to go out of ketosis, it *did* cause my blood glucose to spike – my morning fasted glucose the next morning was 138. the day after it was 40 points lower.

Lesson learned: The way I eat determines if I am a diabetic. This one cheat helps reinforce the reason I have a ‘no cheat’ rule. I still drink from time to time. Usually red wine. It does not knock me out of ketosis and doesn’t raise my blood glucose – but it does increase insulin resistance and does slow weight loss – and does make me feel crappier the next day. I’m still working to minimize, if not eliminate this.

I feel better, but think I could feel better still. I still have a lot to learn not only about a long-term ketogenic diet as so much new research and thinking has been done in the past few years, but I have to learn about Me – my personal physical and emotional makeup at the present time in the context of a ketogenic diet.

Let’s face it: I’m 55. I’m probably late to the game of optimizing health – and there is certainly no shortage of people who want to tell me the right way to do this. Dr. Jason Fung, in the book ‘The Obesity Code‘ wants me to go on extended fasts lasting days.

I don’t know about that. I’ve read that there can be positive benefits – autophagy is one example – which is a recycling and cleaning of your body’s cells when you fast. (Here’s a link to some online doc I just found that discusses why it’s good for you.) Sounds good, but I’m not sure that I can’t get some of that same benefit with my 16 hour fasts – or occasionally eating once a day (which I can pull off with little effort). Or Dr. William Davis’ book and website ‘Undoctored‘ where he suggests you add raw potato as a prebiotic to a smoothie. Not too sure about *that* one, Doc – though I *did* take his advice to NEVER take calcium supplements with vitamin D because adding calcium to the diet has never been shown to help reduce bone loss – but there’s some evidence that this calcium ends up on you artery walls. I’ve got more to learn here, though to fully understand what he is saying.

I recommend both books. Dr. Fung’s makes a strong case that the focus on health for most of us fat folk leads to minimizing insulin resistance. Dr. Davis has a grander goal and proposes an entirely new medical model where patients educate themselves to treat the underlying causes of disease, be smart enough to know when to involve a doctor, and to establish a doctor-patient relationship where they are partners in decisions because the patient might just know more about their disease state – and physicians stop acting like they know it all when the hours they work and the volume of information makes that impossible.

Right now my goal is to have my next blood work 6 months (October, 2018) from the start of my diet. It can take that long for numbers that can go out-of-whack as you begin the diet to normalize. During that time I will hopefully be able to lose more weight – which should help those numbers. I’d like to further explore supplements. Some I’m taking now I could not give you a clear explanation as to why I am taking them. For example: I’m taking 6000IU of vitamin D3 per day. Why? Because my Retinologist – a ketogenic nutrition nerd like myself except way smarter – told me that’s what he takes since he read the book ‘The Vitamin D Solution‘. I have the book, but haven’t read it yet. I am going to supplement with a small amount of iodine – 300mcg – because from what I’ve been reading from multiple sources, I have some symptoms of a sluggish thyroid – and most clinicians do not run the proper tests to determine this – and even the test they do run they misinterpret. But too much can also be bad and actually *cause* hypothyroidism. I have a lot of researching to do here. I want to study this area more closely and understand why I need a TSH test, a Free T3 test, a Free T4 test, a Reverse T3 test, a TPO antibodies test, and a TgAb test. *I* also need to understand the current thinking on how to interpret the results because docs won’t order test they can’t interpret.

I also need to understand a great deal more about why a standard lipid panel is not adequate for someone living a keto lifestyle. I know the short answer: the LDL-C. The ‘C’ in the name means ‘calculated’. It’s not an actual count but a calculation that isn’t particularly accurate for people on a keto diet. The NMR test actually counts the different LDL subfractions and provides a lot more precision as there are only a few of the LDL subfrations that are dangerous. I have to be able to convince my doctor so when *he* gets second-guessed by the health plan as to why he is ordering a more expensive test, he doesn’t have to hear them bitch about it.  Or I have to convince him to write me a prescription for it and then pay for it out-of-pocket – and it doesn’t even appear that I am legally allowed to order my own blood test in New Jersey – I’ll have to drive to PA to be allowed to get a blood work I will pay for myself as New Jersey thinks it is too dangerous to allow me to make these decisions for myself?

There’s also potential dangers to the diet – depending on who you listen to. Of course, a normal diet will most assuredly give me a case of Diabetes with complications of kidney disease, blindness, dementia, and amputations being some of the wonderful complications I can expect from that. But still – if not done right – keto can potentially cause pancreatitis, gallstones, kidney stones, and dangerous heart rhythms. All this leads to the my last point.

