M.D. Anderson on the Keto Diet and Cancer
I first became curious about the keto diet and cancer in 2015. I am a medical doctor that specializes in internal medicine. That means I focus on patients’ ‘long game.’ I think about questions like:
- What are the consequences of 20 years of high blood pressure?
- What happens when you have been overweight for 15 years?
- What are the risks of smoking marijuana for ten years?
I aim to help patients prevent disasters before they ever become aware of a symptom. Thankless in many ways, but rewarding strategically. I specialize in assisting patients in achieving behavioral changes that add years to their lives.
I also like to study chronic brain problems like Parkinson’s, depression, bipolar, seizures, addiction, anxiety, high blood pressure, strokes, and brain fog. My practice displays a calico pattern of brains that don’t work correctly.
However, if you have one of the ‘bad boys’-I’m talking about cancers that kill people within six months- even Mayo Clinic will refer you to the crown jewel of all cancer treatment centers: M.D. Anderson. This organization leads innovation worldwide in treating cancer.
Releasing Their Cancer Protocol
When M.D. Anderson releases a cancer protocol, the medical world should sit up and pay attention. Strangely, M.D. Anderson did not announce their newly implemented ketosis protocol at any medical conference. I did NOT read about this update in any medical journal.
Nope. Instead, a patient whispered this information to me as if she was worried about how I would respond. This earth-shattering information, shared via my patient’s small hushed voice, has since changed my whole approach to patient care.
Her mother was diagnosed with a glioblastoma, one of the worst forms of brain cancer. Her mother lived in Texas, near M.D. Anderson. Accordingly, she landed in the hands of the most respected cancer treatment scientists today. When my patient heard that her mother couldn’t receive the first dose of radiation until she’d been in ketosis for two weeks, the daughter did what I would have done: she asked questions.
When she squeezed out all the information she could get from her mom’s medical staff, she hit the library. Still skeptical whether her mother was getting the very best care, she brought her questions to me-her primary care physician. My response: a blank stare over the rims of my glasses as I processed the word ‘ketosis.’ Not one of my stellar moments.
This happens a lot. Patients bring me a multi-level-marketing-hyped super weird chemical. They ask me what I think. Most of the time these chemicals are a waste of their money. Usually, those products’ effects are so minor they won’t hurt anyone. But that’s not always the case, so I take the time to check them out. This patient’s ketosis question kicked my brain into high gear.
For starters, when she said ‘ketosis’ my brain automatically heard ‘ketoacidosis.’ Fifteen years had passed since I last encountered a ketoacidosis patient. Back in medical school, every time I took a test, they asked about this super scary syndrome of ketoacidosis. When I mistakenly heard ketoacidosis instead of ketosis, I reflexively answered, “Hell no, that sounds scary!”
Except, this woman’s mother was at the crown jewel of all global cancer treatment centers. Why would they be asking this woman to pee ketones before they zap her brain with cancer-killing radiation? Every single day they delayed the radiation therapy made her survival chances worse. There had to be more to this situation.
I bought myself some time and asked the patient for a week to research the question. My trusty researcher flooded my inbox with ketosis research linked to M.D. Anderson. Her research led to the articles that changed my whole practice philosophy.
What I Found
I found the information referring to the new ketosis protocol at M.D. Anderson. It was very technical, advanced biochemistry chatter. I got the essence of the message that cancer cells used blood sugar or glucose for fuel. Cancer cells don’t use ketones for fuel. They don’t have the cellular goods to use ketones.
For starters, ketones are fuel? Hmmpt. Interesting. Ketones are not the super scary, acidic molecules known to send patients to the intensive care unit.
I’m sure we covered this in medical school. But that was so long ago it felt like new information to me. I had lost that fact many brain cells ago.
The articles went on to discuss that when we fed cancer-filled-animals only ketones, certain cancer cells starved. It sounded a little too good to be true. Still, I was not reading the latest self-published update from hucksters selling salts that change your eye color. It was straight from one of the world’s leading cancer research institutions.
I scanned the report for side effects. Patients in ketosis undergoing radiation treatment run the risk of killing off too many problem cells at once. It can clog their filtration system with dead cancer cells. What?
What a fantastic problem for terminally ill patients to have?! Let me pick THAT problem for my patients any day. We kill cancer TOO WELL? Awesome!
