7 Reasons to Stay Off the Scale

 

My previous post walked you through 14 non-weight-loss ways to gauge how a ketogenic or low-carb diet is working for you. But what if you do want to lose weight? Sure, lower blood sugar, lower blood pressure, remission of migraines, disappearance of hypoglycemia and brain fog, and total resolution of acid reflux are all pretty great, but what if one of your goals is to see the number on that dastardly scale go down?

There’s nothing wrong with wanting to change the size and shape of your body. But a scale is a terrible way to assess whether you’re accomplishing that. Here are seven reasons not to depend solely on the scale when you’re using keto to change your physique. (Some of these are excerpts from my book, The Stall Slayer. Lots more info in there about using keto/low-carb for fat loss. I also recommend checking out this video I did on reasons to stay off the scale.)

  

14 Ways to Tell if Keto Is Working for You Besides Weight Loss

 

Based on keto transformation pics on social media, it would be easy to think this very low-carb way of eating is used for just one thing: weight loss. And no doubt, the before and after pictures of people who’ve lost substantial amounts of weight are amazing. But low-carb and ketogenic diets are good for so many other things besides changing the size of your body. Some of these—like lower blood sugar, lower triglycerides, and lower blood pressure—can be shared via pictures of glucometers, home blood pressure cuffs, or printouts of your latest bloodwork. But what about the things we can’t see? What about all the great stuff keto does that you can’t capture in a picture? A picture speaks a thousand words, but what about the great things keto does that you can’t take a picture of? 

People use keto for fat loss, but what if you: 

A) Don’t want or need to lose weight, but you’re dealing with a laundry list of troubling health issues? 

B) Do want to lose body fat but you’re stuck in a stall and the scale hasn’t moved in a while? 

Well, if B is your issue, check out this article I wrote on how to stay motivated during a fat loss stall, and then grab a copy of my book, The Stall Slayer, to help break that stall. (I also encourage you to just stay off the scale altogether for a while.) 

 

Either way, here are 14 ways to know that keto’s working for you that have nothing to do with weight.

Big Updates -- TWO NEW BOOKS!

Hey Everyone!

Lots of good news to share these days.

First: Big news – my book, The Stall Slayer, is now available on Amazon!!

YES! If you prefer reading hard copies of books rather than electronic versions, you can now order a paperback copy of The Stall Slayer from Amazon. And not just in the US – it’s available in many other nations. Check your local Amazon site to see if it’s available where you live. I’ve already had some fans buy it in Japan, Brazil, the UK, Canada, and the Netherlands. (If you happen to be reading this in the Netherlands, I think you have to order from the German site…amazon.de.) I’m even working with someone who’s translating the book into Thai – cool!

If you prefer electronic copies, you can buy The Stall Slayer for Kindle from Amazon, or as a pdf. (Click here to buy the pdf.) Unfortunately, we’ve hit a little snag with Kindle: the book doesn’t appear to be available for Kindle Paperwhite devices, but it works fine on older Kindles and on the Kindle app for PC, Mac, phones, and tablets.

Second: I have another book coming out this year!

This one isn’t just me, though. It’s co-written with the one and only Eric Westman, MD. YES! Can you believe it? I kind of have to pinch myself to make sure I’m actually alive and awake and this isn’t a dream. (I’ve been reading Dr. Westman’s published research for about 15 years, and now I’m writing a book with him. Whaaaat?! The world is a strange, beautiful place, my friends.)

The book is tentatively titled End Your Carb Confusion, but that is subject to change. We have an estimated release date of early December 2020, which is right around the corner. (Insert head exploding emoji.) We’re in the editing stage right now. Thank goodness, our publisher seems pretty happy with it and their suggestions are mostly related to grammar and structure rather than the content. 

What is End Your Carb Confusion about? It’s a guide to finding your own carb tolerance and building your diet from there. *Gasp!* What?! Not everyone needs extra-strict keto for their entire lifetime? Nope! This book will help people figure out where they fall on the carb tolerance spectrum, and how to move from one level to another -- i.e., how to INCREASE your carb intake safely and logically, if you want to. (Everyone can do keto for life; not everyone needs to. There IS room in life for more fruit, beans, starches, and other higher carb foods if they’re appropriate for you. Our book will teach you how to navigate it all.)

Don’t let all that fool you, though. It’s also a SIMPLE, down-to-earth “get started” guide that’s perfect for the person in your life who’s living with all kinds of health issues that would respond well to keto but who feels totally overwhelmed (or turned off) by the nuttiness and zealotry they see about this way of eating on the interwebs. It’s written in very layperson-friendly plain English -- no intense scientific gobbledygook that you need a PhD to understand -- and I know, because I wrote it!

Does keto work if you eat conventional (non-grass-finished) beef? YES! Does keto work if your food isn’t organic? YES! Are you the worst person in the history of the universe if you drink diet sodas or use artificial sweeteners in coffee or keto baking? NO! Isn’t keto only for people who are trying to lose weight? NO! If your blood sugar is normal, why would you bother trying keto? READ THE BOOK AND FIND OUT!

Stay tuned to the blog and my social media accounts for updates as the book release gets closer. Obviously I’ll have lots more to say about it.

Third: Sign up for my newsletter!

