Keto & ApoE4

Hey All!

  

If you’ve been around the low carb and keto communities for a while, you might’ve run across the term “ApoE4.” ApoE4 is a gene that increases risk for cardiovascular disease and even more so for Alzheimer’s disease. In fact, if you’re homozygous for ApoE4 (meaning that you have 2 copies of the gene), you have between a 50-90% chance of developing Alzheimer’s. YIKES! That is not something to take lightly, so what’s the deal here? What is ApoE4 and why does it make people so much more susceptible to this frightening form of cognitive decline & impairment? And what are the implications for people following low-carb, high-fat diets? ApoE4 carriers are often cautioned to go lower in dietary saturated fat, but why? Is this truly warranted? Do you have to give up your beloved butter & cheese if you're E4?  

If you’ve heard of the ApoE4 gene and you’re curious about what it is and what it means, or if you know you carry one or two copies of ApoE4, you’ll want to check out my latest video. I cover the basics on what the gene is (it codes for the epsilon-4 [ε4] variant of the apoE protein, short for apolipoprotein E), why this matters, and what to do about it to potentially reduce your risk for Alzheimer’s and the other issues E4s are at greater risk for.

Most of what I know about ApoE4 is in relation to Alzheimer’s, owing to research I did for my book, The Alzheimer’s Antidote, which is about using a ketogenic or LCHF diet as a nutritional intervention for Alzheimer’s and other forms of cognitive impairment. (Didja know they regularly call Alzheimer's "type 3 diabetes" or "brain insulin resistance?" Now you know why it might be wise to adopt such a dietary approach to support healthy cognitive function.) But I would say that even if you don’t have any ApoE4 genes (the other forms are ApoE2 and ApoE3), or you’re not concerned about Alzheimer’s disease, I encourage you to watch the video anyway, because you might learn something that helps someone you know, and there’s a lot of information in the video that applies to everyone, regardless of your genetics.  

For those of you who prefer to read rather than watch videos, stay tuned. I’ll have a blog post on this in a few weeks. It won’t be a transcript of the video, but it’ll include all the same pertinent information and links to relevant research. But in the meantime, if you can’t wait to learn more and you’d really like to get some clarity on the whole ApoE4 “thing,” hop on over to my YouTube channel and watch the video.

For other videos and podcasts I’ve done on Alzheimer’s, covering issues far beyond ApoE4, you might enjoy these: 

• Video: Alzheimer’s talk at Low Carb Houston (October 2018)
• Video: Alzheimer’s talk at KetoCon (June 2018)
• Podcast: Interview on Ketovangelist (one of my best & most informative ever!)

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.

Eating Keto on the Go

Hey Everyone,

As you know—or, as I hope is pretty obvious—something I try to use my blog for is helping people see how simple low carb and ketogenic diets can be. When we stick with basic principles and get out of our own way, these ways of eating are very straightforward and uncomplicated. There’s not a whole lot of weighing, measuring, tracking, and rules involved. Yes, you can fall down all those rabbit holes and make yourself as fully neurotic as your heart desires, but for those of us who have bigger concerns in our lives than how many grams of omega-6 fat a chicken leg contains, the beauty of low carb and keto is their simplicity.

Awhile back, I offered some suggestions for dining out while adhering to a reduced carb way of eating. Today, let’s take that a step further and talk about how to stay keto while you’re on the road or on the go. What if you’re in the car for a few hours, or maybe even just a short trip, and the hunger monster attacks?

One approach is to think of it as an opportunity to skip a meal or two. I don’t consider skipping meals to be “fasting,” but if thinking of it as intermittent fasting makes you feel like you have special superpowers, then go right ahead. Going longer between meals is a nice way to keep insulin low and “eat” your own stored body fat more than you might if you immediately chowed down on something as soon as a few mild hunger pangs hit.

However, if you’re having a “hangry” moment—and let’s face it, folks, sometimes these still happen even when you’re a “fat burning beast” and are fat- or keto-adapted—then maybe you’re better off pulling into the nearest gas station or convenience store and foraging for some low-carb provisions. (What, you don’t feel hangry on keto? Like, ever? Okay, maybe it’s just me.) 