Department of Defense Studies on Ketosis
My gem of a researcher didn’t stop the search there. She sent me several other articles. One item from the Department of Defense caught my eye. As a doctor, this one resource stood out to me because the Department of Defense does NOT usually take money from Big Pharma.
Medical research requires funding. Someone has to foot the bill. Usually, that someone has a good reason to spend their money. Figure out who funded the study-and you quickly know the results before even reading the report. Call me cynical, but this is how things typically work in the world of Big Pharma or direct-to-consumer industries.
Put it this way, if a multi-level-marketing company funds a study, don’t be surprised if the report concludes that their product saves the world. What a coincidence, right? That is the reason why I don’t get excited quickly when a new ‘groundbreaking study’ starts making the rounds. For me to get excited, I need something more, well, objective.
When it comes to objectivity, the DOD (The United States Department of Defense) does not play around. It is one of those sources where any potential bias is so small that you can almost believe every word you read.
How the DOD Described it
The Department of Defense released an article describing a study involving ketosis and their divers. At first, I thought, “How strange.” Why would a deep-sea diver need ketosis? The short answer: seizures. The resource explained that our Navy SEALS spend a lot of time underwater. They also pride themselves on stealth. SEALS are all about sneak attacks. Accordingly, they don’t use standard scuba equipment. Their breathing devices won’t leak out bubbles. Good idea, right?
If you’re trying to hide from the enemy by swimming underwater, you can’t leave a trail of bubbles. Talk about a dead giveaway.
A rebreather allows divers to breathe the same air over and over again without leaking bubbles. It calculates the gas concentrations of particles in the air. Their oxygen delivery remains steady while toxic gas levels remain low. What an awesome tool. Right? GO NAVY.
The rebreather makes stealth diving possible without a bubble trail-except for one problem: Every single one of the Navy SEALS using this device started having seizures. Oops, that’s not going to work. There’s one thing worse than having a seizure: having one 30 feet underwater!
The DOD’s research team quickly set out to discover how to prevent the seizures. The first approach they used replicated what we kids having hundreds of seizures a day: anti-seizure medicine. They prescribed these meds to Navy SEALS.
The Results? Stupid Navy Seals. No,Really
The medicines slowed their brain processes down-by a lot. Their timing and reaction skills got super slow, and, worst of all it, didn’t prevent one stinkin’ seizure! Back to the drawing board.
After reading through some literature from the 1900s, research team members found that most of the seizure studies available focused on children. Sadly, most kids were prescribed medication that slowed down their brains. This effect, it turns out, was by design.
The most common anti-seizure drugs work this way. Since seizures are spread through the circuits in our our brain’s, slowing down electrical activity should hold the seizures at a standstill. This solution works for most kids at quite a substantial sacrifice of mental speed and performance.
What happens when the medication fails? The DOD Researchers Unearthed the Answer: The Ketogenic Diet.
The results were startling. The skeptic in me wondered about the chances of this DOD report containing your typical Big Pharma version of snake oil hype. I just could not put DOD in the same category as Big Pharma. The DOD is not in the business of getting the public excited about a new treatment for seizures. There’s no conflict of interest, at least, as far as I could see.
Thanks to this study, ketosis remained stuck to the roof of my mind like hard to reach mental peanut butter. Still, I was looking for something more convincing. The DOD report was eye-opening, but something still held me back from recommending ketosis to my patients.
I needed another data source. Something I know that offers little wiggle room for hyped up conclusions. I found it in the form of autopsies. Yes. Autopsy studies are beneficial. You set up a study selecting a set of patients who have a childhood problem and follow them all the way to death.
Once dead, look at their bodies under a microscope. That’s my kind of study. Remember: I am an internist whose job is to predict what crappy things await you in the future and the best strategies to avoid them.
There is just one problem with long-range childhood to autopsy studies: They are very very very RARE.
How come? That is not how most drug research is done. Drug companies hate these kinds of studies. They take too long and are quite expensive. For Pharma companies to keep costs down, they use animal studies.
They might do a 2-year study to see how well their medicine works. From that point, a statistician makes some long-term extrapolation about future effects based on the two-year data. Bla. Bla. Bla. What’s wrong with this picture? How trustworthy is data based on some goofy numbers twisted by a statistician on a drug company’s payroll?