I’ve been threatening promising for a while now to resurrect the blog and start writing more regularly. Considering the two previous posts were from November 2019 and this past April, obviously that has not happened yet. I’ve just made a relatively big change in my professional life, though, and I might have some more time to devote to more frequent blogging. (If this actually comes to pass and I do manage to get myself to follow through with this, the posts will likely be shorter than my past fare, but more frequent. This is probably best for all of us – for me and for you, my readers. More succinct posts, but ones that show up more often.)

In the meantime, you can keep up with current goings-on in my corner of the keto universe by subscribing to my newsletter. The newsletter includes updates about my work, links to featured videos from my YouTube channel, plus book or product reviews & recommendations, supplements I trust, and whatever else I think is worth sharing at any given time. And I promise—no spam! (If you‘ve been around the blog a while, then you’ve come to know that I’m a total dinosaur with regard to technology and I wouldn’t know how to spam you even if I wanted to—which I do not.) The next newsletter will be coming out Monday July 13 – sign up now so you don’t miss it! (And it’s definitely coming, because I’ve already written and saved it, and it’s pre-set to go out that day.)

Fourth: I’m on Patreon!

Do you like my message of Keto Without the Crazy™? Want to support my writing books and blog posts, making videos, and being able to devote time to reading scientific papers and keeping up with the latest research about ketogenic and low-carb diets, plus nutrition, health, and physiology more broadly? Consider joining me on Patreon.

You can subscribe for as little as $2/month, although for $5/month and above you get special patron-only content. For $5/month, you get exclusive videos that are for patrons only and not for my public YouTube channel. (They’re shorter and a bit more ranty and free-form than my public videos. These videos are a place for me to vent about the craziness I see going on the keto world these days, but even more, they’re a place for me to think out loud and share with you various issues I’m tossing around in my head and trying to get a good perspective on.)

For $10/month and up, you get a monthly research review, in which I discuss in detail 2-4 scientific papers I’ve read that month. They’re always health- and nutrition-focused, but not always specifically about ketogenic diets. If you want to get your science on, that level is for you! A bit geekier than my public videos, but I try to keep things layperson-friendly to accommodate all who might be watching.

For a very generous $30/month, you get a weekly group Zoom call with me – ask me anything! (Well not anything. Do try to keep it related to keto/low-carb, health and nutrition, food, physiology, biochemistry, etc.) Keto Q&A, tips for eating this way long-term, and whatever else comes up in the conversation. My audience is very savvy, so you get to benefit from listening to everyone on these calls, not just from me. Ask questions or just listen quietly while the rest of us “think out loud.” Participate as much or as little as you like. At this level of support, you’ll get an hour with me each week – much cheaper than a single one-hour consultation!

Check out all the details and the different support levels here: Tuit Nutrition on Patreon

Thanks for sticking with me, everyone. I know that my actions don’t reflect what I’ve been saying for a while: that writing is my first love and always will be. (Then again, I did just finish writing two books…) Anyway, it was never my intent to abandon the blog. I guess I just started to get a little intimidated by my own blog style – sharing every detail about a topic and exploring every possible nuance to the point that blog posts could take several days to write (in addition to the time spent researching). I’ll have to go a little easier if I’m going to write more often. Making videos is so much quicker – I can get information out a lot faster when I talk than when I type. (It also seems that many more people prefer to watch videos these days rather than reading blog posts, so I can reach a larger audience with videos.) When it’s been a while since there’s been a new blog post, I welcome you to check out my videos, but I also vow to not let it be quite so long between blog posts going forward. Yes, I realize I have made this commitment several times in the past and not followed through. Thank goodness for second … and third … and fourth chances, eh?

See you again soon.

P.S. Do you live near the Raleigh/Durham/Chapel Hill area of North Carolina? Greensboro or Burlington? Guess what? I work at a farm in Efland! If you’re near the Triangle area of NC, check us out: Fickle Creek Farm. We do beef, pork, lamb, poultry, eggs, and produce. We’re normally at several area farmers’ markets, but with the virus situation right now, you can pre-order for on-farm pickup, and there are some drop-off/delivery points, too. You might get a dozen eggs that I gathered or washed, or some lettuce, cilantro, tomatoes, cucumbers, basil, peppers, or squash that I planted, weeded, tended, and harvested! The work is absolutely backbreaking and exhausting (especially in the heat of a southern summer), but it’s also satisfying and fulfilling in a way that sedentary work in front of a computer isn’t. (They both have their place in my life, though.) Here’s a video I did a while back talking about working on the farm: Dispatch from the Farm. (That was way back from last October. I had only been working there for a few weeks at that time. I’ve learned so much more since then…and lost a couple thousand buckets’ worth of sweat, if you must know. Also: a few educational and painful encounters with fire ants! Fun, fun, fun.) If you’re in the area, definitely check out our animal and plant foods, all raised and grown with love, care, and integrity. 

Disclaimer: Amy Berger, MS, CNS is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

The Personal Fat Threshold Concept

Hey Kids!

It’s been ages since I’ve posted what I would call a “real” blog post. Something meaty and educational. Something you can really sink your teeth into. The last one was way back in August, when I wrote about whether protein is bad for the kidneys. (Hint: it’s not.) I’ve posted a few things since then, but nothing all that substantial. I’m glad to say today’s post makes up for lost time, because it is LONG. So grab yourself a cup of coffee or tea (or...*gag*...broth, if you must), put your phone on silent, and dig in.