Here are my suggestions for low carb and keto-friendly foods you can grab in a hurry from gas stations and convenience stores. (We’ll get to supermarkets in a bit, since there are more choices there.) These apply to North America…I’m not sure if convenience stores like this exist on other continents, but I’m guessing you have something similar in other parts of the world. I’ll also tack on suggestions for things to keep in your desk or cubicle if you have an office job and have a place nearby to stash non-perishables.

Food purists, avert your eyes. If you can’t imagine letting anything past your lips that isn’t grass-fed, organic, pastured, small-batch, or biodynamic, this post isn’t for you. (In fact, my entire blog probably isn’t for you, but you’re welcome to stick around anyway.) We’re talking about foods to grab in a pinch, when the highest quality and ethically unassailable stuff might not be available. I’m totally okay with that. If you’re not, that’s fine; I still like ya!

Gas Stations or Convenience Stores

• Pork rinds (plain might be best, but if you’re not a purist, hot & spicy or salt & vinegar flavors are fine; they typically contain little to no sugar but might be seasoned with MSG, yeast extract, maltodextrin, etc. Even so, the carb count is usually 0g per serving.)
• Beef jerky or meat sticks (stick to original or peppered flavors; teriyaki and BBQ are typically higher in sugar)
• String cheese; cheese sticks
• Salami or pepperoni slices or sticks
• Hard boiled eggs
• Nuts (avoid honey-roasted and nut mixes that include dried fruit)
• Dark chocolate (the higher the cocoa percentage, the lower the sugar content, usually)

Beverages: water, diet sodas, hot or iced tea (unsweetened or diet with artificial sweetener), coffee (hot or iced, unsweetened or diet with artificial sweetener—be careful with pre-made iced coffee; it’s usually sweetened with sugar). Pretty much anything that’s sugar-free. This isn’t rocket science, people! 

Supermarket

If you have time to go up an aisle or two in a supermarket, you’ll have a wider selection to choose from. Here are some great go-tos from a supermarket run on the road:

• Pork rinds (with or without sour cream dip or guacamole)
• Beef jerky
• Sliced pepperoni, salami, or dry sausage sticks
• Nuts or nut butter
• Pre-cooked bacon (yes, this is a thing!)
• Deli meats and/or cheese: roast beef, corned beef, and pastrami are probably the lowest in sugar, but baked or roasted turkey is fine; avoid or go easy on “honey baked” or “brown sugar” ham or turkey. Salami, prosciutto, mortadella, and other cured meats are great.
• Pre-made egg salad or tuna salad from the deli (ask about ingredients and sugar content)
• Rotisserie chicken
• Canned tuna, salmon, sardines, or mackerel – be sure to buy ones with a pop-top unless you have a can opener handy
• Hard boiled eggs
• Bagged salad greens
• Raspberries or strawberries (and maybe a small container of sour cream or plain yogurt for dipping)
• Salad bar, olive or antipasto bar – many supermarkets now have salad or antipasto bars stocked with fabulous low-carb fare: olives, cheese, artichoke hearts, bell peppers, marinated mushrooms, sliced or chopped hard boiled egg, turkey, grilled chicken, sunflower seeds, sliced almonds, lettuce, spinach, cucumbers, radishes, etc.  

If you like to live on the edge and are not afraid of eating unwashed produce, you can hit up the produce section and get low-carb vegetables like a cucumber, green bell pepper, radishes, button mushrooms, celery, etc., and just eat them raw. There is zero wrong with this!

Desk Drawer or Cubicle

Lots of flexibility here! You can practically have a supermarket of nonperishables at your fingertips if you have room to store a few things. Keep in mind, however, that if you’re prone to snacking when food is in your immediate vicinity even if you’re not hungry, you might be better off not keeping a keto stash handy. Do what’s right for you.

For those of you who want to have a keto cache at your disposal during the workday, consider the following:

• Pork rinds
• Beef jerky
• Pepperoni or any other cured meats that don’t require refrigeration until opened
• Nuts and/or nut butters (careful here if these are trigger foods for you)
• Jar of coconut, olive, or avocado oil
• Canned tuna, salmon, sardines, mackerel
• Dessicated/dried coconut flakes or chips (unsweetened)
• Your favorite vinegars (can be combined with the oils to make a vinaigrette for a lunch salad)
• Hot sauce (doesn’t need to be refrigerated, since it’s vinegar-based)
• Dark chocolate

Depending on your level of “keto purity,” consider keeping Quest bars, Adapt bars, or other low and low-ish carb products on hand.