That is why the hairs on the back of my neck stood on end when my researcher drew my attention to an autopsy study involving ketosis. Dead people don’t lie … as often. Who are the dead people we were inspecting? They were not cancer patients.
Nope, these were the kids from the 1950s and 1960s who were put on a ketogenic diet because prescription seizure drugs failed to make their seizures go away.
The Ketosis Kids
Those were the called the ketosis kids. When these kids were in their early teens and suffering from severe seizure disorders, their doctors had failed to control the seizures using medication. After running out of other options, they began a ketogenic diet. These kids were hospitalized and underwent ketosis transition.
Even their families were trained by doctors to keep these patients on a ketogenic diet for a lifetime. Their compliance with the diet was nearly perfect. Going out of ketosis caused the return of their seizures.
And now they were dying. Not from seizures mind you. They were dying of old age or health problems unrelated to seizures.
As the dead patients rolled back into the study 60 years later, a few striking findings appeared in the first few corpses. For starters, their brains were some of the healthiest minds the pathologist had ever seen. Wait. Stop.
That is entirely backward. These are seizure patients. The drugs failed them. They got put on this diet as a last resort because they had hundreds of seizures a day.
If you want to see the worst human brains, take a look at the autopsies of seizure patients who suffered decades of untreated and uncontrolled seizures. Seizure patients’ brains are known for being in terrible shape at autopsy. Why are the ketosis kids’ brains so different?
Even when we controlled the seizures, seizure patients’ brains aged differently from normal healthy brains. They tend to be smaller. The insulation coating the nerves throughout seizure patients’ brains are usually thinner. Instead of the smooth areas seen in normal brains, the brain circuits of seizure patients have a poke-a-dot pattern. Simply put, typical seizure patients’ scans look a lot like some of my drug-addicted patients’: broken. Yet, these keto kids’ brains were pristine.
Neurofibril tangles, also called brain plaques, are one of the disease markers we see in brains at autopsy. If you’ve ever looked into the grey matter of people with Alzheimer’s, you’d know what a neurofibril tangle is. For those of you that haven’t heard this word before, here is your crash course in neurofibrillary tangles: think of it as ‘rust’ in your brain. It is a buildup of ‘gunk’ that is linked to many brain diseases. Brains struggling with seizures, even low-level ones, reveal many of these tangles when autopsied.
So why do the grown-up, keto kids’ brains look so good? It seems impossible. How could a seizure brain have no neurofibrillary tangles?
At this point, I became extremely curious about ketosis. If the lack of brain damage among ketosis patients was eye-opening, my curiosity was kicked up a notch when the autopsies showed that the initial set of patients had no cancer. It was shocking to me because everybody has cancer.
Yeah, I hate to break it to you, but we all have some cancer floating around in our bodies. The real question is how well can we fight off that cancer and undo our body’s cellular mistakes. If you were to autopsy an old person and tell me that they don’t have cancer at all in their bodies, I wouldn’t believe you.
I’d insist that you look again. I’d think that you meant that they have a lower amount of cancer. I can’t imagine a human body at autopsy having no cancer. Everybody has little cancer.
In the 1920s, we learned that tumor cells don’t need oxygen to survive, but they certainly need glucose. Strange. Those cancer cells don’t like a high level of oxygen, but they need their sugar.
Here’s the clincher: cancer cells can’t use ketones for fuel. At this point in my research, only two words came to my mind: hot diggity!!
In 20 years of practice, I’ve never canceled my clinic to study. Studying always came in the extra hours of running a private practice. But I found myself canceling patients so I could better understand this phenomenon I’d stumbled upon. This was far too shocking to let another day go by without me understanding, “What’s the deal with ketosis?”
Learn more about what foods to eat through our FOOD GUIDE teaching you the good – better – and best options for ketosis eating.
How to Transition Through Every Ketosis Phase: Part 1
Adapting your body to burn fat instead of carbs involves five specific phases. Each Ketosis phase happens in a predictable order that has been researched and studied. Scientists documented the body’s transitions by entering patients into a fasting study. They fasted for forty days. Each phase marks changes in your blood chemistry and occurs at specific, scientifically predictable times. With hopes of not overwhelming you, I will take three blogs to cover all five phases. Each phase teaches how much of your body is using ketones versus glucose. Take note specifically of what fuels the brain in each phase. This post gets us through phases one and two.