I’m excited to share this with you. So excited, in fact, that I’ve been procrastinating on writing this for no less than 6 months. In looking at the folder of blog post drafts on my computer, I started jotting down notes for this in July 2018. The reason I kept putting it off is that I knew this was going to be a LONG post—massively long, even for me. But then I gave a talk on this topic at a keto event in Canada in December, so I finally had to organize my thoughts and put them together coherently. Once that was done, I figured it would be easier to get this written, since I could just flesh out the details of what was on the slides. Don’t kid yourselves, though. This still took four days to write and edit. (It’s much faster to talk and show images on slides than it is to type everything out in detail in a blog post!) Nevertheless, I’ve wanted to write this for a long time, so here we finally are. And the benefits a blog post has over a talk is that you can read this at your leisure, click on whatever links you’d like to explore further, and go as deeply down any of those rabbit holes as your heart desires. And to any of you who are happy at such a long post and who prefer reading to watching videos, I’m with you. I started my YouTube channel to bring my message of Keto Without the Crazy™ to a wider audience, but I, myself, prefer reading.    

One of the things I love most about writing my blog is sharing with you, my beloved readers, the fascinating and important things I learn as I deepen my understanding of human metabolism and physiology. The reason they call it “commencement” when you graduate with a degree in something is that it’s the start of your education, rather than the end of it. This has certainly proven true for me since getting my M.S. in nutrition.

One of the most intriguing things I’ve come across recently is the concept of the personal fat threshold. I don’t know who first coined this term, but it appears to have been Roy Taylor and Rury Holman, in their 2015 paper, Normal weight individuals who develop type 2 diabetes: the personal fat threshold. Other researchers wrote about the concept long before this paper, but I think Taylor & Holman were the first to use the phrase personal fat threshold. (Their paper is the first place I ever saw it in print, anyway. A researcher named Keith Frayn wrote some outstanding papers on the same topic years before without using the term. I cite his work liberally throughout this post. If you’d like to read the full text of any of the key papers I cite here, feel free to email me and I’ll send you a copy.)

Is There a Male Equivalent to PCOS? (a.k.a. The Detrimental Effects of Hyperinsulinemia on Men's Health)

 

Insulin has gotten a bad reputation in the low carb and keto communities. But insulin isn’t a bad thing. Too much insulin, too often, is a bad thing. If you ask people whose homes are threatened by wildfires whether lots of rain would be a good thing, you’ll probably get a very different answer than if you ask people whose homes have just been destroyed by hurricane floods. Water is not a problem; too much or too little water is a problem, and it’s the same with insulin.

So I’m not trying to demonize insulin. I wrote an 8-part blog series detailing the gnarly and nefarious effects of chronically elevated insulin (soon to be 9 or 10 parts -- new posts coming soon!), but the operative phrase there is chronically elevated. In and of itself, insulin isn’t a problem. (Just ask a type 1 diabetic.) The bad stuff happens only when insulin is too high, too often. Now that that’s out of the way, on with the show!

We know for certain that PCOS (polycystic ovarian syndrome)—which is “is the most common endocrinopathy of reproductive aged women affecting 6-10% of the population,”—is driven primarily by chronic hyperinsulinemia. (Incidence may be as high as 18% among certain cohorts when different diagnostic criteria are used, putting the number of women affected worldwide at around 10 million.)

“Hyperinsulinemia associated with insulin resistance has been causally linked to all features of the syndrome, such as hyperandrogenism, reproductive disorders, acne, hirsutism and metabolic disturbances.” (De Leo et al., 2004)

In fact, the causal link (not just an association!) between hyperinsulinema and PCOS is so well-known (and so powerful) that metformin—best known as a diabetes drug—is among the frontline pharmaceutical interventions for PCOS. Keep this in mind as you read about the men’s issues here.

Facial hair, acne, oily skin, mood swings, weight gain, menstrual irregularities, and infertility are not the only signs and symptoms of PCOS. These signs & symptoms are driven by the underlying hormonal disturbances, which include: elevated insulin, increased adrenal androgen synthesis (more testosterone and/or DHEA), decreased sex hormone binding globulin (SHBG), increased luteinizing hormone (LH), and decreased follicle stimulating hormone (FSH). And while the stereotypical PCOS patient is overweight or obese, as many as 50% of women with PCOS are not overweight or obese. (Remember, chronic hyperinsulinemia leads to obesity in some people, but not all. There are millions of people walking around with a “normal” body weight, but sky-high insulin levels.)

Since men produce all of these hormones as well, could there be a male equivalent of PCOS?

You bet your bald spot there is!

Let’s take a look at three different areas where chronic hyperinsulinemia has adverse effects on men:

• Early onset androgenetic alopecia (a.k.a. male-pattern baldness)
• Erectile dysfunction
• Benign prostatic hypertrophy (BPH) – enlargement of the prostate gland 

Totally Overwhelmed by Conflicting Information on Low Carb or Keto? Take an Information Vacation!

Are you completely overwhelmed by information about low carb or ketogenic diets? Is your neck about to snap from the multiple times you’ve gotten whiplash from trying to follow an endless onslaught of contradictory advice on reduced carb ways of eating?

If your life revolves around weighing and measuring your food, tracking your heart rate, your sleep, your bowel movements, your workouts, the number of steps you take in a day, and more, and you’re afraid that if you let up for even one second, the entire edifice you’re propping up is going to come crashing down around you, this post is for you!