Pro Tips

If you’re a salesperson, company rep, parent, or someone else who spends a lot of time in the car, consider keeping a supply of the following essentials in your trunk. (Also good to keep at the office.) It does no good to buy some of the foods above to eat on the go if you have no way of eating them without making a mess. Tuck a small box in the trunk and stock it with:

• Can opener
• Plastic or metal utensils
• Napkins or paper towels
• Paper plates or bowls (or use plastic containers, wash them at home or in your hotel room, and reuse)

Did I miss anything you consider a staple for when you’re on the go? (Besides, of course, a container of homemade food or leftovers! To be honest, this is really the best way to go if you're a cook. Always make enough to have some left over to spare for another meal or snack. [Tips on that here.])

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.

Is a High Protein Intake Bad for Bones?

Tl;dr Read the very short version of this here.  For the juicy details, stay here!

Let’s start with an enticing tidbit from a paper in no less than the Journal of the American College of Nutrition, with the wonderful title, “Dietary protein: an essential nutrient for bone health.”

“In agreement with both experimental and clinical intervention studies, large prospective epidemiologic observations indicate that relatively high protein intakes, including those from animal sources are associated with increased bone mineral mass and reduced incidence of osteoporotic fractures.”

Let’s not be guilty of the same sloppy epidemiological science we accuse other nutrition camps of, though. Epidemiology can generate hypotheses, and give us ideas to think about that then need to actually be tested.  Epidemiology can’t prove cause and effect, but it can generally disprove it.  For example, in the case of dietary protein, if epidemiological findings suggest that higher protein intakes—including animal protein—are “associated with” better bone health, we can’t conclude that the protein itself is directly responsible for the stronger bones, but we can safely assume that protein isn’t harmful for bones.  And in the case of protein and bone mass, we do have pretty good clinical and experimental evidence showing that indeed, higher protein intakes do induce positive changes in bone tissue.  Not in cultured bone cells. Not in mice. In actual living, breathing humans.

It’s hard to believe that in certain circles, protein has gotten a reputation as being harmful for bone health.  After all, Paleolithic hunter-gatherer diets typically contained a large amount of meat, yet anthropologists can sometimes distinguish the remains of hunter-gatherers from those of agriculturalists solely by examining the bones: the high-protein eating hunter-gatherers typically had bones that were larger, stronger and denser, and showed fewer signs of chronic disease. 

Scientists believe the differences in physical activity between the two civilizations played a bigger role than any dietary changes, and sure, hunting and gathering no doubt required a lot of time on one’s feet, but ask any farmer: farming isn’t exactly sedentary work!  Even if a heavy physical workload was responsible for Paleolithic peoples’ stronger bones, we can still conclude that a high intake of animal protein didn’t work against building bone mass.    

So how did some people come to think that protein—animal protein, in particular—is harmful for bones?

I HATE "BONE BROTH!" a.k.a. Collagen/Gelatin for People Who Hate Broth (a.k.a. Awesome Cuts of Meat You're [Probably] Not Eating: Pork Feet and Hocks)!

Get a load of that gelatin! NICE!

Nutritionist confession: I HATE BONE BROTH!

There, I said it.

I hate broth, I hate stock, and I dislike soup. Kick me out of the nutrient-dense real food club, excommunicate me if you must, but I’m a coffee girl through and through. I gag at the thought of starting my day with a “steaming hot mug of broth,” the way other people happily brag about on social media. Yuck. I know others find broth to be a great way to start their day, but frankly, for me, it’s coffee or bust, and if I have to turn in my membership card, so be it.

I’ve made a few batches of chicken and beef stock in the past, but being that I have zero interest in drinking a mug of this stuff straight-up, and I’m not a big soup fan, what typically happens is, I freeze several quarts of it, and about 18 months later (sometimes longer!), I defrost them and dump ‘em down the drain. It’s not that I don’t understand the benefits of bone broth; it’s that I just plain don’t like it. I’ve used collagen protein powders in post-workout shakes in the past, and I eat a fair amount of meat on the bone, with some other connective tissue bits along for the ride. So it’s not like I’m deficient in the particular amino acids bones and joints are especially rich in (if there is such a thing as being deficient in these). I just prefer to get my collagen and gelatin from sources other than long-simmered bones and joints.