Ketosis Phase 1: Use Up The Sugar In Blood
BURN THROUGH THE SUGAR IN YOUR BLOOD
- TIME REQUIRED: 4 HOURS
- STATUS: Your fuel is 100% glucose during phase one. The glucose you burn comes from the carbs you just ate or drank. NOT ONE section of your body runs off ketones.
- BRAIN: Powered only by glucose.
- Entering Phase 1 is the easiest part of getting into ketosis. You do this every night when you go to sleep. You simply use up the sugar that’s currently in your bloodstream. Every time you eat more than a spoonful of sugar or a handful of carbs you reset your system back to the beginning of Phase 1.
Phase 1 begins by processing the glucose that’s already in your blood. This glucose came from the food you ate over the last 4 hours. Phase 1 is short. It ends after 4 hours unless you reset things by eating more carbs. Then it starts over. Don’t do that.
Go to bed two hours after your last carbohydrate. Before you wake up, you are through Phase 1.
Ketosis Phase 2 Burn Sugar Stored In Liver
- YOUR LIVER MAKES GLUCOSE BY EMPTYING ITS STORED SUGAR
- TIME: 12+ HOURS
- STATUS: Your fuel is still 100% glucose, but now your carb fuel is coming from your stored sugar called glycogen.
- BRAIN: Powered only by glucose.
- You burned up those circulating sugars in your bloodstream. With no more food coming into the body through your mouth, your system will use your stored sugar. This stored sugar is called glycogen, and you keep it in your liver cells. Phase 2 fuels your body using this stored energy.
How Long Will Your Storage of Glycogen Last? Good Question.
The answer depends on a couple of things: the size of your liver and the level of energy usage in Phase 2. Sleeping during this phase takes less fuel than running for 45 minutes. Fighting cancer or infection requires more fuel than living without those issues. Mending a broken bone or repairing from surgery requires more energy than sitting at your desk writing a blog.
In addition, how large is your storage tank? Asked another way: How big is your liver? I bet you’ve never thought about that. Its size depends on how much stress you’ve put on your life in recent years. Your liver constantly grows new cells to meet your body’s needs.
If you drink excessive alcohol for twenty years, you will make additional liver cells to keep up with your drinking. Similarly, if you eat lots of extra carbohydrates for two decades, your liver will expand to store your extra sugar.
From my experience, patients with the largest livers are not alcoholics. Instead, the biggest livers belong to my patients addicted to carbs. If they are not already diabetics, they will be. They have overstuffed their livers with the age-old habit of constantly eating carbohydrates. They don’t allow enough time to empty stored sugars before eating more.
Long before diabetics are diagnosed as such, their livers strain from the pressure of the carbs they eat. They make more and more liver cells to keep up with the carbohydrate onslaught. If they cannot make extra liver cells as fast as they overeat, sugar remains in their bloodstream longer than normal. Insulin works overtime whipping the glucose into the mitochondria’s furnaces or into storage. The danger signal of insulin rings constantly. They keep eating and therefore more sugars enter the bloodstream before the abundant pine needle-like fuel gets burned or stored. The screaming alarm signal of insulin becomes a constant noise. This hormone’s danger signal becomes less and less effective as blood sugars steadily rise.
Diabetes is defined as a state of constantly elevated blood sugars. Diabetics never empty their storage. I do mean NEVER. Their liver cells are stuffed with glycogen. Their cells have no more room. In an attempt to store their extra sugar, they grow additional liver cells.
Did you empty your liver last night? Let’s check. After 12 hours with only water, prick your finger and check your fasting blood sugar.
Don’t roll your eyes. You must know someone who has diabetes and checks their blood sugar. Borrow their glucose monitor for one day. No, they won’t die if they don’t check their sugars for a day.
If you burned through all your glycogen and emptied your storage [emptied your liver] your fasting sugars will fall between 55-80 mg/dL. That’s a surefire sign you have a normal sized liver. If your liver has been stretched and stuffed with too many extra carbs in recent years, you won’t burn through all the storage in 12 hours. It might take you 20 hours to burn all those pine needles. Some severely overweight patients take a week. If your blood sugar is greater than 120 mg/dL at 12 hours of fasting, you have DIABETES. No joke! That’s the rule of how to diagnose a diabetic.
Ideally, your liver should deplete all stored sugar before you eat another bite of food, especially foods filled with carbs. By the end of Phase 2, your body has burned all of your fast-burning fuel.