If diving down every low carb rabbit hole you find has become your main hobby, I totally understand. Perhaps, like me, you spent years doing what you thought were “all the right things” to get healthy or improve your physique. And, perhaps, like me, after years—decades, maybe—of that failing you, you discovered the world of carbohydrate reduction. And after learning nearly all the health and fitness tenets you once held dear were false, you now have a desire—no, an obsession—to learn as much as you can, as fast as you can, from as many different sources as you can. No one could blame you! You’ve got years of misinformation to correct, right? Nearly a lifetime of programming to de-program.

However.

However, if your determination to understand the relevant biochemical pathways and mechanisms even better than the people who make their living measuring the amount of insulin secreted by a mouse pancreas, or measuring the ATP synthesized by cultured neuronal mitochondria from rats, has begun to interfere with your overall quality of life—and possibly even the results you’re getting from your low carb diet, because of all the darn stress—it’s time for you to…

Let's Talk About Thyroid -- Intro: Thyroid Function & Testing (Pt. 1/3)

Long time readers of this blog know that I have been dealing with a low functioning thyroid for quite some time. Even longer than I, myself, realized, now that I look back and think about how long I’ve been plagued by the signs and symptoms. It’s been about five years that things were noticeable, including two and a half during which they were downright unbearable, but in evaluating back even further, individual symptoms popped up here and there going back longer than that. (Why did I let things go on for five years? Details on that in part 3.)

Being that I have far more personal experience with this than I wish I did, and being that I’ve had several clients with thyroid issues, it’s time for me to write in detail about thyroid function. I’ll start off with a general overview of thyroid function and how to properly assess the various hormone levels. In part 2, we’ll look at the potential effects of low carb or ketogenic diets on thyroid function, and in part 3, I’ll talk specifically about my own history and what I’m doing now. Those of you with no interest in any of this, move along; nothing to see here. (I do feel like I write too much about myself, but I think sharing my personal experience can be informative for those who are dealing with similar problems and who’d like to see the struggles and stumbling blocks I encountered, and how I emerged on the other side feeling much better. So yeah, part 3 will be about me, but my hope is that it will be helpful for others.)

On with the show!

New Perspectives on Low Carb Diets for Weight Loss

As I wrote about in a recent post, I’ve finally gotten active in a few Facebook groups dedicated to low carb and ketogenic diets. There’s a world of good being done there, and heaps upon heaps of great information being shared—life-changing and life-saving information people aren’t hearing from their doctors. But there’s also a lot—and I mean a lot—of stuff that makes me want to: a) grab people tightly by the upper arms and shake some sense into them (because that’s more humane than ramming them head-first into a brick wall, which is what I’d really like to do in some cases), or b) wrap them in a long, warm hug, and help them feel better about things. I got all my keto-related anger out in the epic end-of-year rant I posted in December, so today, let’s focus on the kinder, gentler side of things.

I am paraphrasing, but here are a few examples of what I routinely read in various FB groups and blog comments:

1. “I’ve been following a strict ketogenic diet for two months and have only lost 10 pounds. What am I doing wrong?”   
2. “I’ve been doing strict keto for three months. I’m off my blood pressure medication and have reduced my insulin dose by half. I feel fantastic and have tons of energy, but I haven’t lost any weight. Why isn’t this working for me?” 
3. “I’m doing a keto diet and I lost four pounds the first week, three the second week, then only two the third week, and now I’m up a pound. What did I do wrong?” 

Stop Following a Medically Therapeutic Diet "Just 'Cuz" (a.k.a. The Keto Train to CrazyTown)

This is a very long post (even for me). Take it or leave it. You have been warned. Comments have been disabled for this one. Love this post or hate it, agree with some of it, disagree with some of it. Whatever your feelings, you are free to express them elsewhere.  


This will be the last of my emotionally charged posts for a little while. I have to get it out of my system, but once it's out and the new year gets underway, I'll focus on posting things that are more educational and helpful (or intended to be, anyway).

It’s funny. Considering I advertise myself as a low carb and keto-friendly nutritionist, I often find myself recommending that clients eat more carbs. More protein. And that they abandon weighing and measuring every morsel of food and pouring olive oil and melted butter on everything in an effort to arrive at some magical, no-fail, automatic-fat-loss-inducing macronutrient ratio somewhere upward of 75% fat.

I have been threatening promising on social media for a while now that I was going to post an epic rant about some problematic things I see when healthy, fit, active people follow a medically therapeutic diet because they have come to believe they should. (Or worse, have come to believe that they have to, because it’s the only way to be healthy and prevent metabolic illness. 

Now, before I get into things, we’ve got to establish some ground rules:

9 Ketogenic Diet Myths

Let me burst your bubble right here at the beginning. This list is for people who are already following a ketogenic diet or are considering beginning one specifically for the purpose of losing body fat. If you’re looking for a nice, solid debunking of other myths about this way of eating (e.g., “All that saturated fat will clog your arteries,” “All that protein is bad for the kidneys,” “You need carbs for energy,” “I learned in medical school four hundred years ago that ketosis is fatal,” and other such nonsense), here are two excellent debunkings: one from Authority Nutrition, and one from my dear friend Ellen Davis, creator of Ketogenic Diet Resource, which is the single best one-stop-shop, gateway entry I'm aware of for all things ketogenic-diet related. (And I'm not just saying that because Ellen's a friend. I'm saying it because it's true. The reason we became friends is because I came across her site a few years ago, and ... well, the rest is history.)