That being said, I haven’t used collagen powder in a long time, and I know I should probably be getting more of that good collagen and other connective “stuff.” (There are no specific ailments I’m looking to improve by way of this, but I ain't gettin’ any younger, and it would be nice to keep my bones, joints, skin, nails, and tendons in good working order. Plus, maybe, just maybe, increasing my intake of this will help reduce the crow’s feet and wrinkles that have taken up residence on my face the last couple years. Eek!)

So, with that in mind, I’ve been looking for some other ways to get this into my diet, and I’m thrilled to report my recent discovery of the wonders of pig’s feet! Yes! Pigs feet, pork hocks, trotters…they’re all good! I’m Jewish, but I don’t keep kosher, and thank goodness, because frankly, life without bacon and prosciutto is no life at all. (And if you're thinking turkey bacon is a good substitute, please just close the window you're reading my blog in, back away slowly, and never come back. You are dead to me.*)

Those of you who’ve been eating these cuts and making broth for ages may have been using feet and hocks all along, but all I know is, I’m very glad to have found a way to get lots of collagen/gelatin into my diet in a way that is actually really palatable, enjoyable, and delicious.

How does it work?

Book Review: The Case Against Sugar

Gary Taubes wrote another book.

Gary Taubes! (*Fangirl squee!*)

Do I really need to say more?

I don’t, but since this is my blog, I will.

TL;DR: I loved this book and you will too. READ IT.

If you don’t read a lot of blogs and websites outside the low carb bubble, then allow me to tell you that there’s a large contingent of people who loathe Taubes. He takes a boatload of criticism, as does anyone who writes something that condemns or exonerates something other people love or hate (e.g., red meat and saturated fats, refined carbohydrates, and raw milk). But put me squarely in the camp that loves his work and is grateful for his meticulous research. (The endnotes and bibliography of Good Calories, Bad Calories are almost as large as my entire book.) I’m not saying he’s right about everything, nor that I agree with him on everything. I’m only saying I’m a big fan and have been for several years.

I had the pleasure of meeting Gary in spring 2017, first at a reading and book signing in Washington, DC, and then a few weeks later at a literary event in Charlottesville, VA. I actually drove him from Charlottesville back up to Dulles airport in my neck of the woods, so we had some time to chat and shoot the low carb breeze. Let me tell you, folks: I read GCBC during my deployment in Iraq, circa 2008. Having always been a sucker for salt & pepper hair, intellect, and a wry and somewhat dark sense of humor, I developed an immediate nerd crush on Gary. Never in my wildest imagination—and mine is pretty wild—did I think nine years later, I’d have him all to myself on the road for two hours.

Get your minds out of the gutter. Nothing happened except good conversation and Gary being an exceptionally good sport about the fact that my decade-old car has seen better days. (He assured me that his car is older and in even worse disrepair. We writers don’t exactly break the bank; not even ones like Gary, who garner big advances and have multiple bestsellers to their names.) Without revealing too much, I’ll say that it was really nice to talk with a writer of Gary’s caliber, and to find out that many of the emotional demons that plague me are not unique to me. Gary deals with his by throwing himself into work; I deal with mine by avoiding work. Neither strategy is all that healthy, long term. But I can look to Gary as someone with a lot of dark thoughts and inner turmoil who still manages to get shit done produce great work. It helps that he has a wife and two sons depending on him, so he sort of has to bring home the proverbial (and literal) bacon. 

As an aside, Gary has spent time in France, and he longs for it. As he talked about it, his desire to be there—and, maybe, to be the person he was when he was there—was palpable. He has also written and spoken a lot about his history as a smoker. I could totally see him as the quintessential ex-pat, sitting at a roadside café in Paris, sipping coffee and reading poetry, complete with a black turtleneck and a cigarette.  

But enough about Gary. On to the book!

New to Low Carb? Feeling Lost? "Paralysis by Analysis?" READ THIS.

Hey Everyone,

As promised, here’s the follow-up to my post on taking an Information Vacation from social media if you're feeling overwhelmed and panicky from confusing keto information coming at you from all sides. Since there will no doubt be loads of people new to this diet in the new year, I figured this was a good time to put this out there.

If you’re new to low carb, or maybe haven’t even started yet, this one’s for you.