Don’t follow me – I’m lost. Ever see the bumper sticker that says that? It’s probably the best advice – the wisest advice I can give you. Don’t go on a ketogenic diet. Don’t do this. Don’t try this at home. Most people just want to be told what to do – they don’t want to do all this ‘thinking’. Ketogenic diets are poorly understood – or even considered dangerous (often for the wrong reasons) by most doctors.

There are people who learned about the keto diet 2 years ago, lost weight, set themselves up as an expert, and run blogs and Facebook groups signing people up for expensive courses on how to lose weight. They sure *act* like they got it all figured out…but I’m not sure.

I see one group contradict another. how do you calculate your protein intake? One group says calculate it using your current body weight – the other say by your *ideal* body weight. Some say saturated fat is great – others say it’s OK, but any added oil should be monounsaturated olive oil. Some think seed oils like corn oil and soybean oil are OK – I avoid them like the plague. I don’t see much discussion about the Omega-6 to Omega-3 ratio. This is important. I see some people recommend taking a ton of fish oil – but don’t mention that it is a natural blood thinner and could be dangerous to people already on blood thinners.

I could go on…is your head spinning yet? My wife just asked me “What do you do all the time on the computer?” I explain that I spend most of my waking hours reading and researching nutrition and ketogenic diets. I don’t think she believes me – or if she does she thinks I am crazy.

I spend all this time – it’s my hobby/obsession – but the more I learn the more I know I don’t know squat. That is why a long time ago I got out of the advice business. Please read my disclaimer if you even remotely even consider applying anything here to your own life.

I could go on but I’m sure you’ve had enough.

 

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The Keto Dream

I had ‘the dream’.

I’ve had these dreams only a few times in my life. They occured when I had made a change so profound and that I had internalized so deeply that my brain seemed to squirt out these dreams – perhaps as a cautionary tale – or as a confirmation I was doing the right thing.

A previous time I had a similar dream I had changed careers, changed jobs, had a crazy boss, worked in a new, high-stress environment, got married, and was buying a house that was a ‘fixer-upper’ (though I was no handyman) that I wasn’t sure we could afford.

I had a dream that they had rehired me at my old, comfortable, zero-growth-potential job. They walked me back to my old desk and I settled in – then a lightning bolt of terror went down my spine that woke me up with that: “Thank GOD it’s a dream!” feeling.

I took that as: as tough as what you’re doing, you’re better off – hang in there.

Last night, on Day 46 of my current diet, where I am still experimenting – trying to hack together a list of foods I eat and don’t eat, as well as when I eat – both for health as well as for fitting into my lifestyle and simple pleasure, I had the first dream I remember in a while.

In it I was given some sort of chocolate/peanut butter candy. Something with a crunch. I remember little about the dream in particular except that I was offered the stuff and took a big bite. I felt the sweetness in my mouth and a sudden terror came over me as I asked myself: Why are you eating this?!? YOU. DON’T. EAT. THIS!

It was real fright and panic.  

Like the previous dream I had over 20 years ago, whatever part of the mind that is in charge of dreams seems to think, in my estimation: what you’re doing is the the right thing – hang in there.

I told my adult daughter last night: You know what sucks? I gave up bread, McDonald’s, pizza, deli sandwiches, cake, dairy, artificial sweeteners – and you know what? I feel way better. I had so much energy today – I went to work and zipped through a number of different tasks, my brain felt sparkly and sharp, I was full of ideas, rolled with the punches, was in a good mood, and the day flew by.

It seems like there’s a connection: eat like shit – feel like shit. Duh – right?

It’s different to know something in an academic fashion and feeling it in every cell of your body as you live it.

I think I am nearing a point where I’ll have a steady path. There’s still tweaking to do, but I am beginning to lose weight again after giving up dairy and artificial sweeteners, but I am still learning, taking a very different approach to keto than I would have done in the past – and wading through some contradictory information to determine what works for me. No dairy and artificial sweeteners was tough for a few days – and I could not have this at the start of the diet as it would have been too overwhelming to do everything all at once – but now I’m grudgingly OK with it – I do miss the cheese WAY more than the artificial sweeteners, though.

Everything points to: I think I’m on the right path for me. Keep going.

Day 40 on my new approach to a keto diet

There is no one ‘keto diet’. It has many variants that appear more or less the same to the outsider but are very different to someone deep in the thick of it – like Protestantism.

And like Protestantism, each of these variants interpret the same documents that underlie the practice, apply them differently, then follow, or try to follow a certain high-level dogma that results.