Why do these ideas need to be called out for the myths that they are?

Well, now that I’m participating more in social media related to low-carb and keto, I’m noticing—and I could be wrong, but I don’t think this is only my imagination—that there are a few falsehoods that have become quite pervasive in our community. So pervasive, in fact, that they persist despite being flat-out incorrect. And because they persist, we continue to see post after post after post on Facebook, Instagram, Twitter, and wherever else, from people at their wit's end because they aren’t losing fat, are gaining fat, or have not had every single longstanding malady resolve immediately upon ditching bread and loading up a cup of coffee with butter and coconut oil, or drowning everything in cheese, as others may have promised them would happen.  

If these individuals are lucky, they stumble upon a group where logic, sanity, science, long-term experience, and the attainment of actual results rule (rather than chasing ketones for the sake of high ketones). If they’re not lucky, they fall head-first into groups where the same-old not-helpful advice is parroted ad nauseum.

With this in mind, here is my own personal list of the top 9 biggest falsehoods regarding ketogenic diets for fat loss, along with "alternate versions," intended to help us see things from a different perspective. There are probably many more out there; these are just the ones that came to me first. If you have some favorites that I've missed here, share them in the comments so we can all collectively cringe! 

A Word About Upcoming Posts

I try to be a voice of sensibility in the vast and overwhelming sea of information regarding low carbohydrate and ketogenic ways of eating. It even says so at the top of my homepage: “A source of sanity in the sea of nutritional madness.” What I know compared to what there is left to learn is like a thimble of water compared to the Pacific Ocean. There’s a lot more—a lot more—I don’t know than what I do know, but I try to share with you the small bits of knowledge I gain as I hang on for dear life while traversing these tumultuous waters. I’ve done it about digestion, cancer, insulin, fuel partitioning, and more. (My Alzheimer’s book has been completely rewritten and updated for a March 2017 release as a print book from a big name publisher, so I’ll continue do it about Alzheimer’s, too.)   

However, I am starting to worry that, due to my penchant for ranting about things that bother me about the low carb and ketogenic communities, I’m developing a reputation for being an angry, hateful, vicious, and vindictive person. I assure you, I am neither angry, nor hateful, nor vicious, nor vindictive. In fact, “in real life,” I am quiet, shy, and, I’d like to think, gentle and kind. Nevertheless, there’s no denying the fact that I do rant a lot. But what can I say? The utter madness being masqueraded as fact in certain spaces provides no shortage of material to rant about. Being a gentle and kind person, I assume the spreading of misinformation occurs as a result of plain ol’ ignorance, rather than deliberate malice and ill intent. Whatever the intent, the end result is that misinformation is being spread, and because of it, people are experiencing setbacks along their roads to better health, fat loss, better blood sugar control, and more.

Why do I care? Well, like I mentioned in my rant post about fasting, as a nutritionist working with clients, I deal with the consequences of what happens when people follow advice that is either straight-up false, or advice that is perfectly appropriate for a certain context, but which is not applicable to their context.

It’s getting old, folks. I’m tired of trying to respond politely to emails from people who are afraid to eat two ounces of carrots in a serving of mixed vegetables, but who think it’s completely normal to put five tablespoons of butter and coconut oil in a cup of coffee. (Or better yet, to drink that 500-calorie coffee in the morning and say they’re “fasting.”) I’m tired of trying to respond politely to emails from grown adults who are restricting themselves to 45 grams of protein a day because they’re afraid that if they eat more than that, they’ll be at less than 80% fat and they’ll mess up their “keto ratios,” and also because the excess protein will be turned immediately into glucose and cause a huge “spike” in their blood sugar. (No, it won’t. Really, it won’t. Seriously now, it won’t.) I’m tired of trying to respond politely to emails from people who are disappointed and frustrated because they’re not losing weight or are maybe even gaining weight, even though they’re listening to their trusted experts online and are eating more fat – adding lots of extra butter to things, eating fat bombs, and shunning anything that even hints at being lean or low in fat. They’re as afraid of skinless chicken breasts as they are of 64-ounce troughs of Mountain Dew. And I’m tired of trying to respond politely to emails from people who, for whatever reasons—and there are many—are convinced that they must, must be in ketosis at all times. I swear, if I read or hear “I got kicked out of ketosis” one more time…

I am frustrated, and good-hearted people out there trying to follow low carb or ketogenic diets are frustrated, too.

In this spirit, I have a few more rants planned (already written, in fact) about the problematic things I see in the carbohydrate restriction community. But I don’t want to be a one-trick pony. I don’t want to have a reputation as an angry person who only ever posts electronic versions of hissy fits. Nevertheless, now that I’m more active in a few Facebook groups, I am confronted with these problematic things every day, and I feel compelled to address them. Since I don’t want to address them over and over and over again, I am going to post these few rants and then be done with them. (For now. Heaven knows there will always be something else that gets a rise out of me, but I’ll try to keep the ranting to a minimum once these next few posts are out of my system.) And get them out of my system I must. I don’t have children. What I have instead are ideas to write about, and they nag me, metaphorically pulling on my pant leg, until I finally give them they attention they require and see to their care and feeding.