If the reason you haven’t started yet is that, despite being an intelligent, grown adult, you can’t seem to make sense of the eight thousand pieces of conflicting information you’ve read about low carb and ketogenic diets, this one is definitely for you.

If you have already started, and still can’t make sense of the eight thousand pieces of conflicting information you’ve read about low carb and ketogenic diets, this is also for you.

You are not alone!

Here’s a quick list of words and phrases extracted from emails I receive from people looking for help with low carb or keto:

• Confused
• Overwhelmed
• Conflicting info
• Stalled
• Frustrated
• No idea what to do!
• Totally lost!

  

If you’re brand new to all this, I have to be honest: I don’t envy you. As I mentioned in a recent podcast interview (probably my most fun and controversial one yet), getting started with a low carb diet was much easier 17 years ago, when I first gave it a try. Back then, the internet existed, of course, but the contingent of people talking about low carb was much smaller. There were only a handful of low carb chat rooms and forums, virtually no blogs, and if I recall correctly, neither podcasts nor YouTube even existed. So there was a lot less information available to newbie low carbers, but ironically, that was a good thing. Because now, while it’s wonderful that low carb and keto have become so popular, and there are more blogs, books, Facebook groups, podcasts, and YouTube channels than anyone can keep track of, unfortunately, for every good, reliable, accurate piece of information about these ways of eating, there are four pieces of nonsense and falsehoods that have to waded through first.

Like I said, I don’t envy the newbies.  

When I was brand new to this, around the year 2000, I had two main sources of information: the bulletin boards at LowCarbFriends.com (which I’m delighted to see still exist, as I haven’t logged in in about nine years), and Dr. Atkins’ New Diet Revolution. (Linking to the 1997 version because the one that got me started—the 1992 version, with the blue cover—is apparently no longer available.)

That’s right: the Atkins book.

Dining Out on a Low Carb or Ketogenic Diet

 

Q:  Can you dine out if you follow a low carb or ketogenic diet?

A:  Yes, of course you can.

I’m not sure why some people find this difficult, but since the question of how to do this comes up frequently on social media, it’s time for me to provide a little tutorial.

I’m always a little puzzled when people are traveling somewhere new and they ask locals on Facebook or Twitter for recommendations for keto or low carb-friendly restaurants. Every restaurant is friendly to these ways of eating, provided you know how to customize your order. (Okay, if it’s a restaurant that serves literally nothing but funnel cakes, cotton candy, and deep fried cheesecake, you’d be out of luck, but to my knowledge, such an establishment does not exist outside of state fairs in the U.S.)

Before I get into things, here are some caveats:

My advice for dining out on low carb or ketogenic diets is for people eating this way primarily for weight management and/or overall health. If you are following a strict Paleo or autoimmune protocol (AIP) diet, or you have severe intolerances to gluten, soy, dairy, or some other element, then obviously you will have to be more careful and some of my suggestions here won’t apply to you. If you absolutely must avoid these things, I would recommend getting familiar with a select few restaurants in your local area that you trust to prevent cross-contamination and whose staff is well-versed in taking special measures to ensure your food is prepared to your specifications. Stop by these establishments at an off time, when the manager and chef(s) might be available for a chat. (During a busy dinner service is not the time to give these folks your entire medical history.) If you are polite and diplomatic in explaining your needs, I don’t think they will be “bothered” by your special requests or think of you as “that guy” or “that girl.” It might even help to explain that if they are able to accommodate your unique and perhaps somewhat difficult needs, you will be quite happy to patronize their establishment frequently, and recommend that others do, too. Restaurants, nutritionists, mechanics—nothing helps us like word of mouth from satisfied customers.  

Things might be a little different if you’re strict Paleo for environmental or ethical reasons, or prefer to completely avoid certain ingredients on principle (e.g., canola, soybean, or corn oil, grain-fed meats, conventional pork and poultry, farmed fish, etc.). If you prefer to consume exclusively organic produce, grass-fed and pastured meats, poultry, and eggs (especially if they come from local farms), there might be restaurants in your area that can accommodate this, or at least come close. (If your needs or preferences are extremely restrictive, you might be better off just eating at home. I assure you, though, barring a severe allergy, an occasional bit of soybean oil or corn-fed beef ain’t gonna kill you.)