Like any set of competing belief systems, there is a necessary infighting between the variants about details. Just one of the many differences is the use of ‘exogenous ketones’. This is a product that most often contains beta-hydroxybutyric acid, which is the ketone fuel your body creates and runs on when on a keto diet. Some people have put this into a supplement and sell it.

Some variants of the keto diet think this is fine. Others will remove your post from their Facebook group if you even mention them.

Another controversy is: how much protein? Some groups recommend a lot less than others – and both scoff at the other’s interpretations of the documents that support their position.

The same goes for fat. All the groups want you to moderate it, but some make this central to their belief system – others seem to pay lip-service.

Lastly (though by no means the last), there is what I would call the position on what I would call ‘Keto food porn’. To me, this is the intricate and tortured attempt to create keto meals that resemble their high-carb inspiration, or inventions like a bacon-weave taco shell, or a round meatloaf with cheese in the center, wrapped in bacon.

Keto is very trendy right now (which will probably pass as it did before) and people are bringing enormous creativity to foods and recipes.

Some people love this. Some people think this encourages consuming extra calories, and the first group replies: who cares about calories? Just eat to satiety.

On this 2018 version of a keto diet, as usual, I came up with my own road to follow. While this time I have immersed myself in the most current thinking, joining over a half-dozen Facebook groups and listening to at least 50 hours of keto podcasts to learn what the current state of keto is.

One thing it does NOT seem to be is ‘Atkins’. While I believe that none of these people would be talking about keto if it wasn’t for Dr. Robert Atkins, who died in 2003, few people discuss him, and the current products the company he started are not held in high regard.

While you might be forgiven for using these products, you would not be applauded.

Another worrisome thing is just how dangerous this diet can be if you do it wrong – and most of these people climbing aboard the keto bandwagon do not understand the seriousness involved in altering your body fuel source and the serious medical problems it can cause. I will leave the authoritative research to others – and to you to dig up – again, I have nothing to sell and nothing to convince you to believe. These are the things I’m concerned might happen to people who achieve nutritional ketosis but are ill-informed about the pact with the devil you sign:

  1. Alcohol. If you are deep in ketosis, too much alcohol can lower that threshold for alcohol poisoning. Having a ready supply of carbs in your body can help mitigate a bout of binge drinking that ketones cannot, apparently.
  2. Pancreatitis. If you are unknowingly predisposed to this, a massive cheat can push you into this condition
  3. Gallstones. I had read that fat is necessary for the prevention of gallstones. Fat-phobic people predisposed to gallstones who try a high protein and lower fat version of keto might set themselves up for this. There could be other reasons as well.
  4. You can get dehydrated easily and your relationship to water needs to be watched. Too little OR too much can be bad
  5. Electrolytes. One thing normies eating a standard diet don’t tend to worry about is their electrolytes. People doing a keto diet do need to be careful about this because your need for sodium, magnesium, and potassium change. This can screw up the electrical system in your body – and you know what your electrical system does? It controls the beating of your heart! OK they say, I’ll just take supplements. Not so fast. TOO MUCH can be as bad as TOO LITTLE. People are messing with system not only they don’t understand, but that their doctors don’t understand.

It is for these reasons I DO NOT RECOMMEND A KETO DIET! The science surrounding this diet has been my primary hobby for more than a dozen years. To the regular person who comes along with no interest in learning the intricate details, I would not recommend this to them unless they had medical supervision by a doctor who knew the ins and outs of a ketogenic diet – and good luck finding one!

Stop reading yet? No? Ok – the rest of you left, let’s continue.

So what am I doing differently this time?

The first thing is that I have simplified my diet considerably. I have given up almost all artificial sweeteners (except sugar-free ketchup – not ready yet), dairy, nuts, cheese – and of course all grains and carby foods like potatoes. I now drink black coffee and plain water.

A partial list of what I’ve been eating for the most part?

  • Ground beef (moving toward New Zealand raised grass-fed beef)
  • Chicken thighs (moving toward organic – and I’d love to find pastured but haven’t yet)
  • Steak
  • Pork belly
  • Fire-roasted tomatoes and green chilies (for my chili)
  • Red and green bell peppers
  • Organic chicken broth
  • Lettuce (iceberg for now until people stop getting sick off of romaine which is a ‘thing’ as I write this)
  • Beefsteak tomatoes
  • Acocados
  • Asparagus
  • Organic celery
  • Eggs (organic and pasture-raised when possible)
  • Bacon
  • Olive oil
  • Coconut Oil
  • Coconut milk
  • Coconut flour
  • Mushrooms
  • Pickles
  • Kimchi
  • Organic hot dogs from grass-fed cows
  • Sauerkraut
  • Psyllium husks

And I am planning to try experimenting with adding:

  • Ghee (aka clarified butter – considered OK in a dairy-free diet by people not eliminating dairy for religious or ethical reasons)
  • Broccoli florets
  • Nutritional yeast (a powder that sorta kinda of tastes cheesy, is full of nutrients, and might be good sprinkled on my broccoli)
  • Cabbage

I did not start here 40 day ago. It took a while to convert from my diet prior to April 2 where my primary food group was McDonald’s. What prompted the change was a sudden, worrisome trend in my blood glucose. I was seeing numbers up to 140 in the AM and they would stay elevated – even with taking metformin.