I have three such posts in the hopper. You will know them when you see them. One of them—the last one I’ll post—is a candidate for a spot in my top three longest posts ever (alongside the one about my mother and the one about vitamin J). I thought about breaking it up into three or four separate posts, but I’d rather just get it all out at once and be done with it. Plus, that way, if I ever need to respond to someone on social media, or someone who emails me directly, in regard to some of what that post includes, I can just send them a link and it will all be centrally located.

As for what I’m going to write about after that, I’ll continue with more Low Carb Cooking Class (LC3), and I have not forgotten about the series on the metabolic theory of cancer. I do plan to pick it up again, as we have finally, finally gotten to the point where we can talk about the ketogenic diet and have it make sense. And I have been saying for ages now that I’d like to write something about sodium, and how salt is not something to fear, but that’s going to take a while. Before that, I’m going to post a couple of things that I see a need for, if questions on Twitter and Facebook are any indication: a guide to dining out on a low carb or ketogenic diet, and breakfast ideas for people who either don’t like bacon and eggs, or who are “tired of them.” (Yes, apparently such a thing is possible, though I have yet to witness this rare phenomenon in person.) I’m also contemplating sharing my thoughts on “zero carb” diets, as well as my growing suspicion that a plethora of modern chronic illnesses are driven not just by hyperinsulinemia and hyperglycemia, which are both, of course, huge issues, but by chronic nutrient insufficiency. The more I learn about the nuances of certain biochemical processes and the modern food supply, the more I appreciate just how robust the human body is, because frankly, I’m actually surprised there aren’t even more very ill people in our midst. That there aren’t is a testament to the ability of the human body to adapt and overcome and keep on truckin’ even when all indicators suggest someone is about to keel over and die at any moment.  

That’s all. Just wanted to warn you let you know what’s in store for the next few posts. After that, I’ll get back to writing things that might be more helpful for people, and I’ll try to keep my anger out of things. (Although I have to say, while I don’t want a reputation for being angry, my sarcasm and snark seem to go over pretty well, and I’m totally okay with being known for that.)  ;-) 

Disclaimer: Amy Berger, MS, CNS, NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

Attention Data Lovers!

Confession: I am a dinosaur.

I am not tech-savvy, and other than my phone and my computer, I have almost zero electronic gadgets, gizmos, and doohickeys, and cannot for the life of me relate at all to people who line up outside electronics stores the night before a new product is released from their favorite company just so they can be the very first in their family or friend group to get their grubby mitts on the latest and greatest. That I figured out how to create even this sad little blog is nothing short of a miracle. (This is really pathetic, considering I graduated from Carnegie Mellon, which is one of the foremost computer engineering universities in the world. Alas, I studied creative writing there, which is why the writing part of my site is so much better than the aesthetics and functionality.)

BUT: this post is not about me. It’s about you. Specifically, it’s about those of you who are tech savvy, and also those of you who are data junkies.

I am not a data junkie. I don’t have spreadsheets, apps, and wearable devices loaded with numbers and metrics about my body. I don’t own blood or breath ketone meters, nor a heart rate monitor, nor a blood pressure cuff, nor a Fitbit, nor a fancy-schmancy watch that keeps track of running pace. Like I said: di-no-saur.

HOWEVER! I know many of you, dear readers, are not living like it’s 1987 (except my phone and computer are both way smaller now), and you do enjoy employing the technology available to track all sorts of health-related data.

With this in mind, allow me introduce you to Heads Up Health. The people at Heads Up Health have asked me to let you know about the very handy one-stop-shop they’ve created for you to keep track of all your data in one convenient place.

The Complete Guide to Ketogenic Diets

I’ve joined the 21^st Century and have finally started becoming active on a few Facebook groups dedicated to low-carb and ketogenic diets. Some focus on fat loss and bodybuilding, some are exclusively for discussing the science behind the strategy, and some are geared more toward overall health, with members implementing these types of diets to improve, manage, or reverse conditions like type 1 and type 2 diabetes, PCOS, multiple sclerosis, traumatic brain injury, cancer, and more.

Now that I am more active in these groups, I can see why I stayed away for so long. And I’m considering retreating back into my Twitter comfort zone, because if I don’t see the madness and morass of misinformation being propagated on Facebook about ketogenic and low-carb diets, then I can pretend it doesn’t exist. (It’s more difficult to say idiotic and flat-out incorrect things in 140 characters, although it’s certainly possible. [And it happens all the time.])

I realize I am breaking my own rule here and juxtaposing “ketogenic” and “low-carb,” which might give people the impression that these two dietary approaches are exactly the same, and that the words are interchangeable. They are not. However, just for now, I’m using both phrases for the sake of simplicity, since the same inaccuracies abound about both of these.