As for ketogenic diets, if you are following a strict KD wherein you really “need” to have a higher than typical amount of fat in each meal, simply request some extra olive oil or butter on the side. You can even bring your own. Keep olive oil in a small, leakproof glass bottle in your purse or the glove box of your car, and you’ll have it with you more often than not. (This is a good idea if you don’t trust a restaurant to give you “real” olive oil unadulterated with cheap, crappy oils.) This might not be a great idea in the dead of summer, when you wouldn’t want a bottle of olive oil hanging out 24/7 in your overheated car, nor in the dead of winter when the oil might solidify a bit (like it does in the fridge), but it’s no problem when the temperature isn’t at either extreme. (And if it does solidify, it will liquefy again after just a few minutes at room temperature, sped along if you hold the bottle in your warm hands for a bit.) You can do the same thing with coconut oil—take some with you if you need extra fat and you trust yourself more than you trust the wait staff.

Okay. Now that all that preliminary stuff is out of the way, here’s how to actually do this.

Low Carb Breakfast Ideas for People Who Don't Like (or are Tired of) Eggs

Here’s something I see often on Facebook:

“I don’t like eggs.” (Or, “I’m tired of eggs.”)

What can I have for breakfast on low carb?

My knee jerk answer (which I say to myself, but do not write until I calm down a little): Eat something else.

Anything else.

Anything else at all.

Literally any other low carb food.

I’m not sure why breakfast is such an obstacle when there is one food people don’t like. Have you ever heard anyone say, “I don’t like salmon. What can I have for dinner?” Or, “I’m tired of bologna sandwiches. What can I have for lunch?”

There are, like, a zillion other possibilities there. And the same goes for breakfast. 

You see why I’m a bit dumbfounded, right? 

Break Nutrition - A New (and GOOD!) Blog & Podcast

Hey Everyone,

To get the word out about the release of my book, The Alzheimer’s Antidote, I’ve been making the rounds on several podcasts. I’ll post something soon with links to all of them in case you’d like to give a few of them a listen. (Yes, it’s true! You can get your fix of me ranting [and occasionally sharing nifty information] even when there’s no new blog post, haha! And you get to hear it all in my real voice! [For better or worse…ugh…])

Before I get to that, though, there’s a particular show I’d like to tell you about. My friend Raphael has started a new podcast and website called Break Nutrition. Raphi is very darn smart. He’s doing graduate work in molecular biology, with a research focus on cancer. (He is quite familiar with all we’ve covered in the cancer series – the Warburg effect, Dr. Thomas Seyfried’s work, the role of damaged mitochondria, etc. Recall that I picked his brain a bit for one of the posts on hypoxia.) If you’re on Twitter, you’ll want to follow him.

Break Nutrition is brand new, but it looks to be a good source for some pretty intense, intelligent, and science-based arguments covering a lot of what you all love: evolutionary theory informing modern diets, how low carb/ketogenic diets might affect nutrient requirements, fat loss mistakes, and more. Raphi is not the only one writing for Break Nutrition. He’s already had guest posts from some low-carb heavy-hitters. If you’re getting a bit bored with your blog or podcast “routine” and are looking to change things up a little—and are especially seeking things that really make you think, question what you think you know, and go hmmm…, then this is for you.

The podcast is pretty advanced sometimes. I’ve listened to a couple episodes and have more to get to. Raphi has had his friend and colleague Gabor Erdosi on a few times, and they’ve talked about some very interesting theories and mechanisms regarding type 2 diabetes and obesity – things you are not learning about anywhere else, including my blog. (I’ve been reading some papers on these ideas, though, and it’s fascinating stuff! I’ll have a post or two on it in the not-too-distant future. Sneak peek: it’s becoming more and more obvious to me why some people do horribly on keto when they focus on the “high fat” part more than the low carb part.) These episodes might be a bit advanced for some people, but others might soak them up like sponges.

One particular episode you will not need a PhD to understand and enjoy is the one I was on. Raphi and I had a great time talking about Alzheimer’s pathology and possible treatments, but the stuff we chatted about after that was even better. We got into gluconeogenesis (LOADS of misinformation on this all over the ketowebs), exogenous ketones, and why the whole calorie “thing” is almost useless in discussions of fat loss, satiety, energy balance, and body weight regulation. Useless! (Details in this post I wrote. One of my favorites!) You will hear me say I’ve lost 14 pounds since starting thyroid medication in December. The crippling depression that had me sidelined for over two years is about 91% gone as well—for real this time! (Post coming soon on that, too, my darlings!)