In less than 2 weeks I was able to get that number down by 20-40 points. In the mid afternoons I can see numbers in the low 80s – and this is with my stopping the metformin over 2 weeks ago.

Carb withdrawal at first was miserable. I comforted myself with an abundance of American cheese – God, I love the stuff! I also guzzled down seltzer loaded with Orange-Tangerine artificial sweetener in the evenings.

I also had Greek yogurt in work and Kerry Gold butter in my coffee. That was after the coffee and heavy cream I had in my coffee at home. I usually didn’t eat solid foods, though I would grab an Atkins shake and have some chicken broth with extra salt at lunchtime. This seemed to help with the mild headachy feeling I would get – but otherwise I felt good. Here and there was 2 squares of dark chocolate.

I gave up on the Greek yogurt because it seemed to trigger hunger during the first week.

There were some trashy, though low carb choices, along the way. Oscar Mayer bologna as well as bologna’s more refined cousin, Mortadella. Kielbasa. Pork rinds. These didn’t impact my blood ketones, which I measured obsessively. I got as high as 3.5.

I stopped negotiating with myself in the second week. I no longer thought about ordering McDonald’s and not eating the bun. I could watch people in work and at home gobble up carbs – even pizza – and it not bother me. It wasn’t willpower – it was that I had detoxed myself from carby foods and no longer had an interest. While I would not say even now that I don’t miss pizza, I don’t have this terrible craving for it, either.

Besides – I had substituted a bunch of junky keto-friendly foods to take the place of the high-carb junky foods.

To be clear: I started this particular go at the diet primarily for my health. And that worked: I lowered my blood glucose and stopped taking metformin. I also pulled off 10-12 pounds in 2 weeks. That was nice – but not the primary goal.

After the first 2 weeks the scale did not really budge, however, and while I was still committed to the diet for health reasons, I did want the weight loss to be part of it.

Finally, on day 34 I decided I might be strong enough to pull off eliminating all dairy and artificial sweeteners.

Boy oh boy, did this suck!

The cheese got replaced with more calories from meat and tomato slices with my burgers. While I still continue to use sugar-free ketchup, the amount of artificial sweetener is trivial compared with how much of the orange-tangerine stuff I would blast into glass after glass of seltzer on ice.

I started eating avocados more regularly. They can be tricky as they go bad so quickly but I’ve been able to manage. Once almost ripe, they keep in the fridge for a few days. When you take one out, eat it that day. Mostly works well.

I don’t drink the Atkins shakes. I’m drinking my morning coffee with coconut milk – and recently nothing. I no longer put butter in my coffee at work – and find that a little coffee goes way farther than it used to. I sometimes find myself not drinking any coffee at work – and when I do, it’s black. I don’t really drink fats anymore.

While not every day, on some days I find myself only eating one large meal a day. This happened quite by accident, but then I found out it was a ‘thing’ – OMAD (One Meal A DAY) or 23/1 Fasting. It seems there’s this notion called an ‘insulin holiday’. Here’s how I understand it. It is not only sugars that trigger insulin: proteins trigger them almost as well. So while your blood glucose might be low, your insulin might still be high – and as you have insulin resistance if you’re like me, eating nothing for a while gives the body a chance to not have to produce insulin as if you were snacking all day – and this might lessen insulin resistance over the long-term – at least that’s how the thinking goes.

There is a trick to this, however: eat too little and you put your body into ‘Starvation Mode’. Do this and your body can do all sorts of things – like make your hair fall out while holding on to every last calorie like a miser – and make you feel quite crappy – and there are voices on the Internet that don’t think this can be done without putting you into starvation mode.

So what I am doing is counting my macros more closely. I used a calculator I found here, and it gave me these ranges:

Calories:     1200 – 1892

Carbs:        20

Protein:    94-124 (104 is ideal)

Fat:        77-155

So the lower end is my target – and that ends up being one very satisfying meal per day. I don’t do this on all days – sometimes I have an avocado at work, and/or chicken broth. Sometimes I just have salt in water – depends on how I feel.