Ketosis and Skin: Why Fibroblasts Increase Collagen Production
Do you have that friend whose skin looks so awesome? Do you want to know her secret? I am going to tell you … right here.
Touch your face. Those skin cells you are touching were made 2-3 months ago. If you want healthy, glowing skin that’s free from pimples and wrinkles, improve the foundation holding your skin cells. Improve those cells at the base of your skin layer and watch your age reverse over the next 2-3 months. Improved collagen production decreases your wrinkles, hydrates your skin and results in more flexible, resilient, yet firm skin. In a word, it makes you look younger.
Cells called fibroblasts create collagen. Collagen establishes the latticework or framework for our skin, bones, tendons and other tissues connecting our body-parts. Think of collagen as different types of glue. Fibroblasts secrete this “glue,” or matrix, providing structural integrity to all of our connective tissues. The composition of that matrix determines the physical properties of the tissue.
Fibroblasts busily provide the architecture connecting one part of our body to the next. Skin is one example. It holds the highest number of fibroblast. These skin fibroblasts paint the pathway for the skin cells to wrap our entire body. Bone-fibroblasts release a slightly different glue. Corneas, tendons, ligaments, and cartilage have their own unique matrixes coming from these essential cells. The degree of mineralization varies with the type of tissue. Rigid collagen becomes bone. Flexible collagen produces the tissue of a tendon. The cartilage of our ear, eyes, or nose is a gradient between those two extremes.
Other fibroblasts make collagen for your blood vessels, the fascia around each muscle fiber, the discs between your backbones, and the dentin in teeth. Each has a different, unique mineralization of collagen from their fibroblasts. Fibroblasts glue our body together.
The power of healthy fibroblasts is apparent when comparing an athletic 17-year-old to a frail 80-year-old. The seventeen-year-old has tighter glue. As we age, fibroblasts slow down their production of collagen. These aging cells become dormant or disappear altogether. Without the collagen supporting the skin, it begins to crease and wrinkle. Those missing platforms lead to fine wrinkles at first. With less and less collagen, come deeper and more pronounced lines.
Dormant fibroblasts are called fibrocytes. Fibroblasts and fibrocytes are two states of the same cells. A fibroblast cell has a lifespan of a couple of months, whereas fibrocytes live longer in their “hibernating” state. Fibrocytes lurk through our body waiting for the signal to provide more collagen. Months without any sign that the body needs more of their glue, and they disappear.
When I teach patients and students about the impact of a cell, it helps to show what happens when the cell is defective. When fibroblasts suffer a mutation while trying to outline the bones of a growing teenager, bones turn out fragile instead of healthy. Much like a porcelain vase, bones formed from defective collagen cells shatter with the slightest twist or turn.
Building healthier collagen cells does not stop with those looking for youthful skin. Sure improved collagen production decreases wrinkles and produces more youthful looking skin. But that’s not all. Improved collagen production keeps bones from cracking, joints from wearing down, eyes with a clear vision and your heart valves firmly sealing shut each beat of the day. From your eardrum to your muscle fibers, collagen is the source of active functions within your body. Even if we set aside all the vast immune system benefits, we could write an encyclopedia of benefits to keeping collagen cells out of their dormant phase.
Most people don’t care about collagen in their joints, or eyes, or bones. Most people that know the word collagen, care about their skin.
So what’s the secret to youthful skin?
STEP 1: A Ketogenic Diet.
The chemistry shift behind ketosis at its very core removes inflammation. Two months into producing a steady supply of ketones and the improvements in the skin begin to shine through.
First, the pimples fade away. No matter your age, ketosis prevents pimples from popping out of your skin by lowering inflammation throughout your body. At the root of any acne problem lives a soupy mess of cells soaking in the grime of inflammation.
Next, the redness and irritation slowly fade. After 90 days you see the first “ketone” based on skin cells. This means the skin cells you made the first week of ketosis are finally at the top layer of skin where you can see them. Skin cells made during times of lower inflammation show a youthful radiance. These healthy, plump cells outshine any other approach to skin improvement.
Moisturizing creams advertise that they provide a more youthful looking skin. You may find truth in that for a few hours, but not the way ketosis affects your skin. Ketosis provides a much more sustainable process.
In addition to anti-inflammation, ketogenic diets filled with fats support beautiful cell membranes. Call me a geek for pointing this out, but it is true.