Raphi and I had a great conversation and I think you’ll enjoy listening. (Bonus: you get to hear what my favorite Chinese food was, back in the day.)  ;-)

So check out Break Nutrition and download the podcast. (And check out the other shows, too! Available on iTunes, too.)

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.

Book Review - Wired to Eat

Can’t eat just one?

Don’t feel bad. You’re not supposed to be able to eat just one.

People build entire careers out making sure you can’t eat just one.

You can beat yourself up for being a miserable, sad-sack of a sloth, unable to muster a single molecule of willpower and discipline, or you can learn that you are actually an elegantly arranged matrix of carbon, hydrogen, nitrogen, and a bunch of other atoms, that has evolved under dietary and environmental circumstances that make it a rarity not to have “issues” with food. (Or weight, or blood sugar, blood pressure, fertility, gout, mental clarity, and more.) If, in this age of a seemingly infinite supply of extremely inexpensive and, frankly, insanely delicious foods that didn’t even exist a hundred years ago, you are healthy, lean, and fit, you are the exception, not the rule.

Low Carb Cooking Class! (LC3) -- Roasted Vegetables

Time for another installment of Low Carb Cooking Class!

Today’s lesson is for people who claim they don’t like vegetables.

Let’s get one thing out of the way: despite what has been pounded into your head for pretty much your entire life, vegetables are not actually required in the human diet. They’re just not. I’m sure that is quite shocking to some of you. (What about fiber?! What about feeding your gut bacteria? What about the phytochemicals?! Don’t we need quercetin, resveratrol, curcumin, sulphorophane, and other goodies we get from plants? Well, sure, they might be helpful in certain circumstances, but required? Nope.) There are no essential nutrients—none—that you get from plant foods that you can’t get from animal products. You can, indeed, live on a “zero carb” or animal-only diet. (Kind of like the opposite of veganism.) You don't even need the fiber. In fact, lots of people with IBS and other issues related to impaired digestion of plant material seem to do better on diets low in indigestible fiber. I’m not saying I recommend a zero-carb diet; only that it is, technically, possible. (And not only is it possible, but many people are absolutely thriving on this way of eating, when just about everything else—including regular ol’ low carb and ketogenic diets—did not give them the results they were looking for.) According to the Food and Nutrition Board of the Institute of Medicine of the U.S. National Academy of Sciences, “The lower limit of dietary carbohydrate compatible with life apparently is zero, provided that adequate amounts of protein and fat are consumed.” And since fiber is a carbohydrate, zero dietary carbohydrate means zero dietary fiber. But again, I’m not saying a zero carb diet is recommended or optimal; I’m simply noting that you don’t need to force down copious amounts of indigestible plant material if you really, really don't like it.

But for those of you out there who do want to include vegetables in your diet, but maybe aren’t the biggest fan of them, why is this? My guess would be that you grew up in a home where your only exposure to vegetables was via frozen or canned vegetables heated up in a microwave, or fresh vegetables boiled beyond all recognition, with flavor and texture both rendered completely unappetizing. If you don’t like vegetables because you’re accustomed to being served veg that are mushy, soggy, bland, and just plain lifeless, that ends now!

Low Carb Cooking Class! -- Roasted Chicken & Veg

Just when you thought my blog was becoming nothing but rants about ketogenic diets…

It’s time for another installment of Low Carb Cooking Class!

We’ve covered lots of ground so far in this series on very simple and easy cooking for low carbers like myself, who want to eat delicious, homemade low carb foods, but who are not about to spend a fortune on almond or coconut flour, erythritol, coconut aminos, and all sorts of other esoteric ingredients that are absolutely not required in order to put a nutritious and yummy low carb meal together. Here’s the territory we’ve visited so far: 

• Introduction to this series and why I'm writing it

• Stocking your kitchen with low carb staples in order to make all of this a breeze

• How to season food to give things different flavors even when you use the same main proteins and vegetables (i.e., make the same food taste totally different so you don't get bored)

• Tips for cooking in bulk and in advance

• Using salt, heat, and acids to up your cooking game

• Roasting meat and vegetables together in one baking dish -- possibly the easiest way to get real food on the table that doesn’t involve opening a can of tuna or calling for takeout.

