Metabolic Dietary Approaches for Optimal Health
September 04, 2016
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By Dr. Mercola There's emerging scientific evidence that a high-fat, low-net carb, moderate protein diet is an ideal diet for most people. However, compliance tends to be low for a number of reasons. Discussing this is Randy Evans, who has a master's degree in nutrition and works with Dr. Jeanne Drisko at the University of Kansas Integrative Medical Center. I recently interviewed Drisko on her clinical use of nutritional ketosis. Evans grew up on a dairy farm in Southern Iowa at a time when agriculture was largely still organic. "I actually grew up eating mostly real whole foods," he says, noting his interest in nutrition was an outgrowth of his upbringing. His interest in the ketogenic diet emerged when he began working with Drisko five years ago.
Getting Started on a Ketogenic DietThe nutrient ratio Drisko and Evans typically recommend for their new patients is a 1-to-1 ratio of healthy fats to net carbs plus protein. This means your grams of healthy fats will be about equal to your combined grams of non-fiber carbs and protein put together. This ratio, they found, is fairly easy for most people to achieve, and will get most people very close to nutritional ketosis.
Consider MCT OilAdding medium-chain triglyceride (MCT) oil or coconut oil to meals is one way of increasing the amount of healthy fat in your diet. MCTs get their name from their chemical structure. Fats consist of chains of carbon molecules connected to hydrogen atoms. There are two basic types of MCT oil being sold:
The pure C8 oil converts to ketones more effectively than C10, making it a preferred choice, even though it's a bit more expensive. You'll want to start with 1 teaspoon of MCT oil and work your way up, adding 1 teaspoon at a time over the course of a few weeks. A typical dosage is 2 to 3 tablespoons of MCT per day, although you could go up to 5 or 6 tablespoons if needed. If you experience gastrointestinal (GI) distress or diarrhea, it would be necessary to cut back. While it's not harmful to overdose on MCT, your body will rid itself of the excess by causing diarrhea, so starting out with 2 or 3 tablespoons would be asking for trouble. If you have trouble tolerating the MCT oil you could try the powder form, which tends to be easier on the stomach. Advice on Implementing a Ketogenic DietTo implement a ketogenic diet, the first step is to eliminate packaged, processed food items. If you have food allergies or sensitivities, you'll need to be careful to avoid those items as well. Aside from that, the No. 1 emphasis is to eat real whole food, plenty of healthy fats and as few grains as possible. Evans recommends avoiding dairy, as it can be difficult to stay in ketosis if you eat or drink a lot of dairy products. The galactose in dairy is a carbohydrate and you can easily use up your entire net carb allotment by drinking a single glass of milk. The protein casein in dairy can also trigger or contribute to inflammation.
The key to success on a high-fat diet is to eat high-quality healthy fats, not the fats most commonly found in the American diet (the processed fats and vegetable oils used in processed foods and fried restaurant meals). Evans recommends getting two servings of healthy fat with every meal. For example, you could add one-half avocado and a tablespoon of olive oil to your salad. Besides MCT oil, high-quality healthy fats include:
Is Water Fasting a Good Idea?Ray Cronise, author of the yet-to-be-released book, "Our Broken Plate," has done a lot of work with extended water fasting.1 I used to be really opposed to long-term water fasting, but more recently I've started to give it some more thought. He recommends fasting anywhere from three to 21 days, and while this could be dangerous for some especially if you're underweight or have cancer cachexia it may actually be beneficial for overweight or obese individuals.
If you're type 2 diabetic and overweight, I believe fasting for one, two, or even three weeks could really help you jumpstart the process of nutritional ketosis, which will allow you to effectively burn body fat. Barring more advanced strategies such as fasting, it will typically take patients two to three months or even much longer before they're in nutritional ketosis, Evans says. Naturally, if you're diabetic and/or taking multiple medications for chronic illness, fasting is something you need to do under close medical supervision. If You're Ill and/or Taking Medication, Be Sure to Remain Under Close Medical SupervisionAs just one example, if you're on high blood pressure medications and your blood pressure suddenly begins to normalize, you will then become hypotensive and could potentially have a stroke. So if you're on medication, your doctor will need to monitor and alter your medication dosages as you go along. On the upside, if done carefully and correctly, a two- or three-week fast could potentially eliminate a person's need for most drugs.