But you know the weirdest part of this: my narrowed food choices are liberating!

My diet seems easier. I’m not futzing around with food or thinking about food all the time. Diets can make you obsess about food more than not being on a diet. The simplicity makes things easier to track – and I hate tracking. The overhead of the diet is a lot less. I have more time for other thoughts than what I am going to eat – and amazingly enough – I don’t feel deprived.

That was the last thing I ever expected to say.

I could go on – like about what supplements I am taking – but I’ll stop here for now.

 

 

 

Bestketonetest.com / Keto Mojo / Keto Clarity Club Blood Ketone Meter Review

If the title of this post isn’t confusing, then you are missing something.

A far as I can determine, The one-man keto juggernaut Jimmy Moore, who wrote a book ‘Keto Clarity’, has some relationship with a company that is able to sell blood ketone testing strips for a little over $1 each if you join the ‘Keto Clarity Club’. The site is https://bestketonetest.com/  and has Jimmy’s smiling face on the bottom.

There is *another* site – https://keto-mojo.com/ – that is essentially the same but doesn’t have any mention of ‘Keto Clarity’ and no Jimmy Moore. You get the same deal except that you join ‘The Founder’s Club’.

So yeah – a wee bit confusing. Jimmy Moore must get a cut from the first website and maybe nothing from the second.

Good for him. I’ve concluded that Jimmy Moore is far too valuable to the keto community to NOT wish him success in building a brand that generates enough money for him to continue doing what he does.

All of this aside, I bought the meter and joined the ‘Club’. The meter is expensive at $60, but if you really plan on testing for blood ketones, at a little over $1 a strip, you will save in the long run.

Yes – it’s pricy – but it is the most accurate way to measure ketones.

The pee strips that you can find at the drugstore are great to start and cheap, but their major flaw is the damn color change. It’s worthless in measuring how deeply you are in ketosis. They could be dark because you haven’t drunk enough water, or they can be light because you did.

The only thing the keto sticks are good for is a simple yes or no answer to: am I excreting ketone bodies? If the answer is ‘no’ you can fine-tune your diet to see what’s messing you up. Once you start seeing color, then you know you are on the right track.

The problem is that you can only use them at the beginning. If you succeed at getting into ketosis and stay there, the type of ketones excreted change and don’t show up in the urine anymore.

Important: you don’t need a meter to lose weight on a keto diet!

I lost 80 pounds without one.

But…for those of us that can afford one of these things, I think it’s a great product. To be clear: I’m not being paid in any way to write this, I have no connection to the company, and I wasn’t given anything for free. I bought and paid for this myself.

I find the device to be very well-built – perhaps the best-quality meter I’ve encountered. It is easy to use – if you don’t mind stabbing yourself and bleeding of course.

And for a numbers guy like I am, I find the ability to get precise number to be very helpful in staying keto.

You can also save money on the test strips in the long run by a simple testing routine:

  1. At the start of your keto diet, test once in the evening to get a 0.0 reading to prove you’re not in ketosis and the damn thing works.
  2. Don’t test on day 2.
  3. Start testing once in the evening on day 3. If you’re doing things right you should begin to see the numbers go up. They tend to be higher in the evening. It might take longer then 3 days so if you know you’re eating to the keto way and not filling up on processed low carb crap and you’re watching your protein intake, save your strips and wait until day 5.
  4. While you’re in ketosis if the number is above 0.5, the ‘sweet spot’ for weight loss is supposedly between 1.5 and 3.0. At the end of a week without cheats, test yourself throughout one day to measure how your body’s ketone levels fluctuate. Write these down and keep these as your reference levels. If you are not at least at 0.5 at each reading, you might want to examine your diet to see what food might be messing you up.
  5. After that, if you’re numbers are good, there’s little reason to obsessively test except to see if a new food has an impact, you cheated, or your usual routine was disrupted in some other way.
  6. After a month, do another round of testing throughout a normal day. As you become keto-adapted the numbers might change.

Following this plan you can get those 50 strips to last you 3 to 6 months and still have good, solid numbers to reference.

One last note: while I also check my blood glucose, I don’t recommend the Keto Mojo glucose test strips because they are double the price of the meter I use.

I’ll leave that discussion for another post.

‘The Magic Pill’ – A Documentary

 

On April 2, 2018 I started a very strict ketogenic diet. The main reason was not to lose weight.

It was to prevent what seemed to be the onset of diabetes.

Mom, Dad, Sis, and Bro all got it – my siblings got in their 40s. I didn’t, maybe because I’ve been trying at least to maintain a low carb diet since the early 2000s, but at the beginning of my 50s that number began to climb toward a fasting number of 125 – the definition of diabetes. I began taking metformin and got the number to go down.