Perfect looking skin begins will flawless cells. Without enough healthy fat, your cell membranes fail to form that perfect pattern. Defects formed in the cell’s membranes magnify over time to abnormalities seen in your skin. Skin cells that break open or wrinkle are made with these defective cells. Inflammation hides at the root of these problems.
A sunburn provides an easy-to-see example of severely inflamed skin. Lower amounts of skin inflammation aren’t as visible. Low-grade inflammation occurs on a microscopic level. Inflamed skin cells divide into imperfect replicas. These imperfect cells don’t stick together as neatly, forming defects in the skin. These are wrinkles.
As we age, our defective skin cells increase in number. Faulty cells make faulty copies. Those wrinkles around your eyes showed up in your thirties. Maybe the inflammation started after a sunburn. Perhaps it built up during times of high stress. Either way, those cells wrinkled because they were defective. Ten years later, those wrinkles are deeper and more noticeable. In contrast, well-made skin cells are flexible and plump allowing the cell membrane to stretch and squish as needed.
And what about those fibroblasts? How can we spark those to divide more or coax the fibrocytes out of retirement? Micronized Collagen Particles
STEP 2: Micronized Collagen Particles Increase Collagen Production
Yes. It works, and studies prove it. Take collagen parts from a cow, chicken or fish. Now hydrolyzed those particles. Then cut them it into microscopic pieces. Once scoop of those hydrolyzed collagen “snippets,” and you can measure them in your bloodstream within an hour. These tiny specks spark both fibroblasts and fibrocytes into action.
These tiny flecks look like broken down collagen pieces from the cells point of view. The one thing that sparks increased collagen production is the signal that your body is breaking down its collagen. Naturally, this destruction of collagen happens very slowly, causing only a few particles to be present in our system at any time. The increased particle number found in circulation after taking a supplement turns up our collagen produced by the fibroblasts. That same high particle count in your circulation wakes up sleeping fibrocytes. This little trick is the secret to amazing looking skin.
Signal your fibroblasts to make buckets of collage by adding these particles to your circulation. I recommend three doses a day into your coffee or tea or bone broth. Any liquid will do. Stay consistent for a full three months and the results are stunning. You will see your skin look younger.
Don’t take my word for it. Or that found in the science articles. Take a picture. Get a close up of those fine wrinkles on your face. Retake the photo in 60 days, 90 days and 120 days. It is remarkable what you will see.
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Would you like to make some of these flexible, radiant, youthful skin cells? Get to the root of your wrinkles, crows feet, smile lines, thinning skin and other problems of your skin.
- Pee ketones for 90 days.
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Quick and Easy Rules of the Keto Diet
Rules are important when it comes to tricking your body into altering it’s chemistry. The rules of the keto diet are not complicated but I can assure as weird as some of these guidelines sound they will help you.
Step 1: No sugar. No starch. High fat.
The best summary of this diet is “no sugar, no starch, high fat.” Say those words out loud. Again. No sugar. No starch. High fat.
Step 2: Remember the Number 2
It is critical as I will explain later. For now, commit this number to memory:
Step 3: Buy Urine Ketone Strips
I hate even to have to say this, but I recommend you buy something. Yes, as a physician who has been subjected to more multi-level marketing pitches than I care to admit, typing this recommendation makes me uncomfortable. But it is necessary.
To succeed at switching your fuel source from sugar to fat, you need to know if you are producing ketones. Spend some money. Ketone strips typically cost about $15.
Buy the smallest quantity you can. I buy bottles of 50 strips. I have put them in every single bathroom at my clinic and my house. I have even been known to leave a bottle at a friend’s house because she always complained that she could not lose weight.
It is super important because the keto diet is measurable! Here is my favorite part.
I have coached patients for decades that come in and say “Doctor, doctor, my diet is just not working for me.” And they’re right. The scale didn’t move.
These changes seem strange to most everyone I advise. Keto strips allow me to measure patients’ compliance. More importantly, the strips allow patients themselves to monitor their progress.
In the first two weeks, I want you peeing ketones as quickly as possible. Burning fat for fuel is the basis of this diet. Getting to the other side has proven to be unique to each patient. You will need the feedback that what you’re doing in YOUR SPECIFIC situation is the right thing for you.