  

With this in mind, here is a comprehensive and exhaustive list of everything required in order to implement a ketogenic diet:

1. Water
2. Foods that are low in carbohydrate
3. (Maybe) supplemental electrolytes (specifically, sodium, magnesium, and potassium)

  

Here is a list of things that are not required in order to implement a ketogenic diet:

1. A blood ketone meter
2. A breath ketone meter
3. Urine ketone test strips
4. Fasting
5. MCT oil
6. MCT powder
7. Exogenous ketones
8. Coconut oil
9. Coconut butter
10. Erythritol
11. Flavored stevia drops
12. Protein powder
13. 400-calorie cups of “coffee”
14. Fat bombs

Now, the thing is, there are tips, tricks, “hacks” (even though I loathe that word), and other add-ons that can be beneficial—in certain circumstances. As always, context, context, CONTEXT!  (As the theme song to the old 80’s show Diff’rent Strokes said, “What might be right for you might not be right for some.” But I would reverse that:  what might be right for some other people might not be right for you.)  It all depends on your goals, and WHY you are implementing this type of diet. Is it for fat loss? As an adjuvant to conventional cancer treatments? To reduce the frequency of epileptic seizures? To boost ketones to fuel the brain because of Alzheimer’s or another form of cognitive decline? There might be—might be—a role for some of the more esoteric (and expensive!) substances, supplements, and measuring/tracking devices in some of those cases. And some people can truly benefit from fasting, while fasting could be disastrous for others. But in terms of just getting started and mastering the basics, stick with that first list and stop driving yourself crazy.

Again, just so we’re clear: I’m not saying any of the things in the second list are outright harmful. I don’t think they are, and some of them can, in fact, be quite helpful … in the right #CONTEXT. As I wrote about recently: different goals may necessitate a different strategy.

That’s all for now.

Keep calm and keto on.

Disclaimer: Amy Berger, MS, CNS, NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

Back to Basics (a.k.a. Things I Didn't Learn in Nutrition School)

Hey all!

Didja catch the news story not long ago about the kid who subsisted solely on graham crackers and chocolate milk, and whose doctors ran a kazillion expensive and fancy-schmancy tests only to finally, finally figure out this poor little guy had scurvy? SCURVY, for crissake. In the United States of America, circa 2016. This didn’t happen on some British Royal Navy ship 200 years ago, where all the sailors started having bleeding gums and a ship’s doctor realized lemon and lime juice seemed to put a quick & easy end to that. It happened here. Now. (All I know is, as a Nutritional Therapy Practitioner, the second I saw “bleeding gums” in the headline, I said to myself, “scurvy.” I read the whole article only to confirm what I already knew.) I can only imagine if this boy’s diet was so absolutely devoid of vitamin C to the point that he landed in the hospital with freaking scurvy, that there are probably several other essential nutrients he’s deficient in. I would love to write a scathing post about child nutrition someday, but that will have to wait. (Plus, since I don’t actually have any children, I sort of figure I’d be attacked like crazy for daring to even suggest that I have thoughts on the matter, so I’ll hold off for now. [But really, what does that even matter, anyway? What makes someone an “expert?” There are lots of male OB/GYNs. They don’t even have vaginas! But I digress…])

Since we’re on the topic of the most basic, obvious, fundamental aspects of nutrition, let’s talk about something I am an expert on: ME!

Funny story:

I am a proud carrier of O-negative blood, which makes me a “universal donor.” This means that anyone with any other blood type can receive my blood and be good to go. (Unfortunately, the reverse is not true: O-negatives can receive only O- blood. Heaven forbid I were in some sort of accident and needed blood, stat, if I got any kind of A, B, or AB blood, I would quickly face some seriously fatal juju. As an O-, my blood is in serious demand in blood banks, hospitals, and vampire drive-thrus. (Also, mosquitos. Those things love me. My blood must taste something FREAKING DELICIOUS to them, because if I’m outside for more than four seconds without being covered in a protective coating of industrial-strength DEET, I will receive no less than 8 to 10 mosquito bites. But I digress. Again.)

My point: I am a regular blood donor at the American Red Cross. As someone who is not routinely engaged in heroic acts nor generally doing anything positive whatsoever for mankind (unless ranting on my blog counts), donating blood is probably the single most important and satisfying thing I do. (Plus, as they say, “The life you save could be your own.”)

SO: I went to donate a blood several weeks ago and I got rejected because my hemoglobin was too low. (Not hemoglobin A1c, just regular hemoglobin.) This was the second time this has happened this year, and probably the third or fourth time overall. According to the Mayo Clinic, the “normal” range for hemoglobin in adult women is 12.0 to 15.5 g/dL. In order to be eligible to donate blood, the American Red Cross requires that you be at or above 12.5 g/dL. During this attempt to donate, the first reading was 12.0. They ran it a second time, taking the blood from a different finger, because, well, the human body is just funny like that sometimes. The second reading was even lower: 11.5.

Seriously?

Seriously?   

Me?

Low hemoglobin?

Um, it’s not like I’m a vegan or anything. I eat plenty of red meat. I don’t eat a ton of it, but I certainly don’t avoid it. So I was pretty stunned when I left the office with all my blood still inside me, and without my free cookies and juice. (KIDDING, of course. I usually just take water and then leave. No need to load up on liquid glucose when you’re pretty well fat-adapted. [See here.]) As far as I knew, I had no signs or symptoms of low hemoglobin, but considering it had happened a few times before, something had to be up, and I wanted to know what that something was.

Metabolic Theory of Cancer: Speculation on the Causes of Cancer -- and How to Mitigate Them (Pt.5B)

Okay!

I left off last time saying that we have two big issues to address with regard to hypoxia as a cause or exacerbating factor in cancer: 

1. What causes tissue to become hypoxic?
2. Is there a role for hyperbaric oxygen therapy in fighting cancer?

  

Let’s tackle them in order.