That was a few years ago.

Fast-forward to 2018.

While never having diabetes, I spent my own money monitoring it. I began finding that fasting number beginning to come close to 125 – and sometimes leaping into the 140s. i would measure throughout the day and many times it remained elevated.

Because of my family history this set off alarm bells.

On April 2 I began a strict keto diet and have maintained it since. I’m down about 13 pounds, which is a nice side effect, but it wasn’t the focus this time.

Within 2 weeks my blood glucose went down between 20 and 40 points. At certain parts of the day it even goes into the low 80s.

I stopped the metformin about a week ago – and my blood glucose is fine – still touching the 80s during the day.

I eat mainly pastured butter and fatty meat, and zero carbs except for green leafy vegetables and stuff like asparagus, pickles, kimchee, sauerkraut, celery, cabbage – the very low carb veggies.

What has exasperated me in some of the chatter in Vegan circles is an absolutism in their chosen path – like there’s no other way to good health. Being a Vegan is *a* path – and a path with heart – but it’s not the only path. I am not here to say ‘I’m right and they’re wrong’ – I don’t see this as a zero-sum game. And you might notice so far my trademarked snark absent. I do that as sport, though sometime people do get hurt – which is never my intention. I’m being serious here.

What I have envied in the Vegan approach is a spiritual aspect – keto / Atkins – whatever you call it – has always been a Yin without the Yang to me. I’ve buried my nose in the science and found it plausible enough – and my personal experience corroborating it – that I have a scientific belief – but I found it spiritually empty and so my journey to become a ‘Cranky Buddha’ did not fit with my diet.

Now I feel I’ve found the Yang in ‘The Magic Pill’. The documentary shows people experimenting with a keto diet of whole foods and eliminating insulin to treat their Diabetes, eliminating chronic asthma, lessening the symptoms of Autism in 2 children, dramatically reducing epileptic seizures in one child, and appearing to lessen symptoms of early dementia in one woman.

But that’s not the point. I knew these were outcomes reported on a ketogenic diet that are being investigated.

Where I found my Yang was in the last half-hour. In there it shows how we have perverted our natures and ourselves through agriculture – and it does so elegantly.

We have paid the price in chronic health conditions almost unseen before the 20th Century because we have worked against the natural order of nature.

I’m not quite there yet myself, but I believe I an heading in the right direction – and this documentary lights the way in that it frames the keto experience as a natural expression of our humanness. The science behind Keto is attempting to catch up with what Humankind has known for tens of thousands of generations – except for the most recent where we have lost our way.

If you’re a Vegan, I still encourage you to watch. Maybe afterward you can check out the Facebook group ‘Vegan Keto Made Simple’. You won’t find a nicer group of folks on Facebook – I guarantee you.

For you folks either on a low carb / keto diet or doing your research, you shouldn’t miss it either.

You Have Less Chance of Dying if You’re Fat

Doh!

Bad news for us folks who want to lose weight and are using ‘better health’ as a motivation to lose.

From the New York Times:

the study found a 6 percent decrease in mortality risk among people classified as overweight and a 5 percent decrease in people classified as Grade 1 obese, the lowest level (most of the obese fall in this category). This means that average-height women — 5 feet 4 inches — who weigh between 108 and 145 pounds have a higher mortality risk than average-height women who weigh between 146 and 203 pounds. For average-height men — 5 feet 10 inches — those who weigh between 129 and 174 pounds have a higher mortality risk than those who weigh between 175 and 243 pounds.

Maybe it’s better to have a goal of being less fat rather than thin? Personally, I am shooting for 200 lbs. and I’m 5 foot 10 inches.

Maybe some of you might want to consider a diet that focuses on health and not so much on weight?

Maybe Meghan Trainor is right?

The Physical

“I don’t have time for this. I have other patients to see.” Said my doctor, clearly indicating that I had used up all my allocated time for my yearly physical – or had finally pushed enough of his buttons. One or the other. It was awfully late and I thought I was his last patient. Perhaps it was true that he had other patients to see, or maybe it would have been more truthful for him to say: “I’ve had enough of arguing with you. I’m hungry and tired and want to go home and see my wife and kids.”

Either way I wasn’t offended. I am an exasperating patient. I am exasperating human in general, always questioning the obvious, asking questions that generate cow-stares or mild shock from those within earshot, or saying what I believe to be the unvarnished truth when it might be more prudent to just shut the fuck up.