Some patients, usually men, stumble into ketosis. They pee ketones within 24 hours of changing habits. They may not always stay there, but they can pee a ketone mighty quickly. Other patients may take several weeks to burn through their stored sugar and struggle with their body chemistry due to insulin resistance.
Sometimes this is because they don’t know what they’re doing. But more often than not, the bodies were merely locked into using only sugar for fuel for years-if, not decades.
Some have been living with chronically high insulin levels for years. It can take weeks to burn up all the extra stored glucose in the body and finally see their insulin fall back to normal range. Remember, you can’t produce ketones until both your blood sugar and your insulin comes down.
How resistant is your body to insulin?
There is a blood test you can take to get the answer. I offer this to my patients when I see them in the clinic, but I don’t routinely recommend it. The test is expensive and coupled with the cost of a doctor’s visit. It won’t tell you anything you don’t already know you are addicted to sugar and have been for a long time. You have gained weight and can’t seem to lose it because of your body’s insulin cycle.
You will have a rotten time giving up carbs initially. Most people don’t need a blood test to tell them that. Spend your efforts and money measuring something that does matter: The time it took for you to start producing ketones. Start using those urine sticks! If they turn pink, this means you made ketones. Pat yourself on the back, jot down how long it took you to pee that first ketone-and keep going!
Step 3.5: Buy MCT C8: C10
We will get into how to use this powdered fat supplement later. For now, click on BUY and get it shipped to your home. Local stores are not likely to have this on hand, so I recommend searching the internet for direct delivery. Search these words: MCT C8: C10
Step 4: Empty Your Cupboards
It is a challenging step. Empty out your cupboards.
One of the hardest changes you will have to make when adjusting to a high fat, low-carb diet is dealing with temptations. You need to put a lot of distance between yourself and the high carb foods you previously loved to eat. Do yourself a big favor and rid your home entirely of these distractions and temptations. Cleanse the places you control.
When walking addicts through a recovery plan, we start with asking a friend to help them cleanse their environments. It means throwing away all the signals that tempt you to go back to your old habits.
For an alcoholic, this means booze bottles stashed in the silliest places. For a drug addict, it involves needles, spoons, and lighters. For a carb addict, your enemy is processed food. The more food has been prepared, the quicker it ends up in your mouth. Moments later, your system is crammed with glucose molecules ruining your ketosis.
Even when you have cleansed the areas you control, be prepared for temptation. The devil has placed carbohydrates everywhere-from gas stations to coffee shops to your workplace. Protect the sanctuary of your home. Keep carbs out.
How do you know which food items to throw away when rifling through your cupboard?
Look at each item’s label. Any item with a high level of carbohydrates or sugars needs to go. When trying to decide to keep or throw something, another rule-of-thumb centers around processing.
If the food is highly processed, lose it. In our family, we took a box and everything that was made with flour, rice, corn or had sugar in it, we simply put in the box and took to the community food pantry.
This was therapeutic for my household. My kids helped with this. If they considered keeping it, I had them count how many ingredients were in the product. If it had more than 8 ingredients, we tossed it. Keto can be very stressful. Do this with a friend and make sure you don’t quit until it’s done.
Here are just a few things that ended up in the box that we took to the food pantry:
- Hamburger Helper
- Bags of pasta
- Bags of rice
- Refried beans
- Cans of corn
- Cans of pears and other fruits (remember, fruit is evil)
Step 5: PAUSE
After the cupboards are bare, STOP. PAUSE. Do not rush the next steps. Grocery shopping will still be there tomorrow. Just pause long enough to understand these following few steps.
Step 6: Remember That Number?
What was that number you were supposed to remember? Yep: Twenty. 20. To start on your path to ketosis, you are allowed 20 grams of carbohydrates per day. The only thing I want you counting in a day is carbohydrates. Not calories. Not grams of fiber or fat or protein. Not pounds or inches. I only wish you focused on carbohydrate grams.
Forget about net carbs. Forget about dietary fiber. Don’t distract yourself with ‘sugars.’ Just remember 20 and start counting carbohydrates! Restrict yourself to only 20 carbohydrate grams per day.
Transitioning people’s behaviors starts with clear instructions and something measurable.
The clear instructions?
- 20 grams of carbohydrates per day.
The measurable factor?
- Peeing ketones.
Here’s an objection I usually get when I discuss this step with my patients:
“Doc, calories matter. Why aren’t you telling us to count calories?”