To be honest, I feel kind of silly writing blog posts that boil down to, “brown ground meat in a skillet with some onions and zucchini, and add some salt.” I mean, really? There are people who don’t know how to cook low carb like this? But maybe there are. And that’s what this series is all about—low carb cooking that is simple, easy, and above all, practical—the kind of cooking you’ll do all throughout the week, on busy nights when your kids have six different activities going on, or you get home from work and you’re ravenous, and you “don’t know what to make” for dinner.

I have a nice collection of low carb, ketogenic, and Paleo cookbooks, and I love flipping through them for the food porn (and for ideas…food ideas, not porn ideas, haha), but to be honest, I rarely make any of the dishes in them. I have no kids and no boyfriend, so in preparing food for myself, sometimes dinner is as boring simple as a can of salmon and a raw green pepper. I think we somehow got this idea that every meal has to be the stuff of legends and worthy of being posted on Instagram. (I do not post pictures to Instagram, mostly because I’m a terrible photographer, but also because no one wants to see pictures of a can of salmon and a green pepper.)

So, in the interest of keeping things simple yet delicious, today we’re going to cover something that should be a staple of basic cooking for just about everybody, whether they eat low carb or not. It’s time for roasted chicken!

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.

Low Carb Retreat

Calling all introverted low carbers!

Are you intimidated by the mere thought of attending one of the huge, flashy, noisy, low-carb, Paleo, and ketogenic conferences and festivals that are all the rage these days? I remember several years ago, when Jimmy Moore’s Low Carb Cruise was the only event where like-minded low carbers could meet in person, do fun stuff together, and best of all, chow down on low-carb food (and not-so-low-carb food…it is a cruise, after all). Now, however, you can’t shake a stick without hitting an event having something to do with low carb, Paleo, Primal, ketogenic, or ancestral eating.

Just off the top of my head, we have: 

• Paleo F(x)
• Low Carb Cruise
• Low Carb USA – San Diego
• Low Carb Breckenridge
• KetoCon
• KetoFest
• Ancestral Health Symposium
• Metabolic Therapeutics Conference

  

Some of these events are somewhat subdued and more academically focused, while others are basically kombucha keg parties disguised as events about health & fitness. (Not that there’s anything wrong with a good keg party!) Each has its place, and its ideal audience/attendees.

For those of you who prefer something quieter, smaller, and maybe aren’t totally into the Bulletproof-barefoot-orange goggles-six-pack abs-being terrified of Splenda and omega-6-do-you-even-lift-bro, and you wonder if you even really belong to any of the communities where these things reign supreme, I have good news for you!

If that sort of stuff isn’t your speed (lord knows it ain’t mine), but you’d still like to mingle with like-minded people (at least where food is concerned), and do it in a peaceful and beautiful place, where nothing is asked of you but to enjoy nature, take a nap, go hiking or fishing, and eat yummy low carb foods, I’m putting some feelers out for Wendy, a long-time blog reader who has generously offered to organize a low carb weekend retreat near her home in Kemptville, Ontario, just a little south of Ottawa. I’ve haven’t been there, myself (yet), but she assures me it is quite beautiful, and is a great setting for those of you who would enjoy nature walks, kayaking, cycling, or just simply “getting away from it all.”

We would schedule a few sessions throughout the weekend—maybe a couple of talks from yours truly, some group discussions, and a class or two on low-carb cooking and meal planning. (We’re open to other ideas if anyone has any.) Mostly, it would be pretty low-key, with people free to come and go as they please, attend everything or nothing. If all you want to do is take naps in the grass and have someone wake you when it’s time to eat, that can be arranged! (Thinking about doing that, myself, to be honest...)

Anyway, this is all very nebulous right now. This is in the early, early planning stages and at this point we’re just trying to gauge if there’s even an interest for something like this. So if this is something that appeals to you—and if you have ideas for specific things you would like and would not like to be part of the weekend, please contact Wendy directly at wendy@celticrathskallions.ca. (I told her I’ll be happy to attend but am not a good planner and organizer. As I said to her, I make a great Indian but a terrible chief. A bad leader, but a great follower.)  ;-)

Thanks, everyone, and maybe I’ll see you in Canada sometime!

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.

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.