Tip That Can Help Identify Your Ideal Meal TimesIntermittent fasting is an alternative to extended fasts, and it's a lot easier to do for most people. While I used to recommend skipping breakfast and make lunch your first meal, I eventually learned that for most, skipping dinner is a far more effective strategy. This is because your least metabolically active state is while you are sleeping, so the last thing you want to do is add fuel you don't need in the evening. Doing so will simply generate excess dangerous free radicals. The challenge then becomes to determine the most appropriate time to eat your breakfast. By wearing a 24-hour glucose monitor, I have learned that you can pin-point the ideal time to break your fast by tracking your glucose. Simply measure your glucose at regular intervals in the morning, and when you notice your glucose level rising, even though you haven't eaten, it's a sign you're undergoing gluconeogenesis. Basically, your body is starting to break down protein (muscle), turning it into glucose. This is not a healthy process, so when this occurs, you'll want to eat something to avoid muscle degeneration. In my experience, that will typically occur after 16 hours of fasting or so, although it's highly individual. If you're a competitive athlete, this strategy may not be appropriate, but it could work for most average people. Find Your MotivationAny change can be a challenge, and dietary changes can be particularly tricky. It can be helpful to identify your motivation. Why are you making this change? Do you want to lose weight? Have more energy? Sleep better? Recover from a chronic disease? As noted by Evans:
High-Fat Diet Improves Cognition and Weight LossYour brain will also work better when operating on a more efficient fuel (i.e. fat or ketones). Many times, improved cognition will be one of the first things people notice when starting a ketogenic diet. People also report elimination of hunger pangs and food cravings. And then there's the weight loss. When I first started this nutritional program, I weighed 180 pounds. I ate 2,500 to 3,000 calories a day, yet dropped down to 164 pounds. I've since realized I have to eat a minimum of 3,500 to 4,000 calories a day just to maintain my ideal weight. As noted by Evans:
High-Fat Diet Is Anti-InflammatoryThere are two basic fuels your body can use for energy: sugar and fat. One of the reasons why you want to burn fat is because it's a "cleaner" fuel. While it's a bit more complicated than this, a simple way to explain why fat is a preferable fuel over sugar is that it burns without creating a lot of pollution in the form of reactive oxygen species (ROS) and secondary free radicals. Sugar is a dirtier fuel in that it creates far more ROS. In excess, sugar causes inflammation and premature degeneration.
A Nutrient Tracker Is an Invaluable ToolUsing a nutrient tracker will radically improve your ability to understand your ketogenic diet nutrient targets and assess the nutrient value of your food choices. Ideally, you'd enter the foods you plan on eating before you actually eat. This way you can modify your meal if you find your nutrient ratios are off kilter. The other component I place great value on is restricting protein to a certain level. I like to keep mine under 70 grams a day, as eating more protein than your body actually needs for muscle maintenance and repair will activate the mTOR pathway, which plays an important role in aging and cancer development. There are a number of trackers available, but my first choice is Cronometer.com/Mercola. That's my revision of the basic Cronometer tracker, and it's already set to default to macronutrient levels that will support nutritional ketosis.
More InformationYou can find more information about the KU Medicine Center, where Evans works, on www.kumc.edu, including contact information should you want to make an appointment. Dr. Driskos clinic finds that intravenous (IV) vitamin C can be an important adjunct along with the ketogenic diet during cancer care. IV vitamin C is a powerful prooxidative therapy that targets the unhealthy cancer cell and leaves the normal cell unharmed. When combined with ketogenic diet, IV C can be a one-two knockout punch to the cancer cell. To learn more about IV vitamin C, attend the University of Kansas Integrative Medicine conference www.kumc.edu/VitaminC. I would also encourage you to attend the ACIM Conquering Cancer Conference in Orlando, September 22 through 24. I will be there along with a long list of other excellent speakers. There, you'll learn more about how to implement a ketogenic diet and much more. Evans is one of the 10 people I've invited to a brainstorming session the day after the conference, to help improve the quality of information in the new book I'm writing on this topic. © Copyright 1997-2016 Dr. Joseph Mercola. All Rights Reserved. http://articles.mercola.com/sites/articles/archive/2016/09/04/ketogenic-nutritional-ketosis.aspx |