To be honest with you, I still don’t know which comes first: low oxygen, or mitochondrial dysfunction. The fact is, even when there’s plenty of oxygen available, if the mitochondria are malfunctioning, they can’t use it. But what if what’s causing the mitochondria to malfunction is insufficient oxygen? (I told you last time this stuff is complicated!)

It almost doesn’t matter, right? The bottom line is, whether the tissue is hypoxic or not, the mitochondria are not using whatever oxygen might be present. (Well, they’re using some of it. Remember, kids, when it comes to biology and biochemistry, there are very rarely any absolutes, yes or no, on or off. Things aren't binary, but rather, there's a balancing act. Even cancer cells have some mitochondria that are okay; it’s just that the majority of them are messed up.)

I just have a hard time wrapping my head around it all. Think about angiogenesis: the creation of blood vessels specifically so that the cancerous tissue ensures it has a steady supply of fuel and nutrients. But what does blood carry besides fuel and nutrients? OXYGEN. So you would think that angiogenesis would give cancer cells more oxygen, not less. So going one step further, this being the case, it seems like the mitochondrial dysfunction comes first, because theoretically, there should be sufficient oxygen delivery to the cancer cells, what with all those blood vessels they created for their own nefarious purposes. So there is sufficient oxygen (“normoxia”), yet we have hypoxia-inducible factors out the yin-yang upregulating all sorts of nasty pathways and reactions in these cells to keep themselves alive because they think they’re hypoxic. And the reason they think they’re hypoxic is because the mitochondria aren’t using the oxygen. (That’s my logic, anyway. I told you there was going to be a lot of wild speculation here, and so it begins.)

Metabolic Theory of Cancer: Speculation on the Causes of Cancer -- and How to Mitigate Them (Pt.5A)

Graphic adapted from Seyfried et al., 2015

OH. EM. GEE!!!!!

It’s baaa-aaaaack!

Today is June 1, 2016. Looking back through the blog archives, I saw that the previous post in this series on the metabolic theory of cancer was published on June 1, 2015. Yes, kids, it’s been a year. A full year! An entire year to the day. If you have been waiting and waiting (and waiting!) for me to get back to this and address some key concepts we haven’t gotten to yet, believe me, nobody wanted me to get back to this more than I did. I absolutely did not plan on it taking a year. But alas. Hopefully, in that time, you’ve learned a thing or two about insulin, stubborn fat loss, and the use of ketogenic diets for Alzheimer’s disease and other neurological conditions. In fact, I am in the process of adding a new installment to the “ITIS/It’s the Insulin, Stupid” series, but when I saw that I was coming up on the one-year anniversary of neglecting the cancer series, I knew I had to get my rear in gear and just DO IT. I really wanted to do the insulin post first, but considering the date, I thought it would be apropos for me to do this one instead.

Also, just to let you know, since the writing of that last post, I have had the honor of meeting Drs. Seyfried, D’Agostino, and Poff in person. {Squee!!}  I also got to meet Dr. Cunnane, Dr. Newport, Dr. Rho, and Dr. Maffetone. Holy moly…it was a nonstop conference of metabolism rock stars.

I am most definitely going to get to the mamma-jamma, granddaddy of all topics we’ve been waiting for in this cancer series—the ketogenic diet—but please be patient. I’ve very recently had more work stuff come up (in a good way), and I am feeling a bit overwhelmed. I will write about ketosis. I can’t promise when, exactly, that will happen, but I promise it won’t take a year. (Maybe just a couple weeks, considering I’m already working on it.)  ;-)

If you’re new to my blog and have no idea what’s going on right now, the series I’ve written on the metabolic theory of cancer is a “fan favorite” – at least, among the people who like to geek out on the science with me. The cancer series is representative of when my blog becomes a free course in (very basic) biochemistry and physiology, and is peppered with links and quotes from the scientific literature. If you prefer my rants, shakedowns of food labels, and other casual-type posts, no prob! Whatever floats your boat. But for those of you who need to kill lots of time at your desk job, or who perhaps need help falling asleep, you might want to start way back at the beginning and work your way toward today’s post. (Actually, that’s sarcasm. The truth is, I think this stuff is fascinating, and perhaps some of my best work. I swear, that hexokinase 2 stuff STILL blows my mind.)

Since it has been a year (!!) since the last installment, I’ll make it easy for you and list all the posts in order, from first to most recent: 

1. Introduction
2. Cells Behaving Badly
3. Cellular Energy Generation 1 - Glycolysis
4. Cellular Energy Generation 2 - Mighty Mitochondria (Krebs Cycle, Electron Transport Chain)
5. Mitochondrial Dysfunction 1
6. Mitochondrial Dysfunction 2 - They ARE Broken
7. Glycolysis Run Amok & Mutant Hexokinase
8. Aerobic Fermentation (a.k.a. "The Warburg Effect")
9. Cancer Cells are Sugar Junkies
10. Mutations vs. Mitochondria
11. Cancer as a Protective Mechanism
12. Speculation on the Causes of Cancer (Pt.1)
13. Video Lesson! (Thomas Seyfried, PhD)
14. Speculation on the Causes of Cancer -- and How to Mitigate Risk (Pt.2)
15. Speculation on the Causes of Cancer -- and How to Mitigate Them (Pt.3 - Viruses)
16. Speculation on the Causes of Cancer -- and How to Mitigate Them (Pt.4 - Carcinogens)

Buckle up and hang on tight, everyone. HERE WE GO!