In this particular instance of exasperating another human being, it was because my doctor, assessing my spectacular weight gain of 40 pounds since my last visit and a crappy total cholesterol count in the 260s, wanted to put me on statins – cholesterol-lowering drugs.

He showed me a worksheet from the American Heart Association that, when my crappy blood work numbers were plugged in, said I had a 14% chance of a heart attack in the next 5 years. He had done his homework probably because he knew I was a hard sell. We had the ‘statin talk’ last year when I was about 207 pounds and my total cholesterol was only a little elevated. I told him ‘no’ then.

And 40 pounds heavier and with really shitty blood work – the worst ever, I told him ‘no’ again.

I told him: “I have to be honest with you: I’m not a big fan of statins. They have not been shown to reduce all-cause mortality in patients like me and they also have a curious side effect, little discussed, of increasing the risk of violent death and suicide.”

My doc is a chill guy. I like him, though we don’t agree on a lot of things. I’ve mentioned this to people and they say: “Why don’t you change doctors?”

“Why? I’m not looking for somebody to always agree with me.” He’s smart and has a good 15 years of experience as a clinician. I also think he cares. He took the time to prep for me coming in by running that American Heart Association risk assessment. I think that counts as ‘going the extra mile’. He genuinely thought that he had the evidence to convince me – a seemingly rational and  medically knowledgeable layperson – to comply with his recommendation.

And I exasperated him by still saying ‘no’.

So I suppose I like him because, with nearly every relationship I have, there is a certain aspect to it where the other person has to put up with me.

People in their professional roles sometime turn into caricatures – and I suppose doctors are probably more guilty of this than most professions. In a line of business where on any given day your job might be to tell a seemingly young and healthy parent who came in with what they thought to be some minor ill that they need to ‘get their affairs in order’ because they are going to die soon, I can’t judge them harshly for perhaps putting up a wall of sorts between their patients and themselves.

But I am fascinated with these walls we put up as part of our daily interactions – and I love to break through them. Being exasperating frequently causes people’s walls to unexpectedly crumble – and what’s behind them is usually interesting.

So when I mentioned the statin research showing no benefit in all-cause mortality for patients without active cardiac vascular disease – and the crack about the increased risk of suicide and violent death, my doc’s usual chill turned less chill. He seemed slightly taken aback by the all-cause mortality, violent death and suicide bit and said with reserved force: “I challenge you to produce the evidence on these.”

I could easily find these mentioned in respected journals like the Oxford University Press, Pubmed, and the Lancet sitting in my car on my smart phone before leaving the parking lot of his office. I’ll be printing out whatever isn’t paywalled before my next visit.

Here’s one link: http://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease/

It says – and backs it up with a boatload of legitimate citations – that after 5 years of statin use in patients without known cardiac vascular disease:

  • None were helped (life saved)
  • 1 in 104 were helped (preventing heart attack)
  • 1 in 154 were helped (preventing stroke)
  • 1 in 50 were harmed (develop diabetes)
  • 1 in 10 were harmed (muscle damage)

Here’s another: http://qjmed.oxfordjournals.org/content/97/4/229 – you might have heard of Oxford, it is the world’s second oldest university, having been around since 1167. 16 Nobel prizes in medicine were awarded to alumni. It’s not a citation from some jackass with a blog and an axe to grind.

The study was small and warrants further investigation, surely, but a few people put on statins got really grumpy afterward. The link notes:

Manifestations of severe irritability included homicidal impulses, threats to others, road rage, generation of fear in family members, and damage to property.

Now – don’t get me wrong – statins have their place. In people with CVD it is a lifesaver (http://www.thennt.com/nnt/statins-for-heart-disease-prevention-with-known-heart-disease/). However, I come from a family with no predisposition toward heart disease even though my father’s side of my family ate and drank with abandon and all had potbellies and ruddy faces from all the beer they drank. A good part of my heredity ate whatever the hell they wanted and lived well past 80 – with 80 being the point where the dodginess from the family predisposition toward Alzheimer’s began to take full effect.

I don’t have known heart disease, nor do I have diabetes though my brother, sister, father, and mother all had it – with my siblings getting it way before the age I currently am. I don’t have a family history of CVD. I see nothing in my medical history nor my heredity that makes me a good candidate for statins and have to put up with the potential to develop diabetes, the potential for muscle damage, or the potential for negative psychological effects.

Before the ‘statin talk’ I had already parried with him on diet. As I sat in my underwear, an unpleasant sight except perhaps to a clinician who has trained themselves to be detached and doesn’t really give a shit as a protection mechanism from going insane, he mentioned in what in retrospect was carefully chosen language that “I was a much larger patient” than when he last saw me – and he hoped I had a plan.