For the last four decades, the medical establishment in the US has been preaching that calories matter. The truth? They don’t matter when insulin is ruling your body. We can talk about calorie balance after you’re keto-adapted. But the first thing you need to focus on is reducing your bloodstream insulin level, and that means HIGH FATS, LOW CARBS. Your mission right now is to get rid of those carbohydrates!
Step 7: Eat Enough Fat to Feel Full
It is what sets this diet apart-there is no starvation! There is no want for food. I’m not exaggerating. With this approach, there’s enough fat feeding your body that you don’t feel hunger. Your brain receives a powerful chemical message of fullness from your system. This process begins when you eat fat after cutting out sugar or carbs.
Don’t believe me? You have my permission to begin your day tomorrow by eating a stick of butter. Yep. You read that correctly. After not eating anything for several hours (because you were asleep) you can have a stick of butter for breakfast. Add salt for added taste if you like. Pair it with water or black coffee. Still, the only ‘food’ you should eat is butter. Don’t imagine this story. Do it. Listen carefully to what your body is saying. Notice the sensation your brain sends to your body? Your brain detects the signal that you are full when fat fills your stomach.
No wonder, so many of my patients boast about how sustainable and satisfying the ketogenic diet is.
Step 8: Eat Only When You Are Hungry
Do not sabotage your system’s chemical transition from sugar to fat by snacking unnecessarily.
Your habits may seem so automatic that you hardly become aware that you’re snacking until the bag is empty. Recognize these habits. Bring the habit out of your subconscious by keeping a food log.
My downfall was morning breakfast. For so long I told myself that breakfast was the most important meal of the day, that I did not stop to ask myself if I was starving or just eating breakfast out of habit. After two months of keto eating, I challenged myself: No calories until I felt hungry. When hunger hit, I would take in my favorite foods first: coffee with heavy whipping cream. Before long I stopped eating breakfast, sipped on my favorite coffee with cream until well into the afternoon.
If you’re suffering from anxiety or stress, make sure you only eat when you’re hungry instead of eating for comfort. If you do choose to snack, reach for fat instead of carbs!
Step 9: Restrict Protein
Nearly every person I have coached at some point overate protein. They are confusing boosting fats by loading up on protein. Perfectly understandable. The notion of a high protein diet as a healthy option has been around for a long time. Bodybuilders and health food promoters all have a protein supplement to help you remain healthy. In our minds, it all seems natural that protein is healthy. Those same people think high-fat diets are unnatural. According to this ‘conventional wisdom,’ it is safe to eat lots of protein, and it is unhealthy to load up on fat.
What’s going on here? Lipophobia: the fear of fat. The media won this game. They successfully frightened us from enjoying fat.
I correct this thinking by educating patients that we are solving a human biochemistry puzzle. Our body’s chemistry controls weight loss. The most crucial piece of the puzzle is insulin. Keep insulin down, and weight loss happens.
In the absence of carbohydrates, fat does not spike your insulin. Fat also sends a robust hormonal message to your brain to stop eating. This chemical shift is what makes the keto diet so powerful and effective. Fat does not spike insulin. Carbs spike insulin. Excess protein spikes insulin, too. For me, the most challenging pantry item to throw away was the protein powder.
On a ketogenic diet, how much protein does it take to spike your insulin?
Here’s the formula I teach my patients: write down your ideal body weight-the weight you want to be. I’m 5’3” and would love to be 125 lbs again. Divide 125 (your ideal body weight in pounds) by 2.2. This is the number of protein grams per day that you should eat. In my case that is about 56 grams of protein per day. If I stay under that goal for the day, my insulin does not surge. The first month when I failed and failed and failed to produce my first ketone, I was adding a scoop of protein powder to heavy whipping cream. That one scoop had 50 grams of protein and blocked my insulin from falling. No ketosis.
The number 20 was the only number you need to insist remember-I you stick to that for now. This protein number only surfaces when patients are having trouble. If you are in week 2 and you still haven’t peed ketones, you have a problem. The culprit? You’re probably eating a high protein diet instead of a high-fat one. This is the most common mistake I see.
Eat too many proteins, and your body will start to squirt out insulin. Insulin is the enemy of ketones. For more information on the benefits of a ketogenic diet, check out the book ANYWAY YOU CAN written and recorded by Dr. Bosworth.
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