“Yeah. My plan is to go on a low carb diet.” I said.

“Do you mean below 100 grams of carbs or below 50 grams?” He asked.

“Oh, I want to do a ketogenic diet. I’ve been on one on and off for a decade and I find it works quite well for me. It even seems to make me calmer.”

“What is recommended is a calorie-restricted diets with legumes, whole grains, and lean meat, along with vigorous exercise most days of the week.”

“Well, a ketogenic diet has worked for me in the past.”

His tone changed. He was going into his ‘learned clinician schtick’. It became more patronizing. “Well you know, a ketogenic diet puts your body into a mode similar to starving. You body can’t live without glucose. What is most important is that a diet be sustainable – and a low carb diet isn’t sustainable.”

OK – a decade of sustained weight loss shows it isn’t ‘sustainable’ – he’s right – I gained weight after a decade. Got it.

I did counter on the glucose thing, though: “Um…but your body can create the glucose it needs from a moderate protein diet and converts the protein into glucose through gluconeogenesis – right?”

He didn’t say anything for a bit – frankly, I don’t recall a direct response at all. Perhaps he had busied himself with the next part of the examination – the part that included the snap of a latex glove and ‘bend over’.

Given the asymmetry of the situation – he fully clothed and I in my skivvies – I wasn’t about to tell him that my lack of exercise is almost a badge of honor for me. I follow the advice of a quote I once read: ‘Whenever I get the urge to exercise, I lie down until the feeling passes.’ I have a sneaking suspicion that the relentless advocation of ‘exercise for everyone’ is not so much for the health of individuals but rather the health of the economy: every gym membership, every Thighmaster, every pair of running shoes raises the GDP – and so do the attendant sports injuries: muscle pulls and torn ligaments provide physical therapists gainful employment; injections of steroids provide income to doctors as well as relief to the patients who have exercised their way to worn out joints, and finally the people who thrive on a steady stream of former exercise enthusiasts who, instead of choosing the next pair of running shoes to buy, now have a choice between a hip replacement or a walker and constant pain.

I also feel that above a given weight, it is smart to start losing weight without the exercise (it can be done – I did it) – and with an increasingly lighter body comes more energy and the freedom of movement that can make you *want* to exercise.

And I haven’t even begun with my feelings about what constitutes ‘healthy eating’. If my differences with the standard accepted notions on exercise were a flaming match head, my differences on nutrition from most people were a nuclear bomb.

As I left I mentioned he should check out the book ‘The Big Fat Suprise‘ – a masterfully written work that clearly explains just how we ended up vilifying fat as a nutrient because of bad science, big egos, and politics. He just snorted. It was only a:

  • A New York Times bestseller
  • Named one of The Economist’s Books of the Year 2014
  • Named one of The Wall Street Journal’s Top Ten Best Nonfiction Books of 2014
  • Kirkus Reviews Best Nonfiction Books of 2014
  • Forbes’s Most Memorable Healthcare Book of 2014
  • Named a Best Food Book of 2014 by Mother Jones
  • Named one of Library Journal’s Best Books of 2014

Kinda what I expected. 

For those of you unfamiliar with my backstory, in 2003 I lost 80 pounds on a low carb diet. Unlike most people who would have reveled in their success, bought new clothes and left it at that, I needed to know why. How could I eat like I did and lose weight? I had only read the Atkins book, and learned about ketosis: a chemical transformation to your body that allows you to run your body on ketones – the product of burning fat – instead of glucose – which comes from sugars and starches and is what the vast majority of human beings run on these days. In fact, running your body on ketones is so rare that one way of measuring your ketones to track your progress – urine strips – are actually manufactured for people with severe diabetes to manage a severe side effect called ‘ketoacidosis’.

Being slightly obsessive – or maybe a tad more than ‘slight’ – I spent the next 10 years reading books, research, blogs, and articles and all aspects of diet nutrition, the history of diets and dieting, how diet has changed over the centuries, the psychology and sociology of food and eating, as well as a myriad of odd little detours into admittedly wacky material produced by people with dubious credibility as well as my own hare-brained ideas.

All that obsession spilled out into a blog on low carb which I started on a whim and then wrote and published over 500 articles over 7 years. I sort of abandoned writing on low carb and shuttered the blog at the end of 2014 for reasons not entirely clear to me. Perhaps I had grown tired of it all. Perhaps I had said all that I had to say on the subject.

Perhaps I was just paying lip-service to my low carb lifestyle and writing about it – as I gained weight – seemed disingenuous.

Perhaps I needed to regain enough weight to give a